5 Workers Comp Trends That May Affect Your Own Claim

If you’ve ever been injured on the job, you probably have more than a few opinions about workers comp benefits. Workers’ compensation insurance provides medical care, rehabilitation, and cash benefits for employees who get hurt or sick at work.

More Employees Have State-Level Workers’ Compensation Insurance Today Than Ever Before

Each state has its own workers’ compensation program and unique benefits application process. For this reason, the total benefits paid and for how long varies depending on where you live. During 2008’s Great Recession, only 124.6 million employees in the U.S. had coverage. In 2015 (the most recent year data was available for), that number rose 8.8%. In fact, covered wages broke $7 trillion, despite not including self-employed workers.

Let’s look at some recent program changes and data trends that affect injured or sick employees not employed by the federal government.

1. Right now, workers’ compensation payments get split 50/50 between medical expenses and lost wages.

This may seem like no big deal, but it’s very different from workers comp payments in previous years. In 1980, for example, only 29% of workers comp benefits paid for medical expenses. Lost wages accounted for the remaining 71%. Injured employees receive $.77 in benefits for every $100 in covered wages, according to the National Academy of Social Insurance. That means workers comp pays $.39 towards medical expenses and $.38 for wage replacement. While those workers comp benefit numbers are from 2018, it’s much less than insurers paid in previous years. In 2011, for example, insurers paid $1.01 in workers’ compensation benefits for every $100 in covered wages. This is probably the reason employer costs for workers’ compensation covered decreased in 27 states between 2011 and 2015.

2. Most workers’ compensation benefits paid today come from private insurers handling state-level claims.

Federal employees filing workers comp claims nationwide account for just 6% of all benefits currently paid. State funds account for another 15% of all workers comp benefits, and 24% came from self-insured employers.

3. Nearly every state has a mandatory waiting period of 3-7 days before you can receive workers’ compensation benefits.

Typically, the shortest wait time for state-level claims is three days; the longest is seven. Of course, insurers or employers can retroactively waive that required waiting period in cases involving emergency treatment or hospitalization. Once an injured worker misses that 3-7 days at work, workers comp benefits should kick in. Workers comp benefits typically cover 100% of medical costs and 66% of lost wages while injured or sick employees recover. Plus, any workers comp money that’s paid specifically to replace lost wages is tax-exempt. However, workers comp benefits reached a 25-year low for paying lost wages to injured workers in 2015.

4. Recent workers comp law reforms in several states led to a wave of constitutional challenges in court.

A few decades ago, several states amended their statutes to either reduce or limit workers’ compensation benefits in various ways. That trend should continue well into 2019. If you’re living in a state listed below, your benefits might change — even once your claim’s already approved:

  • Alabama
  • Oklahoma
  • Pennsylvania
  • Kansas

5. Only 1 in 3 workplace injuries and illnesses make employees miss enough work to qualify for workers comp benefits.

About three in every 100 full-time workers reported a workplace injury or illness in 2015. Among those, just one either misses work or changes jobs after the incident occurs. This suggests, according to the NASI report, that employers make more accommodations to benefit injured workers today than previous years. And on-the-job illnesses and injuries today are less likely to result in time off requests than they once did. According to the NASI report, workplace injuries fell 63% from 1995 to 2015.

If you believe your employer wrongly denied you workers’ compensation benefits, we can help. A local workers’ comp attorney can review your case for free or offer advice by phone. This free phone call won’t obligate you to do anything other than getting expert help resolving your claim.

Ready to see if you may qualify? Click the button below for your free online workers’ compensation benefits evaluation now!

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Laura Schaefer is the author of The Teashop Girls, The Secret Ingredient, and Littler Women: A Modern Retelling. She is also an active co-author or ghostwriter of several nonfiction books on personal and business development. Laura currently lives in Windermere, Florida with her husband and daughter and works with clients all over the world. Visit her online at lauraschaeferwriter.com and linkedin.com.