What are the Four Types of Workers’ Compensation Benefits?

Most people don’t understand how workers’ comp benefits work until after they’re injured on the job and navigating the claims process. But the question people ask most often is, What types of workers’ compensation are available for people with workplace injuries? And how do you know which ones you might qualify for once your claim’s approved?

We’ll explain the different workers’ compensation benefits available to injured employees in most U.S. states below.

Four Types of Workers’ Compensation Benefits: Key Takeaways

• Every state has its own unique workers’ compensation laws that determine how benefits work for eligible employees. However, injured federal employees follow a different process, no matter which state they live or work in.
• The four types of workers’ compensation benefits are medical benefits, disability benefits, vocational rehabilitation benefits, and death benefits. Disability benefits are essentially wage-loss benefits while injured workers need time off to recover.
• No workers’ compensation program in any U.S. state pays injured employees any amount for pain and suffering.
• While most states have laws that require employers to provide workers’ compensation insurance coverage for employees, Texas does not. It’s the only state that allows private employers to completely opt out with no penalties.
• National Council for Compensation Insurance (NCCI) studies show about 78% of workers’ comp claims only pay for medical treatment. Many injured workers file claims for minor injuries, but don’t qualify for paid time off.
• Denied or believe your employer’s workers’ compensation insurer is short-changing your benefits? Request a free consultation from a local workers’ compensation lawyer through this website.

Understanding How Workers’ Compensation Insurance Works

If your employer has insurance and you’re a covered employee, then you can file a claim on your first day of work. The things that make you eligible for workers’ compensation benefits are as follows:

1. Your employer has insurance coverage. You can confirm this is true by talking to your supervisor, your company’s HR department, or a coworker. In many states, your employer must have a poster up in a high traffic area (like your break room) to inform employees about workers’ compensation.
2. Your employer classifies you as a covered employee. In most states, all full-time workers are eligible for this coverage, and many part-time workers are, too. However, there are exemptions to this coverage requirement that vary significantly from state to state.
3. You have a work-related injury or illness that happened as a result of you doing your required job duties. Not every person hurt at their job will qualify for workers’ comp benefits, however. Some notable examples include coworkers who get hurt when fighting with one another, or car accidents that happen in the company parking lot.
4. You seek medical attention and notify your employer as required under your state’s specific laws. In certain places, you must report your injury before you seek medical attention, for example. Or you can see only see a doctor previously authorized by your employer’s insurance company for care.

Pro Tip: If you don’t seek medical care for your work-related injury or illness, then you don’t have a valid workers’ compensation claim.

Can All Injured Employees File Workers’ Compensation Claims?

Unfortunately, no. Many of the following employees are automatically exempt from filing a workers’ compensation claim in any state:

• Domestic workers
• Farm laborers
• Independent contractors (such as Uber and Lyft drivers, most Amazon warehouse workers)
• Sole proprietors (i.e., self-employed people)
• People who only work seasonally, occasionally, or for certain religious organizations
• LLC members, officers, and business partners

One quick way to know if you’re an eligible employee is if you receive a W2 at tax time and aren’t a federal worker. We’ll explain why federal employees aren’t bound by state-level rules next.

Why Federal Workers’ Comp Follows a Different Process and Rules

Federal employees have the same process to file for workers’ compensation benefits, no matter which U.S. state they’re in. Federal, not state law determines how they file claims and what types of workers’ compensation benefits they’re owed. The only rule is that the injury or illness must be work-related and produce medical bills.

Types of Workers’ Compensation Benefits Available to Eligible Injured Employees

In general, the four types of workers’ compensation you can get with an approved claim are medical, disability (i.e., wage benefits), vocational rehabilitation and death benefits. Learn more about each different type of workers’ compensation benefit below.

1. Medical Treatment Benefits

Nearly all injured workers who file a workers’ comp claim will qualify for medical benefits, which pay all your medical expenses. Once you notify your employer about your accident and request medical care, workers’ compensation insurance should cover:

• Doctor’s visits
• Hospital stays
• Surgery costs
• Prescription medications
• Physical therapy
• Medical equipment you need to recover (i.e., crutches, a mobility scooter, eyepatch, leg brace, etc.)
• Travel expenses related to seeing approved medical providers for necessary care (i.e., mileage reimbursement, toll road fees, hotel stays)

These benefits are unlimited and will cover all medical costs related to your workplace injury or illness.

2. Disability Benefits

There are four types types of workers’ compensation benefits that can help replace some of your lost wages after an accident. Two of them in this tax-free subcategory are temporary disability benefits, and the other two are permanent disability benefits. However, every state has its own rules defining how long you can receive each of these payments. In addition, all states have a 3-7 day required waiting period before you can qualify for disability benefits from workers’ compensation.

Temporary Total Disability Benefits

In nearly every state, temporary total disability benefits equal 66 2/3% of the injured worker’s average weekly wage (AWW). Some notable exceptions are:

Temporary Partial Disability Benefits

If you can go back to work after your accident but any of the following applies, then you may qualify for temporary partial disability:

• You can only work part time or on light duty tasks
• You’re unable to earn the same weekly rate of pay as you did before

In such cases, TPD payments usually equal two-thirds of the difference between your pre-injury and post-injury job earnings. You may receive these workers’ compensation benefits for a set number of weeks in most states.

Permanent Partial Disability Benefits

Permanent partial disability benefits usually only apply to injured workers who permanently lose or can no longer use a body part. One example would be if you crush your hand in a construction site accident and can no longer perform your usual job duties. These types of workers’ compensation benefits usually come in two different formats:

• Weekly, biweekly, or monthly payments equal to TPD benefits that start only once you’ve reached maximum medical improvement (MMI)
• A lump-sum settlement award based on a scheduled injury or loss of body part approved under your state’s laws

Important: In some states, you can receive PPD benefits for life. But in others, PPD benefits stop once you turn 67 and qualify for Social Security retirement.

Permanent Total Disability Benefits

Injured employees who can never work again after an on-the-job accident may qualify for permanent total disability. PTD payments are usually the same amount as TTD benefits, but how long you can receive them varies by state. The following states allow injured workers to get PTD benefits for life:

• Georgia
• Ohio
• Virginia

In most other states, you can only get PTD benefits for a set number of weeks, months, or years.

3. Vocational Rehabilitation Benefits

In some cases, you won’t be able to return to your old job or make the same amount of money you did before. But that doesn’t mean you can’t work; it just means you may need some extra help getting back into the workforce.

That’s where vocational rehabilitation benefits come in.

Your state or employer’s insurance carrier will pay for things that will help you adjust to a new position or career path, such as:

• Job search and application help
• Adult education classes
• Vocational retraining services (think: learning how to become a plumber or a welder instead of a construction worker)
• Work modifications and assistive devices that can help you stay gainfully employed with the limits you have today

4. Death Benefits

Families of a deceased employee killed on the job may become eligible for death benefits in most states. Eligible dependents who can apply for death benefits usually include the spouse and minor children of the deceased employee. Death benefits often include:

• A set dollar amount for funeral and burial expenses (this varies by state)
• Weekly, biweekly or monthly cash payments equal to the deceased worker’s average weekly wage for a set number of weeks
• If a widowed spouse remarries, he or she may receive a lump-sum payment equal to two years of death benefits in most states

Important: To receive death benefits, eligible family members must file a claim according to their state’s laws and processes.

The Role Maximum Medical Improvement Plays in Workers’ Comp Permanent Disability Settlements

Many people ask us about average settlement amounts for certain body parts, or to close a workers’ comp case. Most states have rules in place that say you cannot receive a settlement until you reach something called maximum medical improvement (MMI).

Once you’ve been on workers’ compensation for about 6 months, you may go in for an exam to determine if you’re done healing. If the doctor says you’re healed as much as possible from your injury, that means you’ve reached maximum medical improvement.

At that point, you may qualify for a lump-sum settlement offer if:

• You can go back to work, but earn less money than you did before your job accident
• You’re limited to working part time only or forced to accept a different position that earns less
• You cannot work at all in any job that you’re qualified for in your area
• You’re diagnosed with a “scheduled” injury or loss, or were disfigured in some way as defined by the laws of your state

How to Get a Free Consultation from a Workers’ Compensation Lawyer Year You

If you’re injured in a work-related accident and denied workers’ compensation benefits, an attorney can help during the appeals process. And a workers’ compensation lawyer can also review your situation and tell you whether or not you have a valid claim.

Attorneys that handle workers’ compensation cases work on contingency. This means you pay $0 unless you receive a cash settlement from your employer’s insurance carrier.

Not sure where to find a lawyer who’s available to discuss your claim during a free consultation? We can help with that! Click the button below when you’re ready to begin and we’ll match you with the closest one in your area:

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