In Wisconsin, employees who are eligible to receive workers’ compensation benefits typically receive these benefits on a weekly basis. But, what if this doesn’t work for you? What if you need money up front to pay bills you couldn’t pay while you were waiting for your benefits to come through? What if you don’t want to worry about your employer (or its insurance company) terminating your benefits prematurely?

In these scenarios, it might make sense to try to negotiate a workers’ compensation settlement.

What is a Workers’ Compensation Settlement?

A workers’ compensation settlement is an agreement to resolve your claim for a specific amount—typically in one lump-sum payment. If you and your employer (or your employer’s insurance company) can agree on the amount you are rightfully owed, then you can enter into a settlement agreement that results in payment and termination of your claim.

While this might sound better—and can be better—than receiving weekly benefit checks, there is one critical factor to keep in mind: Once you accept a workers’ compensation settlement, you can’t go back and ask for more. Even if you discover later that your injury is worse than you thought, you will still have to live with the amount you accepted in your settlement.

Can You Get a Workers’ Compensation Settlement in Wisconsin?

Settling is an option in Wisconsin. If you have a workers’ compensation claim and it is in your best interests to settle, then you can attempt to negotiate a settlement with your employer (or its insurance company).

Note that we said you can “attempt” to negotiate a settlement. Even if you are clearly entitled to benefits, your employer (or its insurance company) is not obligated to enter into settlement negotiations. You can try to convince your employer (or its insurance company) that settling is best for everyone, but you shouldn’t expect it to listen—or make a reasonable settlement offer—unless you have an attorney on your side.

When Should You Consider a Workers’ Compensation Settlement?

So, should you consider a workers’ compensation settlement? As we recently discussed, settling too early can be disastrous, as it can leave you without the money you need to cover your medical bills, rent, utilities, and other expenses. Generally speaking, you should not consider accepting a workers’ compensation settlement if:

• You are still receiving treatment and do not yet have a clear understanding of your full medical needs;
• You have not determined your weekly disability benefit rate (rather than relying on your employer (or its insurance company) to calculate your benefits for you); and/or,
• You have not consulted with an attorney to make sure it is in your best interests to accept a workers’ compensation settlement.

On the other hand, if you have recovered as much as you are going to recover (or if you have a clear understanding of your path to recovery), and if you have consulted with an attorney to make sure you know how much you are entitled to receive in disability, then it might make sense to ask your attorney to enter into negotiations on your behalf. But, even then, you will need to consider the potential tax implications, your eligibility for Social Security disability (SSD) and other benefits, and various other factors before deciding whether to accept a settlement.

How Do You Negotiate a Fair Workers’ Compensation Settlement?

Let’s say it is in your best interests to settle your workers’ compensation claim. How do you negotiate?

Theoretically, workers’ compensation settlement negotiations should be fairly straightforward. If you know how much you are entitled to receive and for how long, then determining the value of your claim involves a simple math calculation.

Unfortunately, this isn’t how it works in real life. If you enter into settlement negotiations, your employer (or its insurance company) will take advantage and try to pay you as little as possible. Rather than simply paying what they owe, they will offer less (perhaps much less) hoping to entice you into a quick—but unfair—settlement.

With this in mind, negotiating effectively requires clear proof of the value of your claim. It also requires the ability to withstand and overcome these companies’ aggressive negotiation tactics. You need to know what your claim is worth, and you need to be prepared to say, “No,” even if there is money on the table.

As a practical matter, negotiating a fair workers’ compensation settlement requires legal representation. Many companies won’t even take your negotiation efforts seriously if you don’t have an attorney. On the other hand, hiring an attorney shows that you are serious, and hiring an experienced attorney is one of the best things you can do to improve your chances of obtaining a fair settlement.

Should You Wait to Seek a Workers’ Compensation Settlement?

Given everything we’ve discussed, you might be wondering if you should wait to seek a workers’ compensation settlement. Simply put, the answer could be, “Yes.” In many cases, it will make sense to delay settlement negotiations until you have had the opportunity to learn more about your situation.

With that said, you should not delay your workers’ compensation claim. While you technically have up to two years to file a claim in Wisconsin, the Department of Workforce Development (DWD) recommends filing your claim within 30 days, and it is in your best interests to file your claim as soon as possible. Not only does filing a claim start the process in motion, but it also helps avoid many of the issues that can lead to workers’ compensation denials.

Discuss Your Claim with a Madison Workers’ Compensation Lawyer for Free

Were you injured on the job? Do you have questions about seeking a workers’ compensation settlement in Wisconsin? If so, we encourage you to contact us for more information. To discuss your claim with an experienced Madison workers’ compensation lawyer at Mays Law Office in confidence, call us at 608-305-4518 or request a free consultation online today.

In Wisconsin, physical and mental injures due to accidents or occupational exposure on the job/worksite are deemed workers compensation injuries entitled to benefits for lost time, payment of medical treatment, reimbursement for mileage, and potentially retraining or loss of earning capacity, with certain injuries, if the injury is so serious that it affects your ability to earn the same amount of wages.

Location of Work Injury

If the injury occurs at the workplace, even if the workplace is your house, will be considered a “work injury.”  If your job requires you to travel, and an injury occurs while travelling then that is also considered a “work injury,” unless you deviated from your work duties for a personal reason, such as stopping to get your haircut or shopping for your personal needs.  Work injuries that occur, even at you own fault, are generally also conserved a “work injury.”

Timing of Workers Compensation Benefits

If the workers compensation insurance company does not make payment of your benefit within 14 days of receiving notice of the injury, then they must notify you that they are still in the process of investigating your claim.  If the insurance company denies your claim, then they must inform you within 7 days of its decision.

Choice of Medical Treatment

The injured Wisconsin worker has the sole right to choose their own doctor.  If you want a second opinion, you must notify the workers compensation carrier of such.   In an emergency, the employer may arrange for your treatment until you are able to choose for yourself.  The insurance company does have the right to have you examined by a doctor of their choice which they will call an “Independent Medical Examiner.” however be forewarned these doctors are far from “independent” in their review of you.  These doctors are not hired or intended to provide you with any medical treatment.  They are hired by the insurance carrier with an eye toward denying your workers compensation injury claim.  Call Mays Law Office, Attorney Lisa Pierobon Mays immediately if you are asked to see the insurance companies “independent medical examiner.”  She will prepare you for this meeting and give you suggestions on what to say/not say, how to present yourself, and how to document your visit with this doctor who is paid by the insurance company to see you.

When it comes to medical treatment, the injured worker has the right to every type of treatment which is reasonable and necessary to sure you.  Or prescribed by your doctor.  This includes clinic visits, tests & imaging, therapy, hospitalizations, and prescriptions.  Reimbursement for your travel/mileage to receive such treatment is also paid to you.  Keep receipts and provide such to the insurance adjuster assigned to your claim.

Lost Time Benefit Check (a/k/a TTD)

While you are in a healing phase, you will get a lost time check for 2/3 of you average weekly wage up to a determined maximum rate for the year of injury.  Its 2/3 because its tax free.  Payment is based on a 6-day work week, regardless of the number of days per week that you actually worked.   So, your daily payment is 1/6 of your weekly payment.  The Wisconsin Department of Workforce Development can determine, if in doubt, that your benefit payment is accurate. Your first lost time disability (referred to as “TTD”) check should be paid to you within 14 days of your last worked due to the injury.    You can cash your check without any concern of waiving your legal rights.

Permanent Disability Check (a/k/a PPD)

Once you are healed, or deemed at a healing plateau by your doctor, permanent disability will be considered.  If your injury has resulted in a permanent disability, then you will receive a monthly check, often described as PPD.  This is not paid in a lump sum but over a period of weeks/months, depending on the location of your injury.  Each part of the body has a different number of weeks assigned.  For instance, if you doctor assesses 10% permanent disability to your shoulder, this is equal to 10% of 500 weeks or 50 weeks.  Very serious injuries like those injuries to the back or head are compensated differently if it involves future wage loss.  These types of complex injuries should always involve an attorney representing the injured worker.  Attorney Lisa Pierobon Mays at Mays Law Office has handled many of these types of complex injury claims.

What To Do If Your Injury Claim Is Denied

If your claim is denied by the workers compensation carrier/handler then you can request a formal hearing with an administrative law judge at the Wisconsin Department of Workforce Development.  An application for hearing must be completed in order to get this process started.  Also necessary is medical proof in the form of a document called “Practitioner Report of Injury in Lieu of Testimony” should be completed properly by your treating physician, specialist or surgeon.  In this form, your medical provider will describe your diagnosis and prognosis and give an opinion as to whether he/she agrees that such injury is work-related.  These forms can be obtained on the State website at dwd.wisconsin.gov/wc.  You can represent yourself at a hearing however you choose to hire an attorney as often the paperwork gets complicated, confusing, and difficult to complete.   Moreover, injured workers often feel overwhelmed and intimidated having to communicate with the attorney representing the workers compensation carrier.  The playing field is equalized when each side has an attorney, who concentrates his/her practice in workers compensation.  Mays Law Office, Attorney Lisa Pierobon Mays has been successfully representing and winning for Wisconsin injured workers for over 25 years.  She understands the workers compensation system and will pursue every single benefit for the injured worker.  Injured workers are relieved when they learn that they do not have to pay her anything upfront for her representation.  Attorney Pierobon Mays only gets paid when she gets money for injured worker.

Should I Settle My Workers Compensation Claim?

The injured worker is often enticed to settle their work injury claim by the workers compensation carrier with an offer of money.  No settlement should ever be reached until the injured worker has reached a full healing plateau where medical treatment has ended, or the future medical needs are fully understood and valued.  Settling a work injury claim too early can be disastrous for the injured workers as they may be giving up too much in compared to the amount offered.  After a claim is settled, it is very difficult to change it and you will not receive additional compensation beyond the amount of the compromise.

Contact Mays Law Office Before Settling Your Claim

A settlement should never be reached without, at least, talking to an attorney first.  Attorney Lisa Pierobon Mays gets calls regularly from injured workers telling her that the workers compensation adjuster is offering them a monetary settlement.  Lisa will review your claim with you to understand what the potential value of your claim is and advise as to whether settlement now, versus later, is a good decision.  All of this can be done in a phone or in-office free consultation to 608-305-4518.  Never assume that the worker compensation carrier has your best interests in mind.  The injured worker often does not realize all the potential benefits that they are giving up with a settlement, and the insurance companies are as always trying to lessen their exposure which rarely matches up with what the injured worker needs.

You got injured or sick on the job. Do you qualify for workers’ compensation benefits? If so, what do you need to do to collect the benefits you deserve? Here are 10 important facts about filing for workers’ compensation benefits in Wisconsin:

1. Workers’ Compensation Covers “Employees”

The first thing you need to know about workers’ compensation is that benefits are available to “employees.” If you are an independent contractor, then you generally are not eligible to receive benefits.

Most workers in Wisconsin are employees. If you work for a company, receive a regular paycheck, and receive a W-2 at the end of the year, then you almost certainly qualify. If you receive 1099 instead of a W-2, this suggests that you are an independent contractor—although it is possible that you are being misclassified.

2. Most (But Not All) Employees Are Covered

Wisconsin law requires most employers to carry workers’ compensation insurance that covers their employees. But, there are a few exceptions. For example, farms are generally excluded, and some employers are subject to federal workers’ compensation laws instead of Wisconsin’s workers’ compensation statute.

The law also excludes certain types of employees from workers’ compensation eligibility. Domestic workers and volunteers are two examples. But, as the Wisconsin Department of Workforce Development (DWD) notes, “[n]early all workers in Wisconsin are covered.” So, if you have gotten injured or sick on the job, it is worth speaking with a Madison workers’ compensation lawyer about your legal rights.

3. The Uninsured Employers Fund Covers Employees Whose Employers Don’t Have Insurance

While Wisconsin law requires most employers to carry workers’ compensation insurance, not all employers follow the law. To protect employees whose employers don’t follow the law, the Wisconsin DWD has established the Uninsured Employers Fund (UEF). If you are entitled to workers’ compensation benefits and your employer doesn’t have insurance, you can hire a lawyer to help you file a claim with the UEF.

4. Workers’ Compensation Covers Physical and Mental Harm in Wisconsin

As the Wisconsin DWD explains, an “injury” for workers’ compensation purposes is, “any mental or physical harm due to workplace accidents or diseases.” The DWD provides the following examples of physical and mental harm:

• Burns
• Crushing injuries
• Cuts and bruises
• Dermatitis
• Disfigurement
• Emotional stress
• Fractures
• Hernias
• Hysteria
• Infections
• Loss or paralysis of a body part
• Loss of hearing or vision
• Nervous disorders
• Respiratory diseases
• Sprains and strains
• Stiffness
• Traumatic neurosis

It is important to emphasize that these are just examples. Many more types of job-related injuries and illnesses are covered. If you have any questions about your eligibility you should talk to a Madison workers’ compensation lawyer promptly.

5. You Can (and Should) Choose Your Own Doctor

After suffering a job-related injury or illness, it is important to seek treatment promptly. Under Wisconsin law, you have the right to see “any physician, chiropractor, psychologist, dentist, physician assistant, advanced practice registered nurse, or podiatrist licensed to practice and practicing in this state.” Your employer cannot tell you where to go for treatment; however, you may have to submit to an examination by a doctor who has been selected by your employer. If you receive a request for an “independent medical exam” (or “IME”), you should discuss the request with your lawyer before submitting to the examination.

6. Workers’ Compensation Covers Must (But Not All) Forms of Medical Treatment

If you have a workers’ compensation claim in Wisconsin, you are entitled to receive the treatment you need to get better or to achieve your “maximum medical improvement” (or “MMI”). However, not all forms of treatment are covered. For example, Wisconsin law specifically excludes physical therapy, massage, and pain clinic services from coverage, “unless the treatment is ordered by a doctor or . . . the employer or insurance company specifically agrees in advance to pay for such treatment.”

7. You Must Notify Your Employer of Your Injury or Illness

While you might be hesitant to tell your employer that you have an injury or illness, this is a key step in the process of filing for workers’ compensation benefits. The Wisconsin DWD recommends filing a report within 30 days, but you should generally report your injury or illness as soon as possible. Technically, you have up to two years to file a report with your employer. However, waiting this long can make it much more difficult to collect the benefits you deserve.

It is also important to understand that your employer cannot legally fire you or take other adverse employment action based on the fact that you decided to file for workers’ compensation benefits. Filing for workers’ compensation is your right, and you cannot be punished for exercising it.

8. You May Qualify for Temporary Disability, Permanent Disability, or Both

In addition to coverage for your eligible medical expenses, you may qualify for temporary or permanent disability benefits. You may also qualify for both. These benefits cover a portion of your lost wages while you are unable to work (or while you are only able to work in a limited capacity). Calculating your disability benefits requires a detailed understanding of Wisconsin’s workers’ compensation benefit schedule, and it is best to work with an experienced Madison workers’ compensation lawyer to ensure that you are seeking the maximum benefits available to you.

9. Workers’ Compensation Disputes are Common

From denying that employees’ injuries are work-related to underpaying employees’ benefits, workers’ compensation disputes are common. Hiring a lawyer will help minimize your risk of facing a dispute; and, if you encounter a dispute, your lawyer will be able to handle it for you.

10. You Can Hire a Madison Workers’ Compensation Lawyer at No Out-of-Pocket Cost

Finally, you can hire a Madison workers’ compensation lawyer to handle your claim at no out-of-pocket cost. At Mays Law Office, we help injured workers apply for benefits and deal with benefit denials. To discuss your workers’ compensation claim in confidence, contact us today.

Talk to a Madison Workers’ Compensation Lawyer for Free

Do you have a workers’ compensation claim in Wisconsin? If so, we can help. Call 608-305-4518 or contact us online to get started with a free and confidential consultation.

Now what happens?!  You have been hurt at work, you are scared and do not know what to do or who to listen to.   Mays Law Office hears this question every single day.

Attorney Lisa Pierobon Mays talks to injured workers on a daily basis – free of charge.  Every story varies but the emotions are always the same – fear, confusion, uncertainty, and even anger.  No one wakes up and thinks “Oh Boy, I sure hope I get hurt at work today.”  Accidents causing injuries at workplaces happen daily and fault, for the most part with certain legal exceptions, is not a factor in Wisconsin.  So, let’s say you slip and fall because a puddle of water was carelessly left on the floor, or you are walking too fast and miss a step running up the stairs and you blow out your knee.  In those kinds of situations, blame and fault is not a factor to be considered and not a reason to be denied workers compensation benefits.

So, what is the process once a Wisconsin worker injures himself?  The first question is whether the injury is serious enough that medical treatment is required?  Obviously, any injury involving broken bones, stitches, serious pain, difficulties with mobility and clear thinking should be medically treated immediately.  All work injuries should be reported to the employer so that an Incident/Accident Report can be timely completed by you and your supervisor.  Work comp claims can and have been denied for failure to report them timely to the employer; by not doing so raises suspicion and puts the injured workers credibility and honesty at risk.  With such information, your employer is responsible for notifying their workers compensation insurance carrier so that a claim can be opened, an investigation started, and benefits for lost time and medical treatment paid.

Once a workers compensation claim is filed, everyone has responsibilities.  The Employer is responsible to comply with any requests for complete, truthful and timely information made by the workers compensation carrier.  The Workers Compensation Insurance Carrier is responsible to diligently investigate the claim, respond to the employer’s reporting of the claim, talk to witnesses, get a statement from the injured worker as to the details how the work injury occurred.  The insurance carrier should also be reviewing medical records and sending out medical authorizations for the injured worker to sign for the review of their relevant medical records.  All of this is necessary for the workers compensation carrier to make a timely decision to either accept or deny, in good faith, the workers compensation claim.

The Wisconsin Injured Worker is responsible to give true and accurate statements as to how the injury occurred to their employer, the workers compensation insurance carrier, and their doctors.  Every statement of recollection must be consistent as to date, time, details, witnesses, and pain symptoms.  Any inconsistency can, and likely will, be used against the injured worker in an attempt to deny the claim.  The injured worker must maintain a good relationship with their medical providers.  Meaning, do not miss doctor appointments.  Do not disregard your doctor’s advice, treatment, and recommendations.  Keep in mind that your doctor will not be keen to support your claim if you have been a difficult patient.  Doctors like patients that follow their treatment, listen to their recommendations, and appear to want to get better.  Maintaining integrity with your doctors is of utmost importance because your comments and behavior is being documented in your medical records with every single communication that you have with them and their medical office, meaning their medical assistants, nurses, and even receptionist.  Also, the injured worker must keep their employer informed of their physical restrictions and availability to work.  Don’t just do this verbally.   It should be done by phone, text, email, and in writing so that the employer does not claim that you abandoned your job by failing to communicate after the injury.

Remember, an Injured Worker must never be seen doing anything that would be considered inconsistent with their injury.  Stay away from posting on social media as pictures can be damaging and misunderstood.  For instance, an injured worker suffering from a sore knee should not be posting pictures with their volleyball club team in a competitive setting.  It is only logical to assume that an injured worker with a knee injury would not be able to play volleyball.  Likewise, keep in mind that insurance companies hire investigators to conduct surveillance so be watchful as to how you appear to others, in public and even in your own yard, garage, porch, and deck!

So, now the Wisconsin injured worker says “Damn It, I’ve done all of this and I have still been denied Wisconsin workers compensation benefits!  What next….?!

If a Wisconsin injured worker’s claim for workers compensation has been denied, or even has a sense that their claim for workers compensation benefits will be denied, then they should immediately call Attorney Lisa Pierobon Mays at Mays Law Office.  Attorney Mays will provide a free phone consultation.  She will ask a series of questions to get to know you and your injury claim better.  She will review your communication with the workers compensations insurance carrier.  She will go over your medical treatment to understand your diagnosis and prognosis.  At the end of your conversation, you questions will be answered and suggestions offered as to how to proceed next.

Keep in mind that every work injury is different, unique, and requires it owns customized approach.  If the timing and circumstances of your claim calls for it, then Attorney Lisa Pierobon Mays will invite you to come to her Middleton/Madison office, if convenient, to discuss your claim further.  This in-person meeting is still part of the free consultation provided by Mays Law Office.  The meeting will last about an hour and half so that all the details of your denied claim can be thoroughly discussed and documented.  At the end of this meeting, a well-developed plan will be formalized as to how your workers compensation claim will be pursued.  Attorney Pierobon Mays will detail everything that you can expect and will be involved in the injury claim EVERY STEP OF THE WAY.  Your claim will NEVER be assigned to another attorney or a paralegal.  Every email, phone call, and correspondence will involve Attorney Pierobon Mays.

Attorney Pierobon Mays has been representing Wisconsin injured workers since 1997 – that’s 25 years of experience fighting and winning.  Attorney Lisa Pierobon Mays is not intimidated by any Wisconsin employer or workers compensation insurance carrier.  See her actual results by doing a simple Google review search.  You will see 5 Stars ratings from her actual clients who have found her effective, respected, and aggressive in achieving positive results for them.

Mays Law Office knows that suffering a work injury is scary and intimating but Attorney Lisa Pierobon Mays is only a phone call away from answering all of  your questions and easing your concerns.

There is no doubt that employers HATE work injuries. So what is an injured worker to do…? Stay quiet about her injury for fear that her employer becomes angry at her and in retaliation reduces her hours, changes her duties to something undesirable, or makes the work environment hostile. OR should the injured worker report her injury immediately regardless of her employer’s response because if the injury turns out to be serious and requires medical treatment and lost time from work then she will need to have it covered under workers’ compensation? 

Many injured workers wrongly take the wait-and-see approach. With this approach, they hope that the pain or symptoms are no more than a mere strain or sprain and will improve after a few days. If not then they will worry about reporting it later. 

While this wait-and-see approach may seem like a logical compromise, it will hurt the injured worker if the injury turns out to be more serious than originally thought. Not reporting the accident promptly, allows the employer to question the worker’s credibility which could lead to denial of medical treatment, benefits for missed time from work, and loss of a monetary award based on the permanent injury. Moreover, your private health carrier may also deny coverage of medical treatment if claimed as a work injury as such treatment is the responsibility of the worker’s compensation insurance carrier. Now the worker is in a Catch 22 predicament. 

What about if the employer has a policy requiring strict internal deadlines for reporting accidents, such as within 24 hours of the injury, which the worker deliberately did not follow? Now the employee can be reprimanded and her credibility and job security are jeopardized. 

Ultimately, the injured worker needs to report a work injury to avoid this Catch 22 predicament. When reporting the injury, always do it in writing and get a copy of your written report. Every reputable employer has an Accident Report Form. If no form can be found, draft your own report. Details such as who, what, where, when, how, and why are easily remembered when describing the injury. Details such as dates and times are always crucial. Keep a photocopy of what you report to the employer. If the employer refuses to provide a copy, use your smartphone to take a picture of it. When it comes to a workers compensation injury, document, document, document! Keep a journal with dates, times, witnesses, specifics as to how the injury occurred, and medical appointments because your memory will fade over time. Again, smartphones have lots of apps to keep details documented for you, such as voice recorders, cameras, note-taking, calendars, etc. 

Even if you are late in reporting an injury, you should still follow these recommendations. Remember, better late than never. 

Wisconsin law protects injured workers. Mays Law Office and Attorney Lisa Pierobon Mays are here for you. Call for a free and immediate consultation. Everything we discuss is confidential. We proudly represent the Wisconsin injured worker. See testimonials from our clients.