A Guide to Workers Compensation Waiting Period by State

When an employee is injured on the job, their primary concern is their health. The next is almost always their paycheck. As they focus on recovery, the question of how they will support themselves and their family becomes urgent. This is where workers' compensation wage replacement benefits are supposed to help, but the process is rarely immediate.

A mandatory, unpaid waiting period is the first hurdle to overcome. It’s a major source of confusion for employees and an HR compliance risk for employers. The variations in state systems, including waiting periods, can significantly impact an injured worker's financial stability and their return-to-work timeline.

This guide will demystify the waiting period, explain the critical retroactive period that follows, and provide a state-by-state comparison. 

What Is a Workers' Comp Waiting Period?

A workers' compensation waiting period is a specific number of calendar or business days that an injured employee must be medically certified as unable to work before they become eligible to receive wage replacement benefits. It's important to note that medical care is covered from day one, but wage replacement is not.

The purpose of the waiting period is to discourage the filing of claims for very minor injuries that result in only a day or two of missed work. Plus, it reduces the significant administrative burden on insurers that would result from processing payments for tens of thousands of short-term claims.

However, this initial unpaid period is not always permanent. This is where the ‘retroactive period’ comes into play. The retroactive period is a second, longer timeframe. If an employee's disability lasts long enough to meet this threshold, the employer's insurance carrier is then required to ‘go back’ and pay the employee for the initial waiting period. 

Workers’ Comp Waiting Period: State-By-State Comparison

The number of days for both the waiting period and the retroactive period is set by each state's legislature, leading to variations across the country.

Below is a comprehensive comparison table highlighting the rules in all 50 states.

As the table shows, the experience for an injured worker can differ dramatically depending on their location. An employee in Texas must wait a full four weeks before receiving retroactive pay for their first week of lost time. In contrast, employees in California, Illinois, or Washington only have to wait two weeks to have their waiting period benefits paid back. 

Managing Claims With a Reliable Buddy

A misstep in communication, a missed filing, or a poorly managed return-to-work process can increase the cost of the claim and damage the trust you’ve built with your team. DianaHR safeguards you by simplifying the claims management process. 

• Compliant claims management: When an injury occurs, our HR experts manage the entire claim-filing process, ensuring the first report of injury is filed on time and all workers’ compensation posting requirements by state are met.

• Clear employee communication: They provide clear, empathetic communication to your injured employee, explaining their state-specific waiting period and retroactive pay rules to manage expectations.

• Return-to-work program integration: They help you develop a formal return-to-work (RTW) program. Strategically bringing an employee back to light-duty work during the waiting period can eliminate the need for wage replacement benefits altogether, directly controlling your claims cost.

Manage your claims confidently with DianaHR. Chat with our HR experts today. 

FAQs

1. Does an employee get paid for the workers' comp waiting period? 

Yes, but only retroactively and only if their disability lasts for a certain amount of time. An injured employee will not be paid for the initial waiting period if they return to work quickly. However, every state has a second, longer timeframe called a retroactive period (often 14-21 days). If the employee's injury keeps them out of work long enough to meet this retroactive threshold, the insurance carrier is then required to pay them for the days they missed during the initial waiting period.

2. What is the difference between a waiting period and a retroactive period? 

The waiting period is the initial number of days an employee must be medically unable to work before they become eligible for wage replacement benefits. This period is unpaid at the time it occurs. The retroactive period is a longer duration of disability that acts as a trigger. If an employee's time away from work meets or exceeds the retroactive period, the insurance carrier then pays them for the initial, unpaid waiting period days. 

3. Are workers' compensation waiting periods the same for all types of injuries? 

Yes, the waiting period is generally the same regardless of the type of injury. It is a legally mandated, standard timeframe that applies to any work-related injury or illness that results in an employee being medically certified as unable to perform their job. The length of the waiting period is determined by the state compensation laws where the employee works, not by the nature of the injury itself. The key factor is that the employee must be medically declared unable to work for the days to count toward the waiting period.