Objective:To describe telehealth trends within a population-based workers’ compensation system during the COVID-19 pandemic, and to assess telehealth utilization by sociodemographic characteristics.Methods:This cross-sectional study used Washington State workers’ compensation claims and medical billing data from January 2019 to October 2020.Results:Telehealth use averaged 1.2% of medical bills pre-pandemic, peaked in April 2020 at 8.8%, and leveled off to around 3.6% from July to October 2020. Telehealth utilization differed significantly by age, sex, number of dependents, injury, industry, and receipt of interpreter services. Workers residing in counties with higher population, lower poverty rates, and greater Internet access had higher telehealth usage.Conclusions:There were dramatic shifts in telehealth; usage differed by sociodemographic characteristics. Further studies evaluating disparities in tele-health access among injured workers are needed.