If you were hurt at work, your injuries are typically covered by workers’ compensation insurance. Workers’ comp is a special type of insurance that most employers must carry. While you should make a report to your employer within 30
days of your injury, you must typically report it no later than two years in order to qualify for workers’ compensation benefits. If the employer knew, or should have known, about the injury, the statute of limitations for a claim is six years. If you suffer an occupational disease, there is no time limit to file a workers’ comp claim.
What is the Process for Workers’ Comp Claims?
The first step in the process of a workers’ comp claim is to report the injury to your employer. It is the employer’s responsibility to report the injury to the insurance carrier and to the State of Wisconsin Department of Workforce Development, Workers’ Compensation Division (WC Division). The WC Division manages workers’ comp cases statewide. The employer must report the injury within seven days. The insurance carrier tracks lost time and compensable injury claims electronically.
The insurance company reports the claim to the WC Division within 14 days of the date of the injury. The insurance provider is required to report payments and wage information electronically. The length of time to file a claim is extended for occupational injuries. For example, a repetitive stress injury might take years to show up. Other times, a disease can develop months or years after exposure to a chemical or substance at work.
What to do About a Claim That was Denied
When you file a workers’ comp claim, it has to go through an approval process. Your claim does not automatically get approved. In fact, a number of claims get denied. If your claim is disputed and denied, you have the right to request a hearing before an
Administrative Law Judge (ALJ). You must file an application for a hearing no later than six years from the date of the injury or the date of your last workers’ comp payment.
You will attend a formal hearing where you and the employer both present evidence to prove the claim. Many times, the matter is resolved before the hearing. After the hearing, the ALJ has up to 90 days to render a decision.
Either party may request further review by the Labor Industry Review Commission (LIRC) within 21 days of the issuance of the decision. After the ILRC decision, parties may start an action in the circuit court within 30 days. After a judgment here, the parties may appeal to the Court of Appeals and ultimately to the Wisconsin Supreme Court. Certainly, most cases do not get that far and a resolution is made during the process.
The process of obtaining workers’ compensation benefits can be lengthy and difficult. It is helpful to seek guidance from a reputable attorney. Your lawyer will review your case and assist you with your claim or with a claim denial appeal. Contact our legal team at Moen Sheehan Meyer, Ltd. to discuss the details of your work injury today.