Handling Disputes Over Medical Treatment In Wisconsin Workers’ Compensation Cases

medical treatment

Disputes over medical treatment can create significant challenges for injured workers seeking workers’ compensation benefits in Wisconsin. Wisconsin’s workers’ compensation system is designed to make sure that employees receive necessary medical care and benefits after a workplace injury. However, disagreements can arise between injured workers, employers, and insurance companies regarding medical treatment. These disputes center around what constitutes reasonable and necessary care. When medical treatment disputes arise, the injured workers can feel uncertain about their legal rights, options, and future. As Wisconsin workers’ comp attorneys dedicated to helping injured workers, we aim to clarify how these disputes can be addressed under Wisconsin workers’ compensation law.

Under Wisconsin Statute § 102.16, employers and their insurers must cover the medical expenses related to workplace injuries. However, disputes can occur when employers or insurers question the necessity, cost, or appropriateness of a particular treatment. Understanding your rights and the legal processes involved is crucial to resolving these issues and obtaining the care you need to recover.

Common Reasons For Medical Treatment Disputes

  • Denial Of Treatment – Employers or insurers sometimes deny a specific medical procedure or therapy by claiming the treatment is medically unnecessary or is not related to the work injury.
  • Choice Of Doctor – Wisconsin law permits injured workers to choose their treating physician. Disputes may arise if an employer or insurer questions your doctor’s recommendations or insists on an independent medical examination (IME).
  • Cost Of Treatment – Insurers may argue that a recommended treatment is too expensive and suggest alternative, less costly options.
  • Disagreement Over Diagnosis – If there is a conflict between your treating physician’s diagnosis and the insurer’s IME, the insurer may dispute the recommended course of treatment.

Resolving Medical Treatment Disputes

Under Wisconsin workers’ compensation laws, there are steps you can take to resolve disputes and protect your rights to necessary medical treatment.

    • Know Your Right To Choose A Doctor – Wisconsin law gives injured workers the right to select their treating physician. If the insurer disputes your doctor’s recommendations, you are entitled to seek a second opinion from another qualified healthcare provider.
    • Independent Medical Examinations (IME) – Employers and insurers may require you to undergo an IME conducted by a doctor of their choice. While IMEs are legal, the findings often favor the employer or insurer. You can challenge the IME report by presenting evidence from your treating physician or additional medical experts.
    • File A Dispute With The Wisconsin Department Of Workforce Development (DWD) – If disputes over medical treatment persist, you can file a complaint with the DWD under Wisconsin Statute § 102.16. The DWD can mediate or hold a hearing to determine whether the treatment in question is necessary and covered.
    • Seek Legal Representation – Workers’ compensation claims are complex, involving detailed medical records and legal arguments. This is why working with our workers’ compensation attorneys can help make sure that your workers’ compensation case is presented effectively and that your rights are protected throughout the claims process.

Wisconsin Workers’ Compensation Medical Treatment Frequently Asked Questions

What Medical Treatments Are Covered Under Wisconsin Workers’ Compensation Law?

Wisconsin workers’ compensation law covers all reasonable and necessary medical treatments related to a workplace injury. This includes doctor visits, surgeries, medications, physical therapy, and rehabilitation. The treatment must be deemed necessary by a qualified healthcare provider.

Can I Choose My Own Doctor For Workers’ Compensation Treatment?

Yes, Wisconsin law allows you to choose your treating physician. However, disputes may arise if your employer or their insurer questions your doctor’s recommendations. If this happens, you can seek a second opinion or legal assistance to address the issue.

What Should I Do If My Treatment Is Denied By The Insurer?

If the insurer denies your treatment, start by obtaining a detailed explanation for the denial. You can challenge their decision by providing additional medical evidence from your treating physician. Filing a dispute with the Wisconsin Department of Workforce Development is another option to resolve the matter.

What Is An Independent Medical Examination, And How Does It Affect My Claim?

An independent medical examination (IME) is conducted by a doctor chosen by your employer or insurer to assess your injury and treatment. The IME report can influence the insurer’s decision to approve or deny care. If the IME contradicts your treating physician’s recommendations, you can challenge it with additional evidence.

How Can An Attorney Help With Medical Treatment Disputes?

An attorney can guide you through the dispute resolution process, gather evidence to support your claim and represent you in hearings before the Wisconsin Department of Workforce Development. Legal representation ensures that your rights are protected and that you receive the medical care you need.

Call Our Milwaukee Worker’s Compensation Attorneys For A Free Consultation

If you are facing disputes over medical treatment in your Wisconsin workers’ compensation case, it’s important to act quickly to protect your rights. At Gillick, Wicht, Gillick & Graf, we are committed to helping injured workers secure the medical care they deserve. Our legal team understands the challenges of these disputes and is here to guide you every step of the way.

Contact our Milwaukee worker’s comp attorney at Gillick, Wicht, Gillick & Graf by calling 414-257-2667 to receive your free consultation. With offices in Milwaukee, we proudly represent injured workers throughout Wisconsin. Let us help you fight for the benefits and treatment you need to recover and move forward.

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