BS Summary: This article contains 18 faulty reasoning types, including Negativity Bias, Hasty Generalization, and Availability Heuristic, with Framing Effect as the most egregious example at 24.1% saturation with 914 hits. Analysis detected 2,742 faulty-reasoning hits from 3,790 analyzed words, generating a BS Score of 37.8% and a BS Rank of 25% (14,539 of 19,233 articles). This article is better (less manipulative) than 75.60% of the article peer group.
The workers’ compensation system is broken.
This century-old system, the first component of the social safety net, was created to maintain the income of workers who are hurt on the job, and to ensure they receive adequate medical care.
It was also designed to help prevent future injuries.
Today, it delivers meager benefits to some and nothing to many, especially those with work-related illnesses.
And it makes little contribution to injury and illness prevention.
Nowhere is this failure more visible than in the engineered stone countertop industry.
Workers who cut and polish “quartz” countertops breathe ultrafine silica dust.
A large proportion of them develop silicosis, a devastating, deadly, and entirely preventable disease.
In California alone, more than 500 workers in this small industry have been sickened.
At least 30 have died.
More than 100 of these workers have undergone or are awaiting a lung transplant, a complicated and expensive procedure that extends life but does not provide a long-term cure.
And California is just the tip of the iceberg.
If hundreds of cases have surfaced there, thousands more workers in other states have almost certainly also developed the disease: They just haven’t been found yet, because public-health departments are only now starting to look.
These California workers, 98 percent of whom are Latino men, have all developed a life-threatening disease.
Many face lifelong disability and medical expenses that include lung transplants costing more than $1 million each.
Yet in one study of 114 California countertop workers with silicosis, only eight received wage loss or medical benefits.
Medi-Cal (that state’s Medicaid program) paid the medical expenses for 73 of the 114 cases, meaning that taxpayers, workers, and their families are subsidizing the very employers who made them sick.
Beyond the failure of the workers’ comp system to provide any benefits to more than 90 percent of these sick workers, there is also no indication that any aspect of the workers’ comp system is making any effort to prevent these cases from continuing to occur.
Every state runs its own workers’ comp system, each carrying the DNA of early-20th-century design.
Under these laws, workers have surrendered the right to sue their employer, even when the injury resulted from a hazard the employer knew about and ignored.
In exchange, injured workers are supposed to get wage replacement (now generally capped at two-thirds of the state’s average wage) and full medical coverage with no co-pays or deductibles.
Many get far less.
This trade-off—losing the right to sue in exchange for certain benefits—has been described as a “ grand bargain ,” but for workers it never has been much of a bargain, much less grand.
For the most part, workers are getting a very bad deal .
Every state runs its own workers’ comp system, each carrying the DNA of early-20th-century design.
Before workers’ comp existed, American workplaces were killing fields.
In 1913, the Bureau of Labor Statistics estimated 23,000 workers died on the job during the previous year.
That came to 61 deaths for every 100,000 workers , nearly 20 times today’s rate.
President Theodore Roosevelt and Progressive Era reformers exposed how workplace injuries and deaths impoverished working families; they advocated for an insurance system that would shift the costs of work injuries from workers to employers.
The reformers predicted (correctly) that making employers pay for injuries would push them to invest in prevention.
Although several European countries embraced the employment injury insurance concept in the 1800s, the first state comp programs in the U.S. were struck down as unconstitutional in the early 20th century.
Courts ruled they violated the 14th Amendment’s due process clause by requiring employers to pay for insurance absent proven negligence.
Injured workers who tried to sue their employers generally fared poorly in courts since judges, steeped in free-market ideology, often held that dangerous jobs came with hazard pay (although they rarely did), and that workers who voluntarily took risky jobs had accepted the consequences and therefore did not deserve compensation.
Those attitudes eroded slowly—and then collapsed almost overnight.
The 1911 Triangle Shirtwaist fire killed 146 workers, mostly immigrant women, in a horror that shocked the nation.
Galvanized by muckrakers like Upton Sinclair and Crystal Eastman, judges and legislators could no longer justify blocking a compensation system that would benefit injured workers and grieving families.
Spurred by large verdicts juries returned in a few court cases, some employer and industry groups also supported workers’ comp legislation in order to secure total immunity from tort claims by injured workers.
A few states moved fast, others more slowly, but workers’ comp systems spread across the country.
Mississippi, the last holdout, signed on in 1948, although purchasing insurance coverage remained optional for employers in many states.
The impact was immediate and enormous .
The flood of claims revealed the staggering toll of workplace injuries, demonstrating just how urgently the system was needed.
In 1914, the first year New York’s law took effect, workers filed 40,855 claims.
By 1917, that number had grown to 58,562, representing 3 percent of the state’s entire paid workforce.
Nationally that year, new injury claims exceeded 350,000.
As the reformers predicted, shifting the cost of injuries onto employers transformed the American workplace.
Before comp laws, a seriously injured worker was simply replaced; cheap labor was abundant, and the only real cost was training a newcomer.
Once employers started to pay insurance premiums, they finally had a financial incentive to prevent injuries from occurring.
Many employers embraced safety programs which helped drive dramatic results: Workplace injuries and deaths fell sharply in the years following the introduction of workers’ comp.
Progress continued through the 1920s but then stalled under the weight of the Depression and World War II.
THROUGH THE MIDDLE OF THE LAST CENTURY , the numbers of workers killed, injured, or sickened on the job remained high.
In 1970, workers were fatally injured on the job at the rate of 37 each day.
The failure of state workers’ comp systems to slow the carnage was a primary reason Congress created the Occupational Safety and Health Administration (OSHA) in 1970.
But Congress missed a chance to fix the broken comp system.
It left compensation insurance entirely free of federal regulation, forbidding OSHA to do anything that could be “ construed to supersede or in any manner affect any workmen’s compensation law .”
The industry responded by doing even less to prevent injuries.
As a consolation, Congress created the National Commission on State Workmen’s Compensation Laws to evaluate whether state programs were actually “adequate, prompt, and equitable.”
President Nixon appointed the members, who were virtually all Republicans, according to Commission chair Professor John Burton.
Nonetheless, the Commission’s verdict was damning: State comp laws, it found, were “ in general neither adequate nor equitable .”
The Commission identified a myriad of problems and inequities in the state systems, made 84 recommendations for reform, and unanimously called on Congress to enact federal minimum standards if states didn’t shape up.
The threat worked, at least for a while.
Compensation for injured workers saw improvements in benefits in almost all states, especially where unions had strong lobbying power.
Fear of federal intervention pushed reforms even in weak labor states.
By 1976, only three states still made carrying comp insurance optional, down from 23 in 1968.
Ronald Reagan’s election ended the threat of federal oversight.
Through the 1980s, comp costs rose, driven by the reforms of the previous decade and the soaring costs of medical care generally.
By the early 1990s, with the Commission’s recommendations long forgotten, corporate and insurance lobbyists saw an opening.
Armed with the evidence-free claim that high costs would push businesses to cheaper states, they launched a race to the bottom, with states competing to slash benefits and cut employer premiums.
Employer immunity from lawsuits, though, has never been threatened, no matter how deeply worker benefits have been slashed.
THE REFORMS SPURRED BY THE NATIONAL COMMISSION also made a modest impact in lessening the wide gaps in benefit levels and coverage between states .
But huge gaps remain.
Compensation payments to an injured worker unable to work are generally limited to two-thirds of their weekly wage, up to a limit set by the state.
That limit is often the state average wage, although some states have set higher maximums, and others have capped payments at far lower levels.
The disparity between states is enormous : The maximum weekly payment to workers injured in 2025 ranged from $2,350 in Iowa and $2,309 in New Hampshire to $800 in Georgia and $631 in Mississippi (see chart).
This means that in most states, more highly paid workers, like unionized construction workers, receive far less than two-thirds of their weekly pay when they are injured.
The source of the differences between states, and the meager payments in some states, is no mystery, as workers’ comp is the only part of the national safety net with zero federal oversight.
Unlike unemployment insurance or Medicaid, there are no federally mandated minimums, no guardrails, no floor below which states cannot go.
And currently, no one in Washington is watching the system’s decay—or, it appears, even cares about it.
Perhaps it is not surprising then that in this era when every corporation feels it needs to maximize profits and return to shareholders, the absence of minimum standards has allowed states to conduct a race to the bottom, competing to cut benefits and limit eligibility.
This descent has been driven by business and insurance lobbyists wielding the fictional threat that employers will flee to cheaper states if comp costs aren’t slashed.
As benefits to injured workers shrink, the winners are clear: insurance carriers.
Private insurers collected $41.6 billion in premiums in 2024.
A shamefully large share of that never reaches injured workers.
In California, a state where administrative costs run especially high, 47 percent of collected premiums goes to frictional costs : administration, sales, and legal expenses, including fighting workers in court.
In New York state, from 2014 to 2023 the dollar amount of benefits insurers paid to injured workers dropped by 37 percent while carriers cleared almost $11 billion in profits.
Nationally in 2022, carriers paid out just under 45 cents of every premium dollar in benefits; the other 55 cents went to operating expenses and profits .
In consequence, workers’ compensation has now become one of the most profitable insurance lines in the country , outperforming all other property and casualty lines in recent years.
Comp insurance was designed to spread the risks and costs of workplace injuries across industries.
Instead, those costs are now quietly offloaded onto the people who can least afford them.
In addition to the physical and emotional costs of work injuries and illnesses, the financial burdens of workplace injuries are massively subsidized by injured workers , their families, and taxpayer-funded safety-net programs such as Medicaid.
Although they have been hurt at work, a large proportion of eligible workers never even enter the comp system.
In Washington state, one of the more generous and navigable systems in the country, roughly half of workers who reported a work-related injury or illness received no workers’ comp benefits whatsoever .
And that’s in a good state.
Even when there’s no doubt that a condition is work-related, compensation is far from guaranteed.
In Massachusetts, fewer than half of workers with work-related amputations received any benefits .
And even workers who do receive comp benefits don’t come close to being made whole .
Research on injured workers’ long-term outcomes is thin, itself a telling sign of how little attention this crisis gets.
But what we know is sobering: Workers who received workers’ comp benefits for lost-time injuries saw their incomes drop by roughly 15 percent over the following decade.
For the families of workers killed on the job, the financial devastation runs deeper still .
The financial consequences of the system’s inadequacies ripple far beyond individual workers.
Workers’ comp covers only about 21 percent of the total wages lost and medical costs from workplace injuries and illnesses.
Workers and their families absorb nearly 63 percent.
Government safety-net programs cover the remaining 16 percent, meaning taxpayers pick up almost 42 percent of the medical costs through Medicare and Medicaid.
Though employers caused the harm or at least allowed it to exist, everyone else is paying for it .
Disabled workers who go uncompensated or who exhaust their coverage often end up in the Social Security Disability Insurance (SSDI) system, where benefits are typically far lower than what comp would have provided.
The consequences go beyond pushing injured workers toward poverty.
They are also quietly breaking the SSDI system.
The number of SSDI beneficiaries has grown dramatically in recent years, and the reason is clear: A significant portion of that growth is driven by the workers’ comp system offloading its obligations onto the public .
PARTICIPANTS IN THE COMP SYSTEM often describe it as “Kafkaesque.”
This characterization is more literal than most people realize.
For the last 14 years of his life, Franz Kafka worked as an attorney and workplace safety inspector for the workers’ comp system of what is now the Czech Republic.
What he saw there enraged him: employers lying about workplace hazards to lower their premiums, injured workers denied benefits through bureaucratic manipulation, and a faceless system making irrational, unmeetable demands.
He wrote about it extensively.
Those experiences didn’t just frustrate Kafka, they shaped his fiction.
The nightmarish legal labyrinths in The Trial weren’t invented from whole cloth.
They were drawn from the comp system.
The term “Kafkaesque” was born there.
Workers’ comp covers only about 21 percent of the total wages lost and medical costs from workplace injuries and illnesses.
It isn’t surprising that many injured workers do not file claims for their injuries.
The application process can be challenging to manage.
Workers often face retaliation for filing claims.
Although it is illegal to retaliate against a worker who files a comp claim , enforcement of OSHA whistleblower protections is challenging and there is little evidence that it deters employers from retaliatory policies or actions.
In many states, workers can’t even see their own doctor; they are required to use a provider chosen by the employer or insurer.
Workers who have decent group health coverage and medical leave will often use those instead, even if it means co-pays and burning through sick days, just to avoid the hassle and uncertainty of the comp system.
Then there’s fraud.
The insurance industry wants you to believe the system is filled with workers faking their injuries, a cynical strategy designed to stigmatize workers and deter legitimate claims.
To be sure, workers’ comp fraud is real and widespread—but not the kind the insurance industry wants you to focus on.
Employer fraud is the far bigger problem.
Employers who illegally skip comp insurance may leave injured workers with nothing.
In the engineered stone silicosis cases, many smaller employers never bought coverage at all, hiding behind the fiction that their workers were independent contractors.
But misclassification isn’t confined to dangerous industries.
In 2025, criminal investigators with the North Carolina Industrial Commission documented 21,432 cases of employer fraud —mostly misclassification schemes or outright failure to carry required coverage.
THE WORKERS’ COMP SYSTEM that has long worked poorly for injured workers is now in full crisis, at least for injured workers.
Many workers with job-related injuries, and nearly all with occupational illnesses, never even enter the comp system, pushing costs onto families and taxpayers.
Premiums for employers are down; if employer premiums reflected the true incidence and full costs of their employees’ injuries and illnesses, employers would be incentivized to invest in injury prevention.
But the way that the current system works, high-road employers who invest in prevention are at a financial disadvantage competing with ones who care little about the safety of their employees.
Workers’ compensation was originally conceived as much as a safety mechanism as a compensation one.
Before these laws existed, most employers faced little liability for workplace injuries and therefore had little incentive to prevent them.
Early state programs were explicitly designed to address this issue.
California’s 1913 law was literally titled the Workmen’s Compensation, Insurance and Safety Act , linking compensation with the state’s authority to inspect workplaces and issue safety regulations, while providing employers with immunity from injured-worker lawsuits.
Injury prevention has always been touted as a benefit of workers’ comp, and at one time, insurers employed many experts to help policyholders reduce hazards.
With OSHA’s passage more than 50 years ago, carriers started cutting back on their own prevention services, and now it is the rare carrier that actively works with employers to reduce hazards and prevent injuries.
The industry has also kept OSHA at arm’s length from the start.
In the agency’s first years, labor policy experts promoted the value of data sharing to enable both OSHA and a firm’s carriers to identify where resources could most valuably be targeted.
The industry never agreed to it, and to this day it resists helping OSHA investigate worker injuries and deaths.
When I became assistant secretary of labor for OSHA under President Obama, I saw the pernicious effect of the wall between comp insurance and OSHA.
Although the law didn’t give me the power to tear it down, I tried to get around it as much as possible.
In their marketing materials, comp carriers often claim they help businesses prevent injuries.
I theorized that publicly embarrassing a carrier that had clearly failed at that job might push others to take it more seriously.
I had our communications team start naming the workers’ comp carrier in press releases whenever a worker was killed or an employer’s hazards were bad enough to draw multiple willful violations.
We never accused the carrier of anything; we just listed its name alongside the citations and fines.
But it struck a nerve.
Carrier executives and lawyers complained that we were unfairly dragging their name through the mud.
One executive phoned me directly after his firm turned up in a release about a worker seriously injured by multiple uncontrolled hazards.
He argued his company had nothing to do with it.
“That’s exactly the point,” I told him.
‘My Lungs Had Nothing Left’: Inside the Epidemic Killing Countertop Stonecutters
NOT ALL COMP SYSTEMS HAVE ABDICATED their role in worker safety.
The primary objective of the German Social Accident Insurance (DGUV) system is injury and illness prevention, followed by rehabilitation of injured workers.
Least important is medical cost and wage loss compensation, although those are more generous in Germany than here.
Germany’s workers’ comp system essentially serves as a second safety regulatory agency—a backup OSHA, as it were, complementing Germany’s own OSHA agency, which has more inspectors than the U.S. system.
Prioritizing prevention, the DGUV alone has more workplace inspectors than the U.S. federal and state OSHAs combined.
The U.S. workers’ comp system’s remaining mechanism to prevent injuries is based on experience rating—setting premiums based on an employer’s injury history, meant to create financial incentives for prevention.
In theory, it still does.
In practice, rates are typically averaged across entire industries, meaning individual bad actors, especially small businesses, rarely see meaningful premium spikes.
Claim suppression, in which employers discourage their workers from filing, further dilutes whatever deterrent effect remains.
The final verdict on experience rating is that it probably moves the needle a little , but not much.
If experience rating were applied more directly to individual employers, rather than entire industries, the result would undoubtedly be even more claims suppression.
For work-related illnesses, like cancer, that can develop decades after first exposure, experience rating is essentially irrelevant.
Most workers who develop job-related chronic illness never file a workers’ comp claim at all, so there’s no premium signal to speak of, and no comp-related incentive for employers to clean up the exposures that caused the harm.
To be sure, every state has a built-in presumption that cancer or heart disease in a firefighter is work-related.
For most other workers, though, it is often very difficult to gain compensation even if the disease is very likely work-related, like mesothelioma or asbestosis, which are caused only by exposure to asbestos.
The International Labour Organization compiles a list of work-related illnesses and recommends that nations establish systems to compensate workers if they have one of these listed illnesses.
“Unless proof to the contrary is brought, there should be a presumption of the occupational origin of such diseases,” the ILO has written.
This approach, which has been embraced in many countries, but not the U.S, is the most effective way to ensure eligible workers with work-related illnesses receive the benefits to which they are entitled.
The comp system’s failure to play a role in preventing work-related illnesses is one of the reasons California court dockets are being flooded with lawsuits by workers with engineered stone silicosis.
But tellingly, the companies that are being sued are not their direct employers, since the comp system has blocked that avenue.
Instead, the defendants in the litigation are the manufacturers and suppliers of the quartz slabs out of which the countertops are fabricated.In the first case to go to trial, a Los Angeles jury awarded $52 million to a 34-year-old worker whose lungs were so damaged he was forced to undergo a double lung transplant.
Other cases have been settled for amounts reportedly in the tens of millions .
As public-health departments in other states begin identifying cases , thousands more lawsuits are likely to be filed.
But instead of stopping sales of deadly products, the industry’s response has been to ask Congress to prohibit the lawsuits by sick workers .
That bill was voted out of the House Judiciary Committee last month on a party-line vote.
But lawsuits aren’t the answer.
They’re a symptom of the problem, proof that the comp system has abdicated its role in preventing workplace injuries and illnesses.
One step forward would be to limit or eliminate the tort immunity employers receive if workers are injured or sickened because serious workplace safety violations were present and known to the employer but not addressed.
The most effective way to prevent work injuries is to push the true, long-term costs of these injuries back onto employers, since that will incentivize them to prevent injuries.
It will also enable injured workers to receive the compensation benefits to which they are entitled.
But the comp system has proven unable to reform itself.
We need to return to the solution proposed by the National Commission more than 50 years ago: Federalize the workers’ comp system and set national standards for uniform, fair benefits, with employers bearing the true costs of worker injuries.
The post How America Let Its Workers’ Compensation System Fail appeared first on The American Prospect .
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