Over half our injured worker clients do not have health insurance. Many work for employers who do not provide health insurance, and they simply cannot afford private insurance on meager wages.
Since workers do not have group health insurance coverage, they are denied access to the medical care they need when their injury claims are denied by the worker's compensation insurer. And their claims are routinely denied based on the comp carrier's "hired gun" adverse medical examiner or reviewer. Understandably, hospitals and doctors, who have "bottom line" issues to face, will not provide treatment without some assurance of "upfront" payment, leaving injured workers in the lurch.
Wisconsin injured workers are fortunate that our State law provides a potential remedy for "prospective treatment"; a judge can order a worker's compensation insurance company to pay for treatment (including diagnostic testing, surgery, etc.). But the time lapse in waiting for a hearing (40-6 months) and inevitable insurance company appeal (another potential 6-8 months), realistically means that necessary treatment goes wanting. Injured workers without some insurance alternative to workers compensation suffer while waiting for treatment. Universal health insurance coverage provides an answer to this dilemma.
Thomas M. Domer practices in Milwaukee, Wisconsin (www.domerlaw.com). He has authored and edited several publications including the legal treatise Wisconsin Workers' Compensation Law (West) and he is the Editor of the national publication, Workers' First Watch. Tom is past chair of the Workers' Compensation Section of the American Association for Justice. He is a charter Fellow in the College of Workers' Compensation Lawyers. He co-authors the nationally recognized Wisconsin Workers' Compensation Experts Blog.
