Filing a Workers’ Compensation Claim in Wisconsin
If you were injured on the job, you may be entitled to workers’ compensation benefits. In Wisconsin, workers’ compensation is available to most employees who sustain work-related injuries or illnesses, including occupational diseases.
Because it is a no-fault system, you do not need to prove that your employer (or any other party) was negligent in order to qualify for benefits.
At LawtonCates, we assist injured workers with all aspects of workers’ compensation. Whether you need help filing your initial claim or have already had your claim denied, our attorneys can help you understand your legal rights and options.
We are prepared to advocate for you and fight to secure maximum benefits on your behalf. With two offices located in Jefferson and Madison, our workers’ compensation lawyers represent clients throughout the state of Wisconsin.
To schedule a free consultation with our Wisconsin workers’ compensation lawyers, please call (608) 282-6200 or contact us online.
Who Is Covered by Workers’ Compensation in Wisconsin?
The state of Wisconsin requires all employers (other than farmers) with three or more employees to provide workers’ compensation for all employees.
Employers who have fewer than three employees must also provide workers’ compensation if they pay at least $500 in wages during any quarter of a single calendar year.
Farm-industry employers must have workers’ compensation if they employ at least six employees for 20 or more days in a single calendar year.
Essentially, this means that most employees in the state of Wisconsin are covered by workers’ compensation insurance. Note that to be covered, however, you must be classified as an “employee.” Workers’ compensation does not extend to workers who are classified as “independent contractors.”
What Types of Injuries Are Covered by Workers’ Comp?
Any injury arising from employment is covered by workers’ compensation. This means that if you were injured on the job or while carrying out duties or activities related to your employment, and you meet all other qualification requirements, you are entitled to workers’ compensation benefits.
In Wisconsin, the following types of job-related injuries are covered by workers’ compensation:
- Physical Injuries: Any physical injury, regardless of severity, is covered by workers’ comp if the injury is related to the individual’s employment. This includes injuries such as cuts, bruises, burns, broken bones, sprains, strains, loss of limb, head injuries, back pain, traumatic brain injuries, spinal cord injuries, and more.
- Mental Harm: Workers’ compensation also covers certain mental injuries related to a worker’s employment. Examples include mental and behavioral health disorders arising from head or brain injuries, post-traumatic stress disorder (PTSD), and traumatic neurosis. If a worker sustains a mental health injury that is not the result of a physical injury, they may only recover workers’ compensation benefits if they can prove that the injury resulted from something other than typical everyday stress or tension related to their work.
- Accident-Related Injuries: In addition to injuries related to the worker’s employment, workers’ compensation covers all injuries resulting from on-the-job accidents. This includes both physical and mental harm resulting from a sudden and/or unexpected incident in the workplace or while the employee is actively carrying out job-related duties or activities.
- Occupational Illnesses: Workers’ compensation benefits are also available to individuals who suffer occupational illnesses. An occupational illness (or disease) results from one-time or repeated exposure to harmful conditions, activities, or substances. Examples of occupational diseases include hearing loss, skin infections, respiratory illness, carpal tunnel syndrome, hernias, pneumonia, mesothelioma, and more.
If you believe that your injury or illness is covered by workers’ compensation, it is important that you follow the correct steps in seeking your benefits. If you fail to follow the appropriate processes, you may lose your opportunity to recover compensation.
What to Do If You Suffer a Work-Related Injury or Illness
If you are injured at work, are diagnosed with an occupational illness, or suffer any type of job-related injury or illness, make sure you take the following steps:
- First, seek immediate medical attention. If necessary, call 911. Otherwise, go to the hospital, urgent care, or your doctor right away.
- Next, make sure you report your injury to your employer. In Wisconsin, you must report all work-related injuries and illnesses within seven days.
- Once you have reported the injury, make sure to follow your doctor’s orders and advice. Remember, your employer must allow you to choose your own doctor if you wish.
- You should also file your workers’ compensation claim as soon as possible, as there is a two-year statute of limitations on workers’ comp claims in Wisconsin.
- Lastly, you should reach out to an attorney who can help you understand your rights and help you navigate any disputes that may arise.
Although you are not required by law to have a workers’ compensation attorney, there are many benefits to working with an experienced legal professional.
At LawtonCates, our Wisconsin workers’ compensation attorneys provide free consultations and personalized service throughout the legal process. We can help ensure that you do not miss any important filing deadlines or make any mistakes that could jeopardize your benefits.
Our worker’s compensation attorneys can also represent you if your employer disputes your claim or if their insurance company refuses to pay you the benefits you are owed.
Things to Remember if You Are Injured at Work
While some professions are undoubtedly more hazardous than others, almost all of us will be injured to one extent or another during the course of our professional lives. Thankfully, many of these injuries are minor and do not cause more than a momentary disruption to our weekly work week. However, accidents happen and there is no shortage of serious work-related injuries unfortunately.
Don’t Try to Be “Tough”
If you are injured at work, it is vitally important that you take immediate action. Specifically, the two most important things you can do are to seek immediate medical attention and notify your employer of the injury. However, when discussing your injury do not try to be a “tough guy” and minimize your symptoms or pain.
Your work comp benefits will be paid (or not) based largely what is in your medical records. If the injury is reported as a minor injury that is not causing any pain, then that is what will be recorded in the medical records and future complaints of pain will be view as suspect by the work comp insurance adjuster.
Stay Consistent
It is also important to consistently and accurately report how you were injured to the various medical professionals that treat you. Discordant descriptions of the accident or the injury could lead to an unnecessary reduction in benefits or your claim being denied all together.
Be Prompt
You should notify your employer of the injury as soon as practical. In the majority of cases, employer notification happens literally moments after the injury. In other cases where employees do not necessarily work in one central location, employer notification might not occur until days after depending on the severity of the injury. The important thing is that you promptly and accurately describe how you were injured. Once a workplace injury is reported, employers have an obligation to notify its work comp insurance carrier and the Department of Workforce Development, which is the administrative entity that administers the work comp system.
Know Your Rights
After taking immediate action by notifying your employer and seeking the necessary medical treatment it is important to educate yourself about worker’s compensation. Injured workers have rights and are entitled to benefits. The basic benefits include pay for lost wages, permanent disabilities, medical bills and mileage incurred traveling to and from medical appointments. When an injured worker has to miss work while recovering from a work injury s/he is entitled to temporary benefits, which are paid at 2/3 of that person’s average weekly wage. This is commonly referred to as “TTD” or temporary total disability benefits. If the injured worker is recovering but able to work partial days during the healing period then s/he could recover “TPD” or temporary partial disability benefits.
Once the injured worker reaches a healing plateau his or her doctor will typically provide a permanency rating. The healing plateau simply refers to the point in time when the work injury will not improve dramatically or become significantly worse. Simply put, it means that the injured worker is about as good as s/he will be for the foreseeable future. At that point, the injury has stabilized and the doctor is able to accurately assess whether the injured work suffered a permanent injury. The higher the permanency rating the more “PPD” or permanent partial disability benefits the injured worker would receive. If the injured worker suffered a permanent injury that makes him or her completely unable to work then s/he would be entitled to “PTD” or permanent total disability benefits.
During the healing period, it is a good idea to keep track of your medical appointments. Under the work comp system, you are entitled to a mileage reimbursement for the mileage incurred driving to/from medical appointments. By keeping a log at the beginning of your treatment you will ensure you receive the full amount of compensation to which you are entitled.
In addition to the right to the benefits described above, injured workers also have other important rights. For example, you have a right to see two doctors of your own choosing. In addition, you have a right to seek a second opinion regarding your work injury. You only get one body and it is important to make the most informed decision possible regarding your care. If that means obtaining a second opinion then that is what you should do.
Finally, you have the right to consult with an attorney if you believe you are entitled to benefits that you are not currently receiving or have been denied coverage by the work comp insurance carrier. An attorney can ensure your rights are protected and maximize the amount benefits available to an injured worker. At LawtonCates, we have been representing injured workers for decades. If you have questions about your work injury give us a call for an honest assessment of your situation.
Workers’ Compensation Benefits in Wisconsin
The Wisconsin workers’ compensation system offers qualified individuals the following benefits:
- Medical Benefits: Workers’ compensation pays for all medical expenses related to your qualified injury. This includes costs associated with emergency care, ongoing treatments, medications, medical devices or equipment, rehabilitation, and more. Medical benefits also pay for travel costs to and from medical appointments.
- Temporary Disability: You may qualify for temporary partial disability (TPD) or temporary total disability (TTD) depending on the severity of your injury and your ability to work (or not) during your recovery. Temporary benefits are calculated based on a percentage of your wages and are paid until you can return to work at full capacity or until your doctor determines that you have reached maximum medical improvement (MMI).
- Permanent Disability: If your doctor decides that you have reached MMI and you have a permanent disability that prevents you from working at full capacity or at all, you may qualify for permanent partial disability (PPD) or permanent total disability (PTD). Your eligibility and the amount you can receive in PPD or PTD benefits depends on your impairment rating, which is calculated based on the severity of your disability and/or disfigurement.
- Vocational Rehabilitation: If your injury leaves you with physical or mental impairments that make it difficult or impossible for you to return to your past employment, you may be eligible for vocational rehabilitation benefits. These benefits pay for certain costs associated with job retraining and reentry into the workforce.
- Death Benefits: Lastly, workers’ compensation in Wisconsin provides death benefits to eligible surviving family members when an employee dies due to a work-related injury or illness. Spouses and children under 18, as well as adult children who are incapacitated, typically qualify for death benefits. If no spouse or children exist, other surviving family members may be eligible for these benefits depending on their degree of dependence on the deceased. The state also pays up to $10,000 for reasonable burial and/or funeral expenses.
Our team at LawtonCates can help you determine whether you qualify for these benefits. We are happy to answer your questions and address your concerns during a free case evaluation.
Fighting for Injured Workers Throughout Wisconsin
Our Wisconsin workers’ compensation lawyers are passionate about helping injured employees get back on their feet. You have the right to seek workers’ compensation benefits, and our team can help you navigate this complex process. We are prepared to handle all of the necessary paperwork so that you can focus on what matters most: healing.
Whether you need help filing your first claim or wish to appeal a denied workers’ compensation claim, do not hesitate to contact our team at LawtonCates. We offer free consultations and contingency fees for all workers’ compensation services. This means that you do not pay anything upfront; instead, our Wisconsin workers’ compensation lawyer only recovers lawyer fees if we secure compensation on your behalf.
Call our Wisconsin workers’ compensation attorney at (608) 282-6200 or contact us online to set up a free initial consultation by phone or at either of our office locations.
Workers’ Compensation FAQ
Report the injury or illness to your employer immediately. Ensure that the incident is documented, and seek medical attention promptly. Notify your employer in writing if possible.
In Wisconsin, employers or their insurance carriers generally have the right to choose the initial treating physician. After a certain period, you may have the option to choose your own doctor.
Yes, Workers’ Compensation is a no-fault system, meaning that benefits are provided regardless of who is at fault for the injury or illness.
Wage replacement benefits are typically calculated as a percentage of your average weekly wage, subject to statutory limits.
It is possible to receive both benefits, but the combined amount may be subject to limitations to avoid overcompensation.
In most cases, Workers’ Compensation is an exclusive remedy, preventing employees from suing their employers. However, there may be exceptions in cases of intentional harm.
If your claim is denied, you have the right to appeal. Consult with an experienced Workers’ Compensation attorney to navigate the appeals process.