Know the Time Limits in the Claim Process for Worker’s Compensation

Were You Injured In The Workplace?

If so, it is normal to feel anxious, stressed out, and overwhelmed by the situation. Worker’s compensation insurance offers much-needed financial protection. You do not want to miss out on your opportunity to recover benefits.

If you fail to act before an important deadline runs out, your claim may not be allowed to go forward. Here, our Milwaukee worker’s comp attorney provides an overview of the time limits in the Wisconsin worker’s compensation claims process.

Report a Workplace Injury Immediately or Within 30 Days

First and foremost, injured workers have a legal obligation to report their accident to their employer. According to the Wisconsin Department of Workforce Development, you should report your injuries to your supervisor without delay.

If you fail to report an accident within 30 days, you may not be denied worker’s comp benefits. This is one of the most important deadlines you need to know about. If you get hurt on the job, tell your employer right away. Under Wisconsin law, your company cannot punish you for reporting an accident. Also, your employer has a legal duty to notify its insurer within seven (7) days.

File a Claim or Seek a Formal Hearing (6 Years for Traumatic Event, 12 Years for Occupational Disease)

Reporting a work injury is not the same thing as filing a claim. Ideally, your claim will be handled fairly, and benefits will be given out without much delay. In most cases, injured Wisconsin workers receive an update on their claim within a few weeks. If you are not offered full and fair worker’s compensation benefits, you have the right to request a hearing before an Administrative Law Judge (ALJ). Under Wisconsin law (Wis. Stat. § 102.17(4)), how long you have to request this type of hearing depends, in part, on the nature of your case. More specifically, injured workers typically have:

• Six (6) years to request a formal hearing after sustaining a ‘traumatic injury’; and
• Twelve (12) years to request a hearing for an occupational disease.

There are some exceptions. You may be able to extend the time limit in certain cases. Never assume you are prevented from bringing a claim. If you have any specific questions about the time limit that applies to your case, call an experienced work injury lawyer for guidance.

Appeal an Adverse Decision from an Administrative Law Judge (21 Days)

Unfortunately, injured workers sometimes struggle to get access to the full and fair benefits they rightfully deserve. If the Administrative Law Judge rules against you, it is imperative that you take immediate action to protect your rights. You still have legal options available. You have a very limited amount of time to file an appeal. You must appeal to the Labor Industry Review Commission (LIRC) within 21 days after getting an unfavorable decision from an ALJ.

Frequently Asked Questions on Wisconsin Worker’s Comp Claims

Am I Covered by Worker’s Compensation?

Yes—over 98% of workers in Wisconsin are protected by worker’s compensation from their very first day of employment. This comprehensive coverage applies to a wide range of workers, including full-time employees, part-time workers, seasonal staff, and minors who are legally employed. However, it is important to note that there are some exceptions to this rule; specifically, domestic workers (such as nannies and housekeepers) and volunteers are not covered under Wisconsin’s worker’s compensation laws.

What Injuries Are Covered?

Worker’s compensation in Wisconsin is designed to cover a broad spectrum of injuries and health issues that occur in the workplace. This encompasses both physical injuries, such as cuts, fractures, or sprains, as well as mental injuries, including stress-related illnesses. Coverage also includes repetitive stress injuries, which occur due to repetitive motions over time, and exposure-related illnesses caused by harmful substances in the workplace. Additionally, if you sustain an injury while traveling for work—provided that the travel is related to your job—this will also be covered under worker’s compensation.

How Do I File a Claim?

To initiate a worker’s compensation claim, you need to report your injury to your employer as quickly as possible, ideally within 30 days of the incident. Promptly notifying your employer allows them to take the necessary steps to inform their insurance carrier, which will then begin the claims process. If for any reason you are unable to go through your employer, you have the option to file a claim directly with the Wisconsin Department of Workforce Development, an agency dedicated to assisting workers with these processes.

Can I Choose My Own Doctor?

Absolutely. Under Wisconsin worker’s compensation law, you have the right to select any licensed healthcare provider, including physicians, chiropractors, psychologists, or other approved practitioners within the state. This means you can choose a doctor who specializes in your specific type of injury or condition. If you feel that your current provider is not meeting your needs, you are also permitted to switch to a different provider; however, it is essential to inform your employer or their insurance company about this change to avoid any complications with your claim.

What Benefits Are Included?

Worker’s compensation provides a variety of benefits aimed at supporting injured workers. These benefits may include:

Medical Expenses – Coverage for necessary medical treatments, rehabilitation, and related healthcare costs incurred as a result of your injury.

Lost Wages – Compensation for the wages you lose while you are unable to work, typically amounting to two-thirds of your average weekly wage.

Permanent Disability Compensation – If your injury results in a permanent disability, you may qualify for additional compensation that takes into account the severity and long-term impact of your condition.

Vocational Rehabilitation – Support services that assist injured workers in re-entering the workforce, including job training and placement services.

Death Benefits – In the unfortunate event of a work-related fatality, dependents may receive death benefits to help support them during this difficult time.

What If My Claim Is Denied?

If your claim is denied, the insurance company is obligated to notify you within 7 days of the decision and must inform you of your right to an appeal. You are entitled to challenge the denial and can do so through the Wisconsin Worker’s Compensation Division. This process allows you to present additional evidence or arguments in support of your claim.

What If My Employer Doesn’t Have Insurance?

Employers in Wisconsin are legally required to carry worker’s compensation insurance to protect their employees. If you discover that your employer does not have this coverage, it is crucial to take action. You should reach out to the state’s Uninsured Employers Fund for assistance. This fund is designed to help workers who have been injured while working for employers that fail to provide the required insurance coverage, ensuring that you receive the support and benefits you are entitled to.

Call Our Milwaukee Worker’s Compensation Lawyers for Immediate Assistance

At Gillick, Wicht, Gillick & Graf, our Wisconsin worker’s compensation attorneys are experienced, results-oriented advocates for clients. We are proud to be The Injured Worker’s Law Firm. For a no-fee, no-commitment review of your case, please contact our law firm at (415) 257-2667. We represent injured workers throughout the region, including in Milwaukee County, Racine County, Waukesha County, Ozaukee County, Washington County, and Kenosha County.