Common Workers’ Compensation Questions
What is covered by workers’ compensation?
Employers in Minnesota are required to have workers’ compensation insurance for the protection of their employees. Benefits are available to an employee who suffers any of the following problems, as long as the problems arise out of the employment:
SPECIFIC INJURIES: Any type of injury, such as neck and back injuries, knee and shoulder injuries, broken bones, sprains/strains, head injuries, cuts, burns and any other type of injury are covered;
REPETITIVE INJURIES: Medical problems which occur gradually as a result of work activities are also covered, even where there is no specific incident. This would include things like:
– carpal tunnel syndrome from repetitive use of the hands and wrists,
– gradually increasing back or neck pain from bending, twisting or lifting,
– knee, shoulder or other joint pain from physical labor or repetitive activities,
– and many other types of gradually occurring medical problems.
OCCUPATIONAL DISEASES OR ILLNESSES: Medical problems or disability caused by exposure to chemicals, dust, solvents or other toxins on-the-job or in the workplace.
AGGRAVATIONS OF PRE-EXISTING CONDITIONS: Even if you have had prior medical problems, accidents or injuries, you may still be covered by workers’ compensation if your work activities or an on-the-job injury aggravates one of your preexisting conditions.
I think I have a claim. What should I do next?
REPORT IT TO YOUR EMPLOYER RIGHT AWAY: Even if it seems like a relatively minor injury or medical problem, you should report it to your employer if you think it might be related in any way to your employment. Failure to give this notice can provide the insurance company with a defense to your claim.
TELL YOUR DOCTOR OR CHIROPRACTOR: Make sure that your medical provider understands that you believe the injury or medical condition occurred at work. If the insurance company denies your claim, it is very helpful if your initial medical records say that the problem is work-related.
FOLLOW-UP WITH YOUR EMPLOYER: If you don’t hear from your employer’s workers’ compensation insurance company within 30 days, ask your employer if the claim was turned in. Don’t assume that you have no claim just because the insurance company never contacts you.
What benefits are available under workers’ compensation?
Depending upon the nature of your injury or medical condition, some or all of the following benefits may be available to you:
WAGE LOSS BENEFITS: Wage loss benefits are tax-free and are paid at a percentage of the weekly wage you were earning on the date of your injury. You can receive full wage loss benefits if you are off work completely, or partial wage loss benefits if you are working but earning less than you were when you got hurt.
PERMANENT IMPAIRMENT: If you suffer a permanent injury, you may be entitled to a disability rating and payment under the disability schedules. This is a rating usually given by your doctor after medical treatment is completed.
MEDICAL BENEFITS: The insurance company must pay all of the medical bills which are related to your injury or medical condition. There are no deductibles or co-pays. The insurance company must also reimburse you for your related medical travel expenses.
VOCATIONAL REHABILITATION ASSISTANCE: In many cases, the insurance company must assign you a Qualified Rehabilitation Consultant (QRC). This is a person paid by the insurance company to assist you in returning to work. In some cases, you may also be eligible for retraining, paid for by the insurance company, if you are unable to return to your job. The person who serves as the QRC is your choice, not the insurance company’s.
LUMP SUM SETTLEMENTS: At some point, the insurance company may wish to make a settlement with you for disputed or potential future claims. A “settlement” is not something that you are guaranteed but it is how many claims eventually end. You should never settle a claim without seeking the advice of an experienced workers’ compensation attorney.
Can my employer fire me if I file a Work Comp Claim?
Minnesota law prohibits an employer from retaliating against you for filing a workers’ compensation claim. An employer may not discharge, threaten to discharge or intentionally obstruct you from seeking workers’ compensation benefits.
When should I contact a lawyer?
We regularly speak with people who simply have questions about a claim or a potential claim. There is no charge for a phone call or an office consultation to answer your questions. Whether you have a claim that the insurance company is paying or whether you are considering filing a claim, there are many situations where it’s a good idea to check with an attorney. Here are a few:
YOU AREN’T SURE WHETHER TO FILE AN INJURY REPORT: You’ve been hurt or have a medical condition that you feel is related to your work or job duties, but you just aren’t sure.
YOUR CLAIM HAS BEEN DENIED: The insurance company has denied your claim, for whatever reason. Don’t give up without talking to an attorney.
YOU THINK THE INSURANCE COMPANY CALCULATED YOUR WAGES WRONG: All wage loss benefits paid to you are based upon your “average weekly wage” on the date of injury. Calculating your average weekly wage can be complicated and may include overtime and other compensation. If the insurance company gets this wrong, they may be paying you less than they should.
YOUR BENEFITS HAVE BEEN DISCONTINUED: Your wage loss benefits have been discontinued but you disagree with the reasons given for the discontinuance.
THERE IS A DISPUTE OVER YOUR WORK RESTRICTIONS: The insurance company may send you to one of their own doctors for an “Independent” Medical Examination (referred to as an IME). Almost always, that doctor will disagree with your treating doctor about everything from diagnosis to treatment and restrictions. The insurance company will frequently use their doctor’s IME report to cut off your wage loss and/or medical benefits.
THE INSURANCE COMPANY WON’T PAY A MEDICAL BILL: This can occur for many reasons, but often occurs shortly after you receive the IME report.
THE INSURANCE COMPANY WON’T APPROVE A MEDICAL PROCEDURE: The insurance company will not agree to authorize surgery, injections, physical therapy, an MRI a second opinion, a change of treating doctor, a referral to a specialist, etc.
A QRC IS ASSIGNED TO YOUR CASE: As mentioned above, the choice of QRC is yours, not the insurance company’s. Unfortunately, they don’t usually explain this to you and most injured workers have no idea where to find a QRC they can trust. We have a number of QRC’s that we work with regularly and can strongly recommend.
THE INSURANCE COMPANY OFFERS YOU A SETTLEMENT: If the insurance company wants to settle your case, make sure to at least consult with an attorney before you do so. An insurance company claims adjuster is far more knowledgeable about workers’ compensation than you are. Any settlement must be approved by a workers’ compensation judge.
YOU JUST HAVE A FEW QUESTIONS: A workers’ compensation claim can be a confusing, frightening and frustrating ordeal. Please don’t be afraid to call us, anytime, if we can answer some questions for you. It won’t cost you anything and we will give you our honest assessment about whether you need a lawyer to represent you.
How much does it cost to hire a work comp lawyer?
Nothing. Attorney fees for work comp claims in Minnesota are paid on a contingent basis. This means that we only get paid if we obtain benefits for you. The fees are set by law, so they are the same for all lawyers in all cases. If we recover disputed monetary benefits for you, our fees are 20% of the disputed benefits we recover (for injuries prior to October 1, 2013, attorney fees are 25% of the first $4000 recovered and then 20% after that). If we only recover disputed medical or vocational benefits, our fees are paid by the insurance company. All fees have to be approved by a workers’ compensation judge before they are paid.
If we take your case, we will pay the necessary expenses to obtain medical records and reports, depositions, expert opinions, etc. Unless you have a very unusual case and we make different arrangements in advance, you will never get a bill from us or be asked to pay us any money out of your own pocket.