Frequently Asked Questions

You should report your accident to your employer right away. This should be the person involved with human resources. They will then file a report with your workers’ compensation insurance company.

Additionally, your health is the most important thing. You should get the medical treatment that you need. Under the Wisconsin Workers’ Compensation Law, you have your choice of two medical providers. You do not have to go to the doctor that your employer tells you to go to. You need to make sure that your health is taken care of. If you need to see more than two medical providers, you should get a referral from one of your medical providers to the third provider so that your bills would be paid.

Many times there is no single event that causes an injury. Some injuries simply happen over time as a result of repetitive work performed by the employee. These injuries are still compensable under the Workers’ Compensation Law. Your date of injury becomes the first time that you lose wages as a result of the repetitive work.

You should cooperate with the insurance adjuster. He or she will need to know what happened, where you work, and where you went for medical treatment. He or she may ask you to give a recorded statement. You do not have to have your statement recorded, however, you should give them all of the information that they need. They will also need written authorizations so they can get your medical records and medical bills. Sign the authorizations that they need. The adjuster will then use this information to verify your injury and to get your records so that benefits can be paid.

There are several types of benefits that you may be eligible for. These include:

• Payment of your medical bills, prescription medications, any medical equipment that you may need, and mileage to and from your doctor.

• Payment of wage loss benefits, while your doctor has you off work. Wage loss benefits should be paid at two thirds of what you usually make. However, these payments are not taxable so your net income should be about the same. Make sure you have a note from your doctor to take time off. If you take time off without a doctor’s permission, the insurance company does not have to pay you.

• If you go back to work part-time you may be eligible for a partial disability check. For example, if you go back to work and make 40% of your usual wages, you would be eligible for 60% of your disability check until your doctor determines that you can return to work full time. 

• If you reach the point where your doctor says there is nothing more, they can do for you, you may be eligible for permanent partial disability for loss of function of your body.  Permanent partial disability is paid differently depending on what part of your body was injured. This determination will be made by your doctor.

• Many people ask about a pain and suffering award. Under the Wisconsin Workers’ Compensation Law, there is no payment for pain and suffering. This statutory provision is part of a trade-off to make sure injured workers have their medical bills and other benefits paid. Even if the accident or injury was caused by their mistake.

The insurance company has the right to have you seen by its own doctor. If the insurance company asks you to attend an independent medical evaluation you have to go. If you do not attend the independent medical evaluation, they do not have to pay you any additional workers’ compensation benefits. However, you may want to call an attorney before you attend the independent medical evaluation so you know what to expect.

If your claim is denied you have the right to appeal that decision to the Wisconsin Workers’ Compensation Division. This appeal involves filing your medical records and medical bills with the Workers’ Compensation Division. They will then set up a hearing in front of the Workers’ Compensation judge when you can present your claim.

You have the right to contact an attorney at any time. If the insurance company is making all appropriate benefit payments, then you really don’t need an attorney. However, if the insurance company asks you to attend an independent medical evaluation, you should contact an attorney at that time. If your claim is denied, you will want to hire an attorney to help with the appeals process. You can file an appeal on your own; however, the insurance company will hire an attorney who knows the intricate details of the Workers’ Compensation Law. You will need a strong advocate who also knows those details in your corner.

Attorney’s fees for attorneys who do Workers’ Compensation are regulated by statute. An attorney is paid on a contingency fee basis. By statue an attorney’s fees are 20% of any disability benefits you receive as a result of the attorney’s work. Additionally, the attorney’s office will have additional costs that also may need to be reimbursed. These costs are for items such as obtaining copies of your medical records, medical bills, and reports from the doctors. Importantly, if nothing is recovered, nothing is owed to your attorney. This means that you will never be put in a situation where you will end up owing your attorney money.

If you are left with permanent disability that prevents you from returning to a job at your regular rate of pay, there may be additional benefits available to you. In some cases you may want to return to school to learn a new occupation so that you can make the same kind of money that you are making before your injury. In those cases the Workers’ Compensation insurance company may have to pay for you to return to school. This would include payment of wage benefits. While you are in class, tuition, books, fees, mileage to classes, meals on campus, or if necessary housing, while you are in school.

Depending on the nature of your injuries you may also be eligible for loss of earning capacity benefits to help offset any future wage loss that you may have after you have recovered. You will want to discuss these types of benefits with your attorney.

You have a right to continued Workers’ Compensation benefits for 6 years beyond the date that the last disability benefits were paid. If you need continued medical treatment, you should get it. It should be paid by the Workers’ Compensation insurance company. The Workers’ Compensation insurance company may tell you your case has been closed. However, it can be reopened.

Your Workers’ Compensation claim should not be settled until you have reached the point where your doctor says you are at maximum medical improvement. A “settlement” is only possible if the Workers’ Compensation carrier has denied a portion of your claim. If the Workers’ Compensation carrier is conceding all benefits, then there is nothing to settle. If there is a dispute on what should be paid to you, your case can be settled at any time after you reach the point of maximum medical improvement. However, it may take several months before a final agreement can be reached with the insurance company.

If your case does not settle, you can continue through the appeals process and have a formal hearing in front of the Workers’ Compensation judge. Your attorney will help you with this process and prepare all the documents necessary for your hearing. Your attorney will also prepare you for your hearing beforehand so you know what to expect. Once an application for hearing is filed with the Workers’ Compensation division, you should get a date for a hearing within 4 months.