Frequently Asked Questions

Who Is Entitled to Workers Compensation Benefits?

Most Wisconsin employees who were injured at work or because of their jobs are eligible for workers compensation benefits. You may also be covered if your injury was caused by many years of physical or repetitive work — even if you first noticed your pain somewhere else.

 

What if I was at Fault?

In most cases, it does not matter who was at fault for causing your injury. Even if you violated some safety rule, got distracted, or just did something really dumb, you may still be entitled to workers compensation benefits.

 

Are My Complaints Unusual?

It is all too common for employers and insurance companies to ignore your rights. Many injured workers face the following:

  • A workplace that discourages you from reporting injuries
  • An unexpected telephone interview
  • An employer who ignores your work restrictions
  • Being told to go home and then fired to not coming into work
  • Staying home because there was no work within your restrictions, and then having a boss claim that you refused work within your restrictions
  • Collection notices for unpaid medical bills
  • A boss who is suddenly treating you unfairly
  • A nurse case manager unexpectedly showing up at your medical appointments
  • Days without pay while you are getting medical treatment
  • An insurance adjuster refusing to return your calls
  • A letter telling you that your claim is being investigated or has been denied
  • The workers compensation insurance company refusing to pay for your medical bills or time off of work, and then your health insurance company or short-term disability carrier refusing to pay because it was a work-related injury
  • Notice that you need to be examined for a “second opinion”
  • The insurance company doctor claiming that your injury was caused by a pre-existing condition, even though you never had a problem until the injury at work
  • Fears about getting fired

Frequently Asked Questions About COVID-19

Does Wisconsin Workers Compensation Cover COVID-19 Cases?

Yes, it is possible to successfully claim that a COVID-19 (Coronavirus) infection was a work-related injury.

 

How Does Someone Prove They Got COVID-19 at Work?

Proving someone got infected at work follows the same general process as other workers compensation cases in Wisconsin. One of the biggest challenges may be getting a medical doctor to sign a form agreeing that the worker was infected at (and as a result of) employment.

 

How Convinced Does the Doctor Have to Be?

Before signing the form supporting their patient, a doctor must be more than 50% confident that the infection was work-related. That means that the doctor does not need to be absolutely certain.   

To be credible, the doctor will probably need to know additional information about the work atmosphere and life outside of work, such as:

  • How likely is it that the worker was exposed at work? (How widespread were the infections there and what kind of contact did the worker have with infected people?)
  • What safety precautions were taken at work?
  • How likely is it that the worker was exposed outside of work? (How widespread were the infections in the general community? Was anyone infected at home or places where the worker visited?)
  • Did the worker routinely wear masks outside of work when in public?
  • Did the worker follow social distancing recommendations outside of work?

 

What Documents Might Be Helpful for a Doctor to Review?

While every case is different, following are some documents that might be helpful for a doctor to review:

  • Detailed information about COVID-19 spread at work.
  • A timeline of contacts with COVID-19-positive individuals at work, including the length, distance, and precautions taken.
  • Records showing the hours and specific times at work in the weeks prior to infection. 
  • A written description of the precautions taken at work, including PPE usage, frequency of surface cleaning, availability of hand sanitizer/washing facilities.
  • A written description of all of the precautions taken outside of work.
  • Dated test results for the worker and other members of the household, as well as the dates of initial symptoms. 
  • A timeline of contacts with the public outside of work in the weeks prior to infection, including the length, distance, and precautions taken.
  • Bank records supporting the limited number of visits to taverns, restaurants, hair salons, or other higher-risk activities. 
  • Summary of the standards for doctor’s opinions (clarifying that the doctor need not be absolutely certain, especially since doctors treating COVID-19 patients may not be familiar with workers compensation standards).

 

What Steps Should Be Taken if a Worker Suspects They Were Infected at Work?

  1. Report the infection to work and follow all safety protocols.
  2. Consult with an experienced workers compensation attorney to discuss your specific concerns. 
  3. Gather/create the documents such as those described above to support your claims.
  4. Share relevant documents and ask the treating doctor for an opinion about whether the infection was likely work-related. 
  5. If the doctor is supportive, then contact the employer and formally report the claim.
  6. If the claim is denied, then contact a workers compensation attorney to discuss appealing the claim.

 

What if an Employee Works From Home?

An employee working from home is able to make claims for work-related injuries, but the worker will still need to prove that the injury arose out of and in the course of employment. It may be more difficult to rule out the non-work-related exposures to COVID-19 in these situations. 

 

What Can a Wisconsin Worker Receive in a Successful Workers Compensation Claim for COVID-19?

Potential benefits are the same types as are available in most workers compensation claims, such as:

  • Two-thirds of your average weekly pay while unable to work.
  • Payment of all medical bills.
  • Additional payments if the infection caused permanent injury.
  • Retraining benefits if you are unable to return to your prior job. 

 

Is it Worth the Fight?

That depends. As with every workers compensation case, determining whether it is worth the fight may depend on the strength of the case and the potential for recovery. 

It is clear that most insurance companies will initially deny many if not all COVID-19 claims in Wisconsin, and unfortunately, it is still far too early for any of us to know how the judges will routinely handle these claims. 

At this point, the best course is to probably discuss the details of your case with an experienced workers compensation attorney. We will ask a lot of questions to try to discover the potential strength of your case. We will also review what could possibly be recovered. If there were a lot of days off of work with no pay, significant bills, and either a permanent injury or death, then there may be a lot more to fight for than if the worker was paid for all of the days off work, made a full recovery, and had most or all bills covered by health insurance. 

Please give Osowski Law LLC a call to discuss your work-related COVID-19 concerns.