Wisconsin Medical Report on Industrial Injuries -- To be filed by the insurer or self-insured employer when temporary disability exceeds 3 weeks or permanent disability results.

• Category: Wisconsin Workers Compensation - Official
• State: Wisconsin
• Control #: WI-SKU-2391
• Format: Word

Description

Medical Report on Industrial Injuries -- To be filed by the insurer or self-insured employer when temporary disability exceeds 3 weeks or permanent disability results. The Wisconsin Medical Report on Industrial Injuries -- To be filed by the insurer or self-insured employer when temporary disability exceeds 3 weeks or permanent disability results is a report that must be filled out by the insurer or self-insured employer when a worker has suffered a work-related injury that results in a temporary disability exceeding 3 weeks or a permanent disability. This report must include the employee's name, date of injury, job description, name and address of employer, type of injury, and medical history. Additionally, the report must also include the medical provider's signature, diagnosis, prognosis, and any recommended treatment. There are two main types of this report: the Wisconsin Medical Report on Industrial Injury and the Wisconsin Medical Report on Industrial Injury with PPD Rating. The latter requires a physician's permanent partial rating, which is based on the degree of disability. Both types of report must be submitted to the Wisconsin Department of Workforce Development or the Workers' Compensation Division.

The Wisconsin Medical Report on Industrial Injuries -- To be filed by the insurer or self-insured employer when temporary disability exceeds 3 weeks or permanent disability results is a report that must be filled out by the insurer or self-insured employer when a worker has suffered a work-related injury that results in a temporary disability exceeding 3 weeks or a permanent disability. This report must include the employee's name, date of injury, job description, name and address of employer, type of injury, and medical history. Additionally, the report must also include the medical provider's signature, diagnosis, prognosis, and any recommended treatment. There are two main types of this report: the Wisconsin Medical Report on Industrial Injury and the Wisconsin Medical Report on Industrial Injury with PPD Rating. The latter requires a physician's permanent partial rating, which is based on the degree of disability. Both types of report must be submitted to the Wisconsin Department of Workforce Development or the Workers' Compensation Division.