Workers' Compensation
The statutory bargain
Workers' compensation is a state-based, no-fault system: workers give up most tort claims against employers (exclusive remedy) and receive medical and wage-replacement benefits for injuries or illnesses arising out of and in the course of employment (AOE/COE). State law controls.
Benefits and claims
Medical care; temporary total/partial disability; permanent partial/total disability; death benefits; rehabilitation. Waiting periods and benefit formulas vary. Exceptions to exclusivity can include intentional torts and third-party claims. Experience modification rate (EMR) is an NCCI/state rating factor based on past losses versus expected losses for similar employers; 1.00 is average.
Worked example
An employee twists an ankle while walking to the company cafeteria during a paid break. AOE/COE analysis: the injury occurred on premises and during paid work time, so it likely arises in the course of employment; the cause need not be work-related because the system is no-fault. Contrast an injury during a personal errand off premises, which may be excluded. Report, investigate, reserve, and manage return-to-work.
Traps
Treating every OSHA-recordable case as a compensable claim (different tests); assuming federal OSHA rules decide compensability; ignoring state waiting periods and exclusivity exceptions; and using EMR as a safety score rather than a premium modifier.