Benefits Workers' Compensation Does Not Cover

What Workers' Compensation Covers

Workers' compensation is designed to pay medical costs and a portion of wages for injuries that occur on the job. It also provides temporary or permanent disability payments up to a statutory cap, and it covers the cost of re‑employment services if you can't return to your previous role.

Benefits That Are Explicitly Excluded

Health Insurance and Premiums

The program does not pay for general health insurance premiums or out‑of‑pocket costs for routine medical care that is not injury‑related.

Long‑Term Disability Beyond the Cap

Once the statutory disability benefit limit is reached, any further loss of earnings is not compensated under workers' comp. Employees must rely on private long‑term disability insurance for additional coverage.

Non‑Work Related Injuries or Illnesses

Injuries that do not arise from the employee's job duties, such as a sports injury or a car accident, are outside the scope of workers' compensation.

Legal or Settlement Fees

Legal fees incurred to pursue a claim against the employer are generally not covered. Employees usually cover these costs themselves or seek separate legal aid.

Loss of Benefits Due to Injury

If an employee loses a benefit such as a pension or retirement plan because of a job‑related injury, workers' compensation does not reimburse that loss.

Reimbursement for Relocation Expenses

Workers' comp does not reimburse costs associated with relocating for a new job, unless relocation is part of a structured re‑employment program approved by the state.

Employer‑Provided Pension or Retirement Contributions

State workers' compensation does not replace employer contributions to pension or retirement plans that are cut because of disability.

Benefit of the Doubt: Employer Liability for Personal Injury Claims

Workers' compensation is a no‑fault system; it does not allow employees to sue employers for personal injury damages beyond the compensation limits.

Why These Exclusions Matter

Understanding the gaps in coverage helps employees plan supplemental insurance and anticipate potential financial shortfalls after a workplace injury.