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4 things you need to know about workers’ comp

On Behalf of | Dec 23, 2016 | Workers' Compensation

You retired last year, ready to have the easy life and get back to the woodworking project that’s been in the garage for the last 10 years. Everything was great the first few months, until the boredom set in.

Your social security isn’t quite enough to make you as comfortable as you would like, and since you were running out of things to do, it seemed like a good idea to pick up some part-time work at the local furniture store.

Things were going well, you were settling in to your new role, until you moved that chair on the showroom floor and felt your back go out.

Your Medicare policy can be difficult to deal with, so you’re wondering about secondary options. You were hurt at work, so do you qualify for workers’ compensation?

Filing a workers’ compensation claim in Wisconsin can be a complicated process. Remember that as an employee, you have the right to compensation for medical expenses and lost wages if you are hurt at work.

Read below for the answers to your workers’ compensation questions.

Are you covered?

As a furniture store employee, you are covered by workers’ compensation insurance. However, there are certain jobs that are not covered by workers’ compensation.

Wisconsin’s workers’ compensation laws do not cover domestic servants, some farm employees, certain volunteers working a non-profit, and some religious sect members.

In general, alternative forms of workers’ compensation cover federal employees, railroad workers, and seamen operating on navigable waters.

When does your coverage start?

Your coverage starts on the first day of work. Being in a probationary or training status does not affect your right to workers’ compensation coverage.

If you are injured on your first day of work, or in the first week, you have the same insurance rights as someone that has been working there for 20 years.

How do you file a claim?

If you are injured or become ill on the job, you must alert your supervisor immediately. After your supervisor has been notified, seek medical attention. Be sure to keep all relevant medical records, including payment receipts that pertain to your injury.

Any delay in notifying your manager can result in a denial of your claim. You must report the injury or illness within two years of the time it occurs.

Your employer will notify the insurance company and if the claim is approved, the insurance company will be responsible for your medical expenses and lost wages for excessive days of missing work.

What if your claim is denied?

If your workers’ compensation claim is denied, you can appeal it through a formal or informal process. The informal alternative dispute resolution process requires that your claim be referred to a specialist in the Division’s Alternative Dispute Resolution Unit.

Your claim will then be reviewed to determine if the medical information submitted supports your claim. If the reviewer determines that the dispute can be easily resolved, you and the insurer will be contacted.

If a formal hearing is required, you will have to appear before an Administrative Law Judge to present your case. Any decisions reached in this process will be legally binding. In the case that you believe an incorrect decision was made, you have the option to appeal the case.