If you're running an optometry practice, you probably didn't get into this field to become an insurance expert. But here's the reality: the moment you hire your first employee—whether it's an optician, a receptionist, or an optometric technician—you're almost certainly required to carry workers' compensation insurance. And while your optometry practice isn't exactly a construction site, workplace injuries can and do happen.
The good news? Workers' comp for optometry practices is relatively affordable and straightforward. The average practice pays around $638 per year—about $53 a month. That's less than what you probably spend on coffee supplies for your waiting room. But understanding how class codes, experience modifications, and state requirements work can save you money and headaches down the road.
Do You Actually Need Workers' Comp for Your Optometry Practice?
Let's start with the basics. In most states, if you have employees, you need workers' compensation insurance. Period. This isn't optional coverage—it's legally mandated. But the specifics depend on where you're practicing.
In states like California, Pennsylvania, and New York, all healthcare providers must carry workers' comp if they have even one employee. Florida requires coverage when you have four or more employees. Texas is the odd one out—coverage is optional there, though most practices still choose to carry it because the alternative is risking direct liability for any workplace injuries.
Solo practitioners without employees typically don't need coverage, though you can purchase it for yourself if you want that protection. And if you're bringing on independent contractors, they should carry their own coverage—but make sure they actually are contractors under your state's definition, because misclassifying employees as contractors can land you in serious trouble.
Understanding Class Codes for Optometry
Here's where things get a bit technical, but stay with me—this matters for your bottom line. Workers' comp premiums are calculated based on class codes, which are basically risk categories assigned by the National Council on Compensation Insurance (NCCI). Your class code determines your base rate.
Most optometry practices fall under NCCI class code 8832, which covers "Physicians & Clerical" employees. Some states have their own codes—California uses 8834, while Delaware and Pennsylvania use 957. These codes lump optometrists together with physicians and physical therapists because they all represent similar risk profiles: professional office environments with both clinical and administrative staff.
Why does this matter? Because your employees should be classified correctly. Your optometrists, opticians, and technicians who work directly with patients fall under one rate, while your front-desk staff might be classified differently as clerical workers. Getting this right from the start ensures you're not overpaying—or worse, getting hit with an audit and a surprise bill later.
What Workers' Comp Actually Costs for Optometry Practices
As of 2025, the average optometry practice pays about $53 per month for workers' compensation coverage. That annual cost of $638 is based on a relatively small staff and low claim frequency. Optometry isn't a high-risk industry—you're not dealing with heavy machinery or hazardous materials. But costs can vary significantly based on several factors.
Your state matters. A lot. Workers' comp rates are regulated at the state level, and some states are simply more expensive than others. New York and California tend to have higher rates, while states like Indiana and North Dakota are generally cheaper. The number of employees you have impacts cost, too—more employees mean higher payroll, and premiums are calculated as a percentage of payroll.
But here's what really drives your premium: your claims history. This brings us to something called the experience modification rate, or E-Mod, which we'll dig into next.
How Your Experience Mod Affects Your Premium
Think of your experience modification rate as your workplace safety report card. Every business starts with an E-Mod of 1.00—that's baseline, average risk for your industry. If you maintain a safe workplace and avoid claims, your E-Mod drops below 1.00, and your premium decreases accordingly. If you rack up claims, your E-Mod climbs above 1.00, and your costs increase.
Your E-Mod is calculated based on the last three years of claims data (excluding the most recent year). Both the frequency and severity of claims matter, though the calculation weighs them differently. Here's something most practice owners don't know: medical-only claims—where an employee gets treated but doesn't miss work beyond your state's waiting period—count for only 30% of their actual cost in the E-Mod calculation. Lost-time claims hit much harder.
What does this mean practically? If someone slips in your practice and sprains their wrist, getting them immediate treatment and back to work quickly is better for your E-Mod than a more serious injury that keeps them out for weeks. This is why workplace safety isn't just about protecting your staff—it directly impacts your insurance costs for years to come.
Common Workplace Injuries in Optometry Practices
You might think your optometry practice is pretty safe, and you'd mostly be right. But injuries still happen, and they're worth preventing. The most common claims come from slips and falls—wet floors, cluttered walkways, uneven surfaces in exam rooms. A staff member carrying a tray of frames who trips on a cord and falls isn't just a hypothetical scenario.
Repetitive strain injuries are another issue. Your staff members spend hours at computers, adjusting frames, and working with small instruments. Carpal tunnel syndrome, tendonitis, and chronic back pain from improper ergonomics can lead to workers' comp claims. These tend to be medical-only claims if caught early, but they can escalate if ignored.
Less common but worth noting: lifting injuries from moving equipment or inventory, and needle-stick injuries if your practice performs procedures like injections. The good news is that all of these risks are manageable with basic safety protocols.
How to Lower Your Workers' Comp Costs
The single best way to reduce your workers' comp premium is simple: avoid claims. Implement a workplace safety program. It doesn't need to be elaborate—just regular safety meetings, proper training for new hires, well-maintained equipment, and a culture where employees report hazards before they cause injuries.
Invest in ergonomic workstations for your staff. Adjustable chairs, properly positioned monitors, and anti-fatigue mats for employees who stand all day aren't expensive, and they can prevent the repetitive strain injuries that lead to claims. Keep your practice clean and well-lit, fix trip hazards immediately, and make sure emergency eyewash stations are accessible if you handle chemicals for lens work.
Double-check your employee classifications with your insurance agent. If you're paying the clinical rate for someone who does purely administrative work, you're overpaying. And when you do have a claim, manage it actively. Work with your injured employee to get them appropriate care and back to work as soon as it's medically safe—modified duty if necessary. Claims that close quickly cost less and impact your E-Mod less severely.
Getting Workers' Comp Coverage for Your Practice
Shopping for workers' comp is straightforward. Start by contacting insurance agents who specialize in medical practices—they'll understand your specific needs and can help you navigate state requirements. You'll need to provide information about your payroll, the number of employees, and what roles they fill.
Get quotes from multiple carriers. Premiums can vary significantly between insurers, even for the same coverage, because different companies have different appetites for medical professional risks. Ask about loss control services—many insurers offer free safety consultations that can help you prevent claims.
Once you have coverage, don't just file the policy away. Review it annually, especially if your staff size or payroll changes significantly. And keep detailed records of your safety efforts—they can be valuable if you ever need to dispute a claim or demonstrate your commitment to workplace safety to your insurer. Workers' comp might be legally required, but when managed properly, it's also a reasonable cost of doing business that protects both you and the people who make your practice run.
