Opinion ID: 2221558
Heading Depth: 1
Heading Rank: 1

Heading: the worker's compensation act

Text: ¶ 6. Worker's Compensation benefits in Wisconsin are governed primarily by the Worker's Compensation Act (the Act), which is administered by the Department of Workforce Development (DWD). The Act appears in Chapter 102 of the Wisconsin Statutes. It establishes a complex formula for determining Worker's Compensation benefits. Before we address Mireles's claims, we review the general structure of the Act to aid in reviewing Mireles's situation. ¶ 7. The Act is designed to compensate workers injured in the course of their employment. State v. LIRC, 136 Wis. 2d 281, 288, 401 N.W.2d 585 (1987). Benefits payable under the Act fall under one of two categories, temporary disability benefits or permanent disability benefits. ¶ 8. Temporary disability benefits are payable during an injured worker's healing period. Wis. Stat. § 102.43; John D. Neal and Joseph Danas, Jr., Worker's Compensation Handbook § 5.3 (4th ed. 1997). By contrast, permanent disability benefits compensate an injured worker when a disability remains after the healing period. Wis. Stat. § 102.44; Worker's Compensation Handbook § 5.15. The focus of Mireles's appeal is LIRC's refusal to award permanent disability benefits. ¶ 9. Permanent disability benefits are divided into two distinct categories: compensation for scheduled injuries and compensation for unscheduled injuries. Worker's Compensation Handbook § 5.18. Scheduled injuries are enumerated in Wis. Stat. § 102.52. Scheduled injuries require the payment of benefits for a specific number of weeks, as outlined in the statute. For example, § 102.52(1) mandates an award of 500 weeks of benefits for the loss of an arm at the shoulder. [3] Wisconsin Stat. § 102.53 mandates increases of awards for certain combinations of permanent disabilities. ¶ 10. The schedules contained in Wis. Stat. § 102.52 presume that a worker has lost a body part entirely. As noted, § 102.52(1) awards 500 weeks of benefits for the loss of an arm at the shoulder. If a worker suffers a lesser injury, such as a major loss of motion of the arm at the shoulder, the worker is compensated based on how the injury compares to total loss of the arm. Wis. Stat. § 102.55(3). Thus, if a worker suffers a loss of motion of the arm deemed to be a 50 percent loss by DWD, the worker will receive 50 percent of the scheduled period of benefits, or 250 weeks. ¶ 11. Scheduled injury benefits are presumed to include compensation for an injured worker's loss of earning capacity. Mednicoff v. ILHR, 54 Wis. 2d 7, 14, 194 N.W.2d 670 (1972). ¶ 12. Mireles suffered scheduled injuries to her wrists. She received compensation for permanent partial disability for the damage to her right wrist. Mireles's right wrist injury was assessed to be a three percent permanent disability, and her scheduled award was limited by that determination pursuant to Wis. Stat. § 102.55(3). ¶ 13. Many injuries are not included in the statutory schedules. Worker's Compensation Handbook § 5.20. These unscheduled injuries, which are primarily injuries to the torso and head, as well as mental injuries, usually require more individualized evaluation than scheduled injuries. See Worker's Compensation Handbook § 5.15. Mireles suffered a back injury. Back injuries are unscheduled injuries. ¶ 14. Permanent total disability based upon an unscheduled injury or injuries results in lifetime benefits. Wis. Stat. § 102.44(2). Permanent partial disability from an unscheduled injury or injuries results in benefits payable for a portion of 1,000 weeks, depending upon how the injury compares to one causing permanent total disability. Wis. Stat. § 102.44(3). For example, if a back injury causes a 20 percent permanent partial disability for a worker, the worker is eligible for 200 weeks of benefits, or 20 percent of 1,000 weeks. See Worker's Compensation Handbook § 5.33. ¶ 15. The calculation to determine permanent partial disability is based upon a medical comparison with injuries that would render a person permanently totally disabled for industrial purposes. . .and not to injuries that would totally disable a person functionally without regard to loss of earning capacity. Mednicoff, 54 Wis. 2d at 11 (quoting Kurschner v. ILHR, 40 Wis. 2d 10, 18, 161 N.W.2d 213 (1968)). Such a calculation attempts to measure an injured worker's loss of earning capacity, not simply the physical effects of an injury. [4] ¶ 16. A permanent partial disability that is not scheduled does not always result in compensation for loss of earning capacity. If the employee returns to work, the employee receives compensation for loss of earning capacity if the employee suffers a 15 percent or more wage decrease. Wis. Stat. § 102.44(6)(a)-(b). Otherwise, an employee receives compensation only for the physical limitations resulting from the injury. Id. Whether or not an employee suffers a 15 percent or more wage decrease, an employee still can receive compensation for loss of earning capacity if the employer terminates the employment relationship for any reason, or the employee terminates the relationship because of physical or mental limitations. Wis. Stat. § 102.44(6)(b). ¶ 17. Mireles presents two claims for benefits in this case. Both claims are affected by the fact that Mireles suffered an unscheduled injury followed by a scheduled injury while she worked in a production job at Ametek.