If you were injured or became ill because of your job, you may be entitled to workers’ compensation benefits in Wisconsin. These benefits can help cover medical treatment, lost wages, and other expenses related to a work-related injury or illness.
But who qualifies for workers’ compensation in Wisconsin? Does your employer have to carry workers’ compensation insurance? What if you are a part-time employee, work for a small business, or were injured gradually rather than in a single accident?
Understanding the Wisconsin workers compensation requirements can help you understand your rights and the steps you should take after a workplace injury.
Who Is Covered by Workers’ Compensation in Wisconsin?
Wisconsin workers’ compensation laws cover most employees. According to the Wisconsin Department of Workforce Development (DWD), nearly all private and public employees are covered, including part-time employees, seasonal workers, minors, family members in many circumstances, and corporate officers.
Wisconsin DWD reports that more than 98% of Wisconsin workers are covered by workers’ compensation from the time they begin employment.
Coverage generally depends on whether your employer is subject to Wisconsin’s workers’ compensation law. There are some exceptions, including certain domestic workers, some farm employees, volunteers, and workers covered under Wisconsin workers’ compensation laws.
When Is a Wisconsin Employer Required to Have Workers’ Compensation Insurance?
Wisconsin employers generally must carry workers’ compensation insurance when they meet certain requirements.
An employer must generally have workers’ compensation insurance if it:
- Employs three or more full-time or part-time employees
- Employs one or more employees and pays $500 or more in combined gross wages during a calendar quarter for work performed in Wisconsin
- Is a farm that employs six or more workers on the same day for 20 days during a calendar year, subject to certain exceptions
An employer that meets these requirements generally must obtain workers’ compensation coverage even if the employees are part-time.
Wisconsin DWD: Workers’ Compensation Insurance Requirements
What If Your Employer Does Not Have Workers’ Compensation Insurance?
If you believe your employer is required to carry workers’ compensation insurance but does not have coverage, that does not necessarily mean you have no rights.
Wisconsin DWD advises workers who believe their employer should have workers’ compensation coverage to contact the Workers’ Compensation Division.
It can be helpful to document your employment, the injury, when you reported it, and any medical treatment you received.
What Types of Injuries Qualify for Workers’ Compensation?
Workers’ compensation generally applies to injuries and illnesses that are related to your employment.
A qualifying injury does not necessarily have to result from a dramatic workplace accident. Depending on the circumstances, workers’ compensation may apply to:
- Injuries caused by a workplace accident
- Repetitive-use injuries
- Occupational diseases
- Conditions that develop over time because of work
- Injuries that occur while performing job-related duties
For example, an employee could suffer an injury after falling at work, develop a condition from repetitive movements, or become ill because of workplace exposure.
Whether a particular condition qualifies depends on the facts and medical evidence involved. If an insurance company disputes whether your condition is work-related, you may need to provide additional evidence to support your claim.
Do You Have to Be Injured in an Accident to Receive Workers’ Compensation?
No. A single accident is not always necessary.
Wisconsin workers’ compensation can also apply to certain occupational diseases and injuries that develop over time. This can be particularly important for workers whose symptoms gradually become worse rather than appearing immediately after one specific incident.
If you believe your job caused or contributed to an injury or medical condition, it is important to report it and seek medical attention rather than assuming that a gradual-onset condition is not covered.
What Should You Do After a Workplace Injury?
If you are injured at work, taking the right steps early can help protect your claim.
1. Report the injury to your employer
Wisconsin DWD advises employees to report a work-related injury or suspected occupational disease to their supervisor, human resources department, or another designated employer representative as soon as possible.
In most situations, an employee should report the injury within 30 days. However, Wisconsin law contains different deadlines depending on the circumstances, so you should not assume that you have unlimited time to report an injury.
2. Get medical treatment
Seek appropriate medical care as soon as possible after the injury.
Wisconsin DWD states that injured workers have the right to choose their own doctor for work injuries. You should also tell your medical provider that the injury is work-related.
Keep copies of medical records, work restrictions, bills, and other documents related to your treatment.
3. Give your employer your medical restrictions
If your doctor gives you restrictions or takes you off work, provide your employer with a copy of the doctor’s note.
Your medical restrictions can be important when determining whether your employer can accommodate your condition and whether you may qualify for wage-loss benefits.
4. Keep records
Keep documentation related to your injury, including:
- The date and circumstances of the injury
- When you reported the injury
- Names of people you notified
- Medical appointments
- Work restrictions
- Missed work
- Communications with your employer or insurance company
- Workers’ compensation correspondence
- Benefit payments
Having organized records can make it easier to understand what happened and address disagreements about your claim.
How Long Do You Have to Report a Workplace Injury in Wisconsin?
You should report a workplace injury as soon as possible.
Wisconsin DWD says that, in most situations, employees should report an injury within 30 days. DWD also explains that an employee generally must report an injury to the employer within two years to qualify for workers’ compensation, although exceptions can apply.
Certain occupational diseases and traumatic injuries may be subject to different rules.
Because deadlines can affect your rights, it is better to report a suspected work-related injury promptly rather than waiting to see whether your symptoms improve.
What Benefits Can You Receive Through Workers’ Compensation?
If your claim is accepted, Wisconsin workers’ compensation may provide several types of benefits depending on the nature and severity of your injury.
Medical benefits
Workers’ compensation can cover reasonable and necessary medical expenses related to a compensable work injury or illness.
This can include treatment such as doctor visits, diagnostic testing, physical therapy, medication, and other appropriate medical care.
Temporary disability benefits
If your work injury prevents you from working, or limits the work you can perform, you may qualify for temporary disability benefits.
The amount and type of benefits depend on factors such as your medical restrictions, earnings, and ability to work.
Permanent disability benefits
Some workers do not completely recover from a workplace injury.
If an injury results in permanent disability, you may be entitled to permanent partial disability or, in some circumstances, permanent total disability benefits. The amount of permanent disability benefits depends on the nature and extent of the disability.
Vocational rehabilitation
Workers’ compensation may also provide vocational rehabilitation and retraining in qualifying circumstances.
Death benefits
When a worker dies as a result of a compensable work injury, qualifying family members may be entitled to death benefits and burial expenses, subject to Wisconsin law.
Wisconsin DWD: Worker’s Compensation Worker Resources
What If Your Workers’ Compensation Claim Is Denied?
An employer or insurance company may dispute a workers’ compensation claim for a variety of reasons.
For example, there may be a dispute about:
- Whether the injury happened at work
- Whether the condition is related to your job
- Whether you reported the injury on time
- Whether the medical treatment is related to the workplace injury
- Whether you are entitled to wage-loss benefits
- The extent of your permanent disability
A denied or disputed claim does not necessarily mean you are not entitled to benefits.
If your claim has been denied, delayed, or disputed, consider getting legal advice about your options and the applicable deadlines.
What If You Were Partially at Fault for Your Injury?
Workers’ compensation is generally a no-fault system. This means that you generally do not have to prove that your employer was negligent in order to receive workers’ compensation benefits for a compensable work injury.
The circumstances surrounding the injury can still matter, however, particularly when determining whether the injury arose out of and in the course of employment or whether an exception applies.
If you are concerned that your own actions could prevent you from receiving benefits, it is worth discussing the specific circumstances of your injury with an attorney.
What If You Are a Part-Time or Seasonal Employee?
Being a part-time employee does not automatically prevent you from receiving workers’ compensation.
Wisconsin DWD specifically identifies part-time employees among the workers generally covered by the Wisconsin Workers’ Compensation Act.
Seasonal workers may also be covered depending on their employment circumstances.
Wisconsin DWD: Facts for Injured Workers
What If Your Employer Calls You an Independent Contractor?
Your job title does not necessarily determine whether you are an employee or an independent contractor for workers’ compensation purposes.
Wisconsin has specific rules for determining worker classification. If you are classified as an independent contractor but believe you should be treated as an employee, the issue may require closer examination.
Wisconsin DWD: Worker Classification Under Workers’ Compensation Law
What Happens After You Report Your Injury?
After you report a workplace injury, your employer has reporting responsibilities as well.
Insured employers generally must report a compensable injury to their workers’ compensation insurance carrier within seven days when the applicable reporting conditions are met. Insurance carriers and self-insured employers also have reporting obligations to the Wisconsin Workers’ Compensation Division.
The process can involve medical records, wage information, claim forms, and communications between your employer, insurance company, medical providers, and the Wisconsin Workers’ Compensation Division.
Wisconsin DWD: Work Injuries and Illness Timelines
Wisconsin Workers’ Compensation Requirements: A Quick Checklist
If you were injured at work, consider these steps:
- Report the injury to your employer as soon as possible
- Seek medical attention
- Tell your medical provider that the injury is work-related
- Follow your doctor’s treatment recommendations
- Provide work restrictions to your employer
- Keep copies of medical and employment records
- Keep track of missed work and wage-loss information
- Save correspondence from the insurance company
- Pay attention to claim deadlines
- Consider speaking with a workers’ compensation attorney if your claim is denied, delayed, or disputed
Do You Need a Wisconsin Workers’ Compensation Attorney?
Not every workers’ compensation claim requires an attorney. Some straightforward claims are resolved without a legal dispute.
However, getting legal advice may be particularly important if:
- Your workers’ compensation claim has been denied
- Your benefits have been delayed or stopped
- Your employer or insurance company disputes that your injury is work-related
- You have a serious or permanent injury
- You are unable to return to your previous job
- You are concerned about the amount of benefits you are receiving
- You have a dispute regarding your medical treatment
- You are unsure about your rights or applicable deadlines
A Wisconsin workers’ compensation attorney can review the circumstances of your injury, explain your rights, and help you understand your options.
Injured at Work in Wisconsin? Understand Your Rights.
If you were injured or became ill because of your work, you may be entitled to workers’ compensation benefits. Understanding the Wisconsin workers compensation requirements is an important first step, but every claim is different.
If your claim has been denied, delayed, or disputed, or you are unsure whether your injury qualifies for benefits, consider speaking with an experienced Wisconsin workers’ compensation attorney about your situation.
Call us today for a FREE CONSULTATION with our workers’ compensation attorney at 778-798-2901.
