Wisconsin worker's compensation insurers file this practitioner report when temporary disability lasts more than three weeks or permanent disability results. Usually requested at the end of healing, it records history, diagnosis, surgery, prior disability, prognosis, return-to-work dates and permanent disability, with a second page for finger joint motion losses. Ratings follow DWD 80.32 minimum percentages, not AMA or other guides.
The treating practitioner completes it and signs in their own writing. Final reports on the extent of disability must come from a treating physician, podiatrist, surgeon, psychologist or chiropractor, not a dentist, physician assistant or APRN prescriber.
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Medical Report on Industrial Injury
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DWD rule 80.02(2)(e) calls for a medical report when temporary disability lasts more than 3 weeks, the injury causes permanent disability, the worker had eye treatment 3 or more times outside the workplace, or surgery was performed. It goes in once the worker is released to work or reaches the end of healing.
No. DWD's guidance says a final report's rating must follow DWD 80.32, not AMA or other guidelines. The form's finger page points to DWD 80.32 and 80.33 for evaluating amputations, restricted motion, ankylosis, sensory loss and surgical results at each joint.
A treating physician, podiatrist, surgeon, psychologist or chiropractor. DWD says dentists, physician assistants and APRN prescribers cannot complete a final report addressing the extent of disability, although its guidance lets some of them sign medical reports on other points within their scope.