Medical treatment or choice of doctor under Wisconsin’s worker’s compensation law is that an injured worker is entitled to unlimited medical, surgical, chiropractic, psychological, podiatric, dental, and hospital treatment (including treatment by physician assistants and advanced practice nurse prescribers) “as may be reasonably required to cure and relieve from the effects of the injury.” Wis. Stat. Sec. 102.42(1). The Wisconsin Supreme Court has held that the need for treatment, if disputed, must be proved by expert medical testimony. Wis. Tel. Co. v. Indus. Comm’n, 263 Wis. 380 (1953).
Although the question whether medical treatment is work-related usually has to do with treatment already rendered in the past and is either unpaid or paid for by health insurance, future medical treatment can be ordered at a hearing. Wis. Stat. Sec. 102.18(1)(b)2.
The employer and/or its workers comp insurance carrier is also liable for reasonable and necessary treatment “to prevent further deterioration in the condition of the employee or to maintain the existing status of such condition whether or not healing is completed.” Wis. Stat. § 102.42(1). Responsibility for medical bills does not end with the final payment of disability benefits but is subject to Wis. Stat. § 102.17(4), which bars the filing of an application for hearing after 12 years from the last payment of compensation for occupational disease or, in the case of traumatic injury, after 6 years from the last payment of compensation. Liability for medical expenses generally does not cease with a final order but is subject only to the statute of limitation. Wis. Stat. § 102.17(4) ; Lisney v. LIRC, 171 Wis. 2d 499 , 493 N.W.2d 14 (1992). Liability for future medical expenses can be extinguished by a full and final compromise approved by the Department of Workforce Development. Liability for medical expenses can exist before the official date of injury, if an occupational disease claim is later established. The workers compensation carrier may be required to reimburse a health insurance carrier who paid the otherwise work-related bills.
An injured worker in Wisconsin can treat with any practitioner “licensed to practice and practicing in the state.” Wis. Stat. § 102.42. The injured employee is entitled to a second opinion or choice of doctor physician. There is no third choice covered by workers compensation. However, partners and the same clinic count as one practitioner. More importantly, referrals to other practitioners do not count as additional choices. If a Wisconsin physician refers out of state for medical treatment, it is covered.
McCormick Law Office in Milwaukee, Wisconsin submits medical bills supplied to us by the injured worker at the hearing when going for temporary or permanent disability benefits.
