Understanding Workers’ Compensation Matters: Some Frequently Asked Questions
Workers’ compensation disputes are not straightforward, but Quinlivan & Hughes, P.A., can help. Below are some commonly asked questions concerning workers’ compensation.
1. What constitutes a workers’ compensation claim?
|Answer:||To prove a compensable claim, an employee must prove four different points. First, that the employee sustained a personal or occupational disease. Second, that the employee’s injury arose out of the employment or, in other words, the injury occurred while performing a task for the benefit of the employer. Third, the injury occurred within the course of employment that is a time and place test, meaning the injury occurred while on the job. The fourth requirement is that a notice of the injury was provided to the employer.|
2. Do you receive wage loss when injured on the job?
|Answer:||There are different types of wage-loss benefits. If you are totally disabled from work, you are entitled to temporary total disability benefits, which is a wage-loss benefit that is paid when you are not able to work at all. If you are able to return to work following the injury and are earning less money than you did prior to the time of the injury, you may be entitled to temporary partial disability benefits. There are limitations on your receipt of temporary total and temporary partial disability benefits as to the number of weeks each benefit will be paid. If you can never return to work as a result of a work-related injury, you are entitled to receive permanent total disability benefits. From work injuries on or after October 1, 1995, permanent partial disability (PPD) benefits cease at the age of 67. The Minnesota workers’ compensation law presumes an employee would retire from the labor market at this age, but the presumption is rebuttable.|
3. What if I have a permanent injury?
|Answer:||If you sustain a permanent functional loss of a body part as a result of a work injury, you would be entitled to PPD benefits. PPD ratings since 1984 have been assigned based upon the percentage of disability to the body as a whole using a schedule. The schedule for PPD benefits is published by the Department of Labor and Industry (DLI) and is based upon objective medical evidence. Again, the purpose for PPD benefits is to compensate you for the loss of use and function of your injured back, arm or leg. PPD benefits can be paid concurrently with temporary partial disability and permanent total disability benefits, but not with temporary total disability benefits. If you cannot continue with your employment because of a work injury, you may also be entitled to vocational rehabilitation services.|
4. What if I cannot return to work with the date of injury employer?
5. If my spouse dies in a work-related accident, am I entitled to workers’ compensation benefits?
Yes. A spouse and certain dependents of an employee who dies in a work-related accident are entitled to benefits. The amount of the benefits payable is based on the number of dependents at the time of death. The amount payable is limited to the maximum compensation rate at the time of the employee’s death. In general, benefits are payable as follows:
If there is a surviving spouse and no dependent children, payments continue for 10 years. If there is a surviving spouse and there are dependent children, payments continue for 10 years after the last child ceases to be dependent. The act also provides that burial expenses are payable up to $15,000.
6. Do bankruptcy and divorce impact my workers’ compensation benefits?
|Answer:||Every workers’ compensation claim is unique to that particular individual. If the insurer files for bankruptcy, an employee will continue to collect benefits from the Minnesota Insurance Guaranty Association. In general, workers’ compensation benefits are exempt from creditors under Minnesota and federal law. We suggest that each employee discuss with their bankruptcy attorney when filing for bankruptcy whether to use the Minnesota or federal bankruptcy exemptions. It is our general understanding that in many cases the Minnesota exemptions are more favorable. Because workers’ compensation benefits are specific to an employee, the benefits received are not subject to the divorce laws, especially benefits for permanent partial disability, rehabilitation and medical benefits. Wage-loss benefits such as temporary total disability could be subject to division in divorce, and we recommend consulting with counsel on this issue.|
7. Can my employer fire me for filing a workers’ compensation claim?
|Answer:||No. You cannot be fired if you file a workers’ compensation claim with your employer. In Minnesota, a specific statute — 176.82 — provides if your employer obstructs the filing of your claim or fines you because you filed a claim that you can sue your employer in District Court. You are protected. The statute also provides a cause of action against the employer if the employer refuses your continued employment if employment is available within your physical limitations.|
8. What happens once I notify my employer of my workers’ compensation claim?
|Answer:||Once you have notified the employer of your work-related injury, the employer has 10 days to report the injury to the insurer. If the claimed injury wholly or partially incapacitates you for more than three calendar days, the claim must be made using the First Report of Injury (FROI) form. If the claim involves death or serious injury, the insurer and the Department of Labor and Industry (DLI) must be notified within 48 hours. The insurer must accept or reject your claim by filing a Notice of Insurer’s Primary Liability Determination (NOPLD) within 14 days. If your claim is rejected, you should consult legal counsel to protect your legal rights. A claim petition will be filed by us to pursue your workers’ compensation benefits and start the litigation process.|
9. How do you evaluate a workers’ compensation claim?
There are a number of factors that are important in evaluating and assessing your workers’ compensation claim, such as:
All these facts play a role in evaluating your case. Every case is unique with its own variables, which is why you need to seek legal counsel before settling your claim.
10. What medical benefits are available?
|Answer:||The Minnesota workers’ compensation statute provides that all reasonable and necessary medical expenses associated with a work-related injury are covered. The form of medical treatment and duration are governed by the treatment parameters applicable to the body part injured in the work accident. Doctors are aware of these treatment parameters and will follow them to make sure you are provided appropriate medical care. Medical benefits do continue even after you return to work. Also, surgery is covered, and an injured worker cannot be forced to undergo surgery. In general, you may choose your own physician. However, you can only have one primary physician at a time for an injury. If your employer has a managed care plan certified by the Department of Labor and Industry, then the employer can require you to receive medical care through that plan. Finally, there are procedures in place should the dispute arise over the type of treatment required to return you to work.|
11. How often do workers’ compensation cases settle?
|Answer:||In our experience, most cases settle, but occasionally cases do go to a hearing. Within the workers’ compensation system, there are a variety of procedures available should a dispute arise over your entitlement to workers’ compensation benefits. These include medical rehabilitation conferences, administrative conferences to discontinue wage loss benefits, filing of claim petitions and resultant hearings held before compensation judges. Though most cases settle, almost all matters have some sort of dispute that utilizes one or more of the procedures available within the workers’ compensation system to resolve disputes.|
12. How long do workers’ compensation cases take to reach a conclusion?
|Answer:||In our experience, most workers’ compensation claims take from 18 months to two years to reach some type of resolution. However, some cases can last much longer. One of our cases lasted seven years because it took a very long time for the client to heal from the work injury, as well as being reviewed by the Minnesota Supreme Court on a couple of occasions. Again, on average you can expect that your case will take 18 months to two years before it comes to a conclusion.|
13. Do I receive payment for pain and suffering if I bring a workers’ compensation claim?
|Answer:||The answer is “no.” The Minnesota workers’ compensation scheme does not allow for you to recover for your pain and suffering. One of the principles the system was based upon is that benefits available to an injured worker are limited and do not include any payment for pain and suffering. Also, there is no compensation for the loss of your lifestyle, your family life or the impact your injury has on your spouse. Instead, the system provides increased likelihood that you will receive benefits for your work-related injury but the monetary sum recovered for that injury decreases. The purpose of the system is to provide moderate benefits to injured employees, rather than large awards to a few and no benefit to most injured workers.|
Workers’ Compensation In Minnesota FAQs
1. What is the history of workers’ compensation in Minnesota?
|Answer:||Workers’ compensation came into existence in 1913. Prior to that date, there was no workers’ compensation law in Minnesota. If you were hurt on the job, you had to sue your employer in civil court and prove that the employer was at fault for causing your injury. Since 1913, all you need to establish is that you were hurt in the course and scope of employment, and you are entitled to workers’ compensation benefits. The benefits are limited to what is provided by the law on the date that you were injured.|
2. What types of injuries are covered under workers’ compensation in Minnesota?
|Answer:||Physical injuries are covered by workers’ compensation in Minnesota. There are several types of physical injuries that a person can sustain. The first type of injury occurs in a traumatic accident. As an example, if you are carrying a box and fall down and break your leg, it is easy to establish the injury happened at work. Another type of injury is referred to as a Gillette injury. A Gillette injury is one that occurs over a period of time as a result of repetitive work activity. For example, if you are a barrel maker and spend 30 years making barrels and one day your shoulder freezes up but you did not fall down and injure the shoulder on a specific date, you have a compensable injury based upon the repetitive work activity you performed causing the shoulder to lock up. The third type of injury is an occupational disease. Assume that you work around chemicals and later develop lung cancer caused by chemical exposure. Your lung cancer would be covered by workers’ compensation because of the chemical exposure at work that substantially contributed to your developing lung cancer. Consequential injuries are also covered under the Minnesota workers’ compensation law. Consequential injuries occur if you have a back injury that causes you to limp resulting in the development of leg pain. In such a circumstance, both your back and leg injury are covered by workers’ compensation because the leg pain developed as a consequence of the back injury. Finally, if you sustain an injury while treating for a work-related injury, the injury would also be covered. As an example, if you are treating for a back injury and get into a car accident while going to the doctor to treat for the work-related injury and break your arm, both your back and arm injuries would be covered under the Minnesota Workers’ Compensation Act.|
3. Are stress-related claims covered under workers’ compensation in Minnesota?
|Answer:||Effective October 1, 2013, employees in Minnesota diagnosed with PTSD (post-traumatic stress disorder) caused by an incident at work will be covered for workers’ compensation benefits. The change in law recognized that mental injuries, injuries without any physical injury, are covered. Prior to the change in law, mental injury could result in a compensable claim if it was caused by a physical injury, such as depression caused by a back injury, or if it resulted in a physical injury like a police officer developing an ulcer caused by the stress on the job. The PTSD diagnosis must be made by a licensed psychiatrist or psychologist. Stress caused by workplace actions such as discipline, layoffs or terminations are not covered under the new law.|
4. Who can file a workers’ compensation claim in Minnesota?
|Answer:||Only employees are entitled to workers’ compensation benefits. An employee is someone who works for a business entity or an individual for pay. Certain types of employment situations are not covered. If you are an independent contractor, you are not covered for workers’ compensation. If you are a corporate officer, such as a vice president of a corporation, you are not covered unless you have specifically elected to be covered for workers’ compensation coverage. Also, if you are a family member working for your mom, dad, brother or uncle, you are not covered unless there is a specific election to cover family members for workers’ compensation benefits. Also, if you are farm laborer, you generally are not covered. Volunteers may or may not be covered depending on the specific factual circumstances surrounding their employment.|
5. Can I receive workers’ compensation benefits if I re-injure a preexisting condition?
|Answer:||If you injure a preexisting condition in a work incident, you may be covered by workers’ compensation. In order to have a valid workers’ compensation, the work injury to the preexisting condition has to be a substantial contributing factor. In other words, the work injury does not have to be the sole factor or even a primary factor, only a substantial contributing factor. If you have a preexisting lower back condition and while lifting a box at work develop back pain, workers’ compensation should cover the injury because the work activities substantially aggravated your preexisting back condition.|
6. How do I tell my employer that I was hurt on the job?
|Answer:||In Minnesota, an injured employee must notify the employer of a work-related injury in a timely manner. The report should be made in writing, but in the modern world notice could be made by email, voice mail or text message. The notice should be made to someone in a supervisory position such as your supervisor or in the human resources department. The notice should include the specific detail of how you were injured. Once you report the incident to your supervisor, the supervisor should advise the appropriate human resources individual, who then should complete a First Report of Injury for forwarding to the workers’ compensation insurance carrier. If your employer refuses to file the claim, you should contact the Minnesota Department of Labor and Industry and personnel there will assist you in filing the claim.|
Have More Questions? We Have Answers.
Every workers’ compensation claim is unique. For a more in-depth discussion about your claim, your questions and your concerns, contact us online or call 320-200-4928. We have offices in St. Cloud and Monticello.