If you’ve been injured on the job, you may be wondering what kind of benefits—and how much—you can get through workers’ compensation. States have different rules for deciding how much injured employees can receive in benefits, but the basic outlines are similar.

First, you need to meet the basic eligibility requirements for workers’ comp. In general, you won’t be entitled to benefits if:

• you're not an employee
• your employer doesn’t have workers’ comp insurance
• you weren’t working for your employer when you were hurt, or your injury or illness wasn’t caused by work activities; or
• you didn’t report the injury or file a workers’ comp claim by the deadline in your state.

(Learn more about common reasons workers’ comp claims are denied.)

Once you clear the eligibility hurdle and your claim is approved, you could be entitled to a range of benefits under the rules in your state, from medical care to some replacement for lost income.

Medical Benefits

Your employer’s insurance company should pay for all medical care related to your work injury or illness, without any copays or deductibles. However, the treatment must be necessary and reasonable. (Learn about medical issues in workers’ comp cases, including how to find a doctor and what happens when there are disputes about treatment recommendations or doctors’ opinions.)

In addition, injured employees can usually receive reimbursement for travel expenses to and from doctors’ medical appointments. In some states, you need to have travelled a certain distance to the health care provider before you can receive this mileage reimbursement.

Temporary Disability or Wage Loss Benefits

If your doctor says that you aren’t able to work while you’re recovering from your injury or illness, you’re entitled to weekly payments from workers’ comp, after a brief waiting period (usually three to seven days). There are two types of temporary disability benefits (also called wage or loss benefits in some states):

• Temporary partial disability (TPD) covers periods when you’re earning less because of your work injury or occupational disease, but you’re still getting treatment and recovering. For instance, you may have to cut back on your hours or move temporarily to a lower-paying position that accommodates any restrictions on the work you can do.
• Temporary total disability (TTD) covers periods during your recovery when you can’t work at all, because your doctor has taken you off work entirely or has given your work restrictions that your employer can’t accommodate.

States have different ways of calculating the amount of temporary disability benefits. Typically, however, TTD payments will be about two-thirds of your average weekly wage before the injury, up to a legal maximum. TPD payments are usually two-thirds of the difference between your pre-injury wages and what you’re earning now.

The temporary disability payments will continue until:

• your doctor clears you to return to your normal work duties
• your medical condition has stabilized and isn’t likely to improve in the next year or so—a stage known as maximum medical improvement (MMI), or
• you’ve received these benefits for a certain period of time, if you live in a state with a time limit on temporary disability (typically 104 weeks).

Permanent Disability Benefits

When you’ve reached MMI, your doctor will evaluate you to see whether—and to what extent—you have any lasting physical or mental limitations as a result of your work injury. If you’re totally and permanently disabled (as your state defines that), you generally will receive payments for the rest of your life. If you’re partially disabled, the doctor usually rates the level of your limitations or lost function. That rating will be used to calculate your permanent disability benefits under the formula in your state.

Vocational Rehabilitation Benefits

When you’re not able to return to your old job after you reach MMI, most states offer some form of vocational rehabilitation benefits, which will pay for you to get the training or schooling needed to enter a new line of work.

Death Benefits

If a family member died as a result of a work injury or illness, you may be able to collect workers’ comp death benefits. State law determines who’s eligible and how much they receive. As a rule, however, death benefits go to close relatives who lived with the deceased employees and were financially dependent on them. Certain states also provide some death benefits to family members who were partially dependent on the deceased workers. Death benefits are usually paid in installments, based on the deceased employee's earnings before the work injury. The total amount may or may not be divided up among the dependent survivors.

All states also pay some amount of money to help with funeral expenses for employees who died from their work injuries.

When You Need Help Collecting Benefits

Unfortunately, insurance companies often delay or refuse to pay workers’ comp benefits. Your employer’s insurer may deny your claim entirely, disagree with your doctor’s recommendations for medical treatment or work limitations, or challenge the doctor’s opinion concerning your permanent disability. You can take several steps to improve your odds of collecting workers’ comp benefits. But the most important thing you can do is talk to a lawyer. An experienced workers’ comp attorney will deal with the insurance company and can help you with many aspects of your case, including:

• gathering strong evidence to bolster your claim
• preparing you for a deposition, independent medical exam, or workers’ comp hearing
• challenging a medical examiner’s report
• collecting a hefty penalty for late workers’ comp payments (if that’s available in your state), and
• negotiating a settlement agreement.

(See our survey results on how much workers’ comp lawyers cost and the difference they make in the amount of benefits injured employees receive.)