Wisconsin Work Injury FAQs
Wisconsin workers’ compensation is part of a “grand bargain” between workers and employers, wherein the right to sue an employer is typically forfeited in exchange for prompt, no-fault benefits for job-related injuries and illnesses. This covers all reasonable/ necessary medical expenses, certain wage loss benefits and death benefits.
At least that’s the theory. In reality, today’s workers exchange the right to sue an employer for lengthy delays, frequent denials of benefits, and a system that is reluctant to pay for many damages, let along the full amount to which you are entitled. And, unlike other forms of civil liability, claimants in workers’ compensation cases are also not entitled to collect for certain damages, including pain and suffering or punitive damages.
At Lein Law Offices, our Wisconsin workers’ compensation attorneys in Hayward and Winter continue to see many state legislatures whittle away at important protections for ailing workers, often making it more difficult to obtain rightful benefits. ProPublica reports Wisconsin fared better than most in this regard, with state lawmakers in 2006, 2008 and 2012 slightly increasing wage replacement benefits for workers and surviving dependents.
Wis. Stat. § 102.01 – §102.89 outlines the rights and responsibilities of employees and employers, parameters for qualifying conditions, statute of limitations, disability categories, payment schedule guidelines, and procedures for dispute resolution. State data reveals the 10-year average number of workers’ compensation claims in Wisconsin is nearly 5,300, with the state ranking slightly better for payment rates for temporary and permanent total disability, but toward the bottom for average partial disability rates.
To help employees better understand the benefits and process, we offer this Wisconsin Workers’ Compensation FAQ.
What Is Workers’ Compensation?
Workers’ compensation is paid to the injured worker or his or her family to cover all medical expenses and a percentage of lost wages caused by a work-related injury. Unlike a personal injury claim, you do not have to prove the fault of your employer, but only that the injury occurred in the course of performing work duties. Every employer must have workers’ compensation insurance to cover costs in the event of such an injury.
What Should I Do If I Was Injured On The Job?
If you were injured at work, you should consult with an attorney as soon as possible. Our workers’ compensation attorneys will explain your rights and explore options in filing a workers’ compensation claim. We can represent you at any stage of the process, from the initial application through issues with temporary to permanent disability.
If you have reached maximum expected medical recovery and are permanently disabled, we can assist you in negotiating a lump-sum settlement or in collecting permanent disability benefits.
When Does My Coverage Begin?
Workers’ compensation coverage begins the moment you begin working for an employer. An employee is entitled to workers’ compensation regardless of:
- How long he or she has been an employee of a particular employer
- Whether he or she is a probationary employee or in training
What If I Did Not Receive Benefits?
If you are an employee who did not receive the benefits you feel you were entitled to, you may be concerned about whether you should return to work, how you will pay your bills and what recourse you have. The attorneys at our firm will provide you with a free consultation and can help you address these tough issues.
How Much Will It Cost?
You will not have to pay any money out of pocket for our services. Lein Law Offices works on a contingency basis and will not collect any payment unless you receive the benefits you are entitled to. You have rights. If you believe that an insurance company is treating you unfairly, we can aggressively pursue your benefits and claims.
Am I Eligible For Workers’ Compensation?
If you are injured or suffer illness on-the-job or in performing duties incidental to work, you are most likely eligible for workers’ compensation benefits, per Wis. Stat.§ 102.03. The Wisconsin Workers’ Compensation Act requires work injury insurance of all employers – public and private – with three or more employees (full- or part-time and minors) with limited exception. The Wisconsin Department of Workforce development reports that of the state’s estimated 3.1 million workers, an estimated 3 million – or 97 percent – were covered by laws requiring their employers to purchase workers’ compensation insurance.
Injuries while commuting typically don’t qualify, due to the coming-and-going rule, but there are occasionally exceptions (i.e. on company property, while receiving mileage compensation, etc.). Self-inflicted injuries aren’t eligible, but an employee’s fault is not considered grounds for denial of benefits. The exception is work-related injuries caused or exacerbated by a worker’s intoxication in violation of employer policy, which can reduce benefits by 15 percent. Domestic servants, some farmers and volunteers are not eligible. Independent contractors (as determined by this nine-requirement test) may be covered under their own self-insurance. Federal employees (including the U.S. Postal Service) are covered by Federal Workers’ Compensation Insurance.
What Injuries Are Covered By Wisconsin Workers’ Compensation Law?
State workers’ compensation statutes define injury as any mental or physical harm resulting from workplace accidents or occupational diseases. This can include damage to artificial limbs and dental damage. Mental harm includes nervous disorders, traumatic neurosis and hysteria. If occurrent absent physical injury, workers need to show it was the result of something greater than day-to-day stress and tensions experienced by all employees. Occupational disease is any chronic physical or mental harm resulting from exposure over time to an employment-related substance or activity. This might include loss of function, such as with carpal tunnel syndrome, or illness like mesothelioma, caused by asbestos exposure. Coverage can also be granted for aggravation of a pre-existing condition, even if not work-related.
How Much Time Do I Have to File a Claim for Workers’ Compensation in Wisconsin?
Workers are required per Wis. Stat. §102.12 to provide notice of injury within 30 days of any injury or within 30 days of learning about an occupational disease and its causal correlation to their job. If you don’t provide notice within that time frame, it doesn’t necessarily mean you can’t obtain benefits, so long as you can show the employer wasn’t mislead by lack of it. All claims will be time-barred if employee gives no notice within two years of the date the injury occurred or the occupational causal correlation should have been discovered.
Prior to March 2016, the Wisconsin workers’ compensation claim statute of limitations was 12 years. State lawmakers shortened it to six years for traumatic work injuries. However, occupational diseases (i.e., repetitive motion, carpal tunnel) still qualify for the 12-year statute of limitations, as do all claims originating prior to March 2016.
What Sort of Workers’ Benefits Could I Receive?
There are three types of benefits one can receive from workers’ compensation: Medical Expenses, Wage Loss, Death Benefits.
All reasonable medical expenses for job-related injuries are covered. This is true even for workers who don’t require any time off work for the injury.
For disability/ wage loss compensation, the state’s three-day waiting period requires workers wait at least three full days (excluding Sunday, unless you normally work that day). You can’t receive wage loss / loss of earning capacity compensation if your injury means less than 7 workdays lost. However, if it turns out you’ve lost more than that, wages for those first three days (excluding injury day) will be reimbursed. Depending on the facts, you may be eligible to receive temporary total disability benefits, permanent total disability benefits or temporary/ permanent disability payments. Most totally disabled workers are entitled to two-thirds their average weekly rate. Permanent partial disability is limited to 1,000 weeks of coverage, while permanent total disability can extend through the life of a worker, though many conditions are outlined according to schedule (i.e., loss of a foot or ankle eligible for 250 weeks; 50 percent permanent partial disability rating would entitle worker to 125 weeks).
One can also receive reimbursement for mileage driving to-and-from medical treatment.
Death benefits (funeral expenses and wages losses) per Wis. Stat. §102.46 and §102.47 are available to surviving spouses, children and other dependents, including non-estranged parents to whose support decedent had contributed $500 or less in the last year).
If the state determines your work-related injury was the result of an unsafe condition the employer created, your benefits can increase by 15 percent.
In all cases, receipt of federal Social Security Disability Insurance ( SSDI) (eligible for those terminally ill or injured a year or more) will result in a reduction of workers’ compensation so the employee does not exceed two-thirds weekly wage.
If you have additional questions about Wisconsin workers’ compensation eligibility, help with filing a claim or assistance in resolving a dispute on denial of benefits, our workers’ compensation attorneys in Hayward and Winter can help.