Back Wages in Healthcare: What Local Caregivers Need to Know About Overtime and Employers’ Responsibilities

If you’re a case manager, in‑home caregiver or agency manager worried you haven’t been paid for all your time, you’re not alone.

Late 2025’s federal decision involving a Wisconsin health system — and enforcement activity in early 2026 — shows regulators are focused on off‑the‑clock work in healthcare. This plain‑language guide explains what the Wisconsin back‑wages ruling means locally, how to spot wage violations, how and where to submit complaints, and practical next steps for caregivers, case managers and agencies.

What happened in Wisconsin — the short version

On Dec. 4, 2025, a U.S. District Court entered a consent judgment requiring North Central Health Care (a multicounty medical care partnership in Wisconsin) to pay a total of $162,486 — half in unpaid wages and half in liquidated damages — to 68 case managers after a U.S. Department of Labor (Wage and Hour Division) investigation. The Wage and Hour Division found the employer failed to record and pay for off‑the‑clock hours and overtime between June 17, 2021 and June 16, 2023. The case is a clear example of two common problems in the home‑and‑community care sector: poor timekeeping and misclassification of compensable activities.

“The Department found case managers were working unrecorded hours and not receiving overtime where required.” — summary of the WHD investigation (Dec. 2025)

Why this matters now (2026 trends)

Regulators are prioritizing home‑care and healthcare support workers in 2026. Reasons include:

• Growing awareness of off‑the‑clock documentation and travel work that often goes unpaid.
• Increased Department of Labor scrutiny of health‑sector employers after several high‑profile consent judgments in late 2024–2025.
• Wider adoption of digital timekeeping and geofencing tools that make discrepancies easier to detect — and easier for regulators to validate complaints.
• State and local enforcement teams coordinating with the federal WHD to pursue back wages in regional cases.

Who is covered: caregivers, case managers and agencies — what to know

Case managers and in‑home caregivers are often nonexempt employees under the Fair Labor Standards Act (FLSA), which means they are generally entitled to a minimum wage and overtime (time‑and‑a‑half) for hours worked beyond 40 in a workweek. Activities that commonly go unpaid include post‑visit charting, travel between clients, mandatory trainings that occur off‑site, and work completed at home or on‑call duties.

Agencies and employers are responsible for accurate recordkeeping, correct employee classification, and paying overtime when due. A failure in any of these areas can trigger back‑wage liability and liquidated damages, as the Wisconsin case shows.

Common wage pitfalls in home and community care

• Unrecorded post‑visit documentation (notes completed at home after the shift).
• Travel time between clients during the workday not counted as paid hours.
• On‑call time and employer‑required phone calls not paid.
• Misclassification of employees as exempt or as independent contractors when they function as staff.
• Incorrect overtime calculation because nondiscretionary bonuses and shift differentials were omitted from the regular rate of pay.

How to spot a wage violation — a checklist for workers and case managers

If any of the items below describe your situation, gather evidence and consider filing a complaint. Keep records even if you’re not ready to complain.

1. Time gaps: Your scheduled shift says 8 a.m.–4 p.m., but you regularly finish paperwork at 5:30 p.m. and aren’t paid for the extra time.
2. Travel not paid: You travel between multiple clients as part of your shift and your employer only pays you for the time at client homes.
3. On‑call or phone work: You take employer calls outside your shift with instruction or supervision and aren’t paid.
4. Missing overtime: You worked more than 40 hours in a week and did not receive time‑and‑a‑half.
5. Tasks outside clocking system: You do mandatory training, meetings, or charting off‑site and the employer treats that time as voluntary.
6. Pay stubs don’t match hours: Your pay stubs or direct deposit statements don’t reflect your recorded hours.

Evidence to collect — what helps a complaint

• Copies of schedules and pay stubs for the last 2–3 years (if available).
• Personal time logs (dates, start/stop times, travel time, brief note of duties).
• Texts, emails, or recorded shift assignments showing you were expected to work outside paid hours.
• GPS logs or clock‑in/out screenshots from apps (showing discrepancies).
• Witness names (co‑workers or supervisors) who can corroborate unpaid work.

How to calculate potential back wages — a simple example

Understanding the math will help you assess whether a violation likely occurred.

Example: You earn $20/hour and you worked 45 hours in a single workweek but were only paid for 40 hours.

• Regular pay for 40 hours = 40 x $20 = $800
• Overtime rate = $20 x 1.5 = $30
• Overtime pay owed for 5 hours = 5 x $30 = $150
• If employer also failed to include a nondiscretionary $50 weekly bonus in the regular rate, that bonus must be prorated into the regular rate — which can increase the overtime amount owed.

Tip: If your paystubs show less than the calculation above, you could be owed back wages. For groups of employees, the Department of Labor often performs the math as part of its investigation — but doing your own rough calculation is a useful first step.

Where and how to submit a complaint

You can pursue unpaid wages at both the federal and state level. Here’s how to decide and how to act.

Federal: U.S. Department of Labor, Wage and Hour Division (WHD)

• WHD enforces the FLSA. They investigate complaints about unpaid wages, overtime, recordkeeping and related violations.
• To file: contact the WHD local office (find offices through DOL’s site) or call the national toll‑free WHD line. Complaints can often be filed by phone or in writing. WHD may investigate on behalf of employees and can recover back wages and liquidated damages.
• WHD investigations often begin with an intake interview, followed by document requests and employer interviews. Many cases resolve via voluntary conciliation; others lead to litigation or consent judgments (as in the Wisconsin case).

State: Wisconsin Department of Workforce Development (and other state agencies)

• State agencies handle some wage complaints and may have parallel enforcement authority. In Wisconsin, the Department of Workforce Development (DWD) can be an avenue for wage claims or unemployment issues tied to employment status.
• Filing with both federal and state agencies is sometimes possible and appropriate. An agency or legal aid attorney can advise on strategy.

Private options: civil suits and small claims

You can also file a private lawsuit for unpaid wages. Under the FLSA, successful plaintiffs can recover back wages, liquidated damages (often equal to back wages), and attorney’s fees. For smaller amounts, state small claims court may be an option. Legal assistance is recommended before filing.

What to expect after you file — timeline and protections

Typical sequence after filing with WHD:

1. Intake and screening (weeks): WHD determines jurisdiction and whether the complaint suggests a violation.
2. Investigation (months): WHD requests payroll records, timecards, interviews employer and employees, and analyzes overtime calculations.
3. Resolution (months to a year+): Cases may resolve by conciliation (employer pays voluntarily), or WHD may refer the case to the Department of Justice for litigation. Consent judgments and back‑wage awards may be entered by a court.

Important protections for workers:

• No retaliation: Federal and state laws prohibit employers from retaliating against employees who complain about wage violations. Retaliation complaints can be filed separately.
• Statute of limitations: Under the FLSA, the general rule is a 2‑year statute of limitations for back wages, extended to 3 years if the violation is willful. That’s why prompt action matters.

How agencies and employers should respond — compliance checklist

Agencies that want to avoid back‑wage liability should audit and fix practices now. Use this practical checklist.

• Conduct a timekeeping audit: compare schedules, electronic clock records, and payroll for the last 12–36 months for gaps.
• Classify workers correctly: review duties against FLSA exempt status tests and independent contractor factors.
• Update policies: require clock‑in/out for all compensable work including travel and documentation time.
• Train supervisors: ensure managers understand that asking employees to work off the clock is unlawful.
• Calculate overtime properly: include nondiscretionary bonuses and shift differentials in the regular rate where required.
• Keep records: maintain payroll records and time cards (FLSA recordkeeping requirements). Store copies of schedules, training notices and communications about overtime policy.
• Use technology carefully: time apps and geofencing can help but must be paired with clear policy and employee training to avoid privacy and compliance issues.

Legal help and low‑cost resources for caregivers in Wisconsin (and locally)

If you can’t afford a private attorney, explore these pathways:

• Department of Labor (WHD): Free investigations for FLSA claims.
• State agency: Wisconsin DWD can guide state‑level claims and related issues.
• Legal aid and nonprofit clinics: Many communities have legal aid organizations that take employment cases on a sliding scale or pro bono basis. In Wisconsin, groups such as statewide legal aid organizations and county bar pro bono programs are good starting points.
• Worker centers and unions: If you’re a member of a union or a worker center, they can provide representation, collective complaints or referrals.
• Private employment attorneys: Many employment lawyers handle wage claims on contingency or for a fee; initial consultations can help gauge case strength.

Real‑world example: what the Wisconsin consent judgment teaches local caregivers

The North Central Health Care settlement tells a clear story. Sixty‑eight case managers had recorded hours that undercounted work time; the employer accepted liability through a consent judgment and paid back wages plus liquidated damages. For workers that means two important takeaways:

• Documentation matters: Personal logs and communications helped establish the gap between recorded and actual hours.
• Federal enforcement works: WHD investigations can lead to real monetary recovery without private litigation.

Practical next steps for workers — a 7‑point action plan

1. Start a personal time log now. Record start/stop times, travel and task notes daily.
2. Save pay stubs and schedules for the last 2–3 years if possible.
3. Speak with co‑workers to see if the issue is widespread — collective complaints strengthen enforcement cases.
4. Contact WHD or your state agency for an intake conversation — you don’t need a lawyer to start.
5. If you fear retaliation, document it and ask WHD or a legal aid lawyer about protections.
6. Consider a local legal aid hotline or clinic for free initial advice.
7. Keep doing the work, but avoid signing away rights in settlement discussions without legal advice.

Practical next steps for agencies — reduce risk now

• Run an internal audit of timekeeping and overtime payments for at least the last 24 months.
• Update payroll policies to explicitly include travel, documentation, trainings and on‑call work as compensable where applicable.
• Train supervisors to approve overtime properly and record compensable time.
• Engage an employment lawyer to review classification tests and overtime calculation methods.
• When issues surface, consider voluntary correction and notice to employees — proactive remediation can limit litigation and civil penalties.

Looking forward: what to expect in the rest of 2026

Based on late‑2025 enforcement trends and early‑2026 agency priorities, expect:

• More WHD activity focused on healthcare support and home care providers.
• Greater use of technology evidence (time apps, GPS records) to prove hours worked.
• Heightened state‑federal coordination on regional investigations and multi‑county employers.
• Increased attention to misclassification and the regular rate calculation for nondiscretionary pay elements.

When to get a lawyer — and what questions to ask

Get legal help if you face employer retaliation, your case involves complex pay elements (bonuses, piece rates), or you want to file a private lawsuit. Questions to ask a lawyer in an initial consultation:

• Have you handled FLSA or state wage claims for health‑sector workers before?
• What remedies are realistic in my situation (back wages, liquidated damages, fees)?
• Do you work on contingency for wage claims, or how are fees handled?
• How long do you expect the process to take, and what are the likely next steps?

Final thoughts — protect your time, protect your pay

The Wisconsin consent judgment is a reminder that even public or multi‑county health systems can face liability for unpaid time. For case managers and in‑home caregivers, the gaps are often small (15–60 minutes of paperwork or travel daily) but accumulate into significant unpaid overtime for workers. For agencies, preventing back‑wage claims starts with simple systems: accurate timekeeping, clear policies, and manager training.

Act now: start documenting, check your paystubs, and reach out to the Department of Labor or a local legal aid clinic if you see discrepancies. The sooner you collect evidence and get advice, the stronger your position — and the better your chance of recovering wages owed.

Call to action

If you’re a caregiver or case manager in our borough and suspect wage violations, don’t wait. Begin a written time log today, save your paystubs, and contact the U.S. Department of Labor’s Wage and Hour Division or your state workforce agency for an intake. If you need help finding local legal aid, community clinics, or employment attorneys, visit our local resources page or email our newsroom — we’ll help you locate pro bono and low‑cost options in your neighborhood.

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