Liberty Mutual’s latest Workplace Safety Index has found that workplace accidents cost U.S. employers $58.7 billion annually, with the top 10 causes of injuries accounting for 86 percent of those costs, $50.87 billion.

The Index marks its 25th year identifying the top ten causes of the most serious workplace injuries – those causing an employee to miss more than five days of work – and ranking them by their medical and lost-wage payments.

Even as the rate of serious workplace accidents fell by about 40 percent over the 25 years represented by the Index, the total cost of workers compensation benefits increased by 30 percent, according to data from the Bureau of Labor Statistics and National Academy of Social Insurance.

Overexertion involving outside sources remains the the top cause, accounting for $13.7 billion in costs, largely due to manual material handling. This has held true for 25 years.

Falls on the same level is the second leading cause, with $10.5 billion in costs, emphasizing the need for slip, trip, and fall prevention strategies, the report noted.

Struck by object or equipment and Falls to a lower level also continue to be major injury drivers, together accounting for nearly $11.6 billion in costs.

Injuries due to other exertions and bodily reactions, roadway incidents, and caught-in or compressed by equipment also feature prominently in the top 10, underlining the diverse risks present in today’s workplaces.

While still making the top ten, costs associated with Repetitive motion injuries from micro tasks has dipped by 44 percent. The report outlines safety efforts are helping to reduce these types of injuries.

Workers being Struck against object or equipment rounded out the top ten causes of workplace injuries, totaling $1.7 billion in costs.

The report found that more than half (56 percent) of workplace injuries involving the back, shoulder, knee or multiple body parts drive nearly $32.6 billion in costs.

Seven of this year’s top 10 injury causes appeared in all 25 indices.

“The Index provides employers a trusted roadmap for improving workplace safety,” said Liberty Mutual Senior Vice President and General Manager, Risk Control, Dorothy Doyle. “We’re proud to provide this important report, which offers valuable data and insights to help employers prevent injuries and manage risks more effectively, underscoring our commitment to protecting workers and supporting safer, more resilient businesses.”

Each index is based on data three years prior. Accordingly, the 2025 index reflects 2022 data.