Who Actually Pays for Workers’ Compensation Benefits?

Workers’ Compensation Lawyers

If you experience an injury or illness as a result of your work-related responsibilities, you are likely eligible for workers’ compensation benefits. Employers are required to pay for the insurance that covers workers’ compensation benefits in nearly every U.S. state. There are no payroll deductions for workers’ compensation, as a top workers’ compensation lawyer like one from Hickey & Turim SC can explain to you. Employers have a few options for the administration of workers’ compensation benefits. The actual source of the workers’ compensation payments you receive may come from a state-run program, a private insurance company, or the employer’s self-insurance.

State-Run Workers’ Compensation

Employers in many states have the option to handle workers’ compensation benefits through a state-run program. A state-run program is generally best for smaller employers or workplaces that experience lower rates of work-related accidents or injuries. If an employer chooses to use a state-run program, they will pay an insurance premium to this program. The state government then takes care of any payments that result from workers’ compensation claims. State-run workers’ compensation programs are generally administered by the state’s department of commerce, labor, or industrial relations.

Private Insurance Workers’ Compensation

Most states allow employers to buy workers’ compensation insurance through a private insurance company. The employer pays a premium to the private insurance company, and then the insurance company handles claims and benefits in the event of any employee’s work-related injury or illness. The private insurance company will send the actual workers’ compensation checks, and any complaints or issues are addressed to the insurance company. Large private insurance companies are often able to customize workers’ compensation insurance packages to employers’ needs. 

Workers’ Compensation Through Self-Insurance

Large companies may choose to self-insure. The company must have enough assets that it will be able to cover workers’ compensation benefits. Companies that self-insure will typically experience a considerable amount of oversight by the state to ensure that all processes are fair according to state statutes. Self-insured companies usually utilize a third-party administrator (TPA) that will handle many aspects of the workers’ compensation process, including managing employee claims. If an employee submits a workers’ compensation claim that requires a benefits payout, the employer sends money to the TPA, and the TPA sends benefits to the injured employee.

In all of these options, your employer pays the costs for workers’ compensation—but your employer does not actually handle the process of your workers’ compensation claim or the payout of benefits. One aspect that your employer does handle is strategizing to keep premium costs low. The cost of workers’ compensation for employers is lower if they are able to keep premium costs down—so employers have incentive to keep working conditions safe. 

If you need help or advice regarding a workers’ compensation claim or the payout of benefits, seek the advice of an experienced workers’ compensation lawyer in your area.