Saturday, October 9, 2010

WI: Workman's Comp Agency Cannot Decide Where Incapacitated Individual Lives

In a case presenting a "novel issue," the Wisconsin Appeals Court upheld a circuit court ruling that limits the authority of the Department of Workforce Development in making decisions about where an incapacitated individual can live and receive treatment and care.

In 1979, Paul LaBeree sustained severe brain injuries, causing quadriplegia, while working as an employee of Bowman Plumbing Co. Bowman conceded liability and paid and continues to pay medical treatment expenses under the workers compensation statutes.

Because of the injuries, LaBeree requires protective placement under Wis. Stat. ch. 55, which is designed to place individuals with “mental illness, degenerative brain disorder, developmental disabilities, or other like incapacities” under protective care.

In placing an individual, chapter 55 is designed “to place the least possible restriction on personal liberty and exercise of constitutional rights consistent with due process and protection from abuse, financial exploitation, neglect, and self-neglect.” Wis. Stat. section 55.001.

Through 2004, LaBeree received institutional care at the Dunn County Health Care Center, costing Bowman $174 per day. In 2005, LaBeree’s guardian ad litem proposed a “community integration plan,” costing $549 per day, so LaBeree could live in a specially equipped duplex next to his father. The circuit court approved the plan as “the least restrictive.”

In 2006, LaBeree filed a worker’s compensation claim, alleging Bowman refused to pay the additional expense associated with LaBeree’s home-based care.

An administrative law judge for the DWD denied LaBeree’s claim, finding that LaBeree failed to prove his “transfer from institutional to home care was reasonable and necessary” under Wis. Stat. section 102.42(1), which requires an employer to pay an injured worker’s reasonable and necessary medical treatment expenses.

Full Article and Source:
In Worker’s Compansation Case, Agency Cannot Decide Where Incapacitated Individual Lives

1 comment:

Betty said...

I had no idea this was an issue! Thanks, NASGA.