Oakland, CA — California accounted for 11.9% of all jobs covered by workers’ compensation in the U.S. in 2023, and 14.3% of covered payroll, while it accounted for 21.7% of all workers’ compensation benefits paid to injured workers, according to a California Workers’ Compensation Institute (CWCI) review of new data from the National Academy of Social Insurance (NASI).

The NASI data, based on calendar year 2023 experience, show that workers’ comp programs in the U.S. covered 149.7 million jobs and an estimated $10.84 trillion in payroll and that total medical and indemnity benefits paid under state and federal programs climbed to $64.1 billion, up 3.8% from $61.8 billion in 2022. The 10 states with the largest benefit payments together accounted for 51.4% of covered jobs, 55.0% of covered payroll and 60.5% of U.S. workers’ compensation benefits. California remained by far the nation’s largest workers’ compensation system, with nearly 17.8 million covered jobs and $1.55 trillion in covered payroll. Workers’ comp programs in California paid an estimated $13.88 billion in benefits in 2023, an increase of $916 million, or 7.1%, from 2022. That pushed California’s share of total U.S. benefit payments from 21.0% in 2022 to 21.7% in 2023. The increase occurred despite a significant slowdown in employment growth in the state as NASI reports that after increasing 3.7% in 2021 and 5.6% in 2022, the number of covered jobs in California rose only 0.6% in 2023, or about 99,000 additional jobs, well below the 2.3% growth in covered jobs nationwide. Even with that slowdown, however, covered employment remained 2.2% above the state’s 2019 pre-pandemic level.

California’s $13.88 billion in benefit payments was more than the combined total for New York, Florida, and Washington, which ranked second, third, and fourth in terms of total benefits, and was nearly four times the $3.52 billion paid under federal programs. Aside from California, several other states on the top 10 list registered large increases in total paid benefits in 2023. Texas recorded the largest percentage increase at 8.1%, followed by Georgia at 7.2% and New Jersey at 5.3%. Benefit payments declined in New York, Illinois, and Ohio.

Unlike the nation as a whole, where medical benefits accounted for 47.3% of total payments and indemnity benefits accounted for 52.7%, California’s 2023 payments were almost evenly divided, as medical benefits totaled $6.937 billion and indemnity benefits totaled $6.946 billion. After adjusting for differences in employment and wages, total benefits in California increased 2.7% between 2022 and 2023, from $0.87 to $0.90 per $100 of covered payroll, which ranked seventh among all states. Nationwide, benefits per $100 of covered payroll declined from $0.60 in 2022 to $0.59 in 2023. Private insurers paid $35.6 billion, or 55.6%, of all workers’ comp benefits in 2023; self-insured employers paid $16.4 billion (25.6%), state funds paid nearly $8.6 billion (13.3%), and federal programs paid $3.5 billion. Payments under deductible arrangements totaled $11.6 billion, or 18.1% of all benefits.

NASI estimates that nationwide, employers’ total workers’ comp costs, including premiums, deductible payments, self-insured benefits and administrative expenses, rose to $106.6 billion in 2023, up 3.5% from 2022, but after adjusting for covered payroll, employer costs fell 2% to $0.98 per $100 of covered wages. Employer costs in California increased less than 1% in 2023, but the state continued to rank as one of the highest cost states for employers, as NASI estimates that employer costs in the state averaged $1.43 per $100 of covered payroll.

NASI compiles its estimates from data provided by state agencies, A.M. Best, the National Association of Insurance Commissioners, the U.S. Census Bureau, NCCI, the U.S. Department of Labor and the Social Security Administration. The data measure benefits paid during each calendar year, regardless of when the underlying injury occurred. NASI’s 2023 data on workers’ compensation benefits, coverage and costs is posted here.