Monday, April 28, 1997
It sounds like someone on center-ice at a hockey game. But the"tiebreaker doctor" is a new way to get quick actionon worker's compensation claims.
"Using the tiebreaker doctor, employers and their injuredworkers can resolve, in less than a month, disputes about medicaltreatment that typically take a year or more to resolve throughthe traditional hearing process," explained Greg Krohm, administratorof Worker's Compensation in Wisconsin.
The Wisconsin Department of Workforce Development, which administersthe worker's compensation system for all public and private employersin Wisconsin, has signed a contract with the UW-Madison Hospital'sDepartment of Rehabilitation Medicine to perform the tiebreakerexams. Under the contract, the UW-based physicians agreed tocomplete the exam and issue an opinion within 30 days regardingthe worker's ability to return to work.
The idea is simple. Ask some of the best rehabilitation doctorsin the country to quickly exam the injured worker and decide ifhe or she can go back to work, if there should be any restrictionson work activities to accommodate the injury, and if further medicaltreatment is necessary.
While the tiebreaker doctor's opinion is not binding, it giveseveryone some independent, authoritative guidance about the needfor things like back surgery, knee or hip replacement, or otherexpensive or extended medical care.
"Not only are we getting fast, high-quality opinions,"said Linda Stewart, Secretary of the Department of Workforce Development,"but this tiebreaker-doctor option provides the first effectiveremedy for resolving disputes about the need for future medicaltreatment."
"This process gets at one of the No. #1 complaints in theworker's compensation process: timely medical treatment,"added State Rep. Daniel P. Vrakas, chairman of the Assembly LaborCommittee. "I am pleased with the Department's efforts inworking with the UW Medical School. I believe it will prove tobe a beneficial program." Vrakas is a non-voting member ofthe Worker's Compensation Advisory Council.
Administrative hearings do a good job of looking back at what'shappened to an injured worker and then deciding who was rightor wrong about the course of treatment. But they do not adequatelyaddress disagreements about the injured employee's need for futuremedical care.
State law authorized the tiebreaker option more than a decadeago but finding highly qualified and neutral experts in rehabilitativemedicine was difficult. Stewart said the willingness of a world-class,medical facility like the University of Wisconsin Hospitals andClinics to get involved in worker's compensation issues was thekey to getting this pilot project off the ground.
The Department predicted the tiebreaker option will be used somewherebetween 50 to 250 times a year.