Wisconsin Workers’ Compensation Laws

In Wisconsin, employers are obligated to implement safety programs that follow OSHA requirements. This implies that workers are trained to utilize different safety practices while on the job. 

Yet, there are still instances when employees get hurt during work activities. In 2021, the United States Bureau of Statistics published a survey showing Wisconsin’s incidence rate of 3.2, with most cases in different work industries like manufacturing, transportation, and health. 

The Wisconsin Bureau of State Risk Management also reported that 2,029 workers’ compensation claims had been filed throughout the 2021 fiscal year. This showed that workplace accidents could happen despite an individual’s safety awareness. 

Employees should learn how to navigate the compensation claims process when the need arises. 

The article sections below will help individuals understand workers’ compensation procedures in Wisconsin. It tackles different topics, like compensation denial, requirements, and available benefits. 

Wisconsin Workers’ Compensation Insurance Requirements

The state of Wisconsin follows a no-fault system when it comes to workers’ compensation insurance. This means that employees no longer need to prove a business owner’s negligence before getting the compensation they need. 

Employers are obligated to have workers’ compensation policies that can provide benefits to those who suffer from occupational diseases and other workplace injuries. 

This section provides a brief discussion of the workers’ compensation requirements in Wisconsin and how businesses can fulfill their obligations to the state and their employees.

Who is required to purchase workers’ compensation insurance in Wisconsin?

Businesses with more than three employees are required to purchase workers’ compensation insurance in Wisconsin. 

Employers who are also paying more than $500 in gross payments should also get a policy regardless of whether their employees are working part-time or full-time. 

However, there are still workers not covered under the Workers’ Compensation Act, even if their employers have purchased this type of policy in the market. 

Some workers who are not considered employees include non-profit volunteers, domestic servants, and real estate agents. 

Where can employers obtain workers’ compensation insurance in Wisconsin?

Businesses can obtain workers’ compensation insurance from providers that are authorized to write insurance policies in Wisconsin. Employers seeking to purchase insurance coverage can check the Directory of Licensed Insurers. This is a booklet published annually by the Wisconsin Office of the Commissioner of Insurance. In 2022, the agency listed different carriers within the state, including:

• Allstate Insurance;

• American Compensation Insurance;

• Employers Compensation Insurance; 

• Erie Insurance; 

• Liberty Mutual Insurance.

The Wisconsin Compensation Rating Bureau also assists businesses that are unable to purchase insurance policies on the market. 

What are the workers’ compensation insurance guidelines in Wisconsin that out-of-state employers need to remember?

Out-of-state employers are obligated to purchase additional Wisconsin coverage to supplement their existing policies. 

Section 3-A of each insurance agreement needs to show that a workers’ compensation policy covers the Wisconsin liability of an employer. Those without a valid insurance policy should get coverage from a licensed insurance company within the state. 

New and additional coverage should always be endorsed to the Wisconsin Compensation Rating Bureau. Employers can also send an inquiry letter to the agency at P.O. Box 3080, Milwaukee, Wisconsin 53201-3080.

What is the penalty for not following workers’ compensation requirements in Wisconsin?

In Wisconsin, businesses not carrying workers’ compensation insurance can face penalties amounting to $750. 

The Workers’ Compensation Division can also make business closure orders when an employer refuses to purchase the required insurance coverage. 

Those with coverage lapses lasting for a week may be forced to pay a $100 fine for each day their business remains uninsured. This only shows the importance of purchasing and maintaining insurance coverage requirements in the state. 

Wisconsin Workers’ Compensation Benefits

Most Wisconsin-based employees working in the private and public sectors are protected under the state’s workers’ compensation system. Individuals who have suffered injuries while performing employment-related tasks are eligible to receive compensation payments for their lost wages, medical expenses, and other rehabilitation costs. 

The table below can be used as a guide when determining the coverage benefits applicable to their situation.

There are only a few exemptions when it comes to receiving workers’ compensation benefits. For example, workers who are hurt after deviating from employment-related tasks are not qualified to receive compensation. They also cannot file a workers’ compensation claim if they intentionally cause harm to themselves.

How to File a Workers’ Compensation Claim in Wisconsin

In Wisconsin, employers and their workers have responsibilities during compensation claim procedures. Injured workers should not hesitate to inform their supervisors that they are hurt on the job. Employers who have received an injury notice should also make a report to their insurance providers. It is important for both parties not to delay since this can result in a penalty and loss of benefits. 

When is the Deadline for Workers’ Compensation Claims in Wisconsin?

The deadline for Wisconsin workers’ compensation claims varies based on the type of injuries sustained. According to Section 102.17(4) of the state’s legislature, workers with occupational diseases have 12 years to file their claims from the date that they discovered their medical conditions. Those with traumatic injuries, on the other hand, should submit their claims within six years. 

All injured employees, however, should immediately notify their company about their workplace accidents. They should file an incident report about the nature of their injury and the working hazards that need to be addressed. This should be accomplished in 30 days. 

Step-By-Step Guide on Filing a Workers’ Compensation Claim in Wisconsin

Filing a workers’ compensation claim in Wisconsin can be confusing for individuals while they deal with an injury. They need to manage their expectations by learning each step of the claims process. This can help minimize errors that may negatively affect their potential benefits. 

Those who are seeking to submit a claim can follow the steps enumerated below: 

Step One: Submit an Injury Report.

Workers should not hesitate to inform their employers after getting injured or discovering symptoms of occupational diseases. 

They may be asked to complete a DOA-6058 form that includes details like the date of injury, witnesses, and work facility address. 

This should be accomplished within 24 hours, if possible. Those who are unable to do so can still qualify for workers’ compensation as long as they can provide notice within two years from the date of their injury. 

Step Two: Seek Medical Attention.

When a workplace accident occurs, injured workers should immediately get medical treatment from their physician of choice. 

Employers often allow workers to choose a Wisconsin-based practitioner that can aid their recovery, whether they need a podiatrist, chiropractor, or physician. Insurance providers can allow out-of-state treatments when necessary. 

During this time, employees should also get copies of medical documents that can be used to back up their claims when their compensation payments are suddenly interrupted. 

Step Three: Record Injury Details.

There is usually no guarantee that the insurance claims process will be free of complications. This is why the Wisconsin Department of Workforce Development encourages workers to maintain a written record that shows important details about their occupational disease or traumatic injury. An employee’s file should include the following:

• Signed workers’ compensation agreements;

• Written outline of insurance statements;

• Dates of previous doctor’s appointments;

• Receipts of medical treatments;

• Names of eyewitnesses.

Individuals with disputed claims can easily present the information collected during formal hearings with an administrative law judge. 

Step Four: Determine Applicable Benefits.

Those who have been hurt on the job should carefully consider the different benefits that can be applied to their situation. 

Individuals may be permitted to have permanent or temporary disability benefits based on the nature of their workplace injuries. 

Workers can also receive wage loss compensation payments if they have developed occupational diseases caused by toxic exposure.

Step Five: Give an Accurate Statement.

A representative from the employer’s insurance company can contact those who have recently filed workers’ compensation claims. 

During the call, they can ask employees to give an account of their workplace injury or illness. 

Different providers utilize recorded statements to confirm if a claim should be approved or not. They also give out a printed copy of their statements after the brief interview. 

Step Six: Make Settlement Negotiations.

Injured workers should consider getting the help of a skilled attorney who can perform a thorough evaluation of their claims. This allows them to make well-informed decisions before accepting an insurance company’s settlement offer. They can also be properly represented when undergoing settlement negotiations and maximize their chances of receiving the benefits that they need. 

What Should One Do If a Workers’ Compensation Claim in Wisconsin Has Been Denied?

Injured workers who want to dispute compensation claim rejections should file an appeal with the Wisconsin Department of Workforce Development. 

They can initiate the appellate process by submitting a completed WKC-7 form containing specific information about their date of injury, employer’s identification number, and certification of readiness. 

This should be filed with medical documents that can be used to support their appeal.

An administrative law judge is appointed after the hearing application forms are processed. They preside over formal hearings and make final decisions regarding a compensation claim denial. 

Throughout the legal procedure, they can allow involved parties to submit evidence that can be used to resolve a compensation claim denial. Judges can also permit witnesses to give a statement corroborating the workers’ injuries. 

When a judge decides to deny a compensation claim, workers still have a chance for reconsideration since they have 21 days to file an appeal with the Wisconsin Labor and Industry Review Commission. 

If the agency still declines their request, workers and their representatives should already open a case with the state’s circuit courts. 

Legal Resources for Injured Workers in Wisconsin

Individuals injured on the job may encounter difficulties when looking for appropriate resources that can help them overcome legal and workplace challenges. 

They may still have different questions about safe working conditions, compensation laws, and medical rehabilitation costs. In this section, injured workers can find a list of organizations and agencies that provide safety programs or products that minimize workplace hazards. They can also find legal resources that support employees from low-income families.

Wisconsin Safety Council

The Wisconsin Safety Council assists private companies, organizations, and agencies in developing safety programs that reduce occupational diseases or injuries within the workplace. It is the top provider of different types of emergency equipment, from first aid kits to defibrillators. It also provides training services that educate employees regarding occupational health, regulatory compliance, and safety management techniques. Those who have a membership with this organization can gain access to resources that promote safety initiatives at the workplace. Individuals who want to know more about the organization’s services can email wsc@wisafetycouncil.org.

OSHA Madison Area Office

The Occupational Safety and Health Administration is a government agency under the United States Department of Labor. It aims to protect employees from dangerous workplace conditions by enforcing safety standards throughout various industries, like agriculture, construction, and maritime. It also provides consultation services, compliance assistance, and outreach training programs that help employers and workers maintain healthy work environments. Those who want to inquire can visit OSHA’s Madison office at 1402 Pankratz Street, Suite #114, Madison, WI 53704. The agency also accommodates calls at (608) 733-2822.                

Wisconsin Department of Workforce Development

The Wisconsin Department of Workforce Development aims to support the needs of all workers residing in the state. It also maintains a partnership with the Wisconsin State Laboratory of Hygiene to develop statistical reports regarding illness and injury claims per year. Its website contains helpful information that can assist injured employees who want to file workers’ compensation claims. The resources on this site focus on various topics, like insurance policies, workers’ rights, vocational rehabilitation services, and compensation claim procedures. The department’s staff handles work-related inquiries through its hotline at (608) 266-1340.

Wisconsin Compensation Rating Bureau

Since 1917, the Wisconsin Compensation Rating Bureau has been classifying and collecting employer information along with their rate plans and policies. It makes sure that all companies within the state have an active workers’ compensation policy. In addition, it helps employers fulfill their legal obligations towards their workers. This rate service organization also has a coverage lookup database that can assist employees who want to access specific insurance information before filing their workers’ compensation claims. Those who have questions can directly make a call at 262-796-4540.                  

Wisconsin Free Legal Answers

Wisconsin Free Legal Answers is a pro bono organization that caters to eligible individuals who need legal advice about work or employment-related issues. Its volunteer attorneys are licensed to provide services throughout the state, enabling workers to get free legal recommendations. Those who have any civil questions can post their concerns online and get answers about their unique situations. The organization also has lawyer referral resources for individuals who have decided they need representation.