When the Person You Hired Gets Hurt at Work

First: Get Them Care

Before anything else, make sure the caregiver gets appropriate medical attention — urgent care, an emergency room, or a 911 call if the injury is serious. Sorting out liability, insurance, or paperwork comes after the person is safe and treated, not instead of it.

Once the immediate injury is addressed, write down what happened while it's fresh: the date, time, what the caregiver was doing, and any factors in the home that may have contributed, such as a wet floor, a loose rug, or a lifting task without proper equipment. This record matters regardless of what happens next, whether that's a workers' compensation claim, an insurance question, or nothing more than making sure it doesn't happen again.

Why This Falls on You as the Employer

When you pay a caregiver directly rather than through an agency, the IRS and Social Security Administration generally treat you as their household employer, not a customer paying an independent contractor 1Ref 1Social Security Administration (2026).Household Workers (SSA Publication No. 05-10021).Supports that a household worker such as a privately hired caregiver, paid above the annual wage threshold, generally requires the payer to report wages and pay Social Security and Medicare taxes, establishing household-employer status.2Ref 2Internal Revenue Service (2025).Topic no. 756, Employment taxes for household employees.Supports the federal definition of a household employee and the employment-tax obligations that follow, reinforcing that hiring a caregiver directly creates an employer relationship.. That status is what creates caregiver injury liability in the first place — an agency employs its own aides and typically carries the insurance that responds when one of them is hurt on a job; a private household taking on that same employer role inherits some of that same exposure, without necessarily having the insurance in place to match it.

Household employer status isn't optional or a matter of preference once the working relationship looks like employment — regular hours, tasks you direct, pay you control — which is most private caregiving arrangements. Publication 926 is the IRS's own guide to determining whether a worker you've hired is a household employee and what that triggers in tax obligations 3Ref 3Internal Revenue Service (2026).About Publication 926, Household Employer's Tax Guide.Supports that IRS Publication 926 is the guide for determining whether a privately hired caregiver is a household employee and what tax obligations that status triggers., and the same underlying facts that make someone your household employee for tax purposes are generally what make you responsible for how they're covered when they're hurt at work.

This is one of the clearest differences between hiring a private caregiver and going through an agency: an agency's insurance and workers' compensation coverage exist specifically so that an on-the-job injury doesn't become the client family's direct financial exposure. Choosing private hire doesn't create the injury risk itself — caregiving work involves lifting, transfers, and long hours regardless of who employs the caregiver — but it does shift who absorbs the consequences when an injury happens, which is worth weighing honestly before, not after, someone gets hurt.

Workers' Compensation Is a State Question

Whether you're required to carry household employer workers' comp insurance, and what happens if you don't, depends on your state, not federal law — some states require it once a household worker's hours or pay cross a certain threshold, others treat it differently, and enforcement varies. This is genuinely one to check directly with your state's workers' compensation office or an insurance agent rather than assume either way, because the difference between a covered claim and an uncovered one can be significant.

A related, common assumption is that a standard homeowner's insurance policy covers an injury to someone working in the home. That also varies by policy and by state, and it's worth a direct conversation with your insurance agent before an injury happens, not after — asking specifically whether the policy covers a household employee's on-the-job injury, and whether a separate workers' compensation or umbrella policy is needed to close the gap.

Where a state does require coverage, going without it typically doesn't just leave the household exposed to the medical bills directly — it can also mean fines or other penalties for the missing coverage itself, on top of whatever the injury costs. Where a state doesn't require it, carrying it anyway is still worth pricing out: a lifting or transfer injury, a fall on stairs, or a repetitive-strain injury from months of physical caregiving work can be expensive to cover out of pocket, and a workers' comp policy is often cheaper than the risk it replaces.

How Hours and Pay Interact With an Injury

If a caregiver is injured and needs time to recover, questions about pay during that time follow the same wage rules that applied before the injury. Federal guidance on domestic service work addresses how hours are counted for live-in and shift arrangements, including sleep time, meal periods, and travel time 4Ref 4U.S. Department of Labor, Wage and Hour Division (2025).Domestic Service Final Rule Frequently Asked Questions (FAQs).Supports how hours, sleep time, meal periods, and travel time are counted and paid for live-in and shift home care arrangements, relevant to pay during a caregiver's recovery or adjusted duties., which matters if the caregiver's schedule or duties shift while they recover — lighter duties, shorter shifts, or an adjusted routine while healing.

The regulatory landscape around direct care workers, including which wage and hour exemptions apply to companionship-style work, has also been in flux in recent years, which is one more reason to confirm current rules rather than rely on what applied when the caregiver was first hired 5Ref 5U.S. Department of Labor, Wage and Hour Division (2025).Application of the Fair Labor Standards Act to Direct Care Workers.Supports that the regulatory status of wage and hour exemptions for direct care and companionship workers has changed over time, so current rules should be confirmed rather than assumed..

What to Do in the Days After

Document the injury and the circumstances the same day if possible, keep any medical paperwork the caregiver shares, and start the workers' compensation liability conversation — with your insurance agent or your state's workers' comp office — before deciding how to handle pay or continued work. If the caregiver cannot work while recovering, the household also needs a plan for care coverage in the meantime, which is its own separate problem worth solving in parallel rather than after.

If the injury resulted from something structural in the home — a hazard the household could have fixed — addressing that hazard immediately protects whoever covers the next shift, whether that's the same caregiver returning or someone new.

It's also worth having a candid conversation with the caregiver themselves once the immediate crisis has passed. Ask how the injury happened, whether equipment like a gait belt or transfer board might have prevented it, and whether the physical demands of the job as currently structured are sustainable. A caregiver who feels safe raising a near-miss before it becomes an actual injury is one of the more effective, and least expensive, safety measures a household can put in place.