My Employer Has Denied My Claim, What Do I Do?

A disputed claim occurs when an employee, surviving spouse or dependents believe they are entitled to worker`s compensation benefits, and the employer or insurance company deny liability. Employer or insurance company unwillingness to pay benefits may arise from an honest difference of opinion among witnesses or a conflict of medical testimony between doctors. If there is no settlement, a hearing is held before an Administrative Law Judge. The Judge is to resolve the dispute on the basis of the relevant facts in the case. The Judge`s decision is based on the testimony of all parties, as well as doctor`s reports, other documents, or other pertinent testimony submitted in the case. There is only one hearing. All further appeals are based on the record created in this hearing.

When an employee or employer wants to request a hearing, three copies of a form entitled Application For Hearing (WKC­7) must be filed with the division. The form can also be obtained from the division. The division sends one copy of the WKC­7 to the employer or insurance company for an answer. If an employee is not represented at the time of a scheduled hearing, the ALJ will ask the questions to record all testimony and evidence that is available at the time of hearing. The division and the ALJ cannot prepare the claim in advance, cannot see that the proper evidence is available at the time of hearing, or act as legal counsel to represent any of the parties.

You can contact the Divisions of Worker`s Compensation at the address and number listed below.

Wisconsin Divisions of Worker`s Compensation
Room C100
201 E. Washington Ave.
Madison, WI 53703
(608) 266­1340

The information on this page is meant to provide a general overview of the law. The laws in your state and/or city may deviate significantly from those described here. If you have specific questions related to your situation you should speak with a local attorney.

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