Posted in Workers' Compensation
Do I Need to Prove My Employer Was at Fault?
No. Wisconsin’s workers’ compensation system operates on a no-fault basis, meaning you generally do not need to prove your employer did anything wrong to receive benefits. In exchange for this no-fault protection, workers’ compensation is typically the exclusive remedy against your employer, meaning you generally cannot separately sue your employer for the same injury.
This exchange, sometimes called the compensation bargain, benefits both sides in different ways. Workers receive prompt benefits without the delay and uncertainty of proving negligence in court, while employers gain protection from potentially larger jury verdicts that a traditional negligence lawsuit could produce.
What Benefits Are Available After a Work Injury?
Wisconsin’s system provides wage loss benefits, coverage for medical treatment, disability payments, and vocational rehabilitation benefits when needed. The specific benefit that applies depends on the severity of the injury and where you are in the recovery process.
Medical treatment coverage under this system generally has no dollar cap for reasonable and necessary care connected to the work injury, which distinguishes it from many health insurance plans that carry annual or lifetime limits. This means an injured worker facing extensive treatment does not need to worry about coverage running out partway through recovery.
- Temporary Total Disability: paid while unable to work at all during recovery
- Temporary Partial Disability: paid when working in a reduced capacity
- Permanent Partial Disability: paid for lasting impairment after recovery plateaus
- Permanent Total Disability: paid for the most severe, career-ending injuries
How Is My Weekly Benefit Amount Calculated?
Temporary total disability benefits are generally paid at two-thirds of your average weekly wage, subject to a maximum rate that gets updated annually. Permanent partial disability benefits are also calculated at two-thirds of your average weekly wage, though the maximum rate for this category tends to run lower than the temporary disability maximum.
What Is the Difference Between Scheduled and Unscheduled Injuries?
Scheduled injuries involve a specific body part, such as an arm, leg, or hand, listed in a statutory schedule that assigns a set number of compensable weeks based on the severity of impairment. Unscheduled injuries, such as back injuries or conditions affecting the body as a whole, are evaluated differently, often based on a percentage of overall earning capacity lost rather than a predetermined weeks-based schedule.
This distinction matters considerably for how a workers’ compensation claim ultimately gets valued by the insurer. A scheduled injury calculation is relatively mechanical once the impairment rating is set, while an unscheduled injury often requires vocational evidence addressing how the condition actually affects a worker’s ability to earn income going forward.
When Does Temporary Total Disability Start?
You generally become entitled to temporary total disability benefits after missing more than three days of work due to the injury. These payments continue until you either return to work in some capacity or reach what is called an end of healing, sometimes referred to as maximum medical improvement.
What Happens Once I Reach Maximum Medical Improvement?
At that point, your treating physician evaluates whether any permanent impairment remains. If so, you may be entitled to permanent partial disability benefits based on that impairment rating. An Oak Creek workers compensation lawyer reviewing this determination can identify whether the assigned rating actually reflects the medical evidence in your specific case.
Can I Still Sue if a Third Party Caused My Injury?
Yes, in many cases. While workers’ compensation generally prevents suing your own employer, a claim against a negligent third party, such as a driver who caused a work-related vehicle crash or a defective equipment manufacturer, can proceed separately alongside your workers’ compensation benefits.
Who Can Help With a Wisconsin Workers’ Compensation Claim?
An Oak Creek workers compensation lawyer evaluates a claim to identify which benefits actually apply and whether a related third-party claim might also be available.
Who Handles These Claims in Oak Creek?
Hickey & Turim, S.C. represents Wisconsin workers through the full claims process, from the initial filing through any dispute over benefits that may arise along the wa
