Recent trends have seen some employers hire on-site healthcare providers, oftentimes a nurse or a physical therapist. Depending on your viewpoint and utilization, these healthcare providers can be seen as a convenient benefit to employees, a way to contain healthcare costs, or a way to minimize workplace injuries. While an employer may encourage an injured worker to see the on-site nurse, therapist, or physician, it is important that workers know that Wisconsin’s Worker’s Compensation law allows them to choose their own doctor.
Injured workers in Wisconsin have an almost unrestricted right to choose their treating healthcare provider. Wisconsin statute allows the injured worker his or her choice of any physician, chiropractor, psychologist, dentist, podiatrist, physician assistant, or nurse practitioner, so long as they are licensed to practice in Wisconsin. If the worker wants to obtain treatment out of state, then the worker must obtain a referral from a Wisconsin practitioner or obtain the employer’s consent.
An employee is limited to two choices of a treating provider. If the employee is unhappy with the first treating provider, he or she has the right to choose a second treating provider. However, treatment by providers who practice together as partners or as a clinic only counts as one choice. Further, a referral from one healthcare provider to another healthcare provider also counts as one choice.
Part of the convenience of on-site healthcare for work injuries is offset by the worker’s compensation policy that allows employees to claim reimbursement for mileage related to medical treatment. This policy applies to medical appointments, physical therapy, and pharmacy visits.
More importantly, the choice of a healthcare provider has ramifications well beyond the type and scope of medical treatment that the injured worker receives; the healthcare provider’s opinions about an injured employee’s work injury plays a huge role in determining the amount of compensation the injured worker receives. The healthcare provider determines very important medical-legal issues, such as (1) whether the injury is indeed work-related; (2) whether the injury is permanent; (3) what is the amount of permanency; and (4) what are the work restrictions. The healthcare provider’s answers to these questions can determine the amount of compensation for a work injury.
Because so much of the worker’s compensation system depends on a healthcare provider’s opinions, it is crucial that an injured worker does not feel restricted to their employer’s suggestion. Remember, you have a right to choose your own doctor.