Each of the 50 states and the District of Columbia has a workers’ compensation program. These programs vary by state, as each is authorized by its own state law. There are three federal workers’ compensation programs including the one authorized by FECA, which covers federal employees. Federal and most state workers’ compensation programs were initially enacted in the first part of the 20th century. VA’s disability compensation program, which was based to some extent on state workers’ compensation programs, was substantially overhauled with the enactment of the War Risk Insurance Act of 1917. The act directed VA to establish a schedule to compensate veterans for the average impairment in earning capacity resulting from injuries or diseases incurred during military service. The FECA program and other workers’ compensation programs differ in purpose and design from VA’s disability compensation program (see table 1). Cash benefits under FECA and the workers’ compensation programs and those provided under VA’s disability compensation program are provided for different purposes. FECA and other workers’ compensation programs primarily focus on compensating workers for their actual lost wages and permanent impairments resulting from occupational diseases or injuries. In contrast, VA’s disability program focuses on compensating veterans for the average reduction in earning capacity they are expected to experience as a result of service-connected conditions. An overall goal of workers’ compensation programs is to return injured employees to work, and in some workers’ compensation programs, benefits are terminated if the worker does not participate in vocational rehabilitation. VA’s disability compensation program focuses on providing monetary compensation for service-connected conditions. VA also provides other services, such as vocational rehabilitation, to eligible veterans. However, veterans are not required to participate in vocational rehabilitation in order to receive compensation. Workers’ compensation programs attempt to provide adequate benefits to injured workers while limiting employers’ liabilities strictly to workers’ compensation benefits. These programs provide cash benefits to employees for wage loss and permanent impairments. For selected permanent impairments, the programs use a schedule to determine monetary benefits, which are referred to as “schedule awards.” Workers’ compensation also provides medical care benefits and vocational rehabilitation to help employees return to work. In some programs, workers who refuse vocational rehabilitation services when these services are necessary for the person to be employed again may forfeit their right to receive wage-loss benefits. In addition, if an employee dies from a job-related injury or illness, the employee’s dependents can receive survivors’ benefits. The compensation benefits that are paid to workers depend on the nature and extent of their injuries and the ability of injured employees to earn their usual wages. Employees whose injuries are not serious may only receive reimbursement for medical care for work-related injuries or illnesses. Many workers’ compensation claims result only in payment for medical care rather than in monetary awards for lost wages or permanent impairments. Employees whose injuries or illnesses result in lost wages may be entitled to receive wage-loss benefits. Employees whose injuries or illnesses result in the permanent loss or loss of use of certain body parts or functions are entitled to compensation for permanent impairments. The majority of the monetary benefits that are paid to workers are for wages lost as opposed to permanent impairment. Often wage-loss benefits are paid for temporary disabilities, which may last a relatively short period of time. For example, according to the Department of Labor, for the claims submitted under FECA in fiscal year 1994 for which wage-loss benefits were paid during the first year after submission, the median amount paid was about $4,000. The median time period for which benefits were paid was about 70 days. No two workers’ compensation programs are exactly alike. Despite the various differences among state, FECA, and the District of Columbia programs, to be eligible for benefits under any of these laws, workers’ injuries or occupational diseases must arise out of and occur in the course of employment. These criteria, though used somewhat differently among jurisdictions, generally mean that a worker’s illness or injury must occur in the course of performing his or her job in order to be compensable. To be eligible for monetary benefits under workers’ compensation, workers must experience an actual loss in wages or a permanent impairment. Most states and the District of Columbia require that employees be out of work during a waiting period ranging from 3 to 7 days before benefits for lost wages can be paid. FECA requires a 3-day waiting period that begins after the expiration of any “continuation of pay” to which the worker may be entitled. Continuation of pay is a unique feature of FECA whereby FECA authorizes federal agencies to continue paying employees who are absent from work because of work-related traumatic injuries their regular salaries for up to 45 days before the 3-day waiting period begins. Continuation- of-pay benefits are not payable in occupational disease cases. Under state workers’ compensation programs, if an employee is absent from work continuously for 5 to 42 days after the date of injury, he or she is entitled to wage-loss benefits retroactive to the date of injury. Under FECA, an employee absent for 14 days after continuation of pay ends is eligible for restoration of benefits withheld during the 3-day waiting period. While workers’ compensation programs attempt to protect the interests of both workers and employers, VA’s disability compensation program focuses on economic support for veterans. It is designed to provide cash benefits to veterans for physical or mental service-connected conditions. The benefits paid to veterans depend on the degree to which their specific conditions or injuries are believed to reduce the average earning capacity of veterans in general with that condition. VA’s disability compensation program, like workers’ compensation programs, provides survivors’ benefits and vocational rehabilitation. Unlike most workers’ compensation programs, vocational rehabilitation is optional under VA. Both programs cover medical care, but VA generally provides care for veterans through the Veterans Health Administration. VA’s program, however, does provide for additional compensation for dependents; special needs related to a veteran’s condition; and special monthly compensation—statutory awards—for the loss or loss of use of certain body parts or functions, or procreative organs. VA also provides stipends to veterans in its vocational rehabilitation program in addition to monthly disability compensation. To be eligible for compensation under VA’s disability compensation program, veterans must incur or aggravate injuries or diseases in the line of duty or during a period of active military service. Such illnesses and injuries are considered service-connected. Unlike workers’ compensation programs, a veteran’s injury or illness need not occur because of or in the course of actually performing his or her military-related duty to be compensable. Members of the military are covered 24 hours a day with respect to diseases or injuries they incur, because they are considered on duty 24 hours a day. A veteran does not have to experience an actual reduction in earning capacity or loss in wages to be eligible for disability compensation. Thus, like workers’ compensation for permanent impairments, veterans can receive compensation even if they are working and regardless of the amount they earn. Workers’ compensation programs base compensation on workers’ wages prior to their injury or the onset of occupational disease. Workers are paid a percentage of their wages or the wages they lose as a result of their work-related injury or disease, depending on whether they are being compensated for lost wages or permanent impairments. For selected permanent impairments, workers’ compensation programs use a schedule to determine monetary benefits, or “schedule awards.” For permanent impairments that do not appear on a schedule, programs may use one or more of three methods to determine compensation. In contrast, VA uses its Schedule for Rating Disabilities to determine the degree of impairment in earning capacity presumed to be associated with specific temporary and permanent conditions. This degree of impairment determines the basic amount of compensation veterans are eligible for. An individual veteran’s actual earnings lost as a result of a condition have no bearing on the compensation amount. If employees are unable to earn their usual wages because of work-related disabilities, they are compensated for their lost wages. The amount of monetary compensation a worker receives under workers’ compensation is calculated by taking a specified percentage—in many jurisdictions, 66-2/3 percent—of the worker’s actual wage loss. Thus, the amount of compensation different employees receive for the same disability varies on the basis of their particular wage loss. Most states and the FECA program, however, place minimum and maximum limits on the weekly compensation amounts an individual can receive. Most programs compensate for lost wages for the duration of the wage loss. Workers who become permanently and totally disabled generally receive benefits for life. An employee in Arizona, for example, who earns $600 a week and loses wages as a result of a work-related injury should theoretically receive $400 (66-2/3 percent x $600) a week in compensation. However, this employee would actually receive $323.10 a week because this is the maximum weekly benefit amount Arizona allows for wage loss. Under the FECA program, the same employee also would receive 66-2/3 percent (75 percent if the employee has dependents) of his or her lost wages. However, the employee would receive the full $400 because the weekly maximum FECA allows for wage loss is $1,299.38. This same worker would also receive the full $400 in the District of Columbia, which limits maximum weekly benefits to $723.34. For certain permanent impairments, workers’ compensation programs use a schedule to determine the maximum amount of compensation that can be awarded. As of January 1995, the FECA, District of Columbia, and most state workers’ compensation programs each maintained a schedule that specified the maximum number of weeks of compensation a worker under their jurisdiction could receive for specific permanent impairments that result in the total loss or loss of use of certain members (such as a hand, arm, or foot), organs, and functions of the body. Benefits for these permanent impairments are called “schedule awards.” Permanent partial loss or loss of use of members, organs, or body functions listed on federal or state schedules is also compensable, but for less than the maximum number of weeks.