State workers' compensation programs: Four decades later, still falling short of objectives

Background and Objectives: In the US, each state runs its own workers' compensation program. In 1972, the National Commission on State Workmen's Compensation laws concluded, "State workmen's compensation laws are in general neither adequate nor equitable.” The Commission described five major objectives for workers' compensation programs: broad coverage of employees and of work-related injuries and diseases; substantial protection against interruption of income; provision of sufficient medical care and rehabilitation services; encouragement of safety; and an effective system for delivery of the benefits and services. This research analyzes the extent to which workers' compensation programs four decades later are meeting those objectives, and discusses possible solutions in areas where they fall short.

Methods: Literature and reports will be reviewed, and recommendations from experts and injured workers will be sought.

Results: Four decades later, workers' compensation programs still fail to meet the Commission's five objectives. Many workers with occupational injuries and diseases are never compensated. Among those who are, many still face insufficient medical care and economic hardship. Delays and emotional trauma are common. As a whole, the system fails individual workers while falling far short of its potential to encourage workplace safety.

Conclusion: US workers' compensation programs do not meet the Commission's five objectives. As a result, the burden of unsafe workplaces is distributed inequitably; workers and their families bear a large share of the burden, and this contributes to health disparities. The inequitable distribution prevents the workers' compensation system from achieving its potential to encourage workplace health and safety improvements.