An important message from WAJ President Mark Thomsen
Posted by: Bob Menard
July 02, 2009
Topic: An important message from WAJ President Mark Thomsen

State budget bill passes, has implications for you and your clients

Dear WAJ Members:

The state budget bill is now history. With the stroke of the Governor's pen a series of important changes were enacted that will directly benefit many of our clients.

One of our priorities for this legislative cycle was to make significant changes in Wisconsin's auto insurance laws. In addition to the "Truth in Auto Insurance" provisions the budget also mandates auto insurance in Wisconsin, making New Hampshire the only state that does not require drivers to carry insurance. While WAJ did not make this a priority we urged passage of this provision once it was added to the budget in the State Senate.

The Governor did veto two auto insurance provisions we had advocated. The liability rate increases were to be phased in over a three-year period up to $100,000/$300,000/$25,000. While the first increase goes into effect in 2010 - $50,000/$100,000/$15,000 - the remaining two increases were vetoed. The rates will still be subject to a CPI increase every 5 years beginning in 2017. The elimination of the "drive other car" exclusion was also vetoed.

The budget also provides a provision that takes the regulation of medical record copying fees and places the rate into the statutes. This eliminates the requirement for the Department of Health and Family Services to conduct an administrative review of the rates every 3 years. This language also states that the medical bills are presumed to state the reasonable value of the services provided and that they are presumed reasonable and necessary for the care of the patient.

Thanks goes to all WAJ leaders and staff who worked so diligently on these issues. Without your strength to keep fighting and never giving up we would not be where we are today.

Take a minute to review the list of changes below. I am confident each of you will see the positive benefit of these efforts on behalf of you and your clients. I am hopeful that you will renew your commitment to the efforts of WAJ when called upon.

(The budget act, Act 28, is available online at http://www.legis.state.wi.us/. It is on the right side and designated, "2009 Budget Bill as vetoed (Act 28)" I have put the sections and page numbers after each provision, so you can find the provisions online.

Truth in Auto Insurance Provisions
1. Increase Minimum Automobile Liability Coverage: Jan. 2010 - $50,000/$100,000/$15,000 and subject to a CPI review every 5 years beginning in 2017. (Section 2962t, page 556)
2. UIM will be a required mandatory coverage. (Section 3161, page 590)
3. Increase in UM/UIM minimum coverage to $100,000/$300,000 per policy. (Sections 3159 & 3161, page 590)
4. Defines UIM coverage by comparing the negligent driver's liability insurance limit with the amount of damages (or injuries) actually sustained by the policyholder. (Section 3153, page 590)
5. Elimination of reducing clauses: Insurance companies will no longer be able to deduct the amount of insurance carried by a negligent driver from the uninsured/underinsured coverage purchased by the injured policyholder. This change will make sure injured drivers/passengers can access the full amount of insurance they have paid for when they need it. (Section 3171, page 592)
6. Prohibits anti-stacking provisions in automobile policies, except the policy may limit the number of vehicles covered up to three (3). (Sections 3168 and 3169, page 591)
7. Umbrella Coverage: Requires that the policyholder reject in writing the offer of UM/UIM coverage for umbrella or excess liability policies. (Section 3167, page 591)
8. Hit and run claims: Insurance companies will no longer be able to deny coverage for hit and run accidents because no physical contact occurred. Now with independent third party verification drivers who are injured will have access to UM coverage. (Section 3155, page 590)
9. Prohibits a health insurance plan from not providing coverage on the basis there is coverage under a liability insurance policy. (Section 3197, page 595)
Effective Date: The changes will first apply to motor vehicle insurance policies that are issued or renewed on the first day of the 5th month after publication. Publication is July 1, 2009. (Section 9326(6), page 680 and Section 9426(2) on page 688)

Health Care Copying Costs:
Statutory Limits on Medical Record Copying: Sets the rates in the statute.
1. For paper copies, 35 cents per page.
2. For microfiche or microfilm copies, $1.25 per page.
3. For a print of an X-ray, $10 per image.
4. For certification of copies, $5.
5. For processing and handling, a single $15 charge for all copies requested.
6. Actual shipping costs. (Section 2433e, page 489)
If a patient is requesting his or her own medical records, there is no processing or handling fee. (Section 2433d, page 489) In addition, if your client is medically indigent, they are entitled to one free copy of their medical records. (Section 2433(d)2, page 489)

NOTE: One provision concerning the cost of requesting electronic records was vetoed. Because we are not sure of that implication, the WAJ office is recommending that attorneys request paper copies of all medical records at this time.

In addition, under Wis. Stat. 908.03 (6m) the definition of health care providers was broadened to include all health care providers under 146.81(1) and the billing statements and invoices are presumed to state the reasonable value of health care services provided and are presumed reasonable and necessary to the care of the patient. (Section 3285gb, pages 614-15)

Effective Date: These provisions go into effect on July 1, 2009. (Section 9322(9c), page 680 and Section 9400, page 685)

I look forward to seeing you in Door County at the WAJ Summer Seminar July 10-11 to update you on what additional programs and legislative initiatives we have planned and to hear your views.
Sincerely,
Mark
Mark L. Thomsen
WAJ President

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Importance of Documentation
Posted by: Bob Menard
June 17, 2009
Topic: Importance of Documentation

Please remember that documents, such as the accident report and your medical records, are keys to your case. These documents can get you the benefits that are due and owing to you.

The accident report must be made with your employer as soon as possible. Document exactly how the accident happened and what body parts was injured. Notify your superior as soon as the accident occurs, so that the documentation process can begin immediately.

Medical records are the most important documents for your case. They are vital to your worker's compensation case, as they are the evidence of the cause of the injuries, evidence of the injuries that occurred, as well as the extent of the injuries. Please be sure to tell your health care provider that this injury occurred at work. Some clients forget to tell their doctors that their injuries occurred at work, and this can become a problem later on.

Keep in mind that documents, such as medical records, are vital to your case and are the means of support that will get you the benefits you are owed.

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IME Form Intro
Posted by: Bob Menard
June 10, 2009
Topic: IME Form Intro

Documentation is key for your case. Here is a link to a form about the IME (Independent Medical Exam) that you can complete after the exam. Please be sure to read the questions before you enter the exam. Do not bring this form with you into the examination room.

This form is to keep a record of your thoughts during the exam, as well as a record on the actions of the doctor examining you. This will be a useful tool for your case and will help your attorney with your case.

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IME Letter
Posted by: Bob Menard
June 05, 2009
Topic: IME Letter

When you get injured on the job, some insurance companies will require you to attend an IME (Independent Medical Exam), where a doctor hired by the insurance company will examine you to determine if you are in fact injured from an accident that occurred from your workplace.

If an IME has been scheduled for you, please keep these ideas in mind:

• Be prompt, polite and cooperative.
• Be aware of video surveillance activities to and from the exam.
• Do not exceed any physical limitations set by your doctor (i.e. carry a purse that weighs over ten pounds).
• If you have a back injury, be careful to wear flat shoes.
• If you have a shoulder injury, please wear a shirt that is easily removed.
• Be aware that the doctor and/or employees of the IME office routinely watch individual=s movement in and out of the exam, from the parking lot to the exam office and exiting the building.
• Be honest, accurate and consistent on your recollection on how your injury occurred (stick to your story/history). Be sure to tell the doctor about your current pain and discomfort as a result of your injury and answer truthfully about prior accidents or injuries if specifically asked (do not volunteer information that is not asked).
• Do not complete a questionnaire! If asked to do so, indicate that this is at the advisement of your attorney. Do not bring records, MRI or x-ray films, or lists of complaints to the appointment.
• Do not sign any authorizations, tell them you are represented and they can obtain them through your attorney.
• Do not answer medical and employment questions that are not reasonably related to your injury being claimed.
• Do not ask the IME doctor what his opinion is! He/she will provide a report to the insurance carrier upon the completion of it. He/she is hired to write a report and not to treat your condition.
• Be careful to be exact in your responses (i.e. sometimes a doctor will ask for the exact pinpoint of pain and then mark it with a pen. Later, they will touch a spot an inch away from the mark and ask you again. If you now answer yes to this different spot, they will note it.)
• If you have a back injury, often a doctor will press on your head and ask you if this causes back pain. Please be careful to only answer yes if you actually feel back pain.

This doctor has been hired by the insurance company to provide an independent evaluation of your case. Their report can indicate whether your benefits will continue, or if your benefits will be denied. If you have been denied your benefits, contact the law firm of Derzon & Menard, S.C. here.

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Q: When I report an injury at work should I fill out an accident report?
Posted by: euser
August 20, 2008
Topic: Personal Injury

A:  Yes!  Immediately request an accident report form from your employer.   The accident report needs to be completed in detail.  Even if you dont get medical attention that day.  You need to have something on file.  Always make a copy of he report that you submit to your employer.  I cant tell you how many times the reports are missing.  This is the first step in documenting your case.  Remember in Workers compensation cases DOCUMENTATION is everything.  

 

Learn more about Personal Injury.

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