Health Care Provider Advisory Committee
Meeting Minutes for October 29, 2010
Frances Huntley-Cooper, Barbara Janusiak, Maja Jurisic MD, Steven Kirkhorn
MD, Jeff Lyne DC, Peter Schubbe DC, Jennifer Seidl, Ron Stark MD
Excused: David Bryce MD, Gina Buono MD, Mary Jo Capodice DO, Amanda Gilliland, Mike
Lischak MD, Karen Pease, Sri Vasudevan MD.
Staff present: Joy Schmitt and Jim O'Malley
Observers: None present at meeting.
- Call to Order:
The Health Care Providers Advisory Committee (HCPAC) meeting was called
to order by Frances Huntley-Cooper at approximately 10:20 AM in accordance
with Wisconsin’s open meeting law.
Members of the HCPAC and the Department staff introduced themselves.
- Approval of Minutes: The minutes of the February 19, 2010
meeting were unanimously approved without correction.
- Unfinished business:
The members of the HCPAC had no unfinished business to discuss. Jennifer
Seidl recommended patient access and service delivery as a new topic for
Jim O’Malley discussed the requirements for incorporating standards
established by technical societies and organizations of recognized standing
by reference into administrative rules. When an agency wishes to incorporate
standards by reference in an administrative rule, the agency is required to
submit a written request for authorization to the Wisconsin Attorney
General. The factors considered are whether the rule is of limited
public interest, the extent of unwarranted expense if permission is not
granted, if the standards were established by a society or organization of
nationally recognized standing, and if the standards are readily available
in published form or are available on optical disk or other electronic
format. Jim O’Malley contacted the Attorney General’s Office and was
given an informal opinion that the paper Imaging Guidelines for Low Back
Pain Secondary to Work Injury would not be approved for incorporation by
reference because of its relative short length and there is a concern about
whether it is readily available to the public.
- New business: Review DWD forms & Publications Related to
The committee reviewed the publication Guide for Wisconsin Doctors
(WKC-7280) that included instructions for completing the WKC-16-B. Steve
Kirkhorn stated that sometimes physicians do not have enough information to
respond to Questions 11, 12 and 13 on the WKC-16-B. Ron Stark suggested
adding a third answer block for these questions for the practitioner to
respond “Not Know”.
There was a discussion about the degree of certainty that is required for
physicians to express opinions on the Department’s medical report forms. The
requirement is for opinions to be expressed to a reasonable degree of
medical probability. It is not necessary for opinions to be expressed to a
reasonable degree of medical certainty. Opinions expressed on the basis of
possibility are not sufficient to support an award of compensation.
Steve Kirkhorn suggested that the publication Guide for Wisconsin Doctors
(WKC-7760) should include examples on how to correctly fill out the answers
to Questions 11, 12 and 13 on the WKC-16-B.
The committee reviewed How to Evaluate Permanent Disability (WKC-7761).
In many states the AMA Guidelines are used to assess permanent disability
resulting from work-related injuries. Ron Stark advised that figure 26 on
page 18 showing radial (abduction) and ulnar (adduction) flexion of the
wrist were reversed.
The committee reviewed the information available under the heading
Medical on the Worker’s Compensation Division’s webpage. There was a
discussion about employees being strongly encouraged to see the employer’s
doctor and how this impacts care. Tie-breaker examinations and return
to work at modified duties were discussed.
- Future Meeting:
There were no major issues to cover at this time. Future meetings will be
held as issues come up. The consensus of the committee was that it was not
necessary to schedule another meeting until there were enough items to fill
the agenda. The chairperson may have a teleconference with the committee
members to discuss scheduling future meetings.
- Adjournment: The meeting was adjourned approximately at