In most states, you have the right to attend workers’ comp physical therapy during work hours, and if your employer directs you to go during your shift, nonexempt employees must be paid for that time under federal wage law. Whether other therapy time is paid, and how much scheduling flexibility you’re owed, depends on your state’s workers’ compensation statute and, in some cases, on the FMLA or ADA.
Your Right to Go to Therapy While You’re on the Clock
Workers’ compensation is state law, and the large majority of states require employers to let injured workers attend medical treatment, physical therapy included, without penalty. Some states explicitly bar employers from docking pay or disciplining you for attending authorized treatment. Others use looser language and simply require “reasonable” scheduling accommodations. There is no federal workers’ comp statute covering private-sector employees on this point, so your state’s rules control.
Employers generally prefer that you book appointments at the start or end of your shift to reduce disruption. That’s a fair request when it’s workable, but clinic hours and your treating provider’s availability rarely map cleanly onto a workday. The practical fix is usually a conversation: tell your employer what appointment times are actually available, give as much notice as you can, and put the exchange in writing. If your employer refuses outright to let you attend authorized therapy, that refusal may violate your state’s workers’ comp statute and can trigger retaliation protections on top of it.
When Therapy Time Is Paid
Whether the hours you spend at physical therapy are paid depends on who scheduled the appointment, your exempt or nonexempt status, and what your state’s workers’ comp law says on top of the federal floor.
Under federal wage law, nonexempt employees must be paid for time spent waiting for and receiving medical attention at the employer’s direction during normal working hours.1eCFR. 29 CFR 785.43 – Medical Attention That covers travel to the facility, the wait, and the treatment itself.
Self-scheduled follow-up sessions are different. When you book your own therapy appointments rather than being sent by your employer at a specific time, federal law generally does not require your employer to pay for that time. Many state workers’ compensation statutes are more generous and require compensation for authorized treatment time regardless of who scheduled the visit, so check your state’s rules before assuming an unpaid gap.
Salaried exempt employees usually receive their full salary for any week in which they perform work, so leaving for therapy during the day typically doesn’t cut your pay. An employer that docks an exempt employee’s salary for partial-day medical absences risks that employee’s exempt status altogether.2U.S. Department of Labor. Fact Sheet 53 – The Health Care Industry and Hours Worked
The short version: if you’re nonexempt and your employer tells you to go to therapy during your shift, that’s paid time under federal law. For everything else, the state statute is where the answer lives.
FMLA Intermittent Leave for Recurring Appointments
The Family and Medical Leave Act can protect your job when you need to leave repeatedly for therapy, even where your state’s workers’ comp law doesn’t guarantee job protection on its own. FMLA leave is unpaid, but it prevents your employer from firing or retaliating against you for taking the time.
Do You Qualify?
FMLA doesn’t cover every worker. You qualify only if you’ve worked for your employer for at least 12 months, logged at least 1,250 hours during the prior 12-month period, and work at a location where your employer has 50 or more employees within 75 miles.3Office of the Law Revision Counsel. 29 U.S. Code 2611 – Definitions Miss any of the three, and FMLA doesn’t apply, though your state may have its own leave law with different thresholds.
Taking Leave One Appointment at a Time
A workers’ comp injury that keeps you out of work for more than three days and requires ongoing treatment from a healthcare provider generally qualifies as a “serious health condition” under the FMLA. You can then take FMLA leave intermittently, in blocks as short as a single therapy appointment, instead of all at once.4Office of the Law Revision Counsel. 29 U.S. Code 2612 – Leave Requirement The FMLA provides up to 12 workweeks of protected leave in a 12-month period.5U.S. Department of Labor. Fact Sheet 28P – Taking Leave from Work When You or Your Family Member Has a Serious Health Condition under the FMLA
One thing to know before you ask for intermittent leave: when the treatment is foreseeable and planned, your employer can temporarily move you to an alternative position that better fits recurring absences, so long as the new job carries equivalent pay and benefits.4Office of the Law Revision Counsel. 29 U.S. Code 2612 – Leave Requirement Your employer must restore you to your original position, or an equivalent one, when the leave period ends.
ADA Schedule Accommodations
If your workplace injury also qualifies as a disability under the Americans with Disabilities Act, a modified schedule to attend physical therapy can be a reasonable accommodation. The ADA requires employers to provide reasonable accommodations unless doing so would cause undue hardship.6U.S. Equal Employment Opportunity Commission. Enforcement Guidance on Reasonable Accommodation and Undue Hardship under the ADA
That can mean shifted start and end times, periodic breaks during the day, or unpaid leave for appointments. The EEOC has stated that employers must provide modified or part-time schedules when required as a reasonable accommodation, even if the employer doesn’t offer such schedules to other employees.6U.S. Equal Employment Opportunity Commission. Enforcement Guidance on Reasonable Accommodation and Undue Hardship under the ADA
Not every workers’ comp injury meets the ADA’s disability definition, which asks for a physical or mental impairment that substantially limits a major life activity. Many serious injuries requiring extended therapy do qualify, especially after the ADA Amendments Act broadened the definition in 2008. If it’s a close call, HR or an attorney can help you decide whether to raise the ADA angle in addition to your workers’ comp rights.
Light Duty and Therapy Conflicts
While you’re recovering, your employer may offer light-duty work: a modified role that avoids the physical demands your injury blocks. Light duty is often a workable arrangement, but it can collide with your therapy schedule.
Accepting light duty does not waive your rights. Under the FMLA, taking a light-duty job doesn’t count against your 12 weeks of protected leave and doesn’t erase your right to return to your original position once you’ve recovered.5U.S. Department of Labor. Fact Sheet 28P – Taking Leave from Work When You or Your Family Member Has a Serious Health Condition under the FMLA Under the ADA, an employer that provides a temporary reassignment must restore you to your full duties or original position once you can perform the essential functions of the job.7U.S. Equal Employment Opportunity Commission. Enforcement Guidance – Workers Compensation and the ADA
If a light-duty schedule makes therapy impossible during available clinic times, ask your employer to adjust. Practical options include shifting the light-duty hours around your sessions, letting you leave for appointments and make up the time, or temporarily reassigning tasks that don’t require your presence at a fixed hour.
Travel and Mileage Reimbursement
Workers’ compensation in most states covers the cost of getting to and from authorized medical treatment, physical therapy included. That usually means mileage reimbursement for driving your own car, and many states also cover parking and other incidental travel costs. Some states impose a minimum distance before reimbursement kicks in, so a provider next door to your workplace may not qualify.
Rates vary by state. Many peg their reimbursement to an IRS standard mileage rate, but not always the same one. For 2026, the IRS medical mileage rate is $0.205 per mile, and the business mileage rate is $0.725 per mile.8Internal Revenue Service. IRS Sets 2026 Business Standard Mileage Rate at 72.5 Cents Per Mile Some states apply the higher business rate to workers’ comp travel; others use the medical rate or set their own figure. Your state’s workers’ compensation board or your claims adjuster can confirm which rate applies to you.
To claim it, you’ll usually submit a travel form listing each trip: the date, the provider’s name and address, and the round-trip mileage. Keep a log as you go. Reconstructing months of trips from memory is where reimbursements get denied.
If Your Employer Punishes You for Going
Workers’ compensation anti-retaliation protections are mostly state-level, and nearly every state prohibits employers from firing, demoting, or otherwise punishing an employee for filing a workers’ comp claim or attending authorized treatment. Penalties can include reinstatement, back pay, and additional damages.
Federal law layers on more protection. Under the ADA, penalizing an employee for taking leave as a reasonable accommodation is retaliation; the EEOC has said explicitly that an employer cannot punish a worker for time missed during leave taken as a reasonable accommodation, because that would make the accommodation useless.6U.S. Equal Employment Opportunity Commission. Enforcement Guidance on Reasonable Accommodation and Undue Hardship under the ADA The FMLA separately prohibits employers from interfering with, restraining, or denying the exercise of any FMLA right, which covers intermittent leave for therapy.5U.S. Department of Labor. Fact Sheet 28P – Taking Leave from Work When You or Your Family Member Has a Serious Health Condition under the FMLA
If your employer refuses to let you attend, docks pay it shouldn’t, or retaliates for taking the time, keep documentation of every request and every response. State workers’ compensation boards, state labor departments, and the EEOC each handle different pieces of the picture depending on which law is in play.
If the Insurer Cuts Off Sessions
Even when your employer cooperates, your insurer can push back on how much therapy is covered. Insurers use utilization review to evaluate whether ongoing treatment is medically necessary; a reviewer with qualifications similar to your treating provider examines your records and issues a determination. Your insurer may also request an independent medical examination, in which a doctor of the insurer’s choosing evaluates you and offers a second opinion. If either process reduces or denies further sessions, you have the right to appeal through your state’s workers’ compensation system, usually by filing a petition or claim form and attaching your treating provider’s supporting records. In most states the insurer carries the burden of proving the treatment isn’t necessary, not you. A denial your doctor disagrees with is worth challenging.