Worker's Compensation Basic Facts
Read a brief history of Wisconsin's Worker's Compensation, why it was adopted and an explanation of some of its special funds.
- In 2013 Wisconsin's estimated workforce was 2,867,901, and an estimated 2,781,863 were covered by worker's compensation insurance.
- In 2013 the number of active worker's compensation policies was 123,237 and the number of linked employers and locations was 260,161.
- In 2012 there were 259 entities with a self-insurance order(this number includes government entities).
In 2013 97% of Wisconsin's estimated workforce was covered by a worker's compensation policy. This incredible achievement is due to an ongoing investigative effort by the staff of the WC Division's Bureau of Insurance Programs to bring employers into compliance with the law.
- In 2014, out of 51 jurisdictions Wisconsin ranked 20th with respect to the maximum temporary total disability rates per week ($892).
- In 2014, out of 51 jurisdictions Wisconsin ranked 17th with respect to the maximum permanent total disability rates per week ($892).
- In 2014, out of 45 jurisdictions Wisconsin ranked 41st with respect to the maximum permanent partial disability rates per week ($322)
- From January 1st, 2007 to the end of 2013 the Wisconsin Worker's Compensation Division averaged 34,515 claims reported per year. On average, 7,085 (or 20%) of these are marked as denials, no lost time or non-compensable.
- From January 1st, 2007 to the end of 2013 the average number of litigated worker's compensation claims is 5,709 per year.
- As of May 13, 2014 there were 750 open, non-litigated permanent total disability claims on the Wisconsin Worker's Compensation database.
- In 2012 there were 114 work related fatalities in Wisconsin [Data is preliminary. Fatalities, regardless of coverage, based upon information supplied by OSHA or the Worker's Compensation Division, using a wide variety of reports (death certificates, WC, Coroners/Medical Examiners, OSHA, etc.].
- In 2011 the incurred worker's compensation related indemnity was $227,567,827 and the incurred worker's compensation related medical expenses were $572,356,291. (Note: Data is from insured losses only. The data does not include self-insured losses. Self-insured employers make up approximately 13% to 15% of the total Wisconsin workforce).
Over the last five years, the number of claims reported to the Wisconsin Worker's Compensation Division has gone down by an average of 387 claims per year, while the number of claims marked denials, no lost time or non-compensable has varied from year to year. The number of litigated worker's compensation claims has gone up and down from year to year .
WC Claim Cost and Outcome Information
- In a study comparing 16 states, medical costs per claim with more than seven days of lost time in Wisconsin were higher than typical and grew more rapidly than in most study states during 2006/07 to 2011/12. Higher prices paid for workers’ compensation medical care were the key factor contributing to Wisconsin’s outcomes on these metrics. However, beginning in 2009, and continuing for two years in a row, growth in medical payments in Wisconsin was slower in comparison to earlier years, due largely to more moderate growth in medical prices. [WCRI CompScope™ Benchmarks for Wisconsin, 14th Edition and WCRI Medical Price Index for Workers’ Compensation, Fifth Edition]
- The Wisconsin workers’ compensation system is designed to reduce litigiousness, and it does so because of the following four features: active oversight by the state agency; dispute resolution by final-offer adjudication; mandatory minimum rating for surgery cases; and heavy reliance on the treating physician. For 2009 claims at an average maturity of 36 months, Wisconsin had a lower percentage of claims with payments to defense attorneys (13 percent versus 25 percent in the median study state). [WCRI Avoiding Litigation, July 2010 and WCRI CompScope™ Benchmarks for Wisconsin, 14th Edition].
- For 2009/12 claims at an average maturity of 36 months, the average indemnity payment per claim with more than seven days of lost time in Wisconsin was 32 percent lower than the median state. [WCRI CompScope™ Benchmarks for Wisconsin, 14th Edition]
- The average number of weeks of temporary disability (weeks of temporary partial disability and temporary total disability benefits) is a measure of return to work. At an average of 11 weeks, duration in Wisconsin was lower than most study states—3 weeks lower than the median of the 11 non-wage-loss states in the study. [WCRI CompScope™ Benchmarks for Wisconsin, 14th Edition]
- The average medical payment per claim with more than seven days of lost time in Wisconsin was 39 percent higher than the 16-state median for 2011 claims at 12-months maturity. For 2009 claims at 36-months maturity, the average medical payment per claim in Wisconsin was 21 percent higher than typical. [WCRI CompScope™ Benchmarks for Wisconsin, 14th Edition].
- Nonhospital utilization of medical services for workers’ compensation claims in Wisconsin was typical to lower-than-typical, depending on the service group. Lower utilization in Wisconsin resulted from fewer visits per claim and fewer services per visit compared with other study states. [CompScope™ Medical Benchmarks for Wisconsin, 13th Edition]
- Multiple features of the Wisconsin workers’ compensation system contributed to the state having lower indemnity payments per claim by helping facilitate faster return to work. These features include: unilateral temporary disability termination provisions that create incentives for workers to return to light or modified duty during their healing period and a two-tier structure for permanent partial disability (PPD) benefits that creates incentives for employers to return injured workers to work earning at least 85 percent of their preinjury wage. Other system features described below that help reduce litigation also play a role in facilitating return to work. [WCRI CompScope™ Benchmarks for Wisconsin, 14th Edition]
- Wisconsin had fewer cases involving PPD benefits and lump-sum settlements (44 percent of 2009 claims evaluated in 2012, compared with 50 percent in the median of 8 non-wage-loss state where lump sums of future medical payments are allowed). [WCRI CompScope™ Benchmarks for Wisconsin, 14th Edition]
One key point to emphasize about the Wisconsin workers’ compensation system is that, when compared with other
study states, overall costs per all paid claims in Wisconsin were among the lowest of the 16 study states.
This metric reflected costs after combining claims with less than seven days of lost time and claims with more than seven days of lost time. One contributing factor to lower costs in Wisconsin was that, compared with the other study states, slightly fewer Wisconsin workers lost more than seven days of work as a result of their injury (17 percent versus 19 percent in
the median state). Lower indemnity payments were also a factor. [WCRI CompScope™ Benchmarks for Wisconsin, 14th Edition].
Information was obtained from the following sources: DWD Worknet LAUS Results; WI WC Division's Insurance, Legal and Claims Management Bureaus; Wisconsin Compensation Rating Bureau; 2011 Annual Statistical Bulletin of the National Council on Compensation Insurance.