A Guide to Worker’s Compensation as an Employee

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Workers’ compensation insurance covers employees who get injured at work or suffer illness due to their job. This type of coverage is mandatory for employers with over $500,000 in annual payroll. The workers’ compensation system was created to provide financial protection to employees who are hurt on the job. In return, employers pay premiums to fund the benefits they offer.


Workers’ comp is designed to cover medical expenses, lost wages, and other costs associated with workplace injuries. If you’ve ever had a claim, you’ll probably agree that it’s a complicated process. To help you understand what happens next, we’ve put together this guide to worker’s compensation as an employee.

Why Do I Need Workers’ Compensation?

You must have workers’ compensation if your employer has more than $500,000 in gross payroll each year. The total amount paid to each employee can’t be higher than $250,000 per year. You also need workers’ comp if:

  • Your employer doesn’t have enough insurance.
  • You’re self-employed.
  • Your employer isn’t located within one state.

How Much Does My Employer Have To Pay?

If your employer provides health care services and has more than $1 million in annual payroll, then you may be eligible for a premium subsidy based on your income. Eligibility depends on whether you qualify for Medicaid. See our Medicaid page for more information.

If your employer doesn’t have enough coverage, he will pay part of your workers’ comp premium.

What Is Covered By Workers’ Compensation?

Your employer pays for all of the following types of expenses related to your injury or illness.

  • Medical bills
  • Lost wages
  • Travel costs
  • Loss of future earning capacity

Who Pays If I’m Injured Or Sick?

Generally, the employer pays most of the cost of your treatment, but Medicare usually picks up some of the tabs. This depends on where you work though. Speak to your advisor in order to figure this out.

Who Decides How Much I Get Paid During Recovery?

Most states have laws determining how much money you receive when filing a claim. Workers’ comp lawyers say this law is one reason why the average award is about $80,000. However, there are many different reasons why awards vary so widely. For example, the seriousness of your injury, the doctor who treated you, the length of time you were out of work, and the company culture can all influence the outcome.


The decision becomes permanent if you don’t win an award after a hearing. It’s important to know that the judge has no choice but to follow the statute.

When Should I Seek Legal Help?

You should try to consult a workers’ compensation attorney if you need to in order to protect your rights under workers’ comp. However, they can help you understand exactly what the statutes mean and what options you have. They can advise you on the best way to approach your case, from making a settlement offer to filing a lawsuit against your employer.

How Long Does It Take To Resolve A Claim After Filing A Complaint?

This varies depending on where you live and which lawyer you choose. The first step is filing a claim form. It is similar to filling out a tax return, except instead of reporting income, you declare your loss. You must include every expense related to your injury or sickness when doing so. It’s common for employers to dispute these numbers; however, they often settle before your hearing even begins.


The hearing process requires several steps. First, the worker files a claim form with the Department of Labor. Next, the employer receives a written notice of the claim and 30 days to respond. If no response is received, a representative from the Department of Labor then interviews both parties about their version of events. Afterward, a lawyer representing the employer goes to court to argue that your injury was not compensable. Finally, the judge makes a final determination.


According to the National Bureau of Economic Research, the average time between filing a claim and getting a decision is about 90 days. In cases involving severe injuries, it may be longer.


Like any other area of law, the rules governing workers’ comp change over time. That means you may find yourself in unfamiliar territory when claiming your benefits. But it’s possible to handle a case successfully without hiring a lawyer. We hope we’ve helped explain how workers’ comp works as an employee.