This page provides answers to the following questions:
- I had an accident at work. How do I file a workers compensation claim in my state?
- Should my employer have workers compensation insurance? How do I know I am covered?
- What are the conditions that enable me or prevent me from claiming benefits under my state's law?
- What benefits might I be eligible to receive?
- How much time do I have to file my claim? What are the stages of the claim process? What should I expect?
- If I'm not happy with the determination, how do I appeal?
1. I had an accident at work. How do I file a workers compensation claim in my state?
If you are injured during the course of your work day, you should notify your employer as soon as possible. You should notify your employer of your injury within thirty (30) days of your injury. To qualify for workers' compensation, however, you should notify your employer of the injury within two (2) years. Upon notification, your employer is responsible for filing a report of your injury to their workers' compensation insurance provider within seven (7) days of notification. The insurance provider is then expected to report the injury to the Wisconsin Workers' Compensation Division. This must be done within fourteen (14) days of the injury.
2. Should my employer have workers compensation insurance? How do I know if I am covered?
With the exception of only a few categories of employees, nearly all employees in Wisconsin are covered by workers' compensation insurance. Your employer may become self-insured or purchase a workers' compensation coverage policy to apply to all employees.
3. What are the conditions that enable me or prevent me from claiming benefits under my state's law?
The best way to ensure the receipt of benefits is to timely file all requested documentation and to keep accurate and detailed records of all filings, medical records, and expenses associated with your work related injury.
4. What benefits might I be eligible to receive?
You may be entitled to a variety of types and amount of benefits depending on the extent of your injuries. For example, payments for all reasonably related and necessary medical expenses. Wage replacement benefits for varying degrees of your disability are also available to help sustain you during your treatment and recovery. Payments of wage replacement benefits are subject to a three (3) day waiting period. This means that you will not be entitled to lost wages unless your injury prevents you from returning to work for a period of three (3) days or more. If your injury is more severe, as in you are unable to fully recover from the injury, you may be awarded to the loss of earnings associated with permanent disability.
Vocational rehabilitation and retraining services are available to help you return to the workplace, whether in your previous field of employment or in a new field.
If your injury results in your death, surviving family or dependents may qualify as beneficiaries to receive workers' compensation benefits.
5. How much time do I have to file my claim? What are the stages of the claims process? What should I expect?
Once your claim is established, it will remain open for twelve (12) years from the date of your injury or last payment. You have twelve years to bring forward any disputes for resolution or claims to the Workers' Compensation Division. This will begin with filing for a formal hearing in front of an Administrative Law Judges. The Workers' Compensation Division will recommend that an informal mediation be scheduled to resolve any outstanding disputes. This is because the formal process can become lengthy and costly in different situations. However, you may elect to move forward with the formal hearing.
At the formal hearing, the Administrative Law Judges hear evidence presented from both sides (very similar to a trial). If the dispute is not settled or dismissed before the completion of the formal hearing, the Administrative Law Judge will issue a decision within ninety (90) days of the close of the formal hearing. If you or the opposing party are unhappy with the decision, both sides have a right to appeal the decision to the Labor Industry Review Commission within twenty-one (21) days. You must complete and submit a petition for review with that body to proceed with an appeal. The Labor Industry Review Commission will review the decision of the Administrative Law Judge and make its own determination and finding on the dispute. This will constitute a final order and determination on the dispute.
6. If I am not happy with the determination, how do I appeal?
If you remain unhappy with the determination of the Workers' Compensation Commission after all procedures and appeals have been exhausted, you may appeal the decision of the Labor Industry Review Commission to the state court system. All court rules and procedures will apply.