The bill also provides that DWD may use an alternative nationally recognized
prescription drug pricing source for determining average wholesale prices of
prescription drugs if the Drug Topics Red Book is discontinued and becomes
unavailable.
Minimum permanent partial disability ratings
This bill requires DWD, at least once every eight years, to review and revise the
minimum permanent partial disability ratings that DWD has promulgated by rule
for certain amputation levels, losses of motion, sensory losses, and surgical
procedures resulting from injuries for which permanent partial disability is claimed.
Before revising those ratings, DWD must appoint a medical advisory committee,
composed of physicians practicing on one or more areas of specialization or treating
disciplines within the medical profession, to review those ratings and recommend

revisions of those ratings, based on typical loss of function, to DWD and the Council
on Worker's Compensation.
Hearings and procedures
Health care records in electronic format
This bill permits a physician, chiropractor, psychologist, podiatrist, dentist,
physician assistant, advance practice nurse prescriber, hospital, or health service
provider, upon request by an injured employee, employer, insurer, or DWD, to
provide that person with any written material that is reasonably related to an injury
for which the employee claims worker's compensation in electronic format upon
payment of $26 per request. Current law requires those practitioners to provide that
material to those requesters upon payment of the actual cost of providing those
materials, not to exceed the greater of 45 cents per page or $7.50 per request, plus
the actual costs of postage, but does not address providing those materials in
electronic format.
Final practitioner's report
This bill prohibits DWD from requiring a treating practitioner to submit a final
report to DWD if 1) an injured employee has a period of temporary disability of more
than three weeks or a permanent disability, has undergone surgery to treat an injury,
other than surgery to correct a hernia, or sustains an eye injury requiring medical
treatment on three or more occasions off the employer's premises; 2) the employer
or insurer denies the employee's claim for worker's compensation in its entirety; and
3) the employee does not contest that denial. Current law prohibits DWD from
requiring submission of a final report under those circumstances, but does not
specify that the employee's claim for compensation must be denied in its entirety.
The bill also requires a treating practitioner to complete a final report on a
timely basis and permits a treating practitioner to charge no more than $100 for
completing a final report.
Prospective vocational rehabilitation training orders
This bill permits DHA to include in an interlocutory or final award or order an
order directing the employer or insurer to pay for a future course of instruction or
other rehabilitation training services provided under a rehabilitation training
program. Current law specifically permits DHA to include in an interlocutory or
final award or order an order directing the employer or insurer to pay for any future
treatment that may be necessary to cure and relieve an injured employee from the
effects of the employee's injury, but does not specifically permit DHA to include in
such an order or award an order directing payment for a future course of instruction
or other services provided under a rehabilitation training program.
Administrative review of a worker's compensation decision
This bill requires the Labor and Industry Review Commission (LIRC) to
dismiss a petition for review that is not filed within 21 days after DWD or DHA
mailed a copy of the examiner's findings and order to the petitioner's last-known
address unless the petitioner shows that the petition was filed late for a reason that
was beyond the petitioner's control. Currently, LIRC must dismiss a petition for

review that is not "timely" filed unless the petitioner shows probable good cause that
the reason for failure to timely file the petition was beyond the petitioner's control.
The bill also allows LIRC to set aside a decision for further consideration within
28 days after the date of the decision, not within 28 days after the date of its mailing
as under current law.
Judicial review of a worker's compensation decision
This bill requires LIRC to identify in an order or award made by LIRC the
persons that must be made parties to an action for judicial review of the order or
award. The bill also requires the summons and complaint in the action to name those
persons as defendants. In addition, the bill permits the circuit court to join as a party
to the action any other person determined necessary for the proper resolution of the
action, unless joinder of the person would unduly delay the resolution of the action.
Program administration
Investigation and prosecution of fraudulent activity
This bill permits DWD to request the Department of Justice (DOJ) to assist
DWD in an investigation of a false or fraudulent worker's compensation claim or any
other suspected fraudulent activity on the part of an employer, employee, insurer,
health care provider, or other person related to worker's compensation. If, based on
the investigation, DWD has a reasonable basis to believe that theft, forgery, fraud,
or any other criminal violation has occurred, DWD must refer the matter to the
district attorney or DOJ for prosecution.
Self-insured employers
Election by governmental employer to self-insure. This bill codifies into
statute certain DWD rules that permit the state or a local governmental unit to
self-insure its worker's compensation liability without further order of DWD.
Specifically, the bill permits the state or a local governmental unit that has
independent taxing authority (governmental employer) to elect to self-insure its
worker's compensation liability without further order of DWD if the governmental
employer agrees to report all compensable injuries and to comply with the worker's
compensation law and the rules of DWD. Under the bill, a local governmental unit
that elects to self-insure its liability for the payment of worker's compensation must
notify DWD of that election in writing before commencing to self-insure that
liability, must notify DWD of its intent to continue to self-insure that liability every
three years after that initial notice, and must notify DWD of its intent to withdraw
that election not less than 30 days before the effective date of that withdrawal.
Revocation of governmental employer election to self-insure. This bill
permits DWD to revoke an election by a governmental employer to self-insure its
liability for worker's compensation, without seeking the advice of the Self-Insurer's
Council, if DWD finds that the governmental employer's financial condition is
inadequate to pay its employees' claims for compensation, that the governmental
employer has received an excessive number of claims for compensation, or that the
governmental employer has failed to discharge faithfully its obligations under the
worker's compensation law and the rules of DWD. Under the bill, once such an
election is revoked, the governmental employer whose election is revoked may not

elect to self-insure its liability for the payment of worker's compensation unless at
least three calendar years have elapsed since the revocation and DWD finds that the
governmental employer's financial condition is adequate to pay its employees' claims
for compensation, that the governmental employer has not received an excessive
number of claims for compensation, and that the governmental employer has
faithfully discharged its obligations under the worker's compensation law and the
rules of DWD.
Self-insured employer assessments. This bill requires an initial assessment
for the self-insurer's fund, which is a fund that is used to pay the worker's
compensation liability of self-insured employers that cannot pay that liability, to be
prorated on the basis of the gross payroll for this state of the self-insured employer,
as reported to DWD for the previous calendar year for purposes of unemployment
insurance. Current law requires subsequent assessments for the self-insurer's fund
to be so prorated and requires an initial assessment for that fund to be equal to the
amount assessed upon each other self-insured employer.
The bill also clarifies that governmental employers are not covered under the
self-insurer's fund. Specifically, the bill prohibits DWD from 1) requiring a
governmental employer that elects to self-insure its liability for the payment of
worker's compensation to pay into the self-insurer's fund; and 2) making payments
from that fund for the liability under the worker's compensation law of such an
employer, whether currently or formerly exempt from the duty to insure.
For further information see the state and local fiscal estimate, which will be
printed as an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
SB536,1 1Section 1. 20.445 (1) (ra) of the statutes, as affected by 2015 Wisconsin Act 55,
2is amended to read:
SB536,8,83 20.445 (1) (ra) Worker's compensation operations fund; administration. From
4the worker's compensation operations fund, the amounts in the schedule for the
5administration of the worker's compensation program by the department, for
6assistance to the department of justice in investigating and prosecuting fraudulent
7activity related to worker's compensation,
for transfer to the uninsured employers
8fund under s. 102.81 (1) (c), and for transfer to the appropriation accounts under par.
9(rp) and s. 20.427 (1) (ra). All moneys received under ss. 102.28 (2) (b) and 102.75

1shall be credited to this appropriation account. From this appropriation, an amount
2not to exceed $5,000 may be expended each fiscal year for payment of expenses for
3travel and research by the council on worker's compensation, an amount not to
4exceed $500,000 may be transferred in each fiscal year to the uninsured employers
5fund under s. 102.81 (1) (c), the amount in the schedule under par. (rp) shall be
6transferred to the appropriation account under par. (rp), and the amount in the
7schedule under s. 20.427 (1) (ra) shall be transferred to the appropriation account
8under s. 20.427 (1) (ra).
SB536,2 9Section 2. 46.27 (5) (i) of the statutes is amended to read:
SB536,9,510 46.27 (5) (i) In the instances in which an individual who is provided receives
11direct funding for
long-term community support services under par. (b) for which the
12individual receives direct funding
, serve directly as a fiscal agent or contract with a
13fiscal intermediary to serve as a fiscal agent for that individual for the purposes of
14performing the responsibilities and protecting the interests of the individual under
15the unemployment insurance law. The county department or aging unit may elect
16to act as a fiscal agent or contract with a fiscal intermediary to serve as a fiscal agent
17for an individual who is provided long-term support services under s. 46.275, 46.277,
1846.278, 46.2785, 46.495, 51.42, or 51.437. The fiscal agent under this paragraph is
19responsible for remitting any federal unemployment compensation taxes or state
20unemployment insurance contributions owed by the individual, including any
21interest and penalties which are owed by the individual; for serving as the
22representative of the individual in any investigation, meeting, hearing , or appeal
23involving ch. 108 or the federal unemployment tax act (26 Unemployment Tax Act,
2426
USC 3301 to 3311) 3311, in which the individual is a party; and for receiving,
25reviewing, completing, and returning all forms, reports , and other documents

1required under ch. 108 or the federal unemployment tax act Unemployment Tax Act
2on behalf of the individual. An individual may make an informed, knowing, and
3voluntary election to waive the right to a fiscal agent under this paragraph. The
4waiver may be as to all or any portion of the fiscal agent's responsibilities. The waiver
5may be rescinded in whole or in part at any time.
SB536,3 6Section 3. 46.27 (5m) of the statutes is created to read:
SB536,9,117 46.27 (5m) Worker's compensation coverage. An individual who is
8performing services for a person receiving long-term care benefits under this section
9on a self-directed basis and who does not otherwise have worker's compensation
10coverage for those services is considered to be an employee of the entity that is
11providing financial management services for that person.
SB536,4 12Section 4. 46.275 (4m) of the statutes is created to read:
SB536,9,1713 46.275 (4m) Worker's compensation coverage. An individual who is
14performing services for a person receiving long-term care benefits under this section
15on a self-directed basis and who does not otherwise have worker's compensation
16coverage for those services is considered to be an employee of the entity that is
17providing financial management services for that person.
SB536,5 18Section 5. 46.277 (3r) of the statutes is created to read:
SB536,9,2319 46.277 (3r) Worker's compensation coverage. An individual who is
20performing services for a person receiving long-term care benefits under this section
21on a self-directed basis and who does not otherwise have worker's compensation
22coverage for those services is considered to be an employee of the entity that is
23providing financial management services for that person.
SB536,6 24Section 6. 46.281 (1k) of the statutes is created to read:
SB536,10,5
146.281 (1k) Worker's compensation coverage. An individual who is
2performing services for a person receiving the Family Care benefit, or benefits under
3Family Care Partnership, on a self-directed basis and who does not otherwise have
4worker's compensation coverage for those services is considered to be an employee
5of the entity that is providing financial management services for that person.
SB536,7 6Section 7. 46.2897 (title) of the statutes is amended to read:
SB536,10,7 746.2897 (title) Self-directed services option; advocacy services.
SB536,8 8Section 8. 46.2897 of the statutes is renumbered 46.2897 (2).
SB536,9 9Section 9. 46.2897 (1) of the statutes is created to read:
SB536,10,1310 46.2897 (1) Definition. In this section, "self-directed services option" means
11the program that is operated under a waiver from the secretary of the federal
12department of health and human services under 42 USC 1396n (c) in which an
13enrolled individual selects his or her own services and service providers.
SB536,10 14Section 10. 46.2897 (2) (title) of the statutes is created to read:
SB536,10,1515 46.2897 (2) (title) Advocacy services.
SB536,11 16Section 11. 46.2897 (3) of the statutes is created to read:
SB536,10,2117 46.2897 (3) Worker's compensation coverage. An individual who is
18performing services for a person participating in the self-directed services option
19and who does not otherwise have worker's compensation coverage for those services
20is considered to be an employee of the entity that is providing financial management
21services for that person.
SB536,12 22Section 12. 46.995 (3) of the statutes is created to read:
SB536,11,223 46.995 (3) An individual who is performing services for a person receiving
24long-term care benefits under any children's long-term support waiver program on
25a self-directed basis and who does not otherwise have worker's compensation

1coverage for those services is considered to be an employee of the entity that is
2providing financial management services for that person.
SB536,13 3Section 13. 101.654 (2) (b) of the statutes is amended to read:
SB536,11,84 101.654 (2) (b) If the applicant is required under s. 102.28 (2) (a) to have in force
5a policy of worker's compensation insurance or if the applicant is self-insured in
6accordance with s. 102.28 (2) (b) or (bm), that the applicant has in force a policy of
7worker's compensation insurance issued by an insurer authorized to do business in
8this state or is self-insured in accordance with s. 102.28 (2) (b) or (bm).
SB536,14 9Section 14. 102.01 (2) (d) of the statutes, as affected by 2015 Wisconsin Act 55,
10is amended to read:
SB536,11,1611 102.01 (2) (d) "Municipality" includes a county, city, town, village, school
12district, sewer district, drainage district and long-term care district and
"Local
13governmental unit" means a political subdivision of this state; a special purpose
14district or taxing jurisdiction, as defined in s. 70.114 (1) (f), in this state; an
15instrumentality, corporation, combination, or subunit of any of the foregoing; or any

16other public or quasi-public corporations corporation.
SB536,15 17Section 15. 102.03 (4) of the statutes is amended to read:
SB536,11,2418 102.03 (4) The right to compensation and the amount of the compensation shall
19in all cases be determined in accordance with the provisions of law in effect as of the
20date of the injury except as to employees whose rate of compensation is changed as
21provided in ss. s. 102.43 (5) (c) or (7) or 102.44 (1) or (5) or, before May 1, 2014, as
22provided in s. 102.43 (5) (c)
and employees who are eligible to receive private
23rehabilitative counseling and rehabilitative training under s. 102.61 (1m) and except
24as provided in s. 102.555 (12) (b).
SB536,16
1Section 16. 102.04 (1) (a) of the statutes, as affected by 2015 Wisconsin Act 55,
2is amended to read:
SB536,12,53 102.04 (1) (a) The state, and each county, city, town, village, school district,
4sewer district, drainage district, long-term care district and other public or
5quasi-public corporations therein
local governmental unit in this state.
SB536,17 6Section 17. 102.04 (2m) of the statutes is amended to read:
SB536,12,157 102.04 (2m) A temporary help agency is the employer of an employee whom
8the temporary help agency has placed with or leased to another employer that
9compensates the temporary help agency for the employee's services. A temporary
10help agency is liable under s. 102.03 for all compensation and other payments
11payable under this chapter to or with respect to that employee, including any
12payments required under s. 102.16 (3), 102.18 (1) (b) 3. or (bp), 102.22 (1), 102.35 (3),
13102.57, or 102.60. Except as permitted under s. 102.29, a temporary help agency may
14not seek or receive reimbursement from another employer for any payments made
15as a result of that liability.
SB536,18 16Section 18. 102.07 (1) (a) of the statutes is amended to read:
SB536,13,317 102.07 (1) (a) Every person, including all officials, in the service of the state,
18or of any municipality therein local governmental unit in this state, whether elected
19or under any appointment, or contract of hire, express or implied, and whether a
20resident of the state or employed or injured within or without the state. The state
21and any municipality local governmental unit may require a bond from a contractor
22to protect the state or municipality local governmental unit against compensation to
23employees of such the contractor or to employees of a subcontractor under the
24contractor. This paragraph does not apply beginning on the first day of the first July
25beginning after the day that the secretary files the certificate under s. 102.80 (3) (a),

1except that if the secretary files the certificate under s. 102.80 (3) (ag) this paragraph
2does apply to claims for compensation filed on or after the date specified in that
3certificate.
SB536,19 4Section 19. 102.07 (1) (b) of the statutes is amended to read:
SB536,13,125 102.07 (1) (b) Every person, including all officials, in the service of the state,
6or of any municipality therein local governmental unit in this state, whether elected
7or under any appointment, or contract of hire, express or implied, and whether a
8resident of the state or employed or injured within or without the state. This
9paragraph first applies on the first day of the first July beginning after the day that
10the secretary files the certificate under s. 102.80 (3) (a), except that if the secretary
11files the certificate under s. 102.80 (3) (ag) this paragraph does apply to claims for
12compensation filed on or after the date specified in that certificate.
SB536,20 13Section 20. 102.07 (3) of the statutes is amended to read:
SB536,13,2014 102.07 (3) Nothing herein contained shall prevent municipalities in this
15chapter prevents a local governmental unit
from paying teachers, police officers, fire
16fighters and other employees
a teacher, police officer, fire fighter, or any other
17employee his or her
full salaries salary during a period of disability, nor interfere
18interferes with any pension funds fund, nor prevent prevents payment to teachers,
19police officers or fire fighters therefrom
a teacher, police officer, fire fighter, or any
20other employee from a pension fund
.
SB536,21 21Section 21. 102.07 (7) (a) of the statutes is amended to read:
SB536,14,622 102.07 (7) (a) Every member of a volunteer fire company or fire department
23organized under ch. 213, a legally organized rescue squad, or a legally organized
24diving team is considered to be an employee of that company, department, squad, or
25team. Every member of a company, department, squad, or team described in this

1paragraph, while serving as an auxiliary police officer at an emergency, is also
2considered to be an employee of that company, department, squad, or team. If a
3company, department, squad, or team described in this paragraph has not insured
4its liability for compensation to its employees, the municipality or county political
5subdivision
within which that company, department, squad, or team was organized
6shall be liable for that compensation.
SB536,22 7Section 22. 102.07 (10) of the statutes is amended to read:
SB536,14,188 102.07 (10) Further to effectuate the policy of the state that the benefits of this
9chapter shall extend and be granted to employees in the service of the state, or of any
10municipality therein local governmental unit in this state, on the same basis, in the
11same manner, under the same conditions, and with like right of recovery as in the
12case of employees of persons, firms, or private corporations, any question whether
13any person is an employee under this chapter shall be governed by and determined
14under the same standards, considerations, and rules of decision in all cases under
15subs. (1) to (9). Any statutes, ordinances, or administrative regulations which
16statute, ordinance, or rule that may be otherwise applicable to the classes of
17employees enumerated in sub. (1) shall not be controlling in deciding whether any
18person is an employee for the purposes of this chapter.
SB536,23 19Section 23. 102.07 (20) of the statutes is created to read:
SB536,15,320 102.07 (20) An individual who is performing services for a person participating
21in the self-directed services option, as defined in s. 46.2897 (1), for a person receiving
22long-term care benefits under s. 46.27, 46.275, or 46.277 or under any children's
23long-term support waiver program on a self-directed basis, or for a person receiving
24the Family Care benefit, as defined in s. 46.2805 (4), or benefits under the Family
25Care Partnership program, as described in s. 49.496 (1) (bk) 3., on a self-directed

1basis and who does not otherwise have worker's compensation coverage for those
2services is considered to be an employee of the entity that is providing financial
3management services for that person.
SB536,24 4Section 24. 102.11 (1) (intro.) of the statutes is amended to read:
SB536,15,205 102.11 (1) (intro.) The average weekly earnings for temporary disability,
6permanent total disability, or death benefits for injury in each calendar year on or
7after January 1, 1982, shall be not less than $30 nor more than the wage rate that
8results in a maximum compensation rate of 110 percent of the state's average weekly
9earnings as determined under s. 108.05 as of June 30 of the previous year. The
10average weekly earnings for permanent partial disability shall be not less than $30
11and, for permanent partial disability for injuries occurring on or after April 17, 2012,
12and before January 1, 2013, not more than $468, resulting in a maximum
13compensation rate of $312, and, for permanent partial disability for injuries
14occurring on or after January 1, 2013, not more than $483, resulting in a maximum
15compensation rate of $322, except as provided in 2011 Wisconsin Act 183, section 30
16(2) (a)
the effective date of this subsection .... [LRB inserts date], and before January
171, 2017, not more than $513, resulting in a maximum compensation rate of $342, and,
18for permanent partial disability for injuries occurring on or after January 1, 2017,
19not more than $543, resulting in a maximum compensation rate of $362
. Between
20such limits the average weekly earnings shall be determined as follows:
SB536,25 21Section 25. 102.125 (title) of the statutes is amended to read:
SB536,15,23 22102.125 (title) Fraudulent claims Fraud reporting and, investigation,
23and prosecution
.
SB536,26 24Section 26. 102.125 of the statutes is renumbered 102.125 (1) and amended
25to read:
SB536,16,10
1102.125 (1) Fraudulent claims reporting and investigation. If an insurer or
2self-insured employer has evidence that a claim is false or fraudulent in violation of
3s. 943.395 and if the insurer or self-insured employer is satisfied that reporting the
4claim to the department will not impede its ability to defend the claim, the insurer
5or self-insured employer shall report the claim to the department. The department
6may require an insurer or self-insured employer to investigate an allegedly false or
7fraudulent claim and may provide the insurer or self-insured employer with any
8records of the department relating to that claim. An insurer or self-insured
9employer that investigates a claim under this section subsection shall report on the
10results of that investigation to the department.
SB536,16,16 11(3) Prosecution. If based on the an investigation under sub. (1) or (2) the
12department has a reasonable basis to believe that a violation of s. 943.20, 943.38,
13943.39, 943.392,
943.395, 943.40, or any other criminal law has occurred, the
14department shall refer the results of the investigation to the department of justice
15or
to the district attorney of the county in which the alleged violation occurred for
16prosecution.
SB536,27 17Section 27. 102.125 (2) of the statutes is created to read:
SB536,16,2218 102.125 (2) Assistance by department of justice. The department of workforce
19development may request the department of justice to assist the department of
20workforce development in an investigation under sub. (1) or in the investigation of
21any other suspected fraudulent activity on the part of an employer, employee,
22insurer, health care provider, or other person related to worker's compensation.
SB536,28 23Section 28. 102.13 (2) (b) of the statutes is amended to read:
SB536,17,924 102.13 (2) (b) A physician, chiropractor, podiatrist, psychologist, dentist,
25physician assistant, advanced practice nurse prescriber, hospital, or health service

1provider shall furnish a legible, certified duplicate of the written material requested
2under par. (a) in paper format upon payment of the actual costs of preparing the
3certified duplicate, not to exceed the greater of 45 cents per page or $7.50 per request,
4plus the actual costs of postage, or shall furnish a legible, certified duplicate of that
5material in electronic format upon payment of $26 per request
. Any person who
6refuses to provide certified duplicates of written material in the person's custody that
7is requested under par. (a) shall be liable for reasonable and necessary costs and,
8notwithstanding s. 814.04 (1), reasonable attorney fees incurred in enforcing the
9requester's right to the duplicates under par. (a).
SB536,29 10Section 29. 102.13 (2) (c) of the statutes is amended to read:
SB536,18,211 102.13 (2) (c) Except as provided in this paragraph, if an injured employee has
12a period of temporary disability that exceeds 3 weeks or a permanent disability, if the
13injured employee has undergone surgery to treat his or her injury, other than surgery
14to correct a hernia, or if the injured employee sustained an eye injury requiring
15medical treatment on 3 or more occasions off the employer's premises, the
16department may by rule require the insurer or self-insured employer to submit to
17the department a final report of the employee's treating practitioner. The
18department may not require an insurer or self-insured employer to submit to the
19department a final report of an employee's treating practitioner when the insurer or
20self-insured employer denies the employee's claim for compensation in its entirety
21and the employee does not contest that denial. A treating practitioner shall complete
22a final report on a timely basis and
may charge a reasonable fee for the completion
23of the final report, not to exceed $100, but may not require prepayment of that fee.
24An insurer or self-insured employer that disputes the reasonableness of a fee

1charged for the completion of a treatment practitioner's final report may submit that
2dispute to the department for resolution under s. 102.16 (2).
SB536,30 3Section 30. 102.17 (1) (a) 3. of the statutes, as affected by 2015 Wisconsin Act
455
, is amended to read:
SB536,18,95 102.17 (1) (a) 3. If a party in interest claims that the employer or insurer has
6acted with malice or bad faith as described in s. 102.18 (1) (b) 3. or (bp), that party
7shall provide written notice stating with reasonable specificity the basis for the claim
8to the employer, the insurer, the department, and the division before the division
9schedules a hearing on the claim of malice or bad faith.
SB536,31 10Section 31. 102.17 (4) of the statutes is amended to read:
Loading...
Loading...