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Worker’s compensation is a system that provides benefits to an employee for injuries sustained in the course of employment.  The injured employee is also known as the applicant.

Worker’s compensation in Wisconsin is generally governed by Wis. Stats., Chapter 102, Administrative Code provision DWD 80, and the Worker’s Compensation Division’s own interpretation of policies, statutes and rules.

Worker’s compensation law in general holds the employer strictly liable and prevents the employee from suing the employer in tort.  In other words, for most injuries at work the worker’s compensation system is the employee’s exclusive remedy.

In general, if you are injured at work you should do the following to preserve your rights.

1. Promptly report the injury to the employer.
2. Seek the medical treatment you need.
3. Communicate physician’s work restrictions to the employer and keep a copy of these restrictions.
4. Stay within the restrictions.
5. Treat as you and your care provider agree.
6. Seek competent representation early in the matter, particularly if your matter is denied or if you have questions about your rights.

You may be asked to submit to an Independent Medical Exam (IME).  The employer’s worker’s compensation insurer (respondent) has the right to request that you attend an IME.  They are really not truly independent, as these physicians are generally hired by the insurer to render opinions helpful to the respondent insurer.

If the worker’s compensation insurer denies treatment, you should continue to treat as you and your care provider agree.  The goal is to get better so that you can return to work.

Keep track of your mileage.  Obtain all prescriptions from one source to make it easier to keep track of prescription expenses.  

Be mindful of surveillance that is used by respondents.  Stay within your doctor’s restrictions and assume that you may be surveilled at some point in time during your matter.

Be patient.  These matters take some time to resolve.  One obvious reason is that it often takes a fair amount of time to treat, get better, and eventually reach a healing plateau.  Another reason is that the system itself has a lot of demands put on it with a large number of injured workers.  The worker’s compensation system is administrated by the State of Wisconsin Worker’s Compensation Division.  The Division is not the respondent insurer.  The Division can be contacted for general information.

If you need a hearing it will be held before an administrative law judge (ALJ) who will take sworn testimony, consider exhibits if they are in proper form and timely filed, and issue a written decision.  The decision of the administrative law judge becomes final unless appealed.  The first step in the appellate process is the Labor & Industry Review Commission (LIRC).  The next step is the local circuit court.  If the matter has to go that far, it can really take a lot of time.

Many, if not most, workers’ compensation matters are settled before the first hearing before the administrative law judge.  The case should be settled only when there is a full understanding of all facts.  Damages must be quantifiable and determined.   The applicant should have reached a healing plateau and there should be appropriate medical and/or vocational reports supporting causation and damages.  Know and preserve your legal rights by seeing an attorney early on in your matter.  This is particularly true if your matter is denied by the respondent for any reason.

There are entire treatises on worker’s compensation.  This is only a brief thumbnail sketch of the system.

The following time deadlines apply in worker's compensation matters in general:

1. An employer should be given actual notice of the injury within thirty days of the time the injury occurs.  Absence of notice to the employer will not bar recovery if the employer was not misled, §102.12 Stats.  
2. The right to compensation in a worker's compensation case may be forever barred if no application is filed within two years of the date of injury.  The right to compensation will not be barred if the employer knew or should have known of the injury.

Even if the above notice and filing of application limits do not apply, there can be no claim for benefits in a worker's compensation case made more than twelve years after the date of injury or payment of last non-medical benefits, whichever is later, provided there was no advancement of payments.