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Choice of Treating Doctor Archives

Workers Comp Choice of Treating Doctor

Unlike in some states, choice of treating doctor in Wisconsin workers compensation claims is up to the injured worker, not the employer or insurance company. Years ago an employer was permitted to have a panel of doctors in the area that the injured employee had to choose from. Wis. Stats. Secs. 102.42(2) and (3) have since been amended, and the panel of every employer now includes every practitioner "licensed to practice and practicing in the state." Also, an injured worker is entitled to one second choice. However, keep in mind that any health care provider your first choice refers you to that doctor and all subsequent referrals from that source are within your first choice. So is an injured worker is assiduous about getting referrals, his choices are virtually unlimited. Without a tree of referrals, a third choice or choice of an out-of-state practitioner, can be had but only with the employer's consent. Wis. Stat. § 102.42(2). Partners and clinics count as one practitioner as well. If a Wisconsin physician refers an employee out of state for medical treatment, the employee need not obtain permission from his or her employer before undergoing the out-of-state treatment. UFE Inc. v. LIRC, 193 Wis. 2d 361, 534 N.W.2d 627 (Ct. App. 1995). The Wisconsin Court of Appeals has held that, under section 102.42 , "an employee 'chooses' a practitioner by seeking treatment from that practitioner and by seeking reimbursement for that practitioner's expenses." Hermax Carpet Marts v. LIRC, 220 Wis. 2d 611, 623 , 583 N.W.2d 662 (Ct. App. 1998) . Thus, a worker who sought treatment from four different practitioners but only sought reimbursement for the charges of the first and fourth practitioners did not exceed his choice of physicians under section 102.42.

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