I am self-employed so if anything happens to me on-the-job, it’s tough luck, Charlie. I have a couple of friends who seem to take advantage of the Worker Compensation system. It takes them much much longer to heal and recover compared to someone like me who can’t afford to miss a day of work. Wouldn’t we be better off if there was NO Worker Compensation system at all? Then the “no work, no pay” approach would ensure an equal playing field.

There has been much debate around the issue of Worker Compensation, failure to recover due to the possibility of financial gain, and predictable worse outcomes for workers injured on-the-job compared with those who are not covered by Worker Compensation.

In fact, studies do show that results after surgery for worker compensation patients are worse than for non-worker compensation patients. Worker compensation patients take longer to recover after shoulder/arm surgery compared with non-worker compensation patients treated for the same thing. And worker compensation patients are much slower to return to their jobs at a preinjury level compared with non-worker compensation patients.

It’s also true that more worker compensation patients change jobs because of continued pain after surgery compared with non-worker compensation patients. And fewer worker compensation patients return to employment at all compared with non-worker compensation patients.

What’s behind these differences? Recovery from work-related injuries can be complicated by the fact that workers are financially compensated for bodily injury in the
work place. It is tempting to assume that financial gain is the reason for unfavorable outcomes and worse prognoses for these workers.

But from a review of studies done in this area, several factors have come to light that might help explain the differences in results. First, worker compensation patients tend to be younger and expected to be more physically active on-the-job compared with non-worker compensation patients with the same injuries.

Returning to preinjury levels of activity may differ between these two groups. Workers must get back to their preinjury level of work activities (e.g., pushing, pulling, or lifting heavy objects, operating heavy equipment). Non-worker compensation patients may be having trouble performing less difficult tasks (e.g., brushing teeth, caring for a child, dressing). Of course, your point is well-taken that it doesn’t matter what the level of skill or work that self-employed individuals who are injured on-the-job face — they have to get back to work no matter what if they want a paycheck.

From a historical perspective, Worker Compensation was first started in Prussia back in the late 1800s. Until the United States enacted similar laws, injured workers were on their own when injured, maimed, or even killed on the job. The average worker simply could not afford to bring a lawsuit on his or her behalf — even when the injury was a direct result of their employer’s negligence.

And employers hid behind beliefs that they were not legially liable for injuries resulting from actions, inactions, or outright negligence of other workers. Employees were told “you knew the risks when you signed on” for this job. Some employers even had their employees sign a contract agreeing that the job gave them the right to be killed without compensation. This was referred to as a death contract.

But as the industrialization of America took hold, individual states started passing legislation to protect its workers. The first one (called the American Worker Compensation law) was passed in Wisconsin in 1911. Over time, each state passed its own law governing protection of workers involved in work-related injuries.

Most recently, deaths and injuries in the workplace have started to decline. Better safety measures have helped. The high cost of injuries (medical as well as work place) is a driving force behind the push to reduce work-related accidents. Your point is well taken about the motivation and impetus behind return-to-work for the self-employed versus employees protected by Worker Compensation. But with laws passed in each state to protect workers, it’s not likely the system will be abolished.