There are more than 19,900 businesses in Milwaukee, employing more than 447,000 people. One thing that the vast majority of these businesses have in common is the requirement that they purchase a worker’s compensation policy to provide wages and medical benefits to their workers if they suffer a workplace illness or injury.
While the process of obtaining worker’s compensation is designed so that the worker can report the injury and receive benefits, many problems can arise during the process, resulting in denied claims and delayed payments.
If you’ve suffered a workplace injury or illness, you’re not required to obtain an attorney to help you receive benefits. However, an experienced attorney can provide some services crucial to receiving the benefits you need and ensuring that those benefits continue to be available for you for as long as your injury lasts and impair your ability to work.
Let a Milwaukee worker’s compensation lawyer from Nicolet Law Accident & Injury Lawyers help you understand the available benefits and tell you how they can help you navigate the Wisconsin worker’s compensation claims process.
About Wisconsin's Workers Compensation Program
Nearly all private (non-governmental) employers in Wisconsin must purchase a worker’s compensation insurance policy for their employees. Worker’s compensation is a form of no-fault insurance that benefits employees who have incurred a workplace accident or injury, regardless of who was at fault.
These benefits include:
- Coverage of all reasonable and necessary medical expenses involved during the treatment of workplace illness or injury
- Partial replacement of wage loss, including temporary partial and temporary total benefits for workers during the period of recovery from their workplace injury or illness, and permanent partial or permanent total disability for those who suffer permanent injuries that will partially or completely impair their ability to return to work and earn an income.
Why Do Workplace Accidents Happen in Milwaukee?
Milwaukee is a recognized leader in manufacturing, and this industry is a major employer in the region. There are more than 240 food and beverage manufacturing companies in the region, and others devoted to manufacturing automotive parts, vehicles, medical imaging equipment, and much more. Unfortunately, manufacturing is particularly prone to injuries, including running the equipment used in manufacturing processes, slip-and-fall accidents in walkways or staircases around the facility, electrical hazards, and heavy equipment operation at the facility.
According to the U.S. Bureau of Labor Statistics, there are more than 50,000 workplace injuries or illnesses each year in Wisconsin workplaces, including around 33,000 that are severe enough to result in missed days from work, a job transfer, or a relocation to another job position. Manufacturing is one of just two industries in Wisconsin that account for over half of the occupational injuries and illnesses occurring in the state, along with the trade, transportation, and utility sector.
Who Can Receive Workers Compensation Benefits?
Nearly all private employers in Milwaukee are required to provide worker’s compensation for their employees, with those benefits being available to all the company employees.
The only employees who do not qualify for benefits are:
- Domestic workers.
- Some farm employees.
- Volunteers who receive less than $10 a week in payment of money or other goods.
- Qualified and certified religious sect members.
Employees of federal government agencies, such as postal workers or workers at hospitals run by the Veterans Administration and those in the military, receive worker’s compensation benefits from a federal program, as do those working on interstate railroads and seamen working navigable waters.
The Process of Receiving Workers Compensation Benefits
The process of receiving worker’s compensation benefits in Milwaukee includes:
- The employee reports an injury to their employer as soon as possible. While the time in which an employee can report an injury is within two years of the date on which the injury occurred, in most situations, this report should be made within 30 days. However, if the employer knew or should have known about the injury, the worker has up to six years to report it. There is no statute of limitations for worker’s compensation claims involving occupational diseases, such as illnesses resulting from occupational toxic exposure.
- The employer must report the injury to their worker’s compensation policy provider within seven days of obtaining actual knowledge of the injury. The employer must report the injury to their insurance provider within 24 hours if the injury is fatal.
- The insurance provider must report all injury claims involving lost time from work within 14 days of the injury to the state’s Department of Workforce Development’s Workers Compensation (WC) division. Fatal injuries must be reported in writing to the WC division and the insurance carrier within 24 hours.
- Within 30 days after the injury, the insurance carrier must report supporting information about the claim to the WC division, including a report noting all payments made to the injured employee. If the employee loses more than three weeks of work due to the injury, a final medical report must also be submitted to the WC division.
If a worker wishes to dispute the decision made on their worker’s compensation benefits,:
- The injured worker applies for a hearing within six years of the date of the injury or six years from the date of the last compensation payment.
- An administrative law judge schedules a hearing on a first-in, first-out basis.
- The judge holds the formal WC division hearing and considers the evidence presented both by the worker, their attorney, the employer, and the worker’s compensation insurance provider.
- Within 90 days of the hearing, the judge will decide on the matter. These decisions are often delivered in less than 50 days, and all parties involved in the dispute are notified.
- If the worker is not satisfied with the judge’s decision, they can file an appeal within 21 days for a review of the claim to be conducted by the Labor Industry Review Commission.
- If the worker is not satisfied with the decision of the Labor Industry Review Commission, they can file an appeal with the circuit court within 30 days.
- If dissatisfied with the circuit court’s decision, the worker can take the case to the Court of Appeals within 45-90 days, depending on when the notice of judgment is served.
- If dissatisfied with the Court of Appeals’ decision on the matter, the worker can file their appeal with the Wisconsin Supreme Court within 30 days.
Returning to Work After an Injury
After a worker has sufficiently recovered from their injury to the point where they can perform at least some general working tasks, their physician will advise them about whether there are limitations as to their position’s normal duties. The worker’s employer is not required to hold a position for a worker. However, they are encouraged to either rehire the injured worker when another position becomes available and should offer an available position that accommodates the worker’s physical or mental limitations if possible.
If the injured worker is ready to return to work and no position is available for them within their permanent restrictions, additional worker’s compensation programs and benefits may become available to help the injured worker return to the workforce. Additionally, the worker can apply for a formal hearing to seek a year’s worth of lost wages if they believe there was no good reason for the employer refusing to hire them back.
How an Attorney Can Help You Receive Your Benefits
You were injured at work, immediately sought medical treatment, and reported the injury to your employer within a few days. You should promptly receive the benefits that are owed to you, right? Not necessarily. Unfortunately, several issues can result in delays when you’re seeking the benefits you need to receive proper treatment for your injury and replace the wages you lost due to being unable to work.
Some of the services that an Milwaukee personal injury attorney can provide include:
- Guidance through the process. Injured workers obtaining legal assistance with their claim have the advantage of a legal professional with experience who can explain what needs to happen and when and can assist the worker in gathering the medical evidence needed to prove the claim or to wage an effective dispute.
- Representation through the various levels of appeals for those who have been denied benefits or do not believe they are receiving the full amount of benefits owed to them.
- Negotiate a settlement agreement with the employer’s worker’s compensation provider that includes careful consideration of the extent of your injury and the work you can perform or whether the employer owes you for past temporary disability payments.
- Assistance with making a claim for UEF payments. The Uninsured Employer Fund (UEF) is a program operated by the state’s Department of Workforce Development WC division to provide worker’s compensation benefits to employees whose employers were required to provide coverage and failed to do so.
- An experienced examination of other types of federal, state, or local assistance programs that can also assist you after a workplace injury, such as the federal Social Security Disability Insurance (SSDI) program.
Frequently Asked Questions About Filing a Milwaukee Workers Compensation Claim
Worker’s compensation is often a little-understood aspect of Milwaukee personal injury law. Here are some answers to general questions about the process. For answers to your legal questions about your specific claim, be sure to contact the legal team at Nicolet Law Accident & Injury Lawyers for a free case evaluation.
If I suffer a workplace injury and receive medical benefits, am I allowed to choose my physician?
When a worker is injured in a workplace incident in Milwaukee, the employer is required to allow the worker the right to select the doctor that they wish to receive treatment from. If the employee loses confidence in that doctor’s ability to treat their injury, they are also allowed a second choice of physician. If the injury requires immediate medical assistance and the worker is not able to express their choice of doctor, the employer is permitted to make whatever emergency decisions need to be made in order to ensure the worker is treated. Once the emergency passes, the worker can choose who to receive follow-up care from.
If the worker’s chosen physician is located out-of-state and not licensed to practice medicine in Wisconsin, the treatments will only be covered if the worker receives authorization from the insurer or the out-of-state physician was referred by a Wisconsin physician. Insurers can also refuse to provide benefits to workers who suffer complications or aggravation of an injury over their refusal to submit to reasonable and necessary medical treatment or surgery. The exception to this rule is that workers can refuse surgery that could result in losing a limb or pose a high risk of death.
Employers and insurance providers who hold their worker’s compensation policy are permitted with written notice to require the employee to undergo an independent medical evaluation (IME) with their chosen physician. This is a doctor who is not involved in the regular treatment of the worker’s injury, who evaluates the worker to offer an independent determination of the worker’s medical condition and ability to perform work-related tasks.
Can I sue my employer rather than file a worker’s compensation claim?
Worker’s compensation is considered an exclusive remedy for most on-the-job injury claims. This bars the employee from filing a lawsuit against an employer or co-worker whose negligence resulted in an injury. However, you may file a personal injury claim against a third party that injured you.
Third-party liability refers to an accident caused in the workplace by someone who is not the injured worker’s employer or co-worker.
- A delivery driver injured during the normal scope of their employment in a transportation accident caused by another driver’s negligence.
- A construction worker from a subcontracted company injured by a job-site hazard that the general contractor needed to mitigate.
Workers injured due to their employer’s safety violation are entitled to a 15 percent increase in wage loss compensation, up to a maximum of $15,000. If an employer fails to report an injury to their worker’s compensation provider, the employee might be eligible to seek twice the amount of compensation for their injury. Employers face penalties of up to 10 percent of the claim if their refusal to report the injury results in an untimely payment.
What are some of the reasons that a worker’s comp claim can be denied?
Worker’s compensation is no-fault insurance, meaning injured workers can receive benefits no matter how the injury occurred.
However, worker’s comp can deny a claim if:
- The employer failed to make their insurance payments, resulting in a loss of coverage.
- The employee was found to be under the influence of drugs and alcohol when the accident occurred.
- The employer has reason to believe the employee deliberately caused their injury or misstated the seriousness of their injury to obtain benefits.
- The injury was incurred as a result of horseplay on the job site.
- The employer or their insurance provider has reason to believe that the injury did not occur at the workplace. This is often tricky, particularly when it involves an employee who regularly travels for employment. If the employee is injured in a motor vehicle accident on the way to work, this is generally not considered to be covered by worker’s compensation. However, if that accident occurred while the employee was on the clock and in route to another location as a normal condition of their employment, it can be covered either by worker’s compensation or the personal injury claims process, depending on the details of the accident.
Does Milwaukee worker’s comp cover chiropractic treatments?
Yes. Workers injured in Milwaukee have the right to seek treatment for the injury from any physician, psychologist, chiropractor, or podiatrist licensed to practice in Wisconsin. Workers also have the option to seek treatment from out-of-state providers if their insurance provider approves the treatment or if a Wisconsin medical provider refers the worker to an out-of-state provider.
Can my employer fire me for filing a worker’s comp claim?
If you file a worker’s comp claim, your employer is not permitted to fire you because of the work injury. Employers are encouraged to provide a suitable position for workers returning from an injury that accommodates their physical and mental limitations. However, they’re not required to hold your job for you. If you are ready to return to work and find that there is no longer a position available for you, there may be additional remedies and benefits available to you through the worker’s compensation process.
If you believe you have been terminated as a result of filing a worker’s compensation claim, it is important to speak with an experienced worker’s comp attorney as soon as possible to begin gathering the documentation necessary to prove that your termination was related to your claim.
What happens if my employer doesn’t have worker’s compensation insurance?
Wisconsin’s worker’s compensation law has very few exemptions for employers who do not wish to provide this insurance policy for their employees. If an employee is injured and the employer does not have worker’s compensation insurance but was legally required to provide coverage to their workers, the injured worker’s claim can recover compensation from the Uninsured Employer’s Fund (UEF).
The state’s UEF is funded by penalties assessed against employers who violate the worker’s compensation law. These penalties are mandatory and non-negotiable. Further, an employer penalized for not having worker’s comp can be required to refund the UEF for worker’s compensation benefits paid to the worker through the fund.
UEF funds pay workers who file a claim with the state and provide required documentation, including copies of payroll checks, pay stubs, bank records, wage statements, tax returns, and other documentation that the employer is liable for compensating the injury. Additionally, the worker must show any medical treatment or vocational training they have received to obtain new employment and other expenses related to the claim.
These cases are investigated by those administering the fund, and this information is shared with other agencies, including those involved in tax collection, unemployment insurance, medical assistance, and vocational rehabilitation. Payment for the claim is generally submitted within 14 days of filing the UEF claim.
Need a Worker's Compensation Lawyer? We Can Help You
Worker’s compensation insurance is an important benefit for most Milwaukee employees. Unfortunately, many issues can arise during the claims process that results in injured workers not receiving the timely payments they rely on to stay financially afloat after becoming injured at the workplace or suffering an occupational illness.
The legal team at Nicolet Law Accident & Injury Lawyers hopes that all workers receive the benefits they’re entitled to from their Wisconsin worker’s compensation claim. However, when that doesn’t happen, we are prepared to fight alongside the injured worker to receive the medical treatment and wage replacement they need.
Whether you were just injured in a workplace accident, just diagnosed with an occupational injury, or you’ve been denied benefits and are planning to appeal the decision, we can offer guidance and services to assist you with your claim. For your free case evaluation, contact us online or by calling (414) 260-2220.