Workplace violence is increasing – and it’s a growing Workers’ Compensation concern. When violence enters the workplace, claims can become more complex, costly, and difficult to predict. Unlike many routine injury claims, these events often involve intentionally threatening, aggressive, or nefarious behavior, which can affect claim development and how insurers evaluate the risk.

NCCI’s pre‑2023 trend data showed workplace assaults increasing at a 5.3% annual rate from 2011 through 2021–2022, while the assault rate per 10,000 full-time workers rose 62%.¹ Although later U.S. Bureau of Labor Statistics (BLS) classification changes make direct comparisons more difficult, the broader point remains: this exposure can be concentrated in specific classes and job functions while carrying meaningful frequency and severity potential.

This article defines workplace violence in the context of Workers’ Compensation insurance, examines its concentration and severity, and outlines key underwriting considerations.

Defining Workplace Violence and Why It May Be Compensable

OSHA defines workplace violence broadly as acts or threats “of physical violence, harassment, intimidation, or other threatening behavior at the work site.”² That definition can include assaults by patients, residents, students, customers, coworkers, or other third parties, as well as robberies, threats, and domestic violence entering the workplace.

The key Workers’ Compensation issue is whether the event is sufficiently connected to the employee’s work and causes or contributes to the injury. If so, a violence-related injury may be compensable even when it involves deliberate conduct or an assault by another employee.³

The analysis can become more complicated when the violence stems from a personal dispute or there is disagreement over whether employment created or increased the risk.⁴ In those situations, compensability may depend on state-specific treatment of psychological injuries, mental-only injuries, and PTSD claims.⁵

California illustrates the point: its Workers’ Compensation framework recognizes PTSD tied to traumatic workplace events and applies a predominant-cause standard for psychiatric injuries, with a lower substantial-cause threshold when the employee is the victim of, or directly exposed to, a violent act.⁶

As a result, workplace violence claims can range from straightforward physical injuries to more complex files involving psychological injury, delayed recovery, litigation, and/or permanent impairment.

Workplace Violence Concentration

A useful way to understand this exposure is to look at where incidents are concentrated. NCCI’s 2023–2024 analysis shows healthcare and social assistance as the dominant sector, with 18,860 annualized assault cases.⁷

The data helps explain why healthcare and similar settings stand out: the exposure often arises from direct responsibility for patients, residents, students, or others. Under updated BLS classifications beginning in 2023, NCCI reported that 74.0% of workplace assaults were attributable to individuals under the worker’s care, supervision, instruction, or responsibility.⁸

Healthcare remains the clearest area of elevated exposure, but many of the same risk factors are present in education, retail, transportation, lone-worker settings, and money-handling roles. Fatal workplace violence has a different profile, with NCCI data showing greater concentrations of shootings and robberies, particularly in transportation, sales, and other public-facing work.

Class code and sector mix are important starting points, but they do not capture the full operating environment. Two insureds in the same class can have different profiles depending on employee-public interaction, staffing, supervision, and setting-specific volatility.

Workplace Violence Severity

Severity can arise through catastrophic injury, permanent disability, multiple claimants, long-duration indemnity, and death benefits. NCCI’s analysis noted that gunshot-related Workers’ Compensation claims had the highest average severity among assault-related injury causes.

Fatal workplace violence presents a different severity profile because one event can create immediate, severe loss. NCCI reported roughly 400 to 500 workplace homicides per year on an all-ownership basis and 350 to 400 per year in private industry, with shootings accounting for 83.2% of workplace homicides in 2023–2024.¹¹

Even when injuries are nonfatal, claims can become severe when physical or psychological injuries delay recovery, prolong indemnity, or result in PTSD-related time away from work.¹² A California claims study linked nearly half of primary PTSD Workers’ Compensation claims without physical injury to workplace violence and found longer median medically approved time away from work than for other PTSD claims.¹³

State differences also shape the exposure to workplace violence Workers’ Compensation claims. Beyond firearm laws, underwriters should consider whether a jurisdiction allows stand-alone mental injury claims or if PTSD presumptions are expanding, as well as how claim duration or return-to-work patterns vary by state.¹⁴

Although not among the most frequent Workers’ Compensation exposures, workplace violence warrants attention because of its concentrated frequency, potential for catastrophic outcomes, psychological injury, and claim-duration risk.

Looking Forward

Historical patterns provide valuable context, but underwriters should also monitor social, technological, workforce, and political pressures that may influence where workplace violence occurs and the severity of the resulting claims.

AI‑related disruption, job displacement anxiety, polarization, social media amplification, mental health strain, and scrutiny of public-facing government operations are not proven loss drivers here, but they are practical monitoring points because they may influence interactions with patients, residents, students, customers, or the public.

In many classes, some exposure is inherent to the work; the goal is to distinguish insureds who understand and manage it from those who treat it as random or unavoidable.

Stronger submissions identify the exposure at a level appropriate to the class, including threats, assault-related claims, psychological injury claims, employee-public interaction, staffing, security, training, and management response.

OSHA and NIOSH provide a framework for evaluating management attention, including commitment, worksite analysis, hazard prevention, training, recordkeeping, and program evaluation.¹⁵

Underwriting questions should focus on where interaction is most direct, which roles or settings create volatility, whether threats and near misses are captured, whether controls are tailored to the exposure, and whether loss experience suggests a frequency, severity, or claim-duration problem.

The same approach applies to claims evaluation. Files may involve physical injury, psychiatric injury, delayed reporting, return-to-work concerns, criminal investigations, litigation, media attention, or multiple employees. Early recognition, coordinated treatment, safe return-to-work planning, and attention to delayed psychological symptoms can help prevent longer-tail severity. Workplace violence may not be widespread, but its impact can be disproportionate. When it occurs, it can materially affect claim severity, duration, and portfolio profitability.