Website - Division of Worker's Compensation
Email - WC
Council on Worker’s Compensation
November 12 , 2013
Mr. Beiriger, Ms.
Bloomingdale, Mr. Brand, Mr. Brandl, Mr. Buchen, Mr. Ginsburg, Mr. Kent, Mr.
Metcalf, Ms. Nugent, Ms. Pehler, Mr. Redman, Mr. Schwanda and Ms.
Staff present: Mr. Aiello, Mr. Ezalareb, Mr. Krueger, and Mr. O’Malley
Next Meeting December 3rd, 2013
- Call to Order/Introductions:
Mr. Metcalf convened the
Worker’s Compensation Advisory Council (WCAC) meeting at approximately 10:00
a.m. in accordance with Wisconsin’s
open meetings law. WCAC members,
staff and members of the audience introduced themselves.
Approval of Minutes:
Ms. Bloomingdale moved to approve the minutes of
the October 15th, 2013 meeting.
Mr. Beiriger seconded the motion.
The minutes were unanimously approved
Labor & Industry Review Commission LIRC proposed legislative changes
to CH. 102:
Tracey Schwalbe, LIRC General Counsel, Bill Jordahl, LIRC Commissioner,
and Jeff Shampo, LIRC Attorney, appeared at the meeting.
stated the Labor and Industry Review Commission (LIRC) handles appeals for
worker's compensation cases, unemployment insurance cases and public
accommodation cases with the Equal Rights Division.
LIRC receives appeals on about 200 worker's compensation cases per
year. LIRC receives appeals on
about 100 cases from the Equal Rights Division and about 3,000 cases from
the Unemployment Insurance Division.
LIRC has three commissioners who are appointed by the Governor and
serve staggered six year terms.
LIRC does not generally recommend legislative changes.
LIRC is recommending four legislative changes at this time. Ms. Schwalbe provided a handout that summarized the proposed law
changes for worker's compensation suggested by LIRC.
proposed change results from the Wisconsin Supreme Court's decision in
Xcel Energy Services, Inc. v. LIRC. In that case there was a procedural issue that came up because the
plaintiff did not name the right parties on the summons and complaint, and
there were other issues relating to the merits of the case.
LIRC proposes to amend s.102.23, Stats. to clarify that the party who
files an appeal of a LIRC decision to court shall be named the plaintiff,
and shall name as defendants LIRC and those persons or entities identified
by LIRC in its decision as necessary to be named in the court appeal.
If the plaintiff names LIRC and those persons or entities identified
by LIRC, the case would not be dismissed for not naming a proper party. LIRC's proposed change also provides that a court may join other
parties not identified by LIRC if the court determines the other party is
necessary and would not unduly delay the case.
LIRC created a work group to look at the appeals process and the work group
came up with three other procedural changes.
The first change will require worker's compensation appeals to be filed at
the LIRC. LIRC proposes to amend
s. 102.18 (3), Stats., to provide that appeals will be filed only with LIRC. Under current law appeals of worker's compensation cases may be filed
with either the Department of Workforce Development or LIRC.
The reason for this proposal is to streamline the appeals process so
that only one office is receiving appeals and LIRC has better control over
its workload from the time of the appeal.
LIRC also proposes to amend s. 102.18 (3), Stats., to clarify the language
of the standard for LIRC to consider in reviewing late appeals.
The standard will remain the same and the petition for review must be
late for a reason beyond the petitioner's control before LIRC can entertain
LIRC proposes to amend s. 102.18 (4) (a), Stats., to clarify the time period
for the appeal runs from the date of LIRC's decision. The language proposed by LIRC will clarify that the time during which
LIRC may set aside its decision for further consideration runs from the date
of the LIRC decision. This
proposal does not change the amount of time that LIRC has to set aside
decisions and this change leaves open the option for LIRC to send decisions
to the parties other than by mail in the future.
Ms. Schwalbe stated that these
proposals have also been presented to the Unemployment Insurance Advisory
Council. LIRC will also be looking at
the rules process to update procedural rules to make the review process go
Mr. O’Malley reviewed the
correspondence received by the WCAC since the last meeting.
A letter dated October 29th,
2013 was received from Ms. Jennifer Maurer, Director of Government
Affairs, Automated HealthCare Solutions (AHCS) recommending to the
extent the WCAC is considering a fee schedule for physician dispensed
medications, AHCS supports the adoption of a reasonable fee schedule
that does not go so far as to discourage or restrict physicians' ability
to continue dispensing medication to their injured workers. AHCS
strongly recommends that any fee schedule language under consideration
by WCAC mirror Florida Senate Bill 662 which limits reimbursement for
repackaged prescription medications dispensed by a practitioner to 112.5
percent of the original manufacturer's average wholesale price (AWP),
plus an $8.00 dispensing fee, as of July 1, 2013.
An e-mail message dated November 11th, 2013 from 25 Wisconsin
businesses was received that stressed the importance of bringing down
the cost of worker's compensation in Wisconsin.
The WCAC was requested to put forward a proposal this session
that will effectively bring down worker's compensation related medical
prices and that the legislature works quickly to pass it in to law.
A letter dated November 5th, 2013 from the Health Care
Liaisons to the WCAC was received that contained references to a number
of studies that showed the strengths of the Wisconsin worker's
compensation system and recommended some legislative changes to the
1. Health care service prices for payers
will be discounted for payers that meet administrative and payment
standards. For claims paid
within 30 days, 10 percent will be taken off billed charges. For claims paid within 45 days, 5 percent will be taken off billed
2. Require insurers to move toward an
electronic claims system which can help facilitate the ability to make
payments within the suggested time targets, and that insurers and
self-funded plans must be able to accept electronic claims submissions and
be able to make electronic claims payments by January 1, 2016.
3. Payers will be allowed to reduce health
care provider's bills that are more than 1.2 standard deviations above the
4. The Department of Workforce Development
should create a robust database for calculating the 1.2 standard deviations
above the mean charge using data reported to the Worker's Compensation
Rating Bureau, the Wisconsin Health Information Organization and the WHA
5. Physician dispensing of pharmaceuticals
should be restricted as contained in proposals from Labor and Management.
However, the WCAC should be watchful of any access issues that may
develop with this change.
A rate of $26.00 should be established
as the rate for providing electronic copies of medical records requested by
7. The WCAC should adopt Department's
Proposal Number 4 to amend DWD 80.72 and DWD 81 of the Wisconsin
Administrative Code to reflect the national implementation of ICD-10 codes
as of October 1, 2014.
8. Many of the health care related
suggestions submitted by the Legislators are sound and should become the
Health Care Providers Advisory Committee's agenda for their quarterly
meetings. The HCPAC should
submit recommendations in the following areas for consideration.
Review the treatment guidelines in DWD 81 of the Wisconsin
Administrative Code, review the disability ratings in DWD 80.32 of the
Wisconsin Administrative Code,
conduct a thorough examination of opioid use and prescribing practices, make
recommendations on compounding drugs and make recommendations about
causation and return to work assessments.
- Other Council Business:
Motion by Mr. Beiriger,
seconded by Ms. Bloomingdale to go in to closed caucus.
The motion carried unanimously and the Labor and Management
representatives went in to closed caucus at approximately 10:30 a.m.
The WCAC reconvened in open session at approximately 3:15 p.m.
Mr. Beiriger stated that he and the other members of the WCAC appreciate
everyone's patience during the deliberations for this agreed upon bill. There is so much more to cover this session than in recent sessions.
Employers, employees, Department, LIRC, health care providers, and
legislators have all presented proposals for the WCAC to consider.
The WCAC has tried to be respectful of all information and has tried
to take all of the information into consideration. Today was the first real chance that the WCAC members had to discuss
all of the issues. Progress at
reaching an agreed upon bill is being made.
Motion by Mr. Beiriger, seconded by Ms. Bloomingdale, to accept the
proposals for legislative change from LIRC and the Department.
The motion carried unanimously.
Motion by Mr. Beiriger, seconded by Ms.
Bloomingdale to adjourn.The motion
carried unanimously and the meeting was adjourned at approximately 3:25 p.m