Website - Division of Worker's Compensation
Email - WC Administration
Website - Division of Worker's Compensation
Email - WC Administration
Members present: Ms. Bean, Mr. Beiriger, Mr. Brand, Mr. Buchen, Mr. Furley, Ms. Huntley-Cooper, Mr. Kent, Mr. Newby, Mr. Olson, Mr. Scott, and Ms. Vetter
Excused: Mr. Shaver
Staff present: Mr. Conway, Mr. O’Malley, Ms. Knutson, and Mr. Krueger
Call to Order/Introductions: Ms. Huntley-Cooper convened the Worker’s Compensation Advisory Council (WCAC) meeting at 11:00 a.m. in accordance with Wisconsin’s open meetings law. WCAC members, staff and members of the audience introduced themselves. Ms. Huntley-Cooper introduced Mr. Jeff Scott, Vice President of Worker’s Compensation Claims with Wausau Insurance as the new insurance member of the WCAC.
Minutes: Ms. Vetter moved adoption of the minutes of the May 11, 2006 meeting and Mr. Brand seconded the motion. The minutes are to be amended to correct page 2, the second paragraph, second sentence to read: “While the Office of Commissioner of Insurance has concerns, from the department’s viewpoint it is a registration bill with a significant impact on Chap. 102, Wis. Stats.” The motion was unanimously approved and the minutes were adopted as amended.
Public Comment: Ms. Jane Wester addressed the WCAC and expressed concern regarding insurance carriers scheduling independent medical evaluations without properly investigating claims, delays in scheduling a hearing and release of confidential medical information, and posting of Labor and Industry Review Commission decisions in worker’s compensation cases on LIRC’s website that contain the employee’s name and other personal information, including medical information. Ms. Wester provided a copy of her written comments as well. Mr. O’Malley explained that the Worker’s Compensation Division (WCD) has no website with orders on it; LIRC posts decisions of importance in worker’s compensation, unemployment insurance and equal rights cases on its website. LIRC takes the position that their decision are in the public domain. The WCAC requested that the WCD approach LIRC concerning eliminating identifying information from the worker’s compensation decisions posted on their website to protect employees’ privacy. Mr. O’Malley also explained there is a process for requesting an expedited hearing in appropriate cases. The WCAC requested regular updates on the WCD’s progress in reducing the delay in scheduling formal hearings.
Safe Lift Grant
Sue Gleason and Mr. Rick Orton from DWD provided an update to the WCAC on
Safe Lift Grants, a part of Gov. Doyle’s GROW Wisconsin initiatives. Ms.
Gleason explained that $325,000 in 18 training grants have been awarded to
health care providers to assist in training staff in the use of safe-lifting
equipment. The training is to be provided between now and June 30, 2007.
Mr. Orton provided a few examples of the grants awarded both in terms of
dollars and the number of staff included in the training proposal. Ms.
Gleason will provide an update to the WCAC at a later date on the number of
medical provider staff trained with the grant funds and an evaluation of the
impact of the program on reducing back injuries.
Attorney Fee Proposal Presentation: Attorneys John Edmondson, John Neal and Raymond Clausen presented information on attorney’s fees in worker’s compensation claims. Mr. Neal indicated that the issue of attorney’s fees has not been addressed since 1982. He recommended that a workgroup be formed to review Wis. Admin. Code §DWD 80.43. He specifically raised issues concerning attorney’s fees in cases where the employee is also receiving Social Security Disability benefits; uniform administration by the department of DWD 80.43, specifically attorney’s fees on medical expenses; attorneys claiming fees in cases where there has not been a denial of benefits; and attorneys representing both a party with a right of reimbursement and the injured worker. Mr. Edmondson and Mr. Clausen provided written comments to the WCAC. Mr. Edmondson commented that many injured workers do not dispute denials of benefits because they are unable to retain legal representation. He advocated for a sliding fee scale for attorney’s fees, particularly in small claims, that the applicant’s attorney be named a party in interest when attorney’s fees are awarded or denied in cases, and for the elimination of the limitation on attorney’s fees on penalty claims. Mr. Clausen agreed that a workgroup should be formed to address the issue of attorney’s fees. He expressed concern that injured workers do not receive legal representation on medical expense claims. The WCAC requested that the department organize a meeting of attorneys, insurance company representatives and department staff to discuss issues surrounding approval and payment of attorney’s fees and to review best practices in other states. The department should report back to the WCAC on any recommendations by the workgroup.
Report on the PEO Committee: Mr. O’Malley reported that the committee members had reviewed proposed amendments to Chapter 102, Wis. Stats and appeared to arrive at a consensus. The second committee meeting scheduled for July 18, 2006 was postponed because some committee members were unable to attend. The next meeting will be held in the next three to six months. Mr. Conway explained that the WCRB filing would require separate polices for each client/employer of a PEO. OCI initially extended review of the filing to June 2006 to give the WCAC a chance to study the issue. OCI decided to adopt the filing with an amendment, with a scheduled effective date of November 1, 2006. A lawsuit was then filed by the PEOs. The Senate Committee on Agriculture and Insurance asked OCI to suspend the filing if it would not go through the rulemaking process. The main issue now is whether master policies or separate client/employer policies should be required. The Joint Committee for Review of Administrative Rules has given OCI and WCRI until August 18, 2006 to respond to their concerns. Mr. Buchen commented that the Senate Committee on Agriculture and Insurance wants OCI to wait on the filing until the WCAC has a chance to complete its work. The PEOs are advocating one master policy to track individual experience rather than individual policies. Mr. Krueger explained that “experience dumping” is an issue with master policies. The experience modifier does not follow the employer into the master policy. Some employers cancel PEO contracts years later when the experience modifier has been “cleansed”. Insurance liaisons are invited to join the PEO Committee and Mr. Jeff Scott indicated he would participate.
Health Care Provider Advisory Committee: Ms. Huntley-Cooper advised that committee meetings were held on June 23rd and August 4th. The committee has monthly meetings scheduled through December with the next meeting scheduled on September 9th. The committee is reviewing the current draft of the Treatment Guidelines and has agreed to a few changes to date. The committee’s recommended changes and any minority opinions will be submitted in a report to the WCAC for review and approval. For the next agreed upon bill, it will be recommended that the statute be amended to delete reference to the Minnesota treatment standards. While there are no surgeons on the committee, the physician members have asked other doctors to review the Treatment Guidelines.
Discussion of other Committees: Ms. Knutson reported that a
meeting will be scheduled for late September/early October. Staff has
surveyed other states that have benefit escalator clauses and a SSDI reverse
offset in reviewing issues associated with increases in benefit rates in
Mr. Krueger reported that the Logger’s Bill Committee will have its first meeting within the next month and will report back its findings within the year to the WCAC. Ms. Bean and Mr. Furley are members of this committee.
Correspondence: Mr. O’Malley discussed the resolution passed by
the Wood County Board supporting a change in the law allowing for selection
of a treating practitioner from a pool. At the last public hearing a person
from Wood County appeared and testified on this issue. Mr. Newby commented
that the Worker’s Compensation Research Institute’s (WCRI) recent 12-state
comparison on medical costs indicated that in Wisconsin total medical
expenses per claim were lower than other states but medical care costs for
individual procedures were higher than other states.
Mr. Conway indicated the department received a letter from Mr. Barry Eisenberg, Executive Director of the American College of Occupational and Environmental Medicine (ACOEM) commenting on the Treatment Guidelines. Ms. Huntley-Cooper will share the letter with the Health Care Provider Advisory Committee.
The department received an e-mail message from Mr. Chuck Carr indicating he was unable to make today’s meeting. He expressed concern regarding a lack of appropriate and sufficient input from permanent total disability (PTD) recipients on the issue of PTD benefit rates. He has made for names and addresses of PTD recipients so that he can contact them. The department cannot provide this information. Currently the department advises the public of hearings through the department website, newspapers and the department’s interested persons’ mailing list. Mr. Kent suggested that the department contact Wisconsin Public Radio and television regarding free public service announcements. The department could advertise the WCAC public hearing through a public service announcement.
Ms. Jodie Connor sent an e-mail regarding the issue of the statute of limitations for certain prosthetic devices. Mr. O’Malley explained the amendment to Wis. Stat. §102.17(4) provides the insurance carrier is liable for payment of benefits or treatment expenses for certain traumatic injuries (i.e. prosthetics) occurring more than 12 years from the date of injury or last date of payment of compensation effective April 1, 2006 regardless of the date of injury. Mr. Beiriger indicated that it was not the WCAC’s intent to extend the statute of limitations for hip or knee replacements when no joint replacement had occurred prior to the statute of limitations running on the claim.
Mr. Scott requested that the issue be re-evaluated and placed on the agenda for the next meeting for further discussion.
The letter from OCI to the Senate Committee on Agriculture and Insurance was discussed in the report on the PEO Committee.
The WCAC members requested they be provided a copy of all subcommittee minutes and agendas.
Adjournment: Discussion on all agenda items concluded and the meeting was adjourned at approximately 3:00 p.m. The next meeting is scheduled for October 12, 2006.