When an employee is injured on the job in Wisconsin, navigating medical treatment and wage replacement can quickly become complex, particularly when it comes to time spent attending medical appointments. One area that often causes confusion for both employers and employees is whether time away from work for treatment is paid. The answer is nuanced (or as many attorneys like to respond to almost every general question, “it depends”): medical appointment time is not inherently compensated under Wisconsin workers’ compensation law.
This article outlines how that time is typically handled, best practices for employers and employees, and how Temporary Partial Disability (TPD) benefits may come into play as a last resort—along with a practical example from the construction industry.
Medical Appointment Time Is Not Automatically Paid
Under Wisconsin workers’ compensation law, the primary benefits available to injured workers include (but are not limited to):
- Medical expense coverage
- Wage replacement (Temporary Total Disability or Temporary Partial Disability)
- Permanent disability benefits (if applicable)
However, the statute does not require that employers or carriers pay wages for time spent attending routine medical appointments related to a work injury.
In general:
- If an employee is released to full duty work, no wage loss benefits will be due (temporary disability benefits are paid only while an injured worker is on restricted duty).
- If an employee can work before and after an appointment, missed time is typically unpaid.
- Workers’ compensation does not function like paid sick leave for intermittent medical visits.
This distinction is important: wage loss benefits are only triggered when there is an actual loss of income compared to their average weekly wage (your insurance adjuster will calculate this for you, when applicable) prior to the injury, not merely attendance at an appointment.
Best Practice: Schedule Appointments Outside Working Hours
Because medical appointment time is not inherently compensable, employees should be encouraged—when reasonably possible—to:
- Schedule appointments before or after work or on days off
- Utilize early morning, evening, or weekend availability
- Coordinate care in a way that minimizes disruption to their regular work schedule
This benefits all parties:
- Employees avoid wage interruptions
- Employers maintain productivity and limit administrative burden
- Claims administrators minimize unnecessary indemnity exposure
Of course, this is a guideline, not a strict rule. In many cases (specialists, therapy frequency, rural availability), scheduling outside work hours may not be feasible.
Employer Flexibility: Allow Time Make-Up When Possible
A practical and employee-friendly approach is for employers to either continue the employee’s salary/wage for time spent at treatment, or to allow injured workers to make up missed time when operationally feasible.
Examples include:
- Creating “WC medical appointment” payroll code to pay wages
- Disclaimer: note the potential risk associated with having someone on the clock while not physically on your worksite.
- Making up hours later in the same day
- Adjusting start/end times within the week
- Allowing flexible scheduling for light-duty employees
This approach:
- Reduces the need for wage replacement benefits
- Supports employee recovery and morale
- Demonstrates good faith in accommodating work restrictions
For many organizations, especially those with solid light-duty programs, this flexibility is a key part of effective claims management.
When Wage Loss Occurs: Temporary Partial Disability (TPD)
If an employee cannot make up the time and experiences an actual wage loss due to medical appointments while on restricted duty, Temporary Partial Disability (TPD) may apply.
How TPD Works
TPD is designed to compensate for partial wage loss when an employee:
- Returns to work in a restricted capacity, but
- Earns less than their pre-injury average weekly wage
Calculation (Simplified)
In Wisconsin, TPD is generally calculated as:
TPD Benefit = 2/3 × (Pre-Injury Average Weekly Wage – Post-Injury Earnings)
Key points:
- TPD is not taxed
- Paid only on actual wage loss
- Requires documentation of earnings before and after injury (payroll report)
- Applies only when missed time results in reduced earnings, not just absence from work
Real-World Example: Construction Industry
Let’s look at a practical scenario:
A union carpenter in Wisconsin sustains a shoulder injury and is placed on light duty. He continues working on-site performing modified tasks, but must attend physical therapy twice per week for six weeks.
- Pre-injury wage: $1,200/week
- Post-injury work schedule:
- Misses 2 hours per appointment, twice weekly (4 hours total)
- Hourly rate: $30/hour
- Weekly lost wages due to appointments:
- 4 hours × $30 = $120
Step 1: Can Time Be Made Up?
The employer explores options:
- Offers the employee the ability to stay late or start earlier
- Due to jobsite constraints and safety rules, make-up time is not feasible
Step 2: Is There Wage Loss?
Yes:
- Weekly earnings drop from $1,200 to $1,080
- Actual wage loss = $120
Step 3: TPD Calculation
TPD = 2/3 × $120 = $80 per week
Outcome
- The employee receives $80/week in TPD benefits
- Employer avoids overpaying for non-compensable time
- Claim remains compliant with Wisconsin statutes
- Focus stays on recovery and return to full duty
Key Takeaways for Employers and Employees
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Medical appointments are not inherently paid time under Wisconsin workers’ compensation
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Encourage scheduling appointments outside normal work hours whenever possible
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Employers should support flexibility and allow make-up time when feasible
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TPD is a fallback, not a default—it applies only when actual wage loss occurs
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Clear communication between all parties reduces disputes and claim costs
Final Thoughts
Managing time away from work for medical treatment is a common friction point in workers’ compensation claims, but it doesn’t have to be. By understanding that appointment time is not automatically compensable, encouraging smart scheduling, and reserving TPD benefits for true wage loss situations, both employers and employees can navigate these situations more efficiently and protect their overall workers' comp spend by realizing a 70% savings on medical-only claims when the experience mod is calculated.
In industries like construction & manufacturing, where schedules are rigid and productivity is critical, these principles are especially important to maintaining both compliance and operational stability.
When in doubt, because every claim is highly fact-specific, reach out to your claim adjuster or insurance agent/broker for further guidance.
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