In Wisconsin, most employers must have workers’ compensation coverage. Employers either purchase a workers’ comp policy from a private insurance company or receive certification from the state to self-insure. Self-insured employers pay their own claims. (For this reason, the state typically only grants approval to large companies with enough money to pay out claims.)
Unlike other personal injury claims, workers’ compensation is a no-fault system. This means you can usually get benefits even if your actions contributed to the accident or injury. Likewise, you can collect benefits even if your employer did nothing wrong. As long as your injury happened on the job or was caused by your work activities, you will typically be eligible for benefits.
However, in exchange for this no-fault system, workers are only entitled to specific benefits. Most notably, you cannot receive compensation for your pain and suffering in a workers’ compensation claim. However, eligible workers may receive:
Workers’ comp is also your exclusive remedy against your employer—meaning that you cannot file a civil lawsuit demanding it pay additional damages or compensation.
Every workers’ compensation claim is different. Your eligibility for benefits will vary, depending on the facts of your claim and the severity of your injuries. If you need help calculating your benefits or understanding your rights, contact a workers’ comp lawyer. Or, to learn more, see our article on the different types of workers' comp benefits.
A Wisconsin workers’ compensation claim begins when you notify your employer of an injury or occupational illness. You should notify your employer of a work-related injury within 30 days. If you do not notify your employer of the injury within two years, you will lose your right to collect benefits. Your notice may be either written or oral.
When you notify your employer, you should include the following information:
Your employer may also ask you to fill out a written accident report. When completing the report, be as accurate as possible. Accident reports are frequently used as evidence in disputed claims, and any inconsistencies may be used against you.
Once you report an injury, your employer should let you seek medical treatment. Wisconsin workers typically can choose their own treating doctors. At your doctors' appointments, you should always provide accurate information about how you hurt yourself and the severity of your symptoms. Insurance companies rely heavily on initial medical records when they evaluate claims. Either downplaying or exaggerating your symptoms may result in a denial of benefits.
In Wisconsin, your workers' compensation claim begins once you give your employer notice. You do not need to file any additional paperwork with the Workers’ Compensation Division or your employer. It is your employer's responsibility to file a claim with its insurance company on your behalf.
The Wisconsin Workers’ Compensation Division oversees all workers’ comp claims in the state. However, the Division does not determine your initial eligibility for benefits. Instead, the insurance company or claims administrator will investigate your claim and either approve or deny benefits. This may involve:
Under Wisconsin law, the insurance company must either approve or deny your workers’ compensation benefits within 30 days of receiving your claim. However, it will generally begin benefit payments within 14 days of the last day you worked. Unfortunately, the insurance company may also decide to deny your workers' comp claim. (For common grounds for a denial, see Denied Workers’ Compensation Claims.)
If your claim is denied, you have the right to appeal. To begin an appeal, you must file an Application for Hearing with the Division. Unless your claim is very simple, you should consider hiring a workers’ compensation lawyer. A lawyer can help you negotiate with the insurance company, and if necessary, ensure that your case is properly presented to the workers' comp judge. To learn more, see Should I Hire a Workers' Comp Attorney or Can I Handle My Own Case?