General Guidelines for Temporary Partial Disability Computations

Given today’s unprecedented actions by Gov. Evers and the subsequent decisions Wisconsin business are making, here is some guidance from DWD that may be useful in explaining when TTD is owed vs. when UI benefits can be claimed.

  1. Plant shutdown-compulsory vacation bargained under a union contract Wis. Stat. § 102.43(8)(b)
  2. Plant shutdown for any other reason (lack of work, fire, plant closes)DWD ch. 80.47
    1. Compulsory Vacation Shutdown
      • If receiving TPD prior to the plant shutdown for compulsory vacation, use the employee’s earnings from the week prior to the plant shutdown to calculate continued TPD.
    2. Plant shutdown for other reasons
      • If the employee is unable to work, TTD continues.
      • If the employee finds work elsewhere, TPD may be due if the employee is still in a healing period and the weekly earnings are less than those earned at the time of injury.

https://dwd.wisconsin.gov/wc/insurance/training/tpd/tpd_layoffs.htm

 

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Families First Coronavirus response Act (FFCRA)

President Trump signed the Families First Coronavirus Response Act (FFCRA) into law on March 18, 2020.  This has the potential to significantly impact small and mid-size employers.  The FFCRA requires employers with less than 500 employees to provide sick benefits to employees affected by COVID-19.  It also expands FMLA, requiring covered employers to provide paid protected leave to employees impacted by school closures and interruptions in school care caused by the virus.  Combined paid leave is capped at 12 weeks under the FFCRA.  The changes listed below are effective April 1, 2020.

The FFCRA can be broken down into two parts: The Emergency Paid Sick Leave Act and the FMLA Expansion.  Here is a brief summary.

The Emergency Paid Sick Leave Act

  • Employers with 50 or less Employees can be exempted from coverage if they can show compliance would “jeopardize the viability of a business as a going concern”.
  • Requires employers with less than 500 employees to provide paid sick leave to employees who are unable to work or telework if the employee:
    • Is subject to a federal, state, or local quarantine or isolation order.
    • Was advised by a healthcare provider to self-quarantine due to COVID-19 concerns.
    • Is experiencing symptoms of COVID-19 and seeking a medical diagnosis.
    • Is caring for an individual who is subject to isolation or quarantine order or has been advised by a medical professional to self-quarantine.
    • Is caring for a child whose school or childcare center/provider has closed or is unavailable due to COVID-19 precaution.
    • Experienced a substantially similar condition specified by the Secretary of Health & Human services.
  • Full time employees are eligible for 80 hours of leave.
  • Part-time Employees are eligible for the average number of hours they work in the two-week period prior to work stoppage.
  • Leave is capped at $511/day for an employee’s own COVID-19 diagnosis and $211/day for taking care of a child.
  • Employees are eligible regardless of how long they have worked for the company.
  • Employers cannot require employees to use other paid time off benefits provided by the employer before using the FFCRA benefits.
  • Employers must post notice of the requirements in the workplace where notices are customarily posted.

Expansion of FMLA

  • Applies to employers with less than 500 employees.  However, Employers with 25 or less employees are exempt from the expanded FMLA coverage.
  • Employees must have worked for at least 30 calendar days prior to requesting leave.
  • Secretary of Labor may exempt employers with 50 or less employees where “the imposition of such requirements would jeopardize the viability of the business as a going concern”.
  • Secretary of Labor may also exempt healthcare providers and emergency responders.
  • Leave is unpaid for the first two weeks (10 business days).
  • After first two weeks, leave is paid at 2/3 of the employee’s usual pay and capped at $200/day.
    • Variable scheduled employees use a 6 month average to calculate number of hours to be paid.
  • This removes the exclusion that the employer must employ 50 employees within a 75-mile radius.  In other words, employers with 500 or fewer employees may now be required to provide FFCRA-protected leave.
  • It also removed the 12 month and 1,250 hour employee qualification and replaced it with the 30 day qualification stated above.

If the employee is laid off prior to these provisions take effect (i.e. prior to April 2, 2020), the only benefits they are eligible for are the expanded Unemployment Benefits outlined below.  That said, if an employee has returned to work with restrictions from a prior work related injury, carriers/employers may owe a renewed period of TTD based on the employer’s inability to accommodate those restrictions.

Expanded Unemployment Benefits

  • Secretary of Labor provides emergency funding to the state unemployment trust funds.
  • Eligibility requirements are relaxed, to include work search requirements and waiting a week in Wisconsin.
  • Increased access to unemployment compensation for those directly impacted by COVID-19 due to illness or direction from a public health official to isolate or quarantine workers.

Tax Credits for Employers

  • Employers will receive a dollar-for-dollar payroll tax offset and the IRS will provide a refund for any amount paid that the payroll tax reimbursement would not cover

If you have any question on how to navigate this, please contact our office to discuss.

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Gov Evers’ planned shutdown order for WI – to be signed tomorrow

Wisconsin Gov Tony Evers tweeted that he will sign a Stay At-home Order tomorrow.  As the Order is not finalized, we have not seen the details.  The governor did say there will be exceptions for certain types of businesses.  We can let you know as soon as we have more information.  Please monitor our blog (www.mil-law.com) and/or LinkedIn page (https://www.linkedin.com/in/stephen-mcmanus-9a73822a/detail/recent-activity/shares/) as well.

If your WI employer shuts down due to the governor’s order, this move may require you to reinstate TTD benefits for any employees where the employer was accommodating sedentary or light duty work restrictions due to a work injury.  That said, under the new FFCRA law (that goes into effect on 4/2/20), employers with 26 to 499 employees (unless otherwise exempted by the Department of Labor) are required to continue pay up to 80 hours of paid sick time (depending on whether the employee is full-time or part-time) if the employee is quarantined, taking care of someone who is quarantined, etc.  Also, there is up to an additional 10 weeks of paid family leave at two-thirds the employee’s regular rate of pay where an employee, who has been employed for at least 30 calendar days, is unable to work due to a bona fide need for leave to care for a child whose school or child care provider is closed or unavailable for reasons related to COVID-19.

McManus & Associates LLC will continue to operate as we all have the capability to work from home.  We will continue to monitor our VM as well.  Please let us know if you have any questions.

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FFCRA Update

The FFCRA underwent major changes as the United States House of Representatives limited the availability of 12 weeks of paid family leave only to parents who are at home with children whose schools have closed.  Another major change states small businesses (those with under 50 employees) and many health care providers are now exempted from paying sick leave due to the financial burden it imposes.  This has not passed the Senate nor put/signed in to law by the President, and thus, we anticipate additional changes before this happens.  Check back for updates as we continue to follow this bill’s progress and do not hesitate to contact our firm if you have any questions.

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The Families First Coronavirus Response Act: How does this Impact Employers?

The United States House of Representatives passed the preliminary version of the Families First Coronavirus Response Act or the FFCRA.  The Act has not been addressed by the Senate or signed by the President, but is expected to pass through each hurdle quickly.

Here is a breakdown of what the FFCRA does:

  • Mandates paid leave through the Emergency Paid Sick Leave Act (EPSLA).
  • Amends the Family and Medical Leave Act (FMLA) to allow additional leave (paid and unpaid) when used for a “public health emergency,” as defined by the FFCRA.
  • Provides Employers with significant federal tax credits related to wages paid for the above-described sick leave.
  • Provides additional paid leave on top of any paid leave already offered by the Employer.
    • Note: Employer may not require employees to use all Employer-provided sick leave or paid time off (for those that do not offer sick leave but only offer paid time off), before using emergency sick leave time under the FFCRA.

What Employers need to do under the FFCRA:

  • Provide paid sick leave to any Employees that are not working for any of the following reasons, through December 31, 2020:
    • Self-isolation due to a novel coronavirus diagnosis.
    • Receive testing or see a doctor to obtain a diagnosis – related to the novel coronavirus.
    • Comply recommendations of medical professionals or public officials stating the Employee’s physical presence at the place of employment would risk the health of others because:
      • The Employee was exposed to the novel coronavirus.
      • The Employee exhibited symptoms of the novel coronavirus.
    • To provide care for sick family members who:
      • Are self-isolating due to a novel coronavirus diagnosis.
      • Following the recommendations of a medical professional or public official after being exposed to or is exhibiting symptoms of the novel coronavirus.
    • To care for children if their “school or place of care” has closed or childcare is unavailable due to the novel coronavirus.
  • Pay employees who take leave at the “regular rate” of pay.
    • Regular rate for hourly employees is the hourly rate paid for all non-overtime hours worked in a workweek to include: bonuses, commissions, other compensation received.
    • Regular rate for salaried employees, this is their standard weekly salary.
  • Post and keep posted the notice regarding emergency paid sick leave.  This will be issued by the Department of Labor shortly.

What are Employees entitled to?

  • Full-time Employees = 80 hours of emergency sick paid leave.
  • Part-time Employees = Average number of hours worked over a two-week period.
  • Note: There is no mandatory length of employment for these requirements.

FMLA Expansion:

  • Employees are able to take 12 weeks of “public health emergency leave” to address or comply with:
    • The recommendation of a doctor or public official regarding:
      • Exposure to or exhibited symptoms of the novel coronavirus.
      • The inability to perform functions of their job due to compliance with the above-referenced order.
    • Employers may choose not to pay an employee for the first 14 days of “public health emergency leave.”  Employers may choose to substitute accrued vacation days, sick days, or paid time off (PTO) during this leave.
      • The two weeks provided by the FFCRA can be used for this period if it would otherwise be unpaid.
    • Employers must pay for any leave beyond 14 days that qualifies under the FFCRA.  This can be paid at a rate of no less than two-thirds (2/3) of the “regular rate” for the “number of hours normally scheduled.”
    • Expands the number of employees eligible for other types of leave under the FMLA.
    • Employees only need to work for the Employer for 30 days at the time the leave begins to be eligible for these benefits.
    • All Employers with less than 500 employees must
      • Except for small business with less than 50 employees “when the imposition of the requirements would jeopardize the viability of the business as a going concern.”
    • Employers that employ less than 25 employees do not need to restore an employee to their job after a “public health emergency leave” if:
      • The position no longer exists due to economic conditions or other operating conditions of the Employer.
      • The Employer made reasonable efforts to restore the employee to an equivalent position.
      • The Employer’s effort fails but reasonable efforts are made to contact the employee once a similar positions becomes available the following year.

For more information please follow the link: https://www.congress.gov/bill/116th-congress/house-bill/6201/titles.

If you have questions, please contact our office.

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OWCH Announces Temporary Change to Hearing Procedure

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COVID-19 Update: Work from Home Injuries and Work-Related Exposure

As precautions increase, and more Employers are encouraging work from home, the chance of a work injury occurring at home also increases.  Here are a few pointers to help Employers and Worker’s Compensation Carriers deal with these issues:

  • Employees, even while at home, may still be covered by the Wisconsin Worker’s Compensation Act.
  • Working at home may be covered under the Traveling Employee Doctrine, similar to an Employee working in a hotel room while traveling, unless there is a personal or private deviation from regular work duties.
  • Private or personal deviation do not include injuries covered by the personal comfort doctrine (i.e. getting water, using the restroom, etc.) even though the Employee is at home.
  • There may be some hazards in the Employee’s home, which the Employer cannot exercise control over (i.e. children, pets, stairways (zones of danger), etc.), that could cause an injury, but may not stop a judge from finding the injury compensable.  A good comparison is a traveling Employee who is injured driving for work.  The Employer cannot control the other driver who caused the injury, but the injury will likely be found compensable.
  • A fact specific analysis is key with these types of claims; thus, recorded statements need to be taken early and obtain as many details as possible before facts change to further support a work injury.
    • The recorded statement should include details about the home environment.
    • Employers or Carriers may need to obtain pictures if the claimed injury and/or environment is confusing or warrants clarification.
  • It is unlikely there will be any witnesses, which increases the importance of obtaining a good recorded statement.

Scenarios that may be confusing, but would likely be covered:

  • An on-call Employee is sitting on the couch and gets up to answer the phone.  While getting up in a hurry to answer the phone, the employees hurts a knee or back.  A judge may find this compensable simply because the employee was on-call and doing something for the Employer by getting up to answer the phone.
  • An on-call Employee goes out to salt the driveway just in case he is called in to work.  He slips on the ice.  This could be found compensable because the act was undertaken for the benefit of the Employer (i.e. Applicant being able to come to work).
  • An Employee is walking on a treadmill while responding to work email on a tablet.  The reading and responding to email may be deemed a work activity, and the injury would likely be found compensable.

Basically, activities that are undertaken for the benefit of the Employer will put Employees in the scope of Employment, and an injury while in the scope will likely be covered, unless Employers and Carriers can demonstrate there was a deviation or some other reason the claimed injury should not be covered.

Regarding work-related exposure, there may be compensability issues for Employees who do not travel, but have come in contact with other Employees who have traveled to an infected area or were exposed during the course of their employment.  Some examples include healthcare workers who may have not had direct contact with an infected individual but may have contracted the illness from a coworker.  This claim would likely be found compensable.

Likewise, a construction worker building an addition to a hospital who comes in contact the illness may have a compensable claim if the illness can be traced to the hospital jobsite he/she worked at.  This is similar to the H1N1 analysis referenced in our March 12, 2020 post.

Another example is a faculty member for a school or university who was unknowingly exposed to the illness and was subsequently quarantined.  This period could be deemed a compensable work injury because the exposure occurred at work.  The same holds true for other Employees who had subsequent contact due to their proximity to the infected individual.

 

If you have any questions, contact our office to discuss.

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Employers/WC Carriers: What can you do about COVID-19?

As we are well aware, the novel coronavirus has entered the United States, and the Centers for Disease Control (CDC) has advised Employers to have a plan ready to deal with this virus and the potential spread.  That has left many Employers questioning what they can and cannot do, along with whether an Employee who contracts the virus would be covered under the Wisconsin Worker’s Compensation Act.  Here are a few tips to assist you in navigating these situations:

  • Restrict work travel that is not 100% necessary for job performance.
  • Restrict non-essential personnel access to the workplace (i.e. no unnecessary visits from clients or relatives, especially if they have just traveled outside the state).
  • Offer to pay for testing, especially if you employ traveling sales people.  Not only will this identify potentially sick Employees early enough to be quarantined, it will also help calm concerns of fellow Employees, if the test comes back negative.
  • Identify the precautions you are taking to stay open (i.e. extra cleaning, Employee testing, etc).
  • Encourage Employees to disinfect commonly shared surfaces, encourage good hygiene, provide hand sanitizer, and encourage Employees who feel sick to stay home.
  • Establish telecommuting policies to address potential workplace closings – this may include updating your Employee handbook to provide clear instructions for everyone.

As far as determining whether you owe WC compensation for an employee contracting coronavirus, things to consider:

  • Generally, the flu and cold are not covered by Worker’s Compensation as there is no way to know whether they came from work or elsewhere.
  • That said, when H1N1 (Swine) Flu occurred in 2009, some Wisconsin judges said that if an Employee traveled to an infected area for work and became sick, the sickness may be deemed work related because it was a closer connection.  Thus, if any Employees contract coronavirus, then steps need to be taken to:
    • Identify whether the Employee recently traveled and where to.
    • Whether they had contact with other Employees since returning.
    • Testing or recommending testing for other Employees if they were possibly exposed.
  • If an Employer shuts down due to coronavirus exposure and the same Employer had previously accommodated light duty restrictions for an injured Employee, the Employer/WC carrier may owe a renewed period of TTD based on the inability to accommodate the restrictions.

Contact us if you have any questions.

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Are Discograms a Good Basis for Surgery?

Mustafa-Green v. Birchwood Rehab Ctr. – LIRC

Decided September 30, 2019.

Facts: Applicant alleged a low back injury and claimed a subsequent fusion was due to a work-related injury. She had three low back MRIs done prior to the surgery, and each showed a normal low back. Applicant’s doctor recommended surgery based on discogram findings, not the MRIs.

Decision: The three MRIs done prior to surgery showed no objective evidence for the alleged pain or claimed fusion surgery. Discograms are problematic when used as the sole source of diagnosing low back injuries or pain. Therefore, LIRC denied compensability based on the MRI findings.

 

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Can Retirement Unrelated to a Work Injury Result in a Compensable Wage Loss?

Mueller v. LIRC  – Court of Appeals

Decided August 27, 2019, published.

Facts: Applicant sustained compensable shoulder injury while employed by Ashley furniture.  Was put on light duty after surgery, and subsequently resigned while on light-duty, reporting that she intended to retire.  Ashley stopped paying wages & TPD.  Applicant re-applied for employment with Ashley, but was not re-hired.  Had second shoulder surgery, which Ashley paid medical expenses, but not temporary disability.  During the healing period, Applicant obtained a part-time job as a restaurant server.  Ashley paid the PPD related to the shoulder surgery after Applicant reached EOH.

Issue:  Applicant claimed she was entitled to temporary disability for the period beginning with her retirement date through the end of healing after her second shoulder surgery.

Decision: LIRC determined App re-entered the labor market without the intent to work more than part-time.  Thus, any wage loss sustained was not due to the injury, but instead Applicant’s desire to work less-than-full-time hours.  “Simply put, an Employee who retires for reasons entirely unrelated to his/her injury cannot make such a showing because the Employee’s wage loss was caused by the Employee’s choice to voluntarily retire”. Mueller v. LIRC at 25.

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