Wisconsin Worker's Compensation Law Braces for Winds of Change

Assembly Bill 724 was signed by Governor Walker of Wisconsin on February 29, 2016. This bill passed several amendments to the Wisconsin Worker’s Compensation Act and has an effective date of March 2, 2016.

To provide clarity on each of the relevant changes and how they may impact you, below is a plain language explanation.

Amendments Made to the Worker's Compensation Act

• PPD Rate: The max weekly permanent partial disability (PPD) rate will increase to $342 for any injuries occurring on and after the the effective date. For injuries occurring on and after January 1, 2017, the max weekly PPD will increase to $362.

•  Worker's Comp Fraud: The Department will assign one Department of Justice (DOJ) position to investigate and also prosecute fraud committed by employees, employers, insurance carriers, and providers. 

• Treating Practitioner's Final Report: A treating practitioner's final medical report must be provided on a timely basis at a max charge of $100. A report will not be required in cases where a claim is completely denied. 

• Statute of Limitations: The statute of limitations will be reduced to six years.

• Permanent Disability Apportionment: Apportionment of permanent disability resulting from accidental injuries will be based on causation. A practitioner who prepares a report on permanent disability will now address the issue of causation that includes a determination of the percentage of permanent disability caused by the work-related injury and the percentage caused by other factors before and after the injury. Any employee who claims a work-related injury will have to disclose all previous permanent disabilities or physical impairments.

• Prospective Orders for Retraining: Administrative law judges will have the power to issue prospective orders for vocational rehab retraining benefits for future instruction or training courses.

• Exclusive Remedy: Employees of fiscal agents covered by worker's compensation insurance under s. 102.07 (20) who provide long term care services to elderly and disabled people will be prohibited from bring an action in tort against the elderly or disabled persons who received the long term care services.

• Physician Dispensing: Reimbursement for medications dispensed outside of a licensed pharmacy shall be limited to the pharmacy fee schedule and the existing dispensing fee.

• No Offset for Part-Time Wages During Retraining: There will be no reduction in compensation for vocational rehabilitation training based on wages earned by employees working part-time for the first 24 hours of employment during periods of retraining, and employees will be required to report wages to WC insurance carriers and self-insured employers. There is no sunset on this provision.

• Discharge or Suspension for Misconduct or Substantial Fault: Temporary disability will be denied when an employee is released to light duty work and is suspended or terminated due to misconduct as defined in s. 108. 04 (5) or substantial fault as defined in s. 108.04 (5g) (a) connected with the employee's work.

• Minimum PPD Ratings: The Department will create a medical advisory committee to review the minimum permanent partial disability (PPD) ratings in Chapter DWD 80.32 of the Administrative Code. This committee will review and update the minimum ratings every eight years.

• Violation of Employer's Alcohol/ Drug Policy: There shall be no recovery of indemnity or death benefits when an employee violates the employer's drug and/or alcohol policy and where there is a direct causation between violation of the drug and/or alcohol policy and the workplace injury.

So what’s the next step?  The overall tone is promising for some meaningful change on archaic rules. Medical treatments have advanced, cost of living has advanced, and our employer/employee relationships have advanced. We want to take care of our employees without being constricted by an outdated system.

However we aren’t going to see these change overnight. Future court cases will set precedence for how these laws should be handled. Businesses, claims handlers, litigators, and judicators all have to change the game and put the new rules to the test.