How Does Workers’ Compensation Work?

Workers’ Compensation works differently from state to state. In Wisconsin, Workers’ Compensation is an administrative area of the law that is overseen by a state agency known as the Department of Workforce Development. Below is an outline of how Workers’ Compensation claims typically work in the state of Wisconsin.
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Every Workers’ Compensation claim has a beginning, middle, and end. In the beginning stage, this is how a Worker’s Compensation claim works…
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First, an employee sustains an injury at work. Second, the employee reports the injury to his/her supervisor. It is important that the employee reports the injury in both verbal and written form. A formal incident report must be completed after a workplace injury occurs. Third, the employer reports the injury to their Workers’ Compensation insurance company. That is how the beginning stage of a Worker’s Compensation claim works.
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After the beginning stage concludes, a Workers’ Compensation claim evolves to the middle stage. In the middle stage, this is how a Workers’ Compensation claim works…
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Fourth, the Workers’ Compensation insurance company contacts the employee and begins an investigation of the employee’s claim. This can include, but is not limited to a recorded statement from the employee and a request for a medical authorization that allows the insurance company to get access to the employee’s medical records. Fifth, after the investigation is completed, the insurance company determines whether they are going to continue to pay an employee Workers’ Compensation benefits. If after the investigation is completed the insurance company believes that the employee sustained a compensable work injury, benefits will continue. If there is a red flag or the medical treatment does not seem to be working, the insurance company may schedule what is called an independent medical evaluation. If this occurs, the employee is required, by law, to see a doctor of the insurance company’s choice. After the independent medical evaluation is completed, a report is drafted which either concedes (continues to pay) or denies the employee’s claim for workers’ compensation benefits. That is how the middle stage of a Workers’ Compensation claim works.
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After the middle stage concludes, a Workers’ Compensation claim moves to the end or final stage. In the end/final stage, this is how a Workers’ Compensation claim works…
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Sixth, if the claim is denied by the insurance company, the employee can hire a Milwaukee WI workers’ compensation attorney that handles Workers’ Compensation claims. Seventh, the attorney secures a report from the employee’s treating physician that refutes the report of the independent medical examiner. Eighth, the attorney files a claim/lawsuit on behalf of the employee using the medical support of the employee’s treating doctor. Ninth, the matter either proceeds to a formal hearing or the parties are able to settle/resolve the claim. That is how the end/final stage of a Workers’ Compensation claim works.
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There are several more steps that occur throughout the Workers’ Compensation process. However, the article above provides a general outlook of how a Workers’ Compensation claim works in Wisconsin.
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