Claims Kit

Physician Selection  102.42 (2) 

Generally, the worker is afforded medical control. When a worker reports an injury, the employer must offer the worker the right to select a doctor of the worker's choice for rendering claim-related treatment. The employee may select any physician, psychologist, chiropractor, dentist, podiatrist, physician assistant, advanced practice, or nurse prescriber who is licensed to practice in Wisconsin. By mutual agreement, the employee may have the choice of any qualified practitioner not licensed in Wisconsin so long as they are appropriately licensed in their home state. 

If the injury creates an emergency situation, the employer may make whatever arrangements are necessary to ensure the worker can receive immediate treatment. Once the emergency passes the worker has the right to select a doctor of their choosing to render future treatment.

If the employee is not satisfied with the first doctor they choose, a second choice is allowed. While the worker must notify the employer of this second choice, the employer may not object to it.

After changing doctors once, any further change may be made only by mutual agreement between the employee, employer, and insurance carrier. If the attending doctor refers the employee to a specialist or a series of specialists, this referral is still considered to be treatment by one doctor. If several doctors in one partnership or clinic are seen, these are all considered one doctor.

Failure to notify the employer of the initial selection or of a change of doctors may lead to a disputed claim and the possibility of the injured employee having to pay for the entire cost of treatment.

Penalties for Late Reporting  102.18

An employer may be assessed a 10% penalty for a delay in reporting an injury when the delay causes an untimely payment to the employee. If the penalty amount is not paid by the designated date, a default order may be issued awarding benefits to the worker. 

If an employer intentionally fails to file a report of injury they may be assessed a penalty for bad faith up to $30,000 or 200% of the total compensation due, whichever is lesser. 

Posting Requirements  102.12

The Workers' Compensation Division has developed a poster that informs both employees and employers of their rights and responsibilities under the Wisconsin Worker's Compensation Act. This free publication also provides a space for employers to include information about their insurance carrier or claim administrator in the event of a claim.

These posters should be posted in one or more conspicuous places where notices to employees are customarily placed. The poster can be found below.

Wisconsin Workers' Compensation Notice to Injured Workers and Employers (WKC-19606p)

Reporting of Claim by Employer  80.02

An employer is required to report all alleged work-related injuries or illnesses to its worker's compensation insurance carrier within 7 days after the accident or beginning of a disability from occupational disease. If the injury is a fatality, however, the employer must make this report--in writing, on a paper submission--to the applicable insurance carrier and Division within 24 hours.