Facts for Employers about the Wisconsin Worker's Compensation Law
WKC-7317-P (R. 01/2003)
What Is Worker's Compensation?
Worker's compensation is a system of no-fault insurance that pays benefits to employees for accidental injuries or diseases related to the employee's work. In return for prompt and certain payment of benefits to an employee, an employer's liability is limited.
Is There Any Penalty For Negligence?
Negligence, either by the employer or employee, is not an issue except when the injury occurs because:
- An employer violated a safety order/statute; failed to use safety devices; and/or, disobeyed an established safety rule resulting in the employer possibly being liable for a 15 percent increase in compensation, up to a maximum of $15,000
- An employee was intoxicated by alcohol or illegal drugs resulting in the employee's compensation possibly being reduced by 15 percent with a maximum reduction of $15,000.
Most Wisconsin employers are required by law to have worker's compensation insurance.
- Employers who employ three or more workers on a full-time or part-time
basis must have insurance.
- Employers who employ one or more workers on a full-time or part-time basis
and who pay gross, combined wages of $500 or more in any calendar quarter
for work done in Wisconsin must have insurance by the 10th day of the first
month of the next calendar quarter.
- Farmers who employ six or more workers on any 20 days during a calendar year must have insurance 10 days after the 20th day of employment.
Where Do You Get Insurance?
There are about 350 insurance companies licensed to write worker's compensation insurance in Wisconsin.
If any insurance carrier denies your application for insurance, you may apply to another carrier or to the WISCONSIN COMPENSATION RATING BUREAU, 20700 W Swenson Drive, Suite 100, Waukesha, WI 53186. The telephone number is (262) 796-4540. The Internet URL is http://www.wcrb.org. The Rating Bureau will assign an insurer to write a policy for you. The cost is the same for assigned coverage.
What Will Insurance Cost?
The cost of insurance will vary. There are approximately 650 separate job classifications rated on past experience in industry. Insurance will cost more for the most hazardous occupations and those that are highest in gross payroll.
The Wisconsin Compensation Rating Bureau sets the premium rate for each class with the approval of the Commissioner of Insurance.
What Liability Is Covered?
Any worker's compensation insurance policy covers liability for compensation and medical expense.
The policy will not cover:
- Penalties for false reporting;
- An unreasonable refusal to rehire the employee;
- Increased compensation for a safety violation;
- Illegal employment of a minor; and,
- Penalties for untimely payments caused by delays in reporting.
What Are The Penalties For Failure To Insure?
The penalties are substantial and severe. Employers that fail to obtain insurance when required may be ordered by the Department to cease operations until coverage is obtained. The normal penalty for an illegal lapse in worker's compensation coverage is twice the amount of premium not paid during the uninsured time period or $750, whichever is greater. An employer who has an illegal lapse in worker's compensation insurance of 7 consecutive days or less is subject to a $100 penalty for each uninsured day up to 7 days, provided that the employer has not previously had an illegal lapse in coverage and that no injury occurred during the uninsured period.
An uninsured employer is personally liable to reimburse the Uninsured Employers Fund for benefit payments to an injured employee. Aggressive collection action including warrants, levies, garnishment and execution against property are used to insure reimbursement. The normal exemptions of property from seizure and sale on execution of a judgment do not apply to uninsured employers.
What Is The Uninsured Employers Fund?
The Uninsured Employers Fund (UEF) pays benefits on valid claims filed by employees who are injured while working for illegally uninsured employers. When an employee files a compensable claim, the UEF pays benefits as if the uninsured employer had been insured. The uninsured employer is required to reimburse the UEF for all costs of a claim paid by the Fund.
What Is Self-Insurance?
Approximately 200 private-sector and 50 municipal employers are self-insured. The self-insured do not purchase insurance, but pay their claims using their own funds. Self-insurers must have written approval from the department before becoming self-insured. The approval process includes submitting an application with five years of audited financial data, and documentation demonstrating expertise in safety and claims management. Self-insurers are required to have excess insurance and other security to protect against potential claims.
What Must An Employer Report?
All employers must report all work-related fatalities to the Worker's Compensation Division, Madison Office, within 24 hours.
Insured employers must report any claim of an injury to their insurance carrier within 7 days.
Self-insured employers and insurance carriers must report injuries which result in time lost from work four days or more after the date of injury to the Worker's Compensation Division, Madison Office. The report must be on a form WKC-12-E - First Report of Injury, or electronically filed, and must be filed within 14 days after the injury. Form WKC-13 â€“ Supplemental Report or its electronic equivalent must be filed by the 30th day after the injury or first day of lost time after the date of injury.
Treating physician's medical reports for disabilities of more than 3 weeks as well as final payment reports for all reported claims are required.
Employers are required to provide the Worker's Compensation Division, Madison Office, with OSHA survey information when requested.
What Are The Penalties For Not Filing Injury Reports?
If an employer intentionally fails to file a report of injury, the employer may be assessed a penalty for bad faith up to $15,000 or 200 percent of compensation due.
An employer may be assessed a 10 percent penalty payable to the injured worker for delay in reporting an injury which causes an untimely payment.
What Benefits Are Payable?
- All reasonable and necessary medical costs.
- Lost-time benefits for wage loss (temporary disability) while recovering from an injury. These are based on two-thirds of the employee's wage rate up to a specified maximum.
- Benefits for permanent disability if the employee does not fully recover from the injury. The amount of benefit depends on the severity of the permanent disability.
- Job retraining or placement.
- Death benefits and burial expenses up to specific limits.
Who Picks The Doctor For Treatment?
The employee has the right to select any physician, psychologist, podiatrist, dentist or chiropractor, unless there is an emergency. The employer is obligated to offer the choice and can lose rights by failing to do so. The employee has the right to a second choice on notice to the employer or insurer.
An employer may also require an employee to submit to reasonable medical examinations for the purpose of reviewing claims for compensation. Out-of-state treatment requires an insurer's consent unless it is based upon a referral from an in-state provider.
Is The Injured Employee Guaranteed A Job?
The employer may not "unreasonably" refuse to rehire an injured employee if suitable employment is available within the employee's physical and mental limitations. If the employer has suitable employment available and unreasonably refuses to rehire the worker, the employer is liable for any lost wages, up to a total of one year's wages. The employer is not required to hold or create a job to guarantee the employee a job after an injury.
Who Pays For Worker's Compensation Insurance?
The employer pays for the insurance and may not withhold, deduct or collect payment for premiums from any employee or any other person. Agreements by employees waiving rights to compensation are not valid.
What About Independent Contractors?
There are special provisions in the law covering independent contractors.
An independent contractor, sub-contractor or owner/operator may actually be a statutory employee of the employer for whom he or she is working unless they meet the nine-point test under s. 102.07(8)(b) of the Wisconsin statutes.
An independent contractor, sub-contractor or owner/operator who employs others must provide insurance for his or her employees. The independent contractor/employer must obtain insurance in his or her personal or trade name. No employer may elect to be under the insurance coverage of another employer or contractor.
Independent contractors who do not have employees or who are not required to be insured may choose to purchase insurance for self-coverage. The policy must be endorsed to name the sole proprietor or partners for them to be covered. Employers and independent contractors may purchase insurance without personal benefit coverage.
What About Sole Proprietors and Partners?
Sole proprietors and partners are not considered or counted as employees. Generally, policies exclude the sole proprietor or partners unless they are specifically endorsed to include them.
Sole proprietors and partners may voluntarily purchase insurance to cover their own work-related injuries and illnesses.
What About Corporations?
Corporate officers are employees. Generally, policies covering corporations include corporate officers. In closely held corporations with not more than 10 stockholders, no more than 2 officers can be excluded from insurance coverage. If the corporation has other employees and/or officers, a policy is required and the election must be made by endorsement on the worker's compensation policy. Officers who have made this election will still be counted in determining whether the employer is subject to the Worker's Compensation Act.
If a closely held corporation has no more than 2 corporate officers and has no other employees, a worker's compensation policy is not required if both officers elect not to be subject to the Worker's Compensation Act. This election can be completed by filing a Corporate Officer Option Notice with the Department.
|Worker's Compensation Division
201 E. Washington Avenue
P.O. Box 7901
Madison, WI 53707-7901
(608) 267-0394 (Fax)
Worker's Compensation Division
Worker's Compensation Division
DWD is an equal opportunity employer and service provider. If you have a disability and need information in an alternate format, or need it translated to another language, please contact (608) 266-1340 voice or (866) 265-3142, TTY.