Insights from our Recent Workers’ Compensation 101 Webinar
On November 12, 2025, Special Programs Practice Leader, Chris Mason, helped break down the essentials workers’ compensation, a critical aspect of workplace safety and employee protection, but it’s often misunderstood. Whether you’re new to managing workers’ compensation or looking to improve your organization’s approach, understanding the basics—and the strategies for controlling costs—is essential.
Why Does Workers’ Compensation Exist?
Workers’ compensation laws were established over a century ago, following tragic workplace incidents that highlighted the need for employee protection. In New York, the law provides a no-fault system for employees injured or made ill on the job. This means that even if the employee’s own negligence contributed to the injury, they are still eligible for benefits. In exchange, employers are generally protected from direct civil lawsuits, with damages limited to medical expenses and lost wages.
Key features of workers’ compensation:
- No-fault coverage: Employees receive benefits regardless of fault.
- Limited damages: Only medical expenses and lost wages are covered; no punitive damages.
- Caps on benefits: There are maximums for weekly payments and duration, but medical coverage can continue as long as it’s related to the workplace injury.
- Presumptions favoring employees: Claims are presumed valid unless proven otherwise, making early and thorough documentation crucial for employers.
How Is Workers’ Compensation Insured?
- Mandatory coverage: Any business with employees must carry workers’ compensation insurance.
- Self-insurance: Large employers or municipalities may self-insure, but must meet state requirements and post collateral.
- Captive and high-deductible programs: Employers can opt for alternative risk financing, sharing in profits or taking on more risk for lower premiums.
- State Insurance Fund: Often the most affordable option, especially for organizations with few claims.
Calculating Premiums:
Premiums are based on:
- Industry classification: Each job type has a set rate per $100 of payroll.
- Loss cost multipliers: Carriers adjust rates based on risk and performance.
- Experience modification: Your organization’s claims history affects your rate—better safety records mean lower costs.
- Credits and discounts: Drug-free workplaces, safety programs, and other factors can reduce premiums.
Strategies for Controlling Costs
- Risk Management & Safety Programs
- Invest in training, hazard identification, and regular safety meetings.
- Engage managers and employees in building a safety-focused culture.
- Avoid “safety contests” that discourage reporting; instead, promote open communication.
- Return-to-Work Programs
- Offer light or transitional duty to injured employees.
- Document available jobs and communicate with both employees and their doctors.
- If an employee refuses suitable work, coordinate with your carrier to potentially adjust benefits.
- Claims Management
- Investigate incidents promptly; gather written reports and witness statements.
- Report claims early—within 1-2 days for best outcomes.
- Maintain documentation for 18 years.
- Premium Recovery & Contractual Risk Transfer
- Transfer risk to vendors or contractors through proper contract language.
- Review claims and reserves regularly to ensure accuracy.
Common Questions Answered
- Does workers’ comp cover undocumented workers or independent contractors?
- Yes, if the relationship meets certain criteria. The Workers’ Compensation Board determines eligibility based on control, payment method, and other factors.
- Are illnesses like fainting or asthma attacks covered?
- Only if the workplace contributed to the condition.
- What about remote employees traveling for work?
- Injuries during work-related travel are generally covered.
- Do return-to-work jobs need to pay the same wage?
- No, but employees may receive partial wage replacement for reduced earnings.
Best Practices for Employers
- Stay engaged with injured employees—send updates, offer support, and communicate available work.
- Be consistent in applying return-to-work policies.
- Request regular claims reviews and hearing reports from your carrier or broker.
- Keep up-to-date with regulatory changes and industry trends.
Conclusion and Resources
Workers’ compensation is more than just an insurance requirement—it’s a partnership between employers, employees, and carriers to ensure safety, manage risk, and support recovery. By understanding the system and implementing proactive strategies, organizations can protect their workforce and control costs.
Need more information or help with your workers’ compensation program? Reach out to our dedicated risk management team for resources, training, and support.
This content is for informational purposes only and not for the purpose of providing professional, financial, medical or legal advice. You should contact your licensed professional to obtain advice with respect to any particular issue or problem. Please refer to your policy contract for any specific information or questions on applicability of coverage.
Please note coverage can not be bound or a claim reported without written acknowledgment from a OneGroup Representative.