Built on Family.
Focused on Helping.
Dedicated to Winning.
We win or you don’t pay
500 ★★★★★ reviews
One of the benefits of living in Wisconsin is its laws expressly protect employees’ rights and livelihoods. Workers’ compensation insurance covers nearly everyone in Wisconsin.
But what happens if workers' compensation insurance denies your claim?
A moment of panic may set in. You did not ask for an on-the-job injury. Like nearly every other resident of Wisconsin, you expect workers’ compensation to cover you.
If you have gotten that letter in the mail denying your claim, no doubt, your heart sank. You might wonder how to pay the bills. And there have been plenty of bills you did not expect from doctors, specialists, and maybe even rehabilitation and physical therapy experts. Without checks coming in regularly, how are you supposed to support yourself or your family until you recover? What if your injuries permanently disable you? Let’s look at a few variables regarding the law to understand whether it covers you and your options to remedy the situation.
It's easier to say who the Workers’ Compensation Act does not cover. When it does not cover a worker, other laws may cover them.
Here are a few instances where the Act might not cover you:
Even an employer who has not paid their workers’ compensation insurance must pay for benefits if you are injured personally, and the Uninsured Employers Fund provides this.
The Act would cover virtually every other employee not listed above.
Your employer has an obligation to you, the employee, to harbor a safe work environment. If there are hazards associated with the job, proper training, protective equipment, and methods to prevent injury must be observed.
So what injuries does the Workers’ Compensation Act
cover?
Here are a few instances where an insurer would dispute coverage:
If you were injured at work, document everything.
The most likely reason for a claim denial is missing essential information.
Here is a list of what you should keep track of and tell your lawyer if you were injured.
If what you say about the severity or nature of your injury goes against what your doctor’s report says, workers’ comp may deny you coverage.
Your doctor is a trained professional whose testimony is vital in continuing the claim process. You may need referrals for physical therapy, massage, pain management, etc. Your doctor must order them unless the insurer specifies they will cover them in advance. Otherwise, you might need to pay for them out of pocket.
Your employers can ask for several updates and re-examinations of your medical condition throughout the process. Be sure to comply with these requests, or else insurance companies could deny your benefits through a matter of difference in opinion between what you say and what your doctor or employers say.
You should report your injury to your employer within 30 days of the incident. You have a time limit (statute of limitations) from the moment of the incident to make your claim. This allows for occupational diseases, which might not be so obvious or have a specific origination date, to be covered. However, the longer you take to report the incident might throw a shadow of doubt on the veracity of your claim. Your employer could simply state that you hurt yourself at home and contest your claim.
There are exceptions to this rule, however. There is often no statute of limitations in loss of limb, vision loss, permanent brain injury, partial or total knee/hip replacement.
If your reason for a denied claim has to do with the statute of limitations, a skilled attorney may shine some light on this matter and fight for your benefits.
Your workers’ compensation benefits are essential to your recovery and maintaining your quality of life. We all depend on our jobs. If you were injured, this will affect how you go about your life, not only now but in your future. It may even hurt your family’s future.
Some benefits include:
These are all potential burdens on yourself and your surviving loved ones. Denial of a claim affects many people, and your right to be compensated is worth fighting for.
Employers are responsible for providing a safe work environment, and violations of those rules to protect employees have consequences. You stand to gain up to 15 percent more in benefits for employer violations. Conversely, however, you might stand to lose 15 percent for employee violations or intoxication. Document the incident so it does not become a matter of your word against theirs.
If workers comp denied your benefits, you may dispute these findings in a hearing. You must submit paperwork to the administrative law judge (ADJ), your employer, and legal counsel. Though an appeal can take you all the way to the Wisconsin Supreme Court, this is not common. Your best shot to win your appeal comes during this hearing.
A skilled attorney will take all of your documentation, evidence, and discovery to present it in court or use it as leverage to obtain a settlement.
If workers’ compensation denied your benefits, you need a skilled attorney to fight for your rights. Losing compensation at this critical time in your life can affect you for years to come.
Do not allow some red tape or a matter of different opinions to undermine your ability to provide for yourself and your family. Nobody asks to be injured, which is why laws protect workers and provide for them in their moments of need.
Contact a workers’ compensation attorney to learn more about fighting for your right to benefits when injured on the job.
EAU CLAIRE:
402 Graham Ave.
Suite 305
Eau Claire, WI 54701
Phone: (715) 835-5959
Map & Directions
GREEN BAY:
2300 Riverside Dr,
Suite 105
Green Bay, WI 54301
Phone: (920)-504-3655
Map & Directions
HUDSON:
517 2nd Street
Unit #205
Hudson, WI 54016
Phone: 715-226-6158
Map & Directions
LA CROSSE:
205 5th Avenue S,
Suite 209,
La Crosse, WI 54601
Phone: 608-527-0876
Map & Directions
NEW RICHMOND:
1500 Madison Ave.
Suite 220
New Richmond, WI 54017
Phone: 715-226-6164
Map & Directions
RICE LAKE:
337 North Main Street
Rice Lake, WI 54868
Phone: (715) 790-1114
Map & Directions
RIVER FALLS:
215 S 2nd St #20
River Falls, WI 54022
Phone: (715) 716-5869
Map & Directions
SUPERIOR:
1200 Tower Ave.
Superior, WI 54880
Phone: (715) 718-2969
Map & Directions
WAUSAU:
408 3rd Street
Suite 303
Wausau, WI 54403
Phone: (715) 716-5092
Map & Directions
DULUTH:
306 West Superior Street,
Suite 606 West
Duluth, MN 55802
Phone: (218) 729-0628
Map & Directions
HIBBING:
Howard Court Bldg.
302 Howard Street, Suite 123
Hibbing, MN 55746
Phone: 218-217-0659
Map & Directions
MINNEAPOLIS:
23 - 4th Street SE
Suite #217
Minneapolis, MN 55414
Phone: (612) 446-3999
Map & Directions
WOODBURY:
724 Bielenberg Drive
Suite 126
Woodbury, MN 55125
Phone: (651) 815-0017
Map & Directions