A note from Karil

I write a lot about the cost that doesn’t show up on the report. The experienced worker whose knowledge walks out the door. The strain nobody responded to. The part of an injury that never makes it onto a claim.

Mark put numbers on it. And having sat on the finance side of these decisions, I know that “it’s the right thing to do” rarely survives a budget conversation. Numbers do. This is the piece to bring to that meeting.

About the Author

Mark A. Anderson, MA, PT, CPE, is the principal of ErgoSystems Consulting LLC in Plymouth, MN. A licensed physical therapist turned Certified Professional Ergonomist, Mark has more than 35 years of experience bridging clinical biomechanics and practical workplace design. He is a trusted partner of WorkWell and the developer of the Ergonomics On-Demand! professional training program.

When a worker sustains a musculoskeletal injury on the job, most employers think in terms of the workers’ compensation claim. The direct medical cost is real and visible. But it is typically the smaller part of what that injury actually costs your organization.

Understanding the full picture is what separates reactive safety programs from ones that produce genuine financial results.

The Iceberg Problem

Direct costs sit above the waterline: medical treatment, indemnity payments, claims management. But OSHA’s Safety Pays program, drawing on industry research, applies an indirect cost multiplier of 1.1 to 4.5 times direct costs depending on injury severity. Practitioner experience with complex MSK cases often runs higher. The consistent finding is that indirect costs are real, substantial, and almost entirely uninsured. 

Those hidden costs include:

• Lost productivity from the injured worker and coworkers covering the gap

• Overtime costs to backfill the missing capacity

• Supervisor time spent on incident investigation, OSHA reporting, and accommodation management

• Training and onboarding if the injured worker cannot return to full duty

• Reduced output quality and disrupted cycle times during the transition

• Administrative burden across HR, safety, and operations

According to the National Safety Council’s NCCI data, the average workers’ compensation claim for an arm or shoulder injury runs $55,000 in direct costs alone (2022 to 2023). Add the uninsured indirect burden, and the total exposure on a single moderate MSK injury is substantial, often multiples of what appears on the comp ledger.

Now Look at the Other Side of the Equation

A professional ergonomics workstation assessment typically runs a few hundred to a few thousand dollars depending on scope. Common interventions, such as a height-adjustable surface, a compact keyboard, repositioned storage, or a mechanical lift assist, often cost $200 to $2,000 per workstation.

Against the direct and indirect cost of a single preventable injury, those numbers look very different.

The Liberty Mutual 2025 Workplace Safety Index reports that serious, non-fatal workplace injuries cost U.S. employers $58.78 billion annually. Injuries to the back, shoulder, and knee account for 56 percent of that total, nearly $32.6 billion, with overexertion from manual material handling alone costing $13.7 billion per year. A substantial share of these costs is preventable through systematic ergonomics practice.

The Right Question for Your Operation

The question isn’t whether you can afford to invest in ergonomics. It’s whether you can afford to keep absorbing the cost of not doing so.

Employers who analyze their injury cost data, direct and indirect, across a rolling three-year window, consistently find that the ROI case for ergonomics investment isn’t close. Prevention is almost always the cheaper path. The employers who get ahead of this don’t wait for the next claim. They use the data they already have to identify their highest-risk jobs and make targeted interventions before costs accumulate.