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(Costs typically paid for by workers’ comp insurance.)
(Hidden costs not typically paid for by workers’ comp insurance.)
Instructions
Injury Type or Workers' Compensation Costs (annual sum of costs)
Select an Injury Type Amputation Angina Pectoris Asbestosis Asphyxiation Black Lung Burn Carpal Tunnel Syndrome Concussion Contagious Disease Contusion Crushing Dermatitis Dislocation Dust Disease, NOC (all other pneumoconiosis) Electric Shock Enucleation (to remove ex: tumor, eye, etc.) Foreign Body Fracture Freezing Hearing Loss or Impairment (traumatic only) Heat Prostration Hernia Infection Inflammation Laceration Loss of Hearing Mental Disorder Mental Stress Multiple Injuries Including Both Physical and Psychological Multiple Physical Injuries Only Myocardial Infarction No Physical Injury Poisoning - Chemical (other than metals) Poisoning - General (not OD or cumulative injury) Puncture Respiratory Disorders (gases, fumes, chemicals, etc.) Rupture Severance Sprain Strain Syncope Vascular Vision Loss All Other Cumulative Injury, NOC All Other Occupational Disease All Other Specific Injuries, NOC OR
Enter Profit Margin (%) (leave blank to use default of 3%)
Enter Number of Injuries (leave blank to use default of one)
Estimated Total Cost
The extent to which the employer pays the direct costs depends on the nature of the employer's workers' compensation insurance policy. The employer always pays the indirect costs.
Injury Type
Instances
Direct Cost
Indirect Cost
Total Cost
Additional Sale (Indirect)
Additional Sale (Total)
Totals
Estimated Direct Costs:
Estimated Indirect Costs:
Combined Total (Direct and Indirect Costs):
Sales To Cover Indirect Costs:
Sales To Cover Total Costs:
Provided by osha.gov.