What Workers Comp Covers (and What It Doesn't)
Workers comp covers more than most people expect on the medical side, and less than most people expect on the wage side.
What's Covered
Medical Treatment
All reasonable and necessary treatment related to the work injury — doctor visits, hospitalization, surgery, physical therapy, prescriptions, and durable medical equipment. This is typically covered in full, without deductibles or copays, as long as the treatment is authorized and connected to the injury.
Wage Replacement
A percentage of your average weekly wage — commonly around two-thirds, capped at your state's maximum — while you're unable to work or working reduced hours due to the injury.
Disability Benefits
If the injury results in permanent impairment, compensation based on an impairment rating, separate from the temporary wage-replacement benefits paid during recovery.
Vocational Rehabilitation
If you can't return to your previous occupation, some states offer retraining or job placement assistance on top of disability benefits.
Death Benefits
If a work injury results in death, payments to dependents, typically calculated as a percentage of the worker's wage, plus a burial allowance.
What's Not Covered
- Pain and suffering — not compensated under workers comp, unlike a personal injury claim
- Full wage replacement — you'll typically receive less than 100% of your actual wages, not a full paycheck
- Injuries outside the course of employment — most commute-related injuries are excluded under the going-and-coming rule
- Injuries from intoxication or horseplay — commonly excluded, though the exact standard varies by state
- Purely personal medical conditions — an unrelated medical event that happens to occur at work generally isn't covered unless work contributed to the harm
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