AB 501 (Spiros) compared to WC council bill Prepared by: J.Buchen 12/2/2015

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1 AB 501 (Spiros) compared to WC council bill Prepared by: J.Buchen 12/2/2015 Provisions AB 501 WC Council Bill Employers Covered by Workers Comp Workers Comp coverage triggered by employment of three or more people. In AB 501 Not in Council Bill Misrepresentation of Preexisting Condition Bars recovery if employee made a false representation as to their physical condition on an employment application, the employer relied on the false representation in making a hiring decision and there was a causal connection between the false representation and the injury. In AB 501 Not in Council Bill Workers Comp Denied by Another State Bars an employee from making a claim in Wisconsin if they filed a claim and were denied on the merits in a different state. In AB 501 Not in Council Bill Wellness Programs Adds a requirement to current law exemption for injuries suffered while participated in an uncompensated wellness program that the participation be outside of the employees employment duties. In AB 501 Not in Council Bill Local Governmental Units Technical change to the definition of municipality. In AB 501 In Council Bill Decreased Compensation for Employee Negligence If an employee's injury is caused by negligence attributable to the employee the amount of compensation payable is reduced by the proportion of negligence attributable to the employee. In AB 501 Not in Council Bill

2 Social Security Offset The current offset of social security disability benetfits against wokers comp benefits would be expanded to incude retirement benifits begining July 1, The offset of social security benefits against workers comp benefits would not be available if the injured employee is available for work. In AB 501 Not in Council Bill Reduction for Benefits Paid by Another State Wisconsin workers comp benefits may be reduced by the amount of benefits paid to an injured worker by another state. In AB 501 Not in Council Bill Supplemental Benefits Changes the date at which a perm total employee is eligible for supplemental benefits, from injuries occurring prior to Jan. 1, 2001 to Jan. 1, 2003 and sets the maximum benefit limit. Statute of Limitations for Traumatic Injuries Reduces the current 12 year statute of limitations for filing a claim for workers compensation due to traumatic injury. In AB 501 with the maximum benefit limit set at $615. In AB 501 with the statute of limits set at two years from date of injury. In Council Bill with the maximum benefit limit set at $669. In Council Bill with the statute of limits set at 6 years from the date of injury. Termination for Misconduct or Substantial Fault An employer is not liable for temporary disability benefits during an employees healing period when the employee is suspended or terminated due to "misconduct" or "substantial fault" as defined in the unemployment compensation statute. In AB 501 In Council Bill Renewed Period of Temporary Disability Eliminates the provision in current law whereby an employee that has a renewed period of disability two or more years after the date of injury the benefits are payable at the rate in effect at the time of renewed disability. In AB 501 Not in Council Bill

3 Vocational Rehabilitation Sunset The provision in current law that allows a person receiving vocational rehabilitation services to not reduce temporary disability benefits work of less than 24 hours in a week, sunset April 30, AB 501 extends the sunset date to April The Council Bill eliminates the sunset. Prescription Drug Treatment Generally limits the cost of prescription drugs dispensed outside of a licensed pharmacy to the average wholesale price. In AB 501 In Council Bill Permanent Partial Disability Generally modifies the application of minimum disability ratings In AB 501 disability minimums do not apply if it is shown that there is no actual impairment after the procedure. In the Council Bill DWD is directed to establish a committee of medical professionals to revise the disability ratings and eliminate minimums if deemed appropriate. Violation of Drug and Alcohol Policies If an employee violates an employers drug and alcohol policy and it is a cause of an injury no workers comp indemnity benefits are payable. Not in AB 501 In Council Bill Apportionment of Permanent Disability When an employee sustains a work related injury and a portion of the disability was caused by other factors, the employer is only responsible for the percentage of disability attributable to the work related injury. Not in AB 501 In Council Bill Maximum Perm Partial Disability Benefits Increase the maximum permanent partial disability benefit from $322 to $342 for injuries occurring before Jan. 1, 2017 and to $362 for injuries occurring after that date. Not in AB 501 In Council Bill

4 Notice of Injury Require injured workers to file their application for workers compensation within one year of the date of injury to remain eligible for workers compensation. Current law specifies two years. In AB 501 Not in Council Bill Electronic Health Care Records Allows health care providers to provide health care records in electronic format. In AB 501 with a limit on charges of $26 per request. In Council Bill with a limit on charges of $10 per request. Final Practitioners Report Prohibits DWD from requiring the submission of a final practitioners report where a claim for compensation has been denied in its entirety. In AB 501 In Council Bill with a limit on charges of no more than $100 for a final report. Prospective Voc Rehab Orders Permits DHA to include in an interlocutory or final award and order directing the employer or insurer to pay for a future course of instruction or rehab training service. In AB 501 In Council Bill Review of Disability Awards Requires injured worker receiving permanent partial disability benefits to submit to a reexamination every three years and allows DHA to make new findings and awards based on the level of disability at the time of reexamination. In AB 501 Not in Council Bill Review of Workers Comp Decisions Require LIRC to dismiss a petition for review that is not filed within 21 days. In AB 501 In Council Bill Judicial Review Require LIRC to identify in an order of award the names of the persons that must be made parties to an action for judicial review of the order of award and makes other technical changes. In AB 501 In Council Bill

5 Investigation and Prosecution of Fraud Creates a position in the Department of Justice, funded by workers compensation to investigate and prosecute fraud. In AB 501 In Council Bill Health Service Fee Disputes Establishes any fee for a health care service agreed to between an employer or insurer and a health care provider as per se "reasonable" for the purposes of the fee dispute resolution process in current law. In AB 501 Not in Council Bill Choice of Practitioner Requires employers to offer injured workers their choice of health care practitioner as provided under the employers health benefit plan. Where there is no health benefit plan the employer may specify that the employee select from practitioners of the employers choice. In AB 501 Not in Council Bill Self Insured Employers Makes various technical changes recommended by the Self Insured Council In AB 501 In Council Bill