Tag Archives: Wisconsin

NEW LAW: Wisconsin Enacts Worker’s Compensation Changes

It’s official. The Wisconsin legislature and Governor recently approved amendments to the worker’s compensation system in our state. We have a new law.

The bill arose from the Wisconsin Worker’s Compensation Advisory Council—the historically stabilizing group, consisting of members of labor and management.  The Advisory Council bill produced common sense reforms and improvements to the worker’s compensation system. A competing bill (informally known as the “work comp destruction bill”) never even received a hearing. In stark contrast, the legislature demonstrated support for the Advisory Council recommendations by unanimously passing the bill (Senate vote was 32-0 and Assembly vote was 97-0), and Governor Walker continued that support by swiftly signing the Council recommendations into law.

The new changes are 2015 Wisconsin Act 180. The bill is effective March 2, 2016.

Importantly, the new bill does not alter the underpinnings of the worker’s compensation “grand bargain”, whereby employees gave up the right to sue in court in exchange for scheduled, fixed benefits without having to prove fault.  Additionally, the new law does not affect an employee’s right to choose their own medical doctor and care, nor does the law impose any type of major medical fee schedule.

The Advisory Council bill was a compromise, as per usual, with provisions that benefit workers and employers. Among the major highlights of the new law:

  • Increased PPD Benefits. An injured worker’s maximum weekly benefits for permanent partial disability (PPD) will increase $20 to $342/week for injuries on/after March 2, 2016, and to $362/week for injuries in 2017.
  • Greater Access to Retraining Benefits. Injured workers with permanent limitations that do not allow a return to the time-of-injury employer can pursue academic retraining benefits (weekly maintenance benefits while in school, along with tuition, books, meals, and mileage). Traditionally, a hearing could not be held until the worker actually was enrolled and taking classes, which could be financially prohibitive when a worker is off work with no income. The new law allows a Judge the authority to issue prospective orders for future retraining benefits before the worker is in school.
  • Allowance for Working while in School. A worker pursuing an academic retraining program will be allowed to work up to 24 hours/week without those wages reducing any weekly worker’s compensation maintenance benefits.
  • Statute of Limitations Reduction for Traumas.  The statute of limitations, running from the date of injury or date of last compensation payment, for traumatic injuries only is reduced from 12 years to six (6) years. The statute of limitations for occupational exposure claims is not changed—remaining at 12 years.
    We anticipate that the traumatic injury statute of limitations change does not apply retroactively, meaning the new 6 year statute of limitations applies to traumatic injuries beginning March 2, 2016.
    The impact of this change will play out in the future. The potential for increased litigation exists as workers file hearing applications to protect their medical treatment expense benefits. For example, if a worker has a knee injury in April 2016 with arthroscopic surgery one month later, all disability benefits paid by the end of 2016, and that worker continues to have periodic difficulties ultimately resulting in a proposed knee replacement in 2023, they may be time-barred if no hearing application was filed within 6 years (or the end of 2022). If barred, those expenses are shifted to the worker, group health insurance, or the government.
  • PPD Apportionment. If a worker suffers a traumatic injury resulting in permanent partial disability (PPD), a physician’s report on PPD shall include a determination of the approximate percentage of PPD caused by the work injury along with the percentage attributable to “other factors” before or after the work injury. A worker, upon request, shall disclose any/all previous findings of permanent disability or impairments that are relevant to the work injury. The provision does not apply to occupational exposure injuries and does not mandate that a physician must find some percentage attributable to other factors (i.e., the entire functional PPD percentage can be attributable to the traumatic work event).Heavy litigation is likely given the provision’s ambiguity. By intent, it appears the language is restricted to functional PPD. The provision should not upset the “as is” rules on legal causation of an injury itself. Additionally, it does not appear the provision would affect liability for temporary total disability, medical expenses, retraining benefits, or potential loss of earning capacity or permanent total disability benefits.Litigation likely will occur over the type of competent evidence necessary to constitute “other factors” apportioning a PPD award. With the worker disclosure requirement, one could argue that only documented, ratable disability findings can be used, as opposed to a doctor’s speculation regarding pre-existing condition (e.g., a worker’s complaint of pre-existing sporadic low back pain is different than a pre-injury accident that resulted in a lumbar fusion procedure with a paid 10% PPD).
  • Lost Time Benefit Denial for Misconduct Terminations. Previous law, under the Brakebush case doctrine, allowed a worker to receive lost time benefits (Temporary Total Disability, or TTD) during a healing period even if they had been terminated for misconduct or allegedly valid reasons by the employer. The new law effectively puts an end to components of the Brakebush doctrine.Temporary disability benefits can be suspended when an employee is released to limited duty post-injury and subsequently is suspended/terminated for “misconduct” or “substantial fault,” as defined under the unemployment insurance law (Chapter 108). Based on the statutory language, TTD benefits, however, are still payable if a worker is completely off work in the healing period, per their physician.These terms “misconduct” and “substantial fault” were recently included in the unemployment laws with specific statutory definitions:
    • “Misconduct” is conduct evincing such willful or wanton disregard of an employer’s interests as is found in (1) deliberate violation or disregard of standards of behavior that an employer has a right to expect of his or her employees; or (2) carelessness or negligence of such degree or recurrence as to manifest culpability, wrongful intent, or evil design in disregard of the employer’s interests or to show an intentional and substantial disregard of an employer’s interests or of an employee’s duties and obligations to his or her employer.
    • “Substantial Fault” equals acts or omissions of an employee over which the employee exercised reasonable control that violate reasonable requirements of the employee’s employer, but not including minor infractions, inadvertent errors, or failure to perform work due to insufficient skill, ability, or equipment.
    With the worker’s compensation act now referring to the unemployment rules for the definitions of both terms, the possibility exists for the worker’s termination to result in the cessation of both worker’s compensation and unemployment benefits.
    The exact interpretation of these terms and the legitimacy of terminations will play out through litigation—and presumably a significant amount of litigation.
  • Benefit Denial for Alcohol/Drug Violation. All indemnity benefits are precluded if an employee violates an employer’s consistently enforced drug policy concerning alcohol or drug use when there is a direct causation between the violation and the worker’s injury. The worker, however, can still recovery/pursue medical treatment expenses.Previous law allowed a potential reduction of a worker’s benefits by 15% if an injury was the result of intoxication or the use of controlled substances.Notably, the new provision is a large injection of “fault” concepts into the otherwise no fault system undergirding the grand bargain of worker’s compensation.
  • Fraud Prevention. Worker’s Compensation Department (at DWD) will fund one Department of Justice position to assist in investigating and prosecuting any “fraudulent” claim or “fraudulent activity” on the part of any player in the worker’s compensation system (insurance carrier, employer, employee, or health care provider)
  • Electronic Medical Records. The cost for certified medical records in “electronic format” is fixed at a maximum of $26 per request.
  • Physician Drug Dispensing. Prescription drug dispensing outside of a licensed pharmacy (i.e., physician dispensing) are limited to the existing pharmacy fee schedule and pharmacist dispensing fee.
  • Review of Minimum PPD Ratings. The new law requires the Department to create a medical advisory committee, consisting of various areas of medical specialization, to review and revise the minimum functional PPD ratings found in the Administrative Code every eight years.

Change can mean uncertainty. A number of the statutory enactments and effects will be seen over time and through the litigation process. The key is that the Advisory Council process worked, continuing its vital role in Wisconsin’s beneficial and efficient worker’s compensation system.

Advisory Council Bill Is A Compromise …But The Alternative Is Chaos

Those of us representing injured workers were recently forced into a somewhat difficult decision regarding proposed changes to Wisconsin workers’ compensation law.  As discussed in prior posts, two parallel bills were proposed, one sponsored by the Workers’ Compensation Advisory Council (SB-536 / AB-724) and one sponsored by Republican Representative Spiros (AB-501)  The Spiros bill—aka the worker’s compensation destruction bill —would have completely altered the nature of 100 years of workers’ compensation in Wisconsin, adding the concept of “fault” back into a no-fault system that has been operating based on that premise for a century.  Additionally, the work comp destruction bill would have reduced the Statute of Limitations for filing the claim and claiming medical benefits on the claim from the current twelve years to an incredibly harsh two years. 

The agreed-upon Advisory Council Bill (WCAC bill) also contains benefits for injured workers as well as employer-friendly provisions, some coming at the expense of injured workers. For example, employees who are fired for misconduct or substantial fault could be denied workers’ compensation benefits based upon a definition of misconduct imported from the Unemployment Compensation system. Unemployment Compensation law defines misconduct as a worker showing such a willful disregard of an employer’s interest to be a deliberate violation, or carelessness or negligence showing wrongful intent suggesting an intentional substantial disregard of an employer’s interests. Quite simply, under this provision, injured workers might lose their jobs because of misconduct or substantial fault, thus losing out on both Unemployment Compensation and Workers’ Compensation benefits.

Additional provisions of the WCAC bill would deny benefits to those workers whose injuries have been caused by the use of alcohol or drugs. The Statute of Limitations reduced from twelve to a reasonable six years for traumatic injuries.  Significantly, the workers’ compensation insurance carrier can now ask for medical support to apportion pre-existing disability, which should trigger a substantial increase in litigation. 

Some would suggest that the Advisory Council bill is not “worker-friendly.” It is more appropriately viewed as a COMPROMISE. Labor and management representatives bargained for the changes. The Advisory Council bill is the result of give-and-take compromise and an acknowledgement by labor of the current political reality in Wisconsin.   In any compromise, parties get and give up certain things.  This compromise is the stabilizing force for the successful worker’s compensation system in our state. Lone wolf legislation without consideration by the compromises of the Advisory Council should be rejected. 

Support the Advisory Council process and Agreed-Upon Bill.

Work Comp Advisory Council Officially Produced an Agreed-Upon Bill

As anticipated, on December 22, 2015, the Worker’s Compensation Advisory Council (WCAC) approved its Agreed-Upon Bill.  The official statutory language and bill summary can be found here. The bill now goes to the Wisconsin legislature for consideration and, hopefully, passage.

Production of this Agreed-Upon bill underscores the success and stabilizing hand of the Advisory Council.  The WCAC, composed of members of labor and management (including the Wisconsin Manufacturers and Commerce), typically produced a biennial “agreed upon” bill for approval by the Legislature. The WCAC produces reasoned, incremental changes that maintain the stability of the system for all stakeholders—employers, carriers, and workers.  The WCAC immunized the substance of the Wisconsin WC system from partisan politics and election cycle swings commonly found in other states.

The Advisory Council bill deserves full support of all Wisconsinites that care about our nationally respected worker’s compensation system.  There is, however, lone wolf legislation floating about.  We previously talked about a bill (being pushed by Rep. John Spiros, head of the Trucking Industry Defense Association) that is properly seen as the “worker’s compensation destruction bill.” These ideas in the Spiros-led bill (AB-501) were NOT considered or vetted by the Advisory Council.  The Council protects against just this sort of unchecked effort—protecting against random or crackpot ideas from severely damaging the reputable system.

In stark contrast, the Advisory Council carefully considered changes and produced a reasoned bill that improves or system and benefitsall stakeholders, especially the employers of our state.  Indeed, some “employer-friendly” provisions include the following:

  • A worker’s violation of alcohol or drug policy (if causally related to the injury) denies benefits.
  • No lost time benefits (TTD) if terminated for good cause (using recent unemployment standards)
  • A reasonable and manageable reduction in statute of limitations from 12 to 6 years.
  • Establishing a Dept of Justice position for investigating/prosecuting WC fraud.
  • Apportionment of functional PPD payments, so employers not responsible for pre-injury disability amounts.

Workers also have some incremental, important benefits in the Agreed-Upon bill.  The permanent partial disability payments receive slight annual increases.  Workers also will be allowed to work a certain amount of hours while pursuing academic retraining without having a decrease in work comp benefits, and workers will be allowed to ask a judge for “prospective” retraining claims (benefitting a worker who does not have the financial ability to enroll in school unless the work comp carrier will be paying).

The Advisory Council bill maintains the stability of Wisconsin’s first-class worker’s compensation system.  Lone wolf legislation should be dismissed. We urge the Wisconsin legislature to whole-heartedly endorse the reasoned Advisory Council bill.

LEGISLATIVE ALERT: Worker’s Compensation Destruction Bill?

Time to wake up Wisconsinites! In a short timeframe, the current administration and legislature in Wisconsin has altered the landscape of our state in ways too numerous to count. Well, now we face another attempt to make-over and deform a progressive era landmark: Wisconsin’s Worker’s Compensation System.

A recent bill (LRB 1768) proposes direct and major changes to our state’s nationally recognized model worker’s compensation (WC) system. The proposed changes would dramatically alter and potentially devastate the stability of the system for all stakeholders. We urge all legislators not to support LRB 1768. Instead, there will be a separate, reasoned bill produced by the Worker’s Compensation Advisory Council.

Current System Works for All Stakeholders

Under the grand bargain of Wisconsin’s first-in-the-nation WC system from 1911, injured workers gave up the right to court lawsuits in exchange for timely, lesser, defined benefits without having to prove fault. Employer, in turn, are protected from unknown jury damage awards. Employers purchase WC insurance for this administrative dispute resolution process. The system safeguards the concept that work injury expenses appropriately are an employer’s cost of doing business rather than costs shifted to taxpayers through public assistance such as disability payments and Medicare and Medicaid.

The current system is highly effective for all stakeholders—making our system the gold standard compared to the rest of the country. Wisconsin traditionally has low and stable employer premiums. We have over 300 private section WC insurance carriers collecting premiums (in excess of $1.7 billion). We have faster return to work rates than in most states. We have incredibly low litigation costs and low litigation rates (only 10-15% of work injuries).

Work Comp Advisory Council (WCAC) is the bedrock of Wisconsin’s WC system 

Much of the credit for the beneficial metrics in our national model is from the stability offered by the Worker’s Compensation Advisory Council (WCAC). This Council, composed of voting members of labor and management (including the Wisconsin Manufacturers and Commerce, WMC), has typically produced a biennial “agreed upon” bill for approval by the Legislature. The WCAC produced reasoned, incremental changes that maintained the stability of the system for all stakeholders—employers, carriers, and workers. The WCAC generally has immunized the substance of the Wisconsin WC system from partisan politics and election cycle swings commonly found in other states.

Importantly, the WCAC successfully produced a reasoned Agreed Upon bill in the past weeks! (more details below).

The Proposed GOP Bill (LRB 1768) Would Decimate Worker’s Compensation in Wisconsin

A recent video highlights the egregious nature of the proposed bill:

The bill proposed by GOP legislators was not from or considered by the Advisory Council—it is an end-run around the stability-producing model.  LRB 1768 is a direct legislative attack on the WC system, introducing dramatic and foreign concepts to our system. Among the more outlandish proposal are the following:

  • Reducing WC benefits by amount of employee negligence!
    • This proposal eviscerates the “grand bargain” of WC, whereby a worker who suffers an on-the-job injury receives lower, defined benefits without regard to fault and employers, in turn, are protected from unknown jury damage awards.
    • It would force employees to prove the injury was not their fault while still protecting employers with the WC exclusive remedy (and with no corresponding change in benefits for employer negligence/fault)
    • Also, without any method provided for determining negligence, there would be a massive increase in uncertainty, litigation, and claims costs/premium. 
  • Employer-Directed Medical Care
    • Currently, workers have the right to medical providers of their choosing—creating a system where workers have access to timely, specialized medical care. This quality, unrestricted medical care produces great results: faster return to work rates than most states in the country!
    • Proposed employer-directed medical care allows the employer to choose a specific practitioner for an injured worker (e.g., a podiatrist could be designated to address work injuries, including a back claim). As such, a worker may not receive the appropriate specialized medical care, like physical therapy, chiropractor, psychology, or orthopedic specialist.
    • Employer directed medical care likely means a race to the bottom, focusing on which doctors best minimize WC benefits. The focus should be on swift access to quality medical care.
  • Harsh Reduction from 12 year to Two (2)-Year Statute of Limitations (SOL)
    • WC injuries can result in lengthy healing periods and long-term medical care.
    • A 2 year SOL directly cost-shifts the burden for WC injuries to the taxpayers (Medicaid, Medicare, SSDI).  Taxpayers should not be left holding the bag for the cost of work injuries.
    • A 2 year SOL will result in exponential litigation of WC claims.  WC attorneys will be forced to file applications on any/all claims to preserve the SOL.  Wisconsin could turn into Illinois (!) where litigation rates are 80-85%, versus our current 10-15% rate.
  • Elimination of PPD ratings
    • Current law utilizes minimum permanent partial disability ratings, established by an independent panel of physicians decades ago.
    • The GOP proposed bill would eliminate PPD minimums.  Further explosion in litigation would result as previously uncontested claims would now result in disputes between worker and adverse physician ratings.
    • Notably, the recently-produced WCAC bill provided a reasoned approach to any concerns over PPD ratings, by recommending an independent physician panel review of the ratings.
  • Elimination of benefits if misrepresentation on employment application
    • This ill-considered provision precludes benefits if an employee lied about physical condition on employment application.
    • Such a provision introduces potentially discriminatory quizzing of prospective employees.  It further introduces more litigation issues into this no fault system

The cumulative effect of the GOP bill provisions were not adequately deliberated. The result would be an exponential increase in litigation and a destabilizing effect on the WC system—meaning increased litigation costs, lengthy delays in claims, and increased employer premiums. Any crack in the grand bargain could open the floodgates to potential unlimited damages in personal injury liability lawsuits. One major injury could result in significant jury awards (See http://nypost.com/2014/12/18/injured-construction-worker-gets-record-62m-single-plaintiff-award/)

In stark contrast is the recent WCAC bill ….

WCAC Successfully Produced a Reasoned Reform Bill

The Advisory Council, on October 26, 2015, successfully produced an Agreed-Upon WC Bill. This reasoned WCAC bill was agreed to by labor and management—including the Wis. Manufacturers & Commerce (WMC), who sit on the Council. All stakeholders should get behind this Advisory Council bill. The full statutory language will be available in the upcoming weeks.

As opposed to the GOP bill (LRB 1768), the Advisory Council bill creates WC changes that benefit all stakeholders, especially the employers of our state. Some “employer-friendly” provisions include the following:

  • Worker’s violation of alcohol or drug policy (if related to injury) denies benefits.
  • No lost time benefits (TTD) if terminated for good cause (using recent unemployment standards)
  • A reasonable and manageable reduction in statute of limitations from 12 to 6 years  (vs a 2 year SOL which would drastically alter the system).
  • Establishing DOJ position for investigating/prosecuting WC fraud.
  • Apportionment of functional PPD payments, so employers not responsible for pre-injury disability amounts.

Thus, the Advisory Council produced a bill that addressed many management/employer concerns about the WC system. The Advisory Council listened and—as it has done for decades—successfully produced reasoned changes to the system. The stability of the system is preserved for all stakeholders. The WCAC Agreed-Upon Bill should be supported.

Walker’s Workers’ Compensation in Wisconsin

Mark my words, Scott Walker will use his attempts to revamp and revise Wisconsin’s workers’ compensation system in his national campaign for the presidency in 2016. 

He will tout attempts at “increased efficiency” and cost cutting when, in fact, these efforts are patently false.  His recent assault on workers’ compensation prompted me to revisit a review I wrote of the Center for Justice and Democracy Study “Workers’ Compensation: A Cautionary Tale,” now a decade old. When objective observers corroborate your own instincts, it is gratifying. The study on workers’ compensation, undertaken by the Center for Justice and Democracy, concluded that since workers struck their bargain with employers early in the 20th Century, legislators and administrators have cut benefits and ushered many injured workers completely out of the system. 

Particularly insidious has been the workers’ compensation insurance carrier’s malicious, relentless campaign to advance the notion of employee fraud. In Wisconsin, the aggressive insurance media blitz prompts a response (when I say that I represent injured workers) at every social gathering, wedding, birthday, or cocktail party, about  employees “ripping off” the workers’ compensation system. This, in the face of irrefutable statistical evidence that employee fraud is infinitesimally small is a boil on the butt of the workers’ compensation system.

On the other hand, employer fraud dwarfs employee fraud. Under-representing payroll, mischaracterizing heavy-lifting laborers as clerical workers or independent contractors, and forcing injured workers to claim work injuries against their health insurance is fraud, but not as “media-sexy” as filming an alleged injured worker bowling or rock climbing.

This media barrage of employee fraud has created a milieu in which some workers, legitimately injured, do not even report injuries. For immigrants with an already tenuous status in America, the Center’s study reports that just six in ten workers hurt on the job report their injuries for fear or retaliation. The Center’s study reports alarming national trends that I see in my practice daily, resulting in denials and delays of legitimate claims. These include stricter criteria for proving a workplace injury and insurance company efforts terminating benefits at age 65 (despite increasing evidence that the retirement age is increasing). 

Lastly, ubiquitous adverse medical examiners’ reports assigning causation to some pre-existing condition corresponds to an alarming alteration in the standard for causation. Legislation requiring “substantial” or “major contributing” cause or replacing “contributing” with “prevailing” factor makes workers jump over higher hurdles to obtain compensation more than ever before. Those of us who represent injured workers will continue to try to give injured workers a boost, despite Governor Walker and Republican legislators’ efforts to the contrary.

Article Published: Wisconsin and Minnesota Workers’ Compensation Claims Comparison

Tom Domer just published an article “A Comparison of Wisconsin and Minnesota Workers’ Compensation Claims” in the William Mitchell Law Review.

The article was prompted by calls from Minnesota colleagues asking whether Wisconsin or Minnesota jurisdiction would be appropriate for work injuries.  The article compared a hypothetical injury from Ole a 58 year old truck driver hired in Minnesota by a corporation registered in Minnesota and Wisconsin, who worked half time in Minnesota and half time in Wisconsin.  In route to Milwaukee for a delivery, he tripped in a pot hole at a sex shop in Wisconsin after stopping for lunch and drinking six beers.  He injured his neck, leaving a scar on his forehead, underwent neck fusion surgery with resulting permanent work restrictions.

The article compares Wisconsin and Minnesota on liability, the involvement of alcohol, whether the injury arose out of employment and was in the course of employment.  It further compared benefits in Wisconsin and Minnesota including Temporary Total Disability, permanency benefits, vocational rehabilitation, Loss of Earning Capacity, disfigurement, Permanent Total Disability, and whether there was a Social Security offset for workers’ compensation benefits.

While some benefits were better in Minnesota, overall the likelihood for recovery was better in Wisconsin.

Alternatives to Workers’ Comp: Paranoia or Possibility

I joined a national organization of lawyers representing injured workers (the Work Injury Law and Advocacy Group) twenty years ago when it was first formed. Then, I heard horror stories about legislators messing with an otherwise stable workers’ compensation system after every election cycle. My colleagues in other states were constantly fighting battles over workers’ compensation “deform.” 

I thought we were insulated in Wisconsin because we had a workers’ compensation advisory council composed of labor and management who every two years fought out a compromise bill and submitted it to the legislature, which automatically rubber-stamped the proposed bill without changes. That changed in Wisconsin in 2014. For the first time in nearly 50 years, the Republican legislature rejected the “agreed upon” bill proposed by the workers’ compensation advisory council, despite the approval of the bill by management members.

Governor Scott Walker’s most recent budget contains a provision to dismantle the workers’ compensation system as we know it. Those of us representing injured workers (and those rational members on the management side) are busy lobbying to remove the workers’ compensation dismantling provisions from the budget.

It is no secret that many major corporations dislike workers’ compensation, despite statistics indicating premiums are at their lowest for employers, and profits at their highest for insurers. However, nearly two dozen major corporations including Wal-Mart, Nordstrom’s and Safeway are behind a multi-state lobbying effort to make it harder for workers hurt on the job to collect workers’ compensation benefits. The companies have financed a lobbying group the Association for Responsible Alternatives to Workers’ Compensation (ARAWC) that has already helped write legislation designed to have employers “opt out” of a State workers’ compensation system. ARAWC has already helped write legislation in Tennessee. That group’s executive director Richard Evans told an insurance journal in November that the corporations ultimately want to change workers’ compensation laws in all fifty states. Lowe’s, Macy’s, Kohl’s, SYSCO Food Services, and several insurance companies are also part of the effort. The mission of ARAWC is to pass laws allowing private employers to opt out of the traditional workers’ compensation plans that almost every state requires businesses to carry. Employers who opt out would still be compelled to purchase workers’ compensation plans, but would be allowed to write their own rules governing when, for how long, and for which reasons an injured employee can receive medical benefits and wages. Two states, Texas and Oklahoma, already allow employers to opt out of State-mandated workers’ comp. In that state, for example, Wal-Mart has written a plan that allows the company to select the physician and the arbitration company that hears disputes. A 2012 survey of Texas companies with private plans found that less half the companies offered benefits to seriously injured employees or the families of workers who died in workplace accidents. 

Oklahoma passed an opt out measure in January 2014 and the oil and gas industry along with major retailers such as Hobby Lobby pushed hard for the change. ARAWC wants to take that Texas and Oklahoma model nationwide. Seeing the workers’ compensation provision in Wisconsin’s budget bill as part of this overall “scheme” may seem paranoid, but the history of recent “deform” legislation suggest the connection is at least a possibility. 

See the complete article at http://www.motherjones.com/politics/2015/03/arawc-walmart-campaign-against-workers-compensation.

“No Trauma” Does Not Mean No Injury

I’ve been investigating Wisconsin and national fraud statistics in worker’s compensation to prepare for a national presentation I am making in Cape Cod in July. One fascinating and recurring basis for denial of worker’s comp claims (and potential claims against employees for fraud) stems from an insurance carrier’s review of the initial medical report.

Often the physician or emergency room nurse, physicians assistant or First Responder will ask an injured worker “Did you have any trauma?” If the answer to the question is “no”, the medical records will routinely indicate “no trauma”. This information is translated by the insurance carrier as a denial that an injury occurred. The level of medical sophistication for an injured worker is routinely limited. Most of my clients (and based on inquiries with other workers’ attorneys, their clients as well) believe a trauma is something akin to getting hit by a bus. They do not equate the notion of trauma with lifting a heavy object such as a table or a box. The criteria for traumatic injuries in most states, including Wisconsin, is that a single incident or episode caused the injury or aggravated a pre-existing condition beyond a normal progression. In many cases a lack of “traumatic injury” at the initial medical presentation is not an accurate indication of whether a traumatic injury actually occurred.