What does workers’ compensation cover?

Workers’ compensation insurance generally covers injuries or illnesses that occur in the course and scope of employment. That means if an employee is performing job-related duties at work when the injury happens, it’s likely covered.

Common examples include:

• Slips, trips, and falls on the job site

• Repetitive stress injuries from ongoing strain, such as carpal tunnel syndrome

• Injuries related to machinery and equipment usage

• Occupational illnesses linked to the work environment, such as exposure to chemicals or dust

Coverage often extends to injuries that happen outside a standard workplace if the employee is performing job duties, such as making deliveries, attending client meetings, or working off-site.

Workers’ compensation provides two key types of benefits to support employees’ recovery and financial stability:

This can include hospital visits, surgeries, prescriptions, physical therapy, rehabilitation, and other necessary medical treatments related to the injury or illness. Depending on the specifics of the situation and the employer’s WC policy, the medical provider will either bill the insurance carrier directly, or the employee can request reimbursement.

When an employee is unable to work due to a covered injury, workers’ compensation typically provides a portion of their regular wages through temporary or permanent disability benefits.

In some cases, employees may receive extended medical or vocational rehabilitation to support a full return to work.

Workers’ compensation doesn’t cover every injury or situation. Claims can be denied if the incident wasn’t directly related to an employee’s job responsibilities, or if other factors contributed to the injury or illness.

Examples of situations that are typically not covered include:

• Injuries that occur off the job or during personal time

• Injuries that occur when an employee is under the influence of drugs or alcohol

• Intentional or reckless behavior, such as horseplay or fighting

• Commuting accidents, unless travel is a defined part of the job

• Injuries sustained during the workday and/or on employer property, but outside the employee’s scope of work

When in doubt, report the incident. Workers’ compensation carriers and state agencies can help determine whether an injury qualifies for coverage under state law.