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The National Academy of Social Insurance is a non-profit, non-partisan organization made up of the nation’s leading experts on social insurance. Its mission is to advance solutions to challenges facing the nation by increasing public understanding of how social insurance contributes to economic security.

Social insurance encompasses broad-based systems that help workers and their families pool risks to avoid loss of income due to retirement, death, disability, or unemployment, and to ensure access to health care.

The Academy just published its Workers’ Compensation Benefits, Costs, and Coverage – 2019 Data. These data range from benefits, costs, and coverage to Department of Labor data on injuries and fatalities, and data on the overlaps between Social Security disability insurance and the workers’ compensation system. This latest report is issued annually by the National Academy of Social Insurance.

Drawing on data from surveys of workers’ compensation agencies from all 50 states and the District of Columbia, as well as from A.M. Best and the National Council on Compensation Insurance, this is the only report of its kind available free-of-charge for researchers and students, state and federal agencies, workers’ rights and employer advocates, and others.

While overall, total benefits paid rose slightly over the five-year study period from 2015 to 2019, standardized benefits fell, continuing a ten-year trend. Total benefits paid rose 0.4%. Cash benefits increased by 2.0%, but medical benefits declined by 1.1%. Standardized cash and medical benefits fell by 14.0% and 16.7%, respectively, combining for a 15.4% decline in total standardized benefits between 2015 and 2019.

While medical benefits as a share of total benefits have increased in recent decades (with the share attributable to cash benefits shrinking), the national average masks enormous variation across states. In 2019, for example, medical benefits constituted 49.6% of all workers’ compensation benefits paid out, yet they are only 29.8% of benefits in D.C. and 79.1% of benefits paid in Wisconsin.

There are considerable cross-state differences within standardized benefits, where only one state, Hawaii, saw an increase over the study period. Declines ranged from 2.4% in Massachusetts to 30.5% in Tennessee and 33.1% in Oklahoma. Over that period, 24 states observed standardized benefit declines exceeding 15%, and 11 of those states, exceeding 20%.

Total employer costs for workers’ compensation in 2019 were $100.2 billion.

Like benefits, standardized employer costs vary substantially across states from the 15.0% national-average decline over the study period. In Hawaii, standardized costs rose by 1.9%. Decreases in the other states range from 4.5% in Massachusetts to 30.8% in Oklahoma and a massive 40.2% figure in Tennessee. In all, standardized costs declined by more than 15% in 31 states, and by more than 20% in 13 states.

Coverage continued to increase, largely because the labor force has continued to expand, a fairly consistent trend, at very different rates. The only five exceptions are Alaska, Louisiana, North Dakota, West Virginia, and Wyoming. Even in those states, covered wages increased.

In 2019, workers’ compensation covered 144,407,000 jobs across the country, with a total of $8.6 billion in covered wages. Measured by covered jobs, workers’ compensation coverage increased by 3.2% from 2015 to 2017, and by 2.8% in the following two years, for a total increase of 6.2%.

Certain source data are available upon request to Griffin Murphy,, or Jay Patel,