Workers comp healing period wage loss payments are made while the injured worker is unable to work due to a work-related injury or condition and is in his or her healing period. Healing period is not defined in the statutes, but the courts explained it to mean “the period prior to the time when the condition becomes stationary.” Knobbe v. Industrial Comm’n, 208 Wis. 185 (1932). The court explained that during that period, “the employee is submitting to treatment, is convalescing, still suffering from his injury, and unable to work because of the accident. The interval may continue until the employee is restored so far as the permanent character of his injuries will permit.” The court later explained in Larsen Co. v. Industrial Commission, 9 Wis. 2d 386 (1960), “[a]n employee’s disability is no longer temporary when the point is reached that there has occurred all of the improvement that is likely to occur as a result of treatment and convalescence.” The phrase reaching a plateau is often used to mean that the employee is coming to the end of the healing period.
If the workers comp insurer refuses to pay for necessary treatment, liability for temporary disability benefits may continue even though the injured employee’s condition is at a plateau. Similarly, when surgery for a work-related injury is delayed because of a non-work-related medical condition (e.g., heart condition or blood thinning issues), the employee may still be eligible for temporary disability benefits if the work-related injury is the cause of the employee’s continuing unemployment. An employee is entitled to TTD benefits if he or she remains temporarily disabled during the period in which he did not seek medical treatment because he lacked health insurance.
The period of healing cannot be determined in retrospect by the treating physician or an independent medical examiner or IME doctor. So, if TTD benefits were paid and now a treating doctor or IME says, in looking back the end of healing was earlier, the paid TTD benefits cannot be taken back or credited against other benefits. By the same logic, a treating doctor who did not have an injured worker off for a period of time, he cannot now go back in time and say the worker should have been off due to the work-related injuries so as to make temporary total benefits available. Applicant’s counsel is free to argue that continued treatment, no change in symptoms and a later end of healing date make a case for a past period of healing TTD claim.
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