Form Ls 37 – Fill Out and Use This PDF

A special minimum wage license may be issued to an employer to permit the employment of individual employees at a lesser hourly wage than prescribed by Section DWD 272.03. Such license will cover only those workers who are unable to earn the minimum wage, or who are student learners. The rate paid must be commensurate with the worker’s ability and productivity. The following definitions and policies shall be used when issuing such licenses

(1)“Worker with a disability” means an individual whose earnings or productive capacity is impaired by a physical or mental disability, including those relating to age or injury, for the work to be performed. Disabilities which may affect earning or productive capacity include blindness, mental illness, intellectual disability, cerebral palsy, alcoholism, and drug addiction. The following, taken by themselves, are not considered disabilities for the purposes of this section: vocational, social, cultural, or educational disabilities; chronic unemployment; receipt of welfare benefits; nonattendance at school; juvenile delinquency; and correctional parole or probation. Further, a disability which may affect earning or productive capacity for one type of work may not have this effect for another type of work.

(2)“Student Learner” means a student who is receiving instruction in an accredited school, college or university and who is employed on a part-time basis, pursuant to a bona fide vocational training program.

(3)“Sponsoring Agency” means a sheltered workshop, governmental agency or a nonprofit charitable organization or institution carrying out an occupational rehabilitating activity of an educational or therapeutic nature.

(4)Two types of “worker with a disability” licenses may be granted by the department.

(a)A type 1 license is issued to a specific employer to employ a worker with a disability in their establishment. This license may be issued for a period of time not to exceed one year.

(b)A type 2 license shall be requested by a sponsoring agency on behalf of a worker with a disability. A type 2 license may be issued by the department to a worker with a disability and will authorize any employer to pay the rate of pay stated on the license. An employer who hires a licensed worker with a disability shall retain a photocopy of the license for the employer’s records. This license may be issued for a period of time not to exceed one year.

Note: The intent of issuing a type 2 license to the worker with a disability instead of to the employer is to permit the sponsoring agency to make short-term placements. This would enable the worker to gain a variety of experiences without putting the burden on each employer to obtain a license. This should not be interpreted as relieving any employer from complying with the federal Fair Labor Standards Act which requires an individual special minimum wage certificate be issued to the federally-covered employer.

(5)The license shall be granted for a specific individual only and only for a designated period of time. Minimum wage must be paid the employee until the license is granted, unless renewing. Renewal applications MUST BE received within 2 weeks of the expiration date of the current license. Licenses are issued effective the date the application is received in the department’s office or a specified later date as requested on the application. It shall provide a special minimum rate. The employer may not pay less than this set rate.

LS-37 (R. 04/2019)

5.What was the highest-grade level in school obtained by employee?

6.Describe any vocational training received by this employee.

7.If the type of work to be performed by the licensed employee is primarily performed by nondisabled persons in the employer’s work force, list the job title, brief job description and prevailing wage paid the experienced nondisabled employee performing similar work (also applies to sponsoring agency).

List source(s) for prevailing wage:

8.If the type of work to be performed by the licensed employee is primarily performed by disabled employees in the employer’s workforce, the employer may determine the prevailing wage rate by surveying 3 comparable businesses in the area for similar work and rates of pay for nondisabled workers. Or the employer can use federal bureau of statistics, job service, or an employment service which provides above entry-level wages (does not apply to sponsoring agency).

List source(s) for prevailing wage:

9.Commensurate Per Hour Wage employer will guarantee worker: $ ____________

Attach documentation of productivity tests, information, dates showing the rate arrived at for the worker with a disability.

10. Scheduled hours of work per day

11. List dates you wish this license to cover

From:To:

(Minimum wage must be paid until the effective date of the license. Licenses cannot be backdated. If you are renewing, prior license is in effect until this application Is granted or denied.)

12.Student Learner Information

(Review DWD 272.09(15))Attach a copy of program or signed training agreement.

Wage rate cannot be less than 75% of current minimum wage unless individual is a worker with a disability.

Name of School

(A)The wage rates of all hourly-rated employees paid in accordance with Chapter DWD 272.09 of the Wisconsin Administrative Code will be reviewed at least every six (6) months and

(B)Wages paid to all employees under DWD 272.09 will be adjusted at periodic intervals at least once a year to reflect changes in the prevailing wage paid experienced non-disabled workers employed in the vicinity for essentially the same type of work.

(C)Hours worked over 40 in a 7-consecutive day week must be paid at time and one-half the regular rate of pay.

(D)Time and payroll records shall be kept in accordance with DWD 272.11.