A Guide to Workers’ Compensation for Today’s Attorney

Workers’ compensation is the great bargain between employers and employees. Guided by the principle that the cost of on-the-job injuries is a business expense, worker’s comp is a legislative scheme where benefits are generally automatic and employees can’t sue their employers. 

The result is an often dense and strict legal regime that places obligations on all parties. Employees and employers have to follow detailed rules about claim submission, benefit payments, and return to work. Important terms like “disability” are strictly defined and the content of benefits follows a defined structure. 

There’s nonetheless plenty of cause for disagreement on the facts and different interpretations of the law. Workers’ compensation lawyers are those advocates who represent client interests in claims and appeals, when those “automatic” benefits aren’t so “automatic.” These attorneys might work on either side of the workers’ comp dispute, acting for an employee, employer, or insurance company. 

Let’s have a look at how states, the feds, and attorneys are handling workers’ compensation in 2025. 

The History of Workers’ Compensation

In the U.S., comprehensive workers’ compensation laws were implemented in the first half of the 20th century. The trend began with Wisconsin in 1911 and 36 other states had followed suit by 1920. It was not until 1948 that all U.S. states had legislation on the books.

Workers’ compensation is a no-fault system that generally precludes employers from liability for workplace injuries. When injuries happen at work, worker’s compensation pays out claims to cover wages and medical costs of the employee. State laws can set guidelines around claim rates, reporting procedures, criteria for permanent disability, and other factors.

Every state except Texas requires employers to have some kind of workers’ compensation coverage. In Texas, this insurance is optional, but employees can sue employers for injuries on the job. With some exceptions, filing a workers’ compensation claim means an employee cannot sue the employer for the same injury. 

Federal workers are covered under the Federal Employees’ Compensation Act (FECA), which works similarly to state programs. Separate legislation covers longshore and harbor workers, coal miners, and employees of the Department of Energy.  

The limited circumstances when an employee can sue outside of workers’ compensation include negligence by the employer. With a lawsuit, compensation can exceed the coverage limits set by the state insurance rates. 

Employers typically purchase workers’ compensation insurance from private brokers, although some states have the option of buying through a state insurance fund. Employers can sometimes self-insure. 

States can mandate that employers with as few as one employee have workers’ compensation coverage. Taxpayer dollars do not fund worker’s compensation payments, even though most aspects of the system are strictly regulated by legislation.

Insurance coverage is of two types: coverage A pays out state-mandated benefits. Coverage B kicks in for payments that exceed those state minimums, usually as the result of a lawsuit. Depending on state law, an employer might choose to carry only coverage A.  

The State of Workers’ Compensation in 2025

Worker’s compensation law tends to move slowly in most states, with the general structure and philosophy of legislation remaining unchanged. In 2025, there is some movement as governments revise compensation schedules to account for rising costs of medical care. One overall trend is the declining costs of insurance premiums for employers, reflecting efforts to make workplaces safer with advances in technology. 

State legislatures have also proposed or implemented specific changes. One example is Connecticut’s law that reverses the impact of a court decision that allowed for continuation of temporary partial disability benefits. In Michigan, a controversial bill would have changed the definition of disability under workers’ compensation.

At the federal level, there’s a bipartisan bill that would allow physician assistants and nurse practitioners to be among the medical providers approved under the scheme. This bill would increase the availability of professionals to treat injured workers.

The Role of Workers’ Compensation Attorneys

Attorneys can play a big role in workers’ compensation cases as advocates for employee claimants. They can also represent employers or insurers when there is a dispute about the details of a claim. Workers’ compensation lawyers:

• Prepare claim documentation (medical records, doctor testimony, worksite evidence)
• Advance the client’s cause with the insurer to get quick payment of benefits
• Represent the client in all stages of appeal (affidavit submission, oral advocacy)
• Advise the client on next steps and suggested courses of action
• Recommend legal strategy (staying within the scheme, filing a lawsuit)

Some common challenges in workers’ compensation claims are:

• Fraud. An insurer might deny the claim on the basis that the injury did not occur at work, was not caused by employment, or is not as severe as the employee states. 
• Continuation of benefits. An insurer might argue an employee can return to work and should not continue to receive benefits. The employee might have to submit additional medical evidence to support their claim. 
• Independent contractors. Workers’ compensation usually does not apply to independent contractors. Whether an injured person is an “employee,” and therefore eligible for benefits, can be a legal grey area. 
• Legislative interpretation. Proposed legal changes in Connecticut and Michigan shed light on how the law directly impacts the rights of claimants and employers. The meanings of legislative changes are not fully understood until they are tested in the courts. Attorneys therefore often face uncertainties in asserting their client’s rights.
• Suing outside the scheme. Although workers’ compensation is a “no-fault” system, an employee might have the right to sue under certain circumstances. The plaintiff and defense might argue over whether a specific claim can proceed to litigation. 

Worker’s compensation lawyers often represent clients in administrative law tribunals and boards specifically tasked with resolving these types of disputes. These legal settings have their own set of procedures that the lawyer must follow to properly advance their client’s interests. 

How Lawyers can Prepare

The landscape of worker’s compensation is constantly changing, even through simple changes in compensation amounts. Attorneys can develop their skills in this area by gathering knowledge about the current state of the law.

• Stay up-to-date on legislative changes. Subscribe to news bulletins and updates from the state legislature to stay informed on pending laws that impact worker’s compensation. If you represent federal employees, follow updates from Congress or your local representatives.
• Join local Worker’s compensation bar sections. Fellow attorneys can provide insights gathered from “on the ground” work in this area. They can share experiences in recent legal settings that might give you a sense of how administrators and judges are ruling on certain issues. 
• Understand tribunal and board policies and procedures. Workers’ compensation cases operate in a different judicial setting than a civil or criminal court. If you’re unfamiliar with tribunal procedures, review them before presenting your case. The rules about submitting evidence, presentation of witnesses, and grounds for appeal might all be different from what you’re used to. 
• Know workplace health and safety laws. The Occupational Safety and Health Administration (OSHA) gives employees certain rights, such as to refuse unsafe work in good faith. OSHA regulations can have a direct impact on workers’ compensation claims, in particular if failure to comply with OSHA has led to your client’s injury and might open up the option to sue. 
• Review employment laws. In the “gig economy,” more and more people are falling outside the traditional employer/employee relationship. Employee status is central to a worker’s compensation claim. Stay abreast of case law updates to learn when a worker might be classified as an independent contractor and have a different set of legal options.
• Follow insurance industry news. Worker’s compensation benefits are typically paid out by private insurance companies. Staying up-to-date on the insurance industry can help you to better understand the insurer’s perspective on claim payouts, so you have more information to be a better advocate for your client.
• Learn about healthcare professionals. Insight into the healthcare industry can help with worker’s compensation claims. You can advise your client on how to receive care under the insurance scheme and also argue on their behalf in the event of a dispute. With proposed changes like the expansion of approved professionals under federal worker’s compensation legislation, knowing each provider’s role is increasingly essential. 

Lawyers can also increase the tools in their toolkit by keeping up to speed with local business news. Real estate developments, construction sites, and new, large-scale business operations all have the potential to increase worker safety obligations on employers. As a worker’s compensation attorney, you can stand ready to assist in the case of an injury or dispute. 

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