What Types of Accidents Does Workers’ Compensation Cover in Wisconsin?

by Mays Law Office | Jun 20, 2022 | Workers Compensation

We recently published an article discussing the types of injuries that qualify for workers’ compensation coverage in Wisconsin. In that article, we emphasized the fact that eligibility for workers’ compensation benefits is primarily based on your employment status and the cause of your injury—rather than the nature of your injury itself. To follow up on that discussion, this article focuses on the types of accidents that workers’ compensation covers under Wisconsin law.

Workers’ Compensation Covers On-the-Job Accidents

While some states allow eligible employees to collect workers’ compensation benefits for injuries they suffer on personal time, workers’ compensation only covers on-the-job accidents in Wisconsin. If you got injured on personal time you are not eligible to file for workers’ comp—even if your injury prevents you from working (you may, however, qualify for Social Security disability (SSD) or other benefits).

To qualify as an “on-the-job” accident, an accident does not have to involve your specific job duties. As long as you were on the clock and acting within the scope of your employment, most types of accidents will qualify. This means, generally speaking, eligible employees in Wisconsin can seek workers’ compensation benefits for accidents ranging from industrial equipment and power tool accidents to slip-and-fall accidents on the way to the bathroom.

When isn’t an accident covered under workers’ compensation in Wisconsin? Aside from being ineligible for benefits (i.e., if you are an independent contractor instead of an employee), your accident might not be covered if:

You were injured while commuting. As the Wisconsin Department of Workforce Development (DWD) explains, “Usually, the only time an employee can be compensated for an injury which happens on the way to or from work is if it occurs on company-owned property, or under conditions cited in the law.”
You were injured off-premises during a break. “Generally, an employee who is injured at work while attending to personal needs, such as smoking, eating, getting refreshments or going to the lavatory, is paid worker’s compensation. Injuries off the employer’s premises during a break or lunch hour are usually not covered.”
You were running a personal errand. “[A]n employee who while driving on the job runs a private errand and deviates from the ordinary driving route would not be compensated.”
You initiated horseplay. “The circumstances surrounding horseplay or fighting determine[] if an injured worker should be compensated. If the injured employee started the horseplay or was the aggressor in the fight, it is unlikely that the employee will be paid compensation.”
You intentionally injured yourself. “The law provides that if an injury is intentionally self-inflicted, it is not compensable.”

Otherwise, most types of job-related accidents can qualify for workers’ compensation benefits in Wisconsin. This includes accidents both on and off company property.

Common On-the-Job Accidents Covered Under Workers’ Comp

Now that we’ve covered the types of accidents that aren’t eligible for workers compensation, when can you file a claim for benefits? Some of the most common types of on-the-job accidents covered under workers’ comp in Wisconsin include:

Slips and Falls

Slips and falls are among the leading causes of job-related injuries across all occupations. If you slipped and fell at work, this type of accident generally qualifies for workers’ compensation benefits. Again, this is true whether you were performing your job duties or you were walking to your office, to the cafeteria, or to the bathroom.

Hand Tool and Power Tool Accidents

Hand tool and power tool accidents also generally qualify for workers’ compensation benefits. Another important point to clarify is that workers’ compensation provides coverage regardless of the cause of an accident (with some exceptions, such as horseplay, as discussed above). So, even if you accidentally injured yourself with a hand tool or power tool, you can still file a claim for benefits.

Industrial Equipment and Machinery Accidents

Accidents involving forklifts, presses, assembly lines, and other types of industrial equipment and machinery are covered under Wisconsin’s workers’ compensation law. As long as you are a covered employee (which most industrial workers are), your accident should be covered unless a specific exception applies.

Lifting, Bending, and Twisting Accidents

You don’t have to be injured in a major accident to qualify for workers’ compensation benefits. Lifting, bending, twisting, and other similar types of accidents resulting in soft tissue damage or lower back pain also generally qualify for coverage.

Vehicle Collisions

As we mentioned above, you don’t have to be at the office or on the jobsite to qualify for workers’ compensation benefits. If you were injured in a vehicle collision within the scope of your employment, you can file for workers’ compensation based on the injuries you sustained in the collision.

Electrocutions

Electrocutions are also common jobsite injuries. While these accidents often result from coworkers’ or subcontractors’ negligence, you don’t need to be able to prove negligence to file a successful claim for workers’ compensation benefits.

Exposure to Harmful Fumes, Substances, or Fire

Exposure incidents involving hazardous materials, dangerous particulates, harmful fumes, and fire all fall under workers’ compensation in Wisconsin. If you were injured in any of these types of incidents while working—whether on your employer’s premises, at a customer’s property, or on the road—you may have a claim for workers’ comp benefits.

These are just examples. If you were injured in any type of job-related accident, you should speak with a lawyer about your legal rights. You should also talk to a lawyer if you think you might not qualify for workers’ comp. Even if you don’t have a claim for workers’ compensation benefits, you may still have other options for recovering your medical bills, lost earnings, and other accident-related losses.

Schedule a Free Consultation with Madison Workers’ Compensation Lawyer Stephen E. Mays

Do you have questions about filing for workers’ comp benefits in Wisconsin? If so, we encourage you to contact us for more information. To schedule a free, no-obligation consultation with Madison workers’ compensation lawyer Stephen E. Mays, please call 608-257-0440 or tell us how we can reach you online today.

What Does a Workers Compensation Lawyer do in Wisconsin?

by Mays Law Office | Jun 13, 2022 | Workers Compensation

A Wisconsin workers compensation lawyer practices a very specialized area of personal injury. It involves an injury that occurs to the body occurring in the workplace. In Wisconsin, the body of law governing this type of injury can be found in the Workers Compensation Act under Chapter 102 of the statutes. If you are employed, meaning you receive a paycheck and have taxes withheld, then an employer-employee relationship exists. If during such employment you are hurt in the course and scope of this employment then your injury will be covered under an insurance policy purchased by your employer, known as workers compensation insurance. Injuries occurring in the course and scope of your employment need to be timely reported and medical treatment sought. The benefits available to an injured worker are (1) lost time (termed TTD or TPD) if you miss work due to the injury either because you are totally unable to work, or you have physical restrictions from doing your full work and the employer does not offer you accommodating work. Also, all your (2) medical treatment and (3) medical mileage required to attend medical appointments should be paid/reimbursed to you in the amount of .51 cents a mile. Another benefit paid to an injured worker is (4) disability for permanent, long-lasting injuries (termed PPD) that affect you physically and/or mentally. Lastly, (5) claims can be made for losses in future earnings, or vocational claims for future retraining if unable to return after an injury to comparable paying work.

What is the benefit of hiring a workers compensation lawyer?

The Wisconsin Workers Compensation Act is about 250 pages long and very technical; it takes years for an attorney to confidently practice this area of the law. Hiring a workers compensation lawyer ensures that you are getting every benefit you are entitled to under this law. A Wisconsin lawyer who dedicates their practice to representing injured workers knows the intricacies necessary to develop the claim from building evidence, to meeting deadlines, completing and filing appropriate documentation, undertaking the necessary communication and appearances with the workers compensation insurance carrier and Wisconsin Department of Workforce Development in presenting/arguing the work injury claim at a hearing, or negotiating the claim for settlement with the insurance carrier. The process can be intimidating and stressful. The injured worker is better served concentrating their time, attention, and energies in healing than trying to act as their own attorney.

How much does it cost to hire a workers compensation lawyer and who pays the attorney fee?

In Wisconsin, hiring a workers compensation lawyer is done on a contingency fee basis. This means that the attorney is paid contingent upon the injured worker getting paid. According to the Wisconsin Workers Compensation Act, an attorney can take no more than 20% of the amount recovered for the injured worker, but it cannot include amounts for the recovery of the medical expenses.

It is wrong to think that hiring an attorney on a contingency fee basis is “free” because ultimately at the end of the case, the monies come out of the proceeds recovered for the injured worker. But, keep in mind, if the injured worker’s claim has been denied then no money is being received by the injured worker. So, hiring a workers compensation attorney is a very good investment where the injured worker invests/pay nothing at the beginning of their case and the attorney only gets paid if/when the client gets paid. The injured worker gets a check directly from the insurance carrier and their attorney gets a check at an 80/20% split.

What is the difference between going to a Hearing versus a Settlement in workers compensation?

A Hearing involves a presentation of the facts, medical evidence, and testimony to a Wisconsin Department of Workforce Development Administrative Law Judge who will make a legal determination as to the work-relatedness of a work injury and award past and future workers compensation benefits. Such a determination can be appealed by either side to the Wisconsin Labor & Industry Review Commission. The Hearing generally lasts no more than one day and involves direct cross-examination of the injured worker and other relevant witnesses. Exhibits are entered into the record as evidence, such as medical records and reports from supporting and opposing doctors. Ultimately, it is the injured workers opportunity to formally present their work injury claim to an adjudicator who will make a legal determination either awarding or denying benefits, in whole or in part.

A Settlement involves an offer of money from the workers compensation insurance carrier to the Wisconsin injured worker to settle their workers compensation injury claim short of going to a formal hearing. It involves a reduced or discounted amount of money compared to what the injured worker could potentially get awarded at the hearing, if victorious in everything pled and argued. The majority of Wisconsin workers compensation injury claims settle because a good outcome at the hearing is never guaranteed for either side. Even good outcomes at the hearing can and likely will be appealed by the losing party, thereby delaying any monetary recovery and costing money due to prolonged litigation.

How long does it take to get the money after a workers compensation settlement?

If a settlement between a Wisconsin injured worker and workers compensation insurance company is achieved, then paperwork in the form of an Agreement will be created describing the terms as either a Full and Final Compromise Agreement or a Limited Compromise Agreement. Such an agreement is signed by all the parties, and their attorneys, and then presented to the Wisconsin Department of Workforce Development for approval from an administrative law judge. The Administrative Law Judge (a/k/a ALJ) reviews the Agreement ensuring that it meets certain perimeters and requirements dictated by the Wisconsin Workers Compensation Act and Department policies. If approved, the Agreement is then turned into a written Order which is dated and signed by an ALJ. The insurance company then has twenty-one (21) days from the date of the Order to get the settlement monies in the mail or electronically transferred to the injured worker.

What to Expect When Meeting With a Wisconsin Workers Compensation Attorney

by Mays Law Office | Jun 1, 2022 | Workers Compensation

You’ve been hurt at work, and you have questions for a Wisconsin attorney who practices workers compensation. At Mays Law Office, we offer free consultations to answer all your questions. If your worker’s compensation claim has been denied, then it is time to hire an attorney. Make sure that you hire an attorney who concentrates their law practice representing injured Wisconsin workers. In preparing to meet with such an attorney, it will be helpful to know what to expect at your first meeting.

Let’s Meet!

At Mays Law Office, you will meet with our attorney, Lisa Pierobon Mays, who concentrates her practice advocating for injured workers. Be prepared for the meeting to last 1.5 to 2 hours long as generally there is much to discuss to learn about you and your work injury. For instance, at the start of the meeting, basic information will be gathered, such as your contact information – address, cell/text number and E-Mail address. Also identifying information, such as your date of birth and social security will be requested.

Tell us about you

Quickly, Attorney Pierobon Mays will get to the heart of the matter and ask about your employer, their address, dates of employment, your job title and duties, hours worked, and wage/earnings history. Work attendance, pre-existing physical and health issues, quality of life/hobbies information will be important for Lisa to know to get a picture of what your life was like prior to suffering the work injury.

How were you hurt?

The meeting will then center around the details of your actual work injury – date, time, location, and a detailed description explaining how the injury occurred and what part(s) of your body were affected and hurt. A vivid memory of the events leading up to and actual moment of your injury will be very important to describe to Attorney Pierobon Mays. Environmental details will be important too, such as the weather, lighting, condition of the floor, surroundings, and witnesses who saw your injury or came to your aid at the time of the injury.

How has the injury affected you?

The discussion will then move to questions as to the pain and symptoms that you felt and suffered after the injury occurred. Did bleeding, bruising, swelling, broken bones, loss of consciousness occur? What was your response to such pain? Did you cry, scream, sit in stillness, lay down, seek help? Also, what was the response of those around you and your employer, meaning were you moved to a safe place, given ice or pain medication, was an ambulance called, and was an incident report timely completed by your supervisor/employer?

Your behavior and condition after the injury is very important for Attorney Pierobon Mays to understand because too often claims are denied by the workers compensation insurance company because the injured worker failed to timely inform their employer of the injury, or made light of it to other co-workers or supervisor. In doing so, it may be presumed that the injury was not significant which can undermine an injured workers credibility. Understanding what was your response/behavior after the injury is crucial, such as did you continue working your usual job and finish your shift, or did you immediately seek medical treatment?

Having you review your cell phone and retrieving text messages and E-Mails pertaining to the injury will be considered at this meeting. Also, looking for pictures of the injury scene and your injuries will be helpful to your case.

Who has medically treated you?

Your post-injury medical treatment will be an important discussion. Bring all personal notes, calendars & journals, medical receipts, and medical records to our meeting so that we can recreate your medical timeline. Documenting where and when you treated medically is important because medical records and billing itemizations will have to be retrieved as part of the litigation of your claim. Names of providers, dates, medical procedures and surgeries, prescriptions, physical restrictions, ongoing symptoms and complications along with improvements will all be well documented in your medical records. These medical records will tell the story of your injury and how it progressed.

How are you feeling now?

How you are doing in the present will also be discussed. Are you still seeking medical treatment? Has your specialist released you from treatment, and if so what is your long-term prognosis? Do you have permanent physical restrictions preventing you from returning to work or finding new employment? If so, an understanding of your educational and employment history will be something to discuss to determine what claims to pursue. It is at this point in the meeting that a strategy will be determined in terms of timing and benefits to pursue on your behalf.

How has the workers compensation carrier treated you?

Questions regarding your communications with the workers compensation insurance carrier will also be reviewed. Bring all correspondence received from the carrier as it will have the name and contact information of the Adjuster handling your file. If you gave the insurance carrier a verbal statement about the details of your injury, then Attorney Pierobon Mays will want to request a written transcript of it. Attorney Pierobon Mays will also want to know what position the insurance company is taking regarding your claim. Are they accepting, denying, or investigating it in whole or in part, and what is the basis for their position? Is it supported by a report of an IME? If so, make sure to bring this correspondence and report to our meeting. Also, bring check stubs for benefits paid to you for lost time or disability (a/k/a TTD, TPD, PPD), medical treatment bills, and medical mileage reimbursement.

Have you received financial help from others?

Attorney Pierobon Mays will also need to know if you received any supplemental income or benefits from third parties, such as private short-term disability, private medical insurance (like an HMO), Wisconsin Unemployment Compensation, SSDI, Medicare, or State Medicaid. Careful attention to any potential liens will have to be considered to protect you from future claims requesting reimbursement back.

Let’s get moving?

At the end of your meeting with Attorney Lisa Pierobon Mays, she will present you with a packet of forms that will need to be completed to hire her as your attorney. She will go over each of the forms with you and help you complete them at her office. Any and all questions will be answered, and concerns addressed. The timeline and strategy of your claim will be finalized and reviewed for your understanding and approval. Lastly, your claim will not be transferred to another attorney or a paralegal. Attorney Pierobon Mays will handle every aspect of your file from the beginning of this first meeting through the end of litigation.

So, it is good to have an understanding of what to expect when meeting with a Wisconsin workers compensation attorney because it will make the meeting so much more productive and effective for everyone. Knowing what is expected of you will give you confidence and lessen your anxiety.