Work injuries and illnesses exact a tremendous toll on society. Despite the decades-old legal requirement that employers provide workplaces free of serious hazards, every year, more than three million workers are seriously injured, and thousands more are killed on the job. The financial and social impacts of these injuries and illnesses are huge, with workers and their families and taxpayer-supported programs paying most of the costs.

For many injured workers and their families, a workplace injury creates a trap which leaves them less able to save for the future or to make the investments in skills and education that provide the opportunity for advancement. These injuries and illnesses contribute to the pressing issue of income inequality: they force working families out of the middle class and into poverty, and keep the families of lower-wage workers from entering the middle class. Work injuries hamper the ability of many working families to realize the American Dream.

The costs of workplace injuries are borne primarily by injured workers, their families, and taxpayer-supported components of the social safety net. Changes in statebased workers’ compensation insurance programs have made it increasingly difficult for injured workers to receive the full benefits (including adequate wagereplacement payments and coverage for medical expenses) to which they are entitled. Employers now provide only a small percentage (about 20%) of the overall financial cost of workplace injuries and illnesses through workers’ compensation. This cost-shift has forced injured workers, their families and taxpayers to subsidize the vast majority of the lost income and medical care costs generated by these conditions.

Important changes in the structure of the employment relationships in U.S. workplaces are also exacerbating the incidence and consequences of work injuries. The pervasive misclassification of wage employees as independent contractors and the widespread use of temporary workers have increased the risk of injury and the number of workers facing financial hardships imposed by workplace injuries. The change in employment relationships also reduces the incentives for companies to assume responsibility for providing safe working conditions, which may result in increased overall risk of workplace injury.

The most effective solution to the problem posed by this paper is to prevent workplace injuries and illnesses from occurring. This would spare workers and their families from needless hardship and suffering, as well as the loss of income and benefits associated with these conditions. At the same time, it is vitally important that state-based workers’ compensation programs take steps to eliminate roadblocks that prevent workers with compensable injuries or illnesses from receiving the full compensation to which they are entitled.

The failure of many employers to prevent millions of work injuries and illnesses each year, and the failure of the broken workers’ compensation system to ensure that workers do not bear the costs of their injuries and illnesses, are truly adding inequality to injury