Workers' compensation, the state-based system that compensates employees for the economic consequences of work-related injury, illness and disease without regard to the fault of the employer or employee, was and remains a truly great social compact. However, today's burgeoning cost pressures threaten that historical mission. This study seeks to provide an analysis and build understanding of the operation of the system and of the broader themes linking particular state issues so that the affected interests can come together to address these concerns. Co-published with the Insurance Information Institute, Inc.