Wisconsin Worker's Compensation - Help For Injured Wisconsin Workers

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  1. #1
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    Dec 2008
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    Default Re-Opening a Comp Case That Was Closed

    Here we go......new to this board and I am very glad I found it.....alot of good info here. I had a claim against a former employer and I went to court with it and it was dismissed or closed. Since then I have come up with some info that was over looked by the judge and also have medical info to back up what we were trying to prove in the first place. Bad thing is that my lawyer at the time did not represent me very well and I got rid of him after that. How does one go about this if it can be done? Thank you in advanced for the help!

  2. #2
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    Default Re: Re-Opening a Comp Case That Was Closed?

    How long ago is the orginial claim dismissed...?
    There are SOL's on filing claims for WC benefits...

    If you are within the SOL, call the CA at the IC, and request the foms for re-opening the claim, or you may have to file a new claim...which may or may not be easier in the long run.

    Information on WI WC is here...http://www.dwd.state.wi.us/wc/workers/default.htm

  3. #3
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    Oct 2006
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    Default Re: Re-Opening a Comp Case That Was Closed?

    the time limits for reopening, appealing and/or presenting new evidence may have passed.
    contact the workers comp division for information
    http://www.dwd.state.wi.us/wc/about_us/direct.htm

  4. #4
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    Default Re: Re-Opening a Comp Case That Was Closed?

    Quote Quoting BvIA View Post
    How long ago is the orginial claim dismissed...?
    There are SOL's on filing claims for WC benefits...

    If you are within the SOL, call the CA at the IC, and request the foms for re-opening the claim, or you may have to file a new claim...which may or may not be easier in the long run.

    Information on WI WC is here...http://www.dwd.state.wi.us/wc/workers/default.htm
    Claim was dismissed in Nov. 06. Some medical things have come forward and some of the witnesses that testified against me at hearing have come forward and told me that the guy who ownes the place told them what to say since then they have been let go or fired so they told me what happened!

  5. #5
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    Default Re: Re-Opening a Comp Case That Was Closed?

    sounds like you need to prove fraud before you can challenge the comp decision in the original claim.
    they are two separate issues.
    contact your state department of Insurance
    http://oci.wi.gov/com_form.htm

  6. #6
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    Default Re: Re-Opening a Comp Case That Was Closed?

    the witnesses that testified against me at hearing have come forward and told me that the guy who ownes the place told them what to say since then they have been let go or fired so they told me what happened!
    Ya know... there may be a lot of sour grapes here...
    In the first place, IF these witnesses were in court, under oath as a witness would be... WHY would they perjure themselves by telling something that another person had directed them to do...?
    IF they were creditable witness in the first place... that question would have to be posed...

    Second... you don't need witnesses for a WC claim... WC is 'no fault', and you are entitled to benefits while your claim is investigated... the basis for an accepted claim...is AOE/COE, that it occurred due to and in the course of your employment.

    I don't know the reason your claim was denied...or 'tossed out'... but everything in WC is based on medical evidence, and the statement/opinion of your doctors, and/or the med/legal evaluation of your condition/claim.
    Some medical things have come forward ...
    IF you are experiencing symptoms of your injury at this point, since it has been about 2 + years or so, file a claim with your current ER... and as an ''aggreviation'' to the previous 'non-industrial' injury, (which it is, since the claim was denied) ... you claim could be accepted as compensable at this time.

    and some of the witnesses that testified against me at hearing have come forward
    I don't know that you would prevail in a 'fraud' claim.. If you want to pursue this, you notify the proper authority, and they will investigate.(as in District Atty or fraud unit of the State Dept of Insurance) There are laws that provide that anyone who makes statement with the intent of denying benefits to an IW, can be found guilty of 'fraud'... which would include your 'witnesses'... 'cuz, that is exactly what they did, by not telling the truth the first time around... and supposedly they knew what they were doing at the time.

    So,... bottom line... if you are experiencing symptoms of 'pain' etc due to the underlying condition,...file a claim for benefits under your current ER's WC plan.

    OR, if you are attempting to re-open the denied claim...for whatever reasoning... and I don't know what that may be at this point... I think I would go another route here....you gotta can of worms here, and could bring a lot of people into something you can't control. Besides getting an attorney to represent you in a fraud claim...

  7. #7
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    7

    Default Re: Re-Opening a Comp Case That Was Closed?

    Quote Quoting BvIA View Post
    Ya know... there may be a lot of sour grapes here...
    In the first place, IF these witnesses were in court, under oath as a witness would be... WHY would they perjure themselves by telling something that another person had directed them to do...?
    IF they were creditable witness in the first place... that question would have to be posed...

    Second... you don't need witnesses for a WC claim... WC is 'no fault', and you are entitled to benefits while your claim is investigated... the basis for an accepted claim...is AOE/COE, that it occurred due to and in the course of your employment.

    I don't know the reason your claim was denied...or 'tossed out'... but everything in WC is based on medical evidence, and the statement/opinion of your doctors, and/or the med/legal evaluation of your condition/claim.

    IF you are experiencing symptoms of your injury at this point, since it has been about 2 + years or so, file a claim with your current ER... and as an ''aggreviation'' to the previous 'non-industrial' injury, (which it is, since the claim was denied) ... you claim could be accepted as compensable at this time.


    I don't know that you would prevail in a 'fraud' claim.. If you want to pursue this, you notify the proper authority, and they will investigate.(as in District Atty or fraud unit of the State Dept of Insurance) There are laws that provide that anyone who makes statement with the intent of denying benefits to an IW, can be found guilty of 'fraud'... which would include your 'witnesses'... 'cuz, that is exactly what they did, by not telling the truth the first time around... and supposedly they knew what they were doing at the time.

    So,... bottom line... if you are experiencing symptoms of 'pain' etc due to the underlying condition,...file a claim for benefits under your current ER's WC plan.

    OR, if you are attempting to re-open the denied claim...for whatever reasoning... and I don't know what that may be at this point... I think I would go another route here....you gotta can of worms here, and could bring a lot of people into something you can't control. Besides getting an attorney to represent you in a fraud claim...
    I see what you are saying! here are a few things...............I claimed that I fell off the wall I was working on that was atleast 10-15ft. During that time I had a huge hemotomen that I got when I feel. I reinjured my back and I thought I broke my two fingers. I worked almost 3 days after the injury. Each day I told the forman I needed to go to the ER cuz it continued to swell and it was hard for me to get my pants on and off. Also the forman taped my fingers up with white tape at the time and told me they were'nt broken. He told me that the owner of the company was planning to get rid of me cuz I was not working out so if i was to say something about going to the ER it would make things worse for me. So I tried to stick it out until the weekend but it was to late I kept getting more and more tired and could hardly walk. So I went in to ER that weekend. Dr told me that when they took my blood work it showed that my creatine level was way overboard and it was causing my kindy to shut down so they put me in over nite to watch me. I have found out that the reason my creatine was so high was cuz of the hemotomen on my leg...........levels rise when there is blunt trauma to the muscles. The defence and other employees said that there was no way I fell 10ft but only 2ft at most. So the creatine levels were never brought into play cuz my lawyer never knew this nor did I until I have done some reaserch myself cuz I am going to school to be a paramedic now. Also the defence said that no where is there a mention that my fingers were hurt or looked at in the Dr's ER report. After reveiwing the records myself I found on the report of cheif complaints it was stated to flanges on left hand broken or sprained. Long and short of it was that the defence said I was lying about the injury and that it happened over the weekend and there was no way I was able to continue working if I was in this much pain. People stated that I never complained of the injury which was not true I complained everyday but I was told if I made a big deal out of it I would be let go. So I continued to work no matter the pain. Finally over the week end there was so much break down of muscle tissue from the fall it had caused my kidneys to start to shut down which caused my creatine levels to rise. The defence painted a picture of me as a pain -pill addicted lier who would do anything for money to not have to work. My lawyer at the time did nothing when he needled me on the stand. Asked why he didnt he replyed it was legit what he was doing.............but the defence kept bringing up my past and not alot about the case its self. The IME did not do any better for me either. I came to that thing and the doctor had me in there for about 15mintues tops but says he looked at me for over hour and a half and wrote a 12 page report stating I was lying and I injured myself working out that weekend and was affraid to admit it. Alot of BS!!

  8. #8
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    Default Re: Re-Opening a Comp Case That Was Closed?

    You still have not answered the question..."Are you suffering any symptoms now that you feel, or your doctor can attribute to the orginial claimed injury?"

    IF you have those symptoms... File a claim for WC benefits with your current ER...

    OR, IF you have sufficient "medical evidence" to prove up your contentions regarding the previous claim... then file for a 're-consideration' on the former denial...
    Bear in mind that your personal reasearch, or current training, is not going to be something that is admissable here... 'cuz, you are not a medical professional capable of 'self-diagnosis' or ''medical'' reporting on your own person.

    There is no need to continue to concentrate on the "IF's'' of the previous denial...or the people who may or may not have 'lied' about what occurred..that is over at this point. What will be and IS important is the medical evidence, and the reporting/opinion of the treating physican, and med/legal..."IME" evaluation done previously.

    I'm still not clear what you are attempting here, why are you trying to -
    ''re-open'' the previous claim at this point...
    You still may be past the SOL/statute of limitations here on a recon of the denial...(?)


    BTW>.. in future posts could you try to break up the 'solid' paragraphs...?
    It would make is much easier to read and respond by any other persons here...

    Thanx...!

  9. #9
    Join Date
    Dec 2008
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    7

    Default Re: Re-Opening a Comp Case That Was Closed?

    Quote Quoting BvIA View Post
    You still have not answered the question..."Are you suffering any symptoms now that you feel, or your doctor can attribute to the orginial claimed injury?"

    IF you have those symptoms... File a claim for WC benefits with your current ER...

    OR, IF you have sufficient "medical evidence" to prove up your contentions regarding the previous claim... then file for a 're-consideration' on the former denial...
    Bear in mind that your personal reasearch, or current training, is not going to be something that is admissable here... 'cuz, you are not a medical professional capable of 'self-diagnosis' or ''medical'' reporting on your own person.

    There is no need to continue to concentrate on the "IF's'' of the previous denial...or the people who may or may not have 'lied' about what occurred..that is over at this point. What will be and IS important is the medical evidence, and the reporting/opinion of the treating physican, and med/legal..."IME" evaluation done previously.

    I'm still not clear what you are attempting here, why are you trying to -
    ''re-open'' the previous claim at this point...
    You still may be past the SOL/statute of limitations here on a recon of the denial...(?)


    BTW>.. in future posts could you try to break up the 'solid' paragraphs...?
    It would make is much easier to read and respond by any other persons here...

    Thanx...!
    Sorry! Did not mean to do that.

    I want to re-open the case cuz I feel that I was not represented right and that I was injured and I did go through all this. I have medical bills that have not been paid buy them but my insurance has payed them. I have out of pocket expences. I still have pain in my leg, back and fingers.

    I always have the worry of my left kindey shutting down again. I just want my wrong to me made right. I fell and know I did but do not think it is fair that they can get away with this. I have a 10% PPD as a whole that was never paid. I have an IME that was writen up my a doctor who is retired and gets payed big bucks to do this for the company's.

    If they are able to do it to me they can do it to someone else.

  10. #10
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    Default Re: Re-Opening a Comp Case That Was Closed?

    If they are able to do it to me they can do it to someone else.
    Don't worry about what 'they' may do to someone else...it is unlikely that your claim will send any 'message' to the ER, or IC....

    I have a 10% PPD as a whole that was never paid. I have an IME that was writen up my a doctor who is retired and gets payed big bucks to do this for the company's.
    If you had a 10% WPI/PPD, why was there not a simple stipulation to the rating, and possible need for future medical care, and let the claim settle that way...?
    What happened to your case is a risk of takeing the claim to trial...there is always the possibility of a ''take nothing'' decision...and again, this all will be based on medical evidecne...and unfortunately in your case, there were outside witnesses brought in...probably who had little knowledge to what really happened.

    As I said, you are going to have to find the statute defining the SOL to recon or re-open a claim... I doubt now that we know more facts here, that you will be able to re-open a claim that has a finding by the judge...you're right, they got a dismissal...not necessarily a 'denial' of your claim...

    I have an IME that was writen up my a doctor who is retired and gets payed big bucks to do this for the company's.
    This is in part what WI WC web site provides regarding disputes/denials...
    As a legally binding procedure, the ALJ is required to obtain information from all parties during the hearing. The ALJ reviews all pertinent information related to the hearing and issues a decision based on his/her findings. This decision by the ALJ becomes a formal "order" to which the parties of the hearing must adhere. The order specifies the conditions under which the dispute will be resolved.

    You may appeal a decision by an ALJ if you believe the decision was incorrect. Your appeal would be made to the Labor and Industry Review Commission (LIRC). Your case would be reviewed by LIRC and they will provide you with a decision. If you disagree with the decision from LIRC, you may appeal to circuit court.
    http://www.dwd.state.wi.us/wc/workers/claim_denied.htm
    And you can file your appeal on-line here...http://www.dwd.state.wi.us/mail/asp/...p?WhoTo=DWDDWC

    The site also provides...
    Any party to a worker's compensation dispute may petition the three-member Labor and Industry Review Commission to reverse, modify or set aside an administrative law judge’s decision awarding or denying compensation. The parties have 21 days to file a petition for review with the Commission in Madison or at the offices of the Worker's Compensation Division in Madison, Milwaukee or Appleton. The Commission’s rules of practice are in Chapter LIRC 1 of the Wisconsin Administrative Code.
    It appears to be a bit late to file for this reconsideration...so it would stand to reason, you are past the civil appeals as well...nearly 2 years is not a reasonable time to come back on a denial.

    So, as I said, file a claim with your current ER, as an aggrreviation to a pre exsisting condition...that is compensable. IF the court finds liability to your previous ER...(doubtful at this point) that ER/IC can be brought in to share the costs of the claim.

    But, you treating physicans must be able to relate your current job as an 'aggreviation', or a new 'injury' to get this accepted by the ER/IC.

    I want to re-open the case cuz I feel that I was not represented right and that I was injured and I did go through all this.
    That's the kicker here... WC is 'no fault', there are no benefits for 'pain and suffering', so what you ''went through'' is not relative at this point...your claim was denied, so your own health coverage picked up the cost of treatment...and your out of pocket are now yours.

    Unless you can find a statute that provides otherwise,... you are 'SOL' on this one...(that doesn't mean 'statute of limitations' this time....)

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