An Injured Worker’s Guide to Workers’ Comp Benefits in Wisconsin
No one expects to get hurt on the job or develop an illness due to unsafe working conditions, but it happens more often than you think. Each year, in Wisconsin, an average of 5,300 workers’ compensation claims are filed, according to the Wisconsin Department of Workforce Development. Dealing with a workplace injury or illness can be overwhelming and leave you wondering how you’re going to pay for your medical bills or keep up with your living expenses while you’re at home recovering and not at work.
The good news is you may be eligible to receive workers’ compensation benefits through your employer’s insurance coverage. Understanding what benefits may be available to you can help put your mind at ease and make the workers’ comp claims process less stressful for you and your family.
What am I entitled to under Wisconsin worker’s compensation laws?
In Wisconsin, nearly 97% of businesses provide workers’ compensation insurance
for injured employees. These benefits include payment for medical care, reimbursement for lost wages, job training services and death benefits for a surviving spouse, parent or relative.
Types of workers’ compensation benefits in Wisconsin
Medical Benefits
Wisconsin workers’ compensation insurance helps cover all medical care that is necessary to treat a work-related injury or illness, including:
Hospital stays
Doctors’ appointments
Surgery
Physical therapy
Labs, x-rays, MRIs and other diagnostic tests
Mileage to and from doctor appointments
Prescription medications
Medical devices (crutches, wheelchairs and artificial limbs, etc.)
It’s important to know that after you report your injury to your employer, you have the right to choose your own licensed health care provider to treat your condition. You also have the right to a second choice of provider if you aren't happy with the first one. The only time you need to get permission from the insurance company is if you’d like to see a doctor out of state.
Wage Loss Benefits
In addition to payment for medical expenses, you may be eligible to receive income replacement benefits during the time you’re unable to work. The amount of compensation you can receive and for how long depends on how serious your injury or illness is.
There are four types of workers comp wage loss benefits available in Wisconsin
1. Temporary Total Disability (TTD) benefits
If your doctor has told you that you need to take time off work to recover from your work-related injury or illness, you may be able to receive temporary total disability benefits while you heal.
TTD benefits are paid at the rate of two-thirds of the average weekly wage you earned before your workplace injury or illness. These payments are tax-free and are paid weekly.
How is the Average Weekly Wage calculated?
The Average Weekly Wage is calculated by using one of two different mathematical formulas:
Hourly Wage X 40 Hours/Week or
Gross Earnings 52 Weeks Prior to Injury/52 Weeks (takes the higher of the two)
The maximum weekly TTD benefit you can receive in WI is $1,094.00.
You can collect TTD benefits up until your doctor determines your condition is stabilized.
If you miss seven days of work, you will have to wait three days to receive your first TTD benefit check. If you are out of work longer than seven days, you will be reimbursed for the first three days.
2. Temporary Partial Disability (TPD) benefits
If you’re able to go back to work but your hours and wages have been reduced because of your medical condition, you may be able to collect temporary partial disability benefits.
These benefits are meant to cover the lost wages from your reduced pay. Payments will be calculated by taking the difference between your average weekly wage before your injury and what you earn now, up to a maximum weekly benefit of $1,094.
3. Permanent Partial Disability (PPD) benefits
If your work-related injury or illness has left you with a lasting disability but you’re still able to work in some capacity, you may be able to get permanent partial disability benefits.
You may become eligible to receive PPD when your doctor has said you have reached maximum medical improvement (MMI), meaning your recovery is “as good as it’s going to get” and not likely to improve in the future.
The amount of PPD benefits you will receive depends on the impairment rating your doctor assigns to your injury. An impairment rating is the percentage of the loss of use or functionality of your injured body part on a scale from 0 to 100. The higher the rating, the higher your PPD benefits will be.
Injuries that may qualify for PPD in Wisconsin include deafness, blindness, loss of a body part or loss of function of a body part.
4. Permanent total disability
If your injury is so severe that it has left you with a permanent impairment that prevents you from ever returning to the workforce, you may be able to claim permanent total disability benefits (PTD). PTD benefits are two-thirds of your average weekly wage and are paid out for the rest of your life
Additional Workers’ Comp Benefits
Vocational rehabilitation
If you are not able to return to your old job and your employer is not able to give you a new job that you are medically capable of doing, you may be entitled to additional benefits for job training or retraining services and job placement assistance.
The goal of these benefits is to help you find a job within your capabilities that pays as close as possible to your pre-injury wages. To find out more about this program, you may contact the Division of Vocational Rehabilitation administrative office.
Death and funeral benefits
If your loved one has died as a direct result of a workplace injury or illness in Wisconsin, you may be eligible for compensation for funeral expenses (up to $10,000), income replacement and educational benefits (available for surviving spouse).
Injured At Work? Contact the Fox Valley and Green Bay’s Trusted Workers’ Comp Lawyers
The Wisconsin workers’ compensation system is designed to financially assist workers, but many still find it difficult to obtain the benefits they are entitled to. Di Renzo & Bomier is here to help make the process easier and to ensure you get the payout you deserve. To schedule a free consultation, call (920) 383-3310 or (800) 725-8464 or fill out our online form.
The content of this blog was prepared by Law Offices of DiRenzo & Bomier, LLC for educational and informational purposes only. It is not intended to solicit business or provide legal advice. Laws differ by jurisdiction, and the information in this blog may not apply to you. You should seek the assistance of an attorney licensed to practice in your state before taking any action. Using this blog site does not create an attorney-client relationship between you and Law Offices of DiRenzo & Bomier, LLC.