Important: We updated this article in August 2024 after reviewing Wisconsin worker’s compensation laws and state policy. Unless you’re a federal employee, state law outlines who gets Wisconsin workers’ compensation benefits and how the process works. If you get injured or sick at work in the Badger State, you may be eligible for benefits from your employer’s insurer. Learn the steps to file your claim, how much to expect in wage loss payments, and which doctor to see below.
Confirming Your Employer has Coverage with the Wisconsin Department of Workforce Development
According to the Wisconsin Worker’s Compensation Act, all businesses with at least 3 employees must provide insurance coverage. This means most eligible injured full and part-time employees can receive worker’s compensation benefits. However, there are some exceptions to this workers’ compensation insurance requirement for certain employees, such as:
- Certain farm employees
- Domestic workers employed in private homes
- Federal workers (such as postal delivery carriers and VA employees), who have separate coverage under the Federal Employers Liability Act
- Independent contractors
- Religious sect members who choose to waive their right to Wisconsin workers’ compensation insurance coverage
- Sole proprietors, LLC members, and company officers
- Some real estate workers
- Volunteers
Pro Tip: Not sure if your employer has worker’s compensation insurance? Use this online application from the Wisconsin Compensation Rating Bureau (WRCB) to search for your company by name.
How to File Your Wisconsin Workers’ Compensation Claim
According to the Wisconsin Department of Workforce Development, here are the steps to file your Wisconsin worker’s compensation claim. However, every claim is unique, so your own experience may vary.
1. Seek treatment immediately at the nearest facility, clinic, or ER if you require emergency or urgent medical care.
Tell the doctor your injury or illness is work-related and keep copies of every bill and receipt for your records. Workers’ comp insurance in Wisconsin allows you to choose any doctor to treat you after your accident. However, your employer also has the right to request an independent medical exam for ongoing treatment, if needed.
Important: You cannot receive any benefits for work-related injuries unless a doctor first provides you with medical attention.
2. Be sure to report your work-related injury or illness to your supervisor within 30 days.
Failing to report work-related injuries and illnesses in a timely manner puts your worker’s compensation case at risk. In other words, miss this deadline and your employer’s insurance provider can legally deny your workers’ comp claim.
For repetitive motion injuries that happen gradually, like tendonitis, state law says you must file your claim within two years.
3. Your employer must then report your job injury to their insurance carrier within 7 days.
That insurer must then notify the Wisconsin Workers’ Compensation Division of their decision within 14 days. Once they decide to approve or deny your claim, you should receive a letter in the mail explaining why.
4. If approved, you also become eligible for wage replacement benefits once the required 3-day waiting period ends. Expect your first check within 14 days after the date you notify to your supervisor.
Wisconsin state law says that your first 3 days off due to work-related injury or illness are always unpaid. Once a doctor says you cannot work for at least a week after your accident, insurance should cover those first 3 days off.
Don’t need more than 3 days off to recover after your incident? Then you’ll only qualify for Wisconsin worker’s compensation medical benefits. That means insurance pays your medical bills, but you aren’t eligible for any paid time off work.
Wisconsin workers’ compensation insurance will pay up to 66 2/3% of your average weekly wage to help cover some lost wages.
You can receive these payments either until you return to work again or reach maximum medical improvement.
5. Denied benefits? The Division will automatically refer your case to the their Alternative Dispute Resolution (ADR) for review unless you have an attorney.
You should receive a letter in the mail stating the reason why they denied your claim and how to dispute their decision. Denied claims with attorney representation can also request an appeals hearing before an administrative law judge (ALJ).
Important: Consult an experienced workers’ comp attorney for free, private claim assistance, especially if you’re denied benefits.
Recent Wisconsin Workers’ Compensation Statistics
Total claims in America’s Dairyland dropped 18% from 2018 to 2022, mostly thanks to Covid-19 closings and reduced employment. Days away from work shrank 12% during this time period, while claims from service industry workers dropped 19%. In most years, Wisconsin employees working in service jobs file anywhere from 50%-55% of worker’s comp cases.
Learn more about workers’ compensation benefits in general, including what it covers and the usual filing process.
Get Professional Help Securing Worker’s Compensation Benefits in Wisconsin
When dealing with a work-related illness or injury, trying to learn the Wisconsin workers’ compensation system can make things harder. Experienced workers’ comp attorneys always work on a contingency basis. That means means you don’t pay anything unless you win benefits. And if you’re successful, then you only owe one reasonable fee afterwards.
How do you know if you really need an attorney or not? According to the state’s own data, insurance companies denied about 16% of worker’s compensation claims in 2022. That’s a little over 1 in 6 injured workers! If your claim is denied, talk to an attorney for free to learn whether your employer owes you any money.
Want to speak with someone who understands Wisconsin worker’s compensation law well and how it applies to your case? Click the button below to start your free online benefits quiz now and see if you may qualify:
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Lori Polemenakos is Director of Consumer Content and SEO strategist for LeadingResponse, a legal marketing company. An award-winning journalist, writer and editor based in Dallas, Texas, she's produced articles for major brands such as Match.com, Yahoo!, MSN, AOL, Xfinity, Mail.com, and edited several published books. Since 2016, she's published hundreds of articles about Social Security disability, workers' compensation, veterans' benefits, personal injury, mass tort, auto accident claims, bankruptcy, employment law and other related legal issues.
