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)257-0440. 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.