Can I cash the check from the insurance company or am I signing off on my claim?
If you receive payment of benefits from your employer’s workers’ compensation insurance carrier (insurer), you may cash the check without fear of losing any legal rights or additional benefits for your claim. A settlement that may affect your rights to make additional claims for workers’ compensation benefits may be made only by a compromise agreement. This is a formal document, which must be signed by all parties involved and approved by the Department of Workforce Development. A worker does not compromise his claim by accepting benefits voluntarily paid by the WC insurer.
Do I have to sign a release for full disclosure of my medical records?
Once you have obtained an attorney, all correspondence between you and the insurer should be conducted through your attorney. It is not uncommon for knowledgeable insurance adjusters to obtain information that seems unimportant to you at first but could be potentially damaging to your case in the future. Please allow your attorney to specifically indicate situations when you may or should correspond directly with the workers’ compensation insurance carrier. Keep in mind that by law the insurance company does have the right to review your medical records as part of their defense to your claim.
What is an IME?
The insurer is entitled by law to conduct a medical examination by a doctor of its choice to render an opinion on your condition. Insurers may call this an “Independent Medical Examination” (IME), but it is really an “Insurer’s Medical Examination.” The insurer is permitted to send you to an IME at reasonable intervals, and it generally must be the same doctor each time. You are not forming a doctor-patient relationship by attending this examination, so this doctor does not have the right to actually treat you. The insurer must pay for both the examination itself and mileage to get to the examination. If you miss time for work to attend the IME, the insurer should compensate you for the missed time.
Do I have to return to work within my temporary limitations?
There is a dual responsibility between your employer and yourself to make sure your doctor’s temporary limitations are being followed. If your employer offers you a job within the restriction of your doctor, you should try to do the work. If the job, even within the limitations, is too difficult, please make an appointment to see your doctor and get these restrictions adjusted.
My employer does not have work available within my permanent limitations – what should I do?
If you have an injury resulting in permanent partial disability, permanent restrictions and wage loss, you may be entitled to additional benefits for retraining. If you have an injury to your back, torso or body (body as a whole) that has resulted in permanent partial disability, permanent restrictions and wage loss, contact us to discuss bringing a loss of earning capacity claim. If you believe that you are physically able to do an available job and your employer does not allow you to do this job, please contact us to discuss a possible “unreasonable refusal to rehire” claim.
The insurance company is investigating my claim – what does this mean?
Remember that the insurer has the right to investigate your claim to formulate a defense. This includes reviewing your medical records and monitoring your medical treatment. Please be aware that the use of video surveillance has been an increasing method for insurers to monitor whether an employee is following their restrictions. If your claim is denied or you feel the insurer is taking too long to make a decision, please contact us to see if we may pursue a claim on your behalf.
Do I have to allow a rehabilitation nurse, assigned by the insurance company, into my doctor’s appointments?
While the insurer is allowed to investigate your claim, you do NOT have to allow anyone else to come into the actual doctor’s appointment with you. The insurer may send a representative to talk to your doctor, but you should not allow this person to interfere with your appointment.
How long do I have to bring a claim in Wisconsin?
We always recommend reporting injuries as soon as they happen in the form of an employer’s incident report. In most workers’ compensation cases, claims can be made within 12 years of the date of injury or the last date of a compensation payment, whichever date occurs later in time.