Why are most workers' comp claims worth so little? The harsh reality is that the system isn’t built in your favor. A recent study found that 55% of claims are worth between $2,000 and $20,000, and 12% are worth less than $2,000—meaning a whopping 67% of claims nationwide don’t go above $20,000.
That’s not great news if you’re an injured worker, but it doesn’t mean you’re out of luck. One-third of claims are worth more, and understanding why most claims fall short can help you take the right steps to maximize your payout. Knowing the challenges upfront gives you a better shot at getting the compensation you deserve.
To better understand how the workers' comp system is stacked against you, let's imagine two different scenarios.
Picture this: it’s the weekend, and you’re driving to the store for groceries when—bam!—a careless driver rear-ends you. Next thing you know, you’re in the hospital with a serious back injury that could take months to heal. You’re in constant pain, can’t work, and everyday things like exercising or picking up your kid are suddenly off-limits.
To get compensated for how this accident has turned your life upside down, you file a personal injury lawsuit against the driver who hit you. In court, you might sue for $15,000 to cover medical bills and lost wages, plus another $27,000 for pain and suffering—bringing the total to $42,000. And if the court decides the other driver’s actions were especially reckless, they might even tack on extra punitive damages.
Now, let’s look at a different situation. You’re at work, lifting something heavy because your supervisor told you to. Out of nowhere, your back gives out. Just like in the car accident scenario, the doctor says you have a serious injury that’ll take months to heal. You’re in constant pain, out of work, and struggling to get through daily life.
To get compensated, you file a workers' comp claim—but here’s the catch: you can’t sue anyone for a workplace injury, even if your supervisor shouldn’t have made you lift something so heavy. Workers' comp only covers medical bills, lost wages, and disability benefits—no extra money for pain and suffering, even though you’re going through just as much as if you’d been in a car accident.
In the first scenario, you could get $42,000 or more for your injury. But in this case? You might only get $15,000 for medical bills and lost wages—and even that isn’t guaranteed. Workers' comp doesn’t even pay your full salary; it typically covers only two-thirds of your average weekly wage, which could drop your total payout to $13,000 or less.
To make things worse, the insurance company will fight you every step of the way because the less they pay you, the more they keep. They’ll delay, deny, and try to minimize your benefits however they can. After months of frustration, you’re so drained from the whole process that you settle for $7,000 or $8,000, just so you can move on with your life.
The ugly truth about workers' comp is that it's designed to compensate workers as little as possible for their workplace injuries and to make it as difficult as possible to get paid. You can't sue your boss or the company you work for, you can't get paid for your pain and suffering, you don't receive the full amount of your wages or salary, and you often have to fight the insurance company every step of the way.
So, is it even worth it to file a workers' compensation claim? Absolutely. While the system is far from ideal, it's still your best chance of getting compensated for your workplace injury. Plus, it has its perks.
Don’t let the system being stacked against you stop you from filing a workers' comp claim. If you get hurt on the job, use the benefits that are there for you—and make sure you get everything you’re owed.
My name is Rex Zachofsky, and I became a New York workers' comp lawyer 17 years ago after getting injured on the job. If you're looking for a lawyer to help you with your claim for New York State workers' compensation benefits, please give me a call for a free consultation at 212-406-8989.
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