WI Workers Compensation Claims Require Support from a Medical Doctor The Practitioner Who Evaluates You Matters
As the U.S. healthcare industry grows in complexity, healthcare professionals without traditional doctorates in medicine, like physician’s assistants and nurse practitioners, have increasingly assumed primary and specialized medical care roles. In the context of Wisconsin worker’s compensation, this seemingly harmless diversification of medical practitioners providing treatment can create headaches when securing and submitting the appropriate medical support to the worker’s compensation insurer.
WI Workers’ Compensation Law Limits Medical Support to Doctors
In Wisconsin, a Department of Workforce Development (“DWD”) form known as the WKC-16-B is used to formally notify the state and the worker’s compensation insurer that a specific injury, disease, and/or condition is work-related. However, only certain medical practitioners are permitted to complete WKC-16-B’s on the
cause and extent of a work injury under the
Worker's Compensation Act. Specifically, an actual physician – either a
Doctor of Medicine (MD) or
Doctor of Osteopathic Medicine (DO) – must state on a WKC-16-B that a given injury or health condition is work-related for the claim to be accepted. For mental injuries like post-traumatic stress disorder, a treating
clinical psychologist (PsyD) is permitted to complete a WKC-16-B on behalf of the worker. Regrettably, this means a WKC-16-B from a treating physician assistant or nurse practitioner that opines on the cause and extent of a work injury may be rejected by the worker’s compensation insurer or an administrative law judge.
You May Need to See a Doctor After a Nurse Practitioner or Physician Assistant Diagnoses Your Injuries or Illness
The rule requiring a physician to complete your WKC-16-B can be arbitrary at times, especially when your nurse practitioner or physician assistant is the only medical practitioner you have seen. In addition, your treating nurse practitioner or physician assistant might be the healthcare professional most knowledgeable about the facts of your case. Therefore, as the roles of providers like chiropractors, nurse practitioners, physician assistants, and physical therapists increase in providing primary care for work injuries, keep in mind that a medical doctor may be necessary to officially certify on a WKC-16-B that your injury is work-related.
If your worker’s compensation claim was denied due to lacking a WKC-16-B from a qualified medical practitioner, contact Hawks Quindel’s experienced
worker’s compensation attorneys for a free evaluation of your claim.