Wisconsin Workers Comp Claims: Eligibility, Filing and Appeals

Within the state of Wisconsin the Workers Compensation Program is administered by the Department of Workforce Development. Throughout the state it is compulsory for employers to belong to the program, which an be insured either through self-insurance or private carriers as there is no state fund and no option for groups of employers to provide insurance. Employers with less than 3 employees are exempt from the program, but farmers are exempt with less than 6 employees or that are providing work for less than 20 days per year.  The state also has an Uninsured Employers Fund which compensates employees should the employer not be insured.

Common Covered Work Related Injuries

In Wisconsin if you are injured on the job or become disabled because of a work related accident or while completing a work related task you can claim on workers compensation. This does not include injuries that develop over time unless they are a condition or disease that is directly linked to the workplace and is within the defined parameters for workers compensation claims.

How to File a Wisconsin Workers Compensation Claim

Filling in the required forms, which are available from your employer or online at the Wisconsin Department of Workforce Development website is the second step after reporting the accident to the employer. All information including the date of the accident, wages, medical records, hospital records or other supporting documentation has to be provide upon request, some which will be required at the initial filing stage.

Workers Compensation Claim Denials

In most cases workers compensation claims that are denied are either filed after the time limitation, submitted with incorrect or missing information or lack the required supporting documents and evidence. Typically these issues can be corrected through a review or an informal process, however sometimes additional action may be required. Variations in doctors reports or testimony can also lead to denial of a claim.

Appealing a Wisconsin Workers Compensation Denial

Denial issues will often be settled through mediation or discussion and providing additional supporting evidence. If it cannot be settled a hearing in front of a Administrative Law Judge is held and a finding determined. Appeals to a Commission Review and the Court are also possible.

Collecting Wisconsin Workers Compensation Benefits

Benefits are based on a percentage of the total wage (2/3 of the average weekly wage) of the employee and the severity of the injury. There are limits based on the amount of time for some injuries and permanent partial injuries are based on a medical evaluation of the condition and the continuing disability. Different injuries, including loss of limbs or fingers will also be paid on a scheduled number of weeks per injury. Often employees will have to provide medical documentation as requested.

Although legal representation is not mandatory when preparing for a hearing or even a denial of claim meeting, having legal representation will ensure you receive the benefits that you are entitled to. Attempting to represent yourself is never recommended as this is a complex and very specific area of the law.

Wisconsin Workers Compensation Office Locations

Main Office, Claim Files
Room C100
201 E. Washington Avenue
P.O. Box 7901
Madison, WI 53707-7901

Milwaukee Office
State Office Building
819 N. Sixth St, Room 330
Milwaukee, WI 53203

Appleton Office
Associated Bank Building
1500 N. Casaloma Drive, Suite 310
Appleton, WI 54913-8220