If you have suffered an injury and cannot work, you have a safety net that can provide you with medical care and some means of financial support until you can work again. You may even qualify for benefits permanently until retirement if you cannot work at all in the future. Minnesota law requires employers to purchase workers' compensation insurance, which becomes your exclusive remedy when you suffer an injury while working.
You must go through a process before qualifying for workers' compensation benefits. First, you must formally apply for benefits after you have notified your employer of your injury and sought medical treatment. The insurance carrier for your employer will then determine whether they will pay your claim. Carriers do not always side with the injured worker, and you may have to file a workers' compensation appeal.
Consider hiring a Minnetonka workers’ compensation lawyer to assist you with your claim, especially if you have suffered a severe injury. You should also hire a lawyer if you anticipate that you will have a problematic claim and potential problems with the insurance company. Injured employees need a lawyer if the insurance company has denied their claim, and they must file an appeal to fight for benefits.
One of the key advantages of hiring a lawyer for your workers' compensation claim is their experience handling these cases. They have a deep understanding of the intricacies of the law and can navigate the complex legal system on your behalf. They have the knowledge and experience to properly assess the value of your claim, considering not only your medical expenses and lost income, but also any potential future expenses related to your injury.
When You May File for Workers' Compensation Benefits in Minnesota
You may file a workers' compensation claim when you have suffered an injury on the job. Workers' compensation is a no-fault system, meaning you can still receive benefits if you were negligent in the events surrounding your accident. You can also file a claim if you have a job-related injury that occurred over time, such as an overuse injury like bursitis or tendonitis. Workers' compensation claims even cover instances in which your job has subjected you to such stress that you have developed a mental health condition. Finally, you can also file for benefits if your job duties aggravated your existing condition (although you cannot receive benefits for a pre-existing condition itself).
Only Employees Can File for Workers' Compensation Benefits
You must have been an employee to qualify for workers' compensation benefits, and those who are independent contractors cannot receive workers' compensation benefits. For example, if you suffered an injury while driving for Uber, you are an independent contractor and are not eligible to file a workers' compensation claim. However, you can legally challenge your employer if they have wrongfully classified you as an independent contractor.
You Have a Tight Timeline to Notify Your Employer of Your Injury
The first thing you should do after a work-related injury in Minnesota is notify your employer of your injury. This notification is not a courtesy; it is a legal requirement, and you must notify your employer within 14 days of your accident or when you should have known about your injury. This period is extremely tight, and there is no room for error. If you miss this deadline, you can lose the right to receive benefits entirely. Preferably, you should notify your employer of your injury in writing so you have proof that you complied with the law, and they cannot deny that you gave them notice.
Seek Medical Treatment from Your Doctor After Your Injury
One of the first things you must do to file a workers' compensation claim in Minnesota is to see the doctor. Minnesota law favors workers when they get medical care for their injuries, and unlike other states, you can choose your own doctor to provide treatment. Your employer may try to steer you to a particular physician, but you are the one who will make the final decision.
Be careful of the doctors your employer tries to suggest to you because the doctor may feel like they have an obligation to your employer, who is sending business their way.
The doctor will examine you and diagnose your injuries. They will give you treatment notes and medical records that you can use to file your claim. The doctor will also begin to treat your injury and help put you on a course to the fullest possible recovery.
There Is a Waiting Period to File a Claim
There is a mandatory waiting period before you can file a workers' compensation claim. Minnesota has a three-day waiting period from the time of your injury before you can file for benefits. You can only receive workers' compensation benefits for those three days if you have an injury resulting in you being in the hospital overnight or missing at least ten days from work.
Filing Your Claim with the Insurance Company
You will submit your claim to your employer's insurance company, and it will determine whether to grant your benefits. You will disclose medical information about your condition and any other factual evidence that will allow the insurance company to assess the merits of your claim.
Insurance companies have 30 business days from the time they receive the claim to decide whether to grant or deny it. If they approve the claim, they will need to pay benefits retroactively.
The Insurance Company Makes a Decision About Your Claim
Insurance companies will send you a Notice of Insurer's Primary Liability Determination when they have decided to grant your benefits. The insurer must start paying income-loss benefits within 14 days of the day your employer knew or was informed about your work injury and lost income.
If the insurance company denies your claim, it must explain why. You will need to understand the basis of the denial so you can effectively file an appeal.
Workers' Compensation Benefits You May Receive
If your claim for benefits is successful, you will receive the following benefits:
- Reasonable medical costs to treat your injury - medical expenses are not just limited to payments to medical providers. The insurance company must also pay for prescriptions, rehabilitation, and medical equipment. You will often have difficulty with insurance companies because they may refuse to cover specific things.
- A portion of your lost income - Minnesota law allows you to receive two-thirds of your average weekly income before your injury, subject to a certain statutory cap.
- Vocational training - if you can no longer do your job, you can receive vocational training to help retrain you to do another job.
Why the Insurance Company May Deny Your Claim
Insurance companies will decide whether to grant your benefits. In some cases, they may deny your claim and may give the following reasons for the denial:
- You did not provide enough evidence of an injury.
- Your injury was not sufficient to keep you from working.
- Your injury was a pre-existing condition and was not work-related
- You did not suffer your injury on the job.
- Your injury came from horseplay or intentional misconduct.
- You did not follow the technical requirements of the claim.
- You did not notify your employer of your injury in time.
Remember that insurance companies are for-profit businesses and may not make objective decisions about your claim. Their self-interest often comes into play when they deny your claim. Insurance companies may hope that you go away, or they may try to force you into a settlement where you may accept less than you would have otherwise gotten.
You Can Appeal When the Insurance Company Denies Your Workers' Compensation
If you still need a workers' compensation attorney, you must hire one soon to help you file an appeal. First, your attorney can have a conversation with the insurance company to clarify any misunderstanding that may have led to your claim's denial. If that does not work, you have legal options that can get an objective hearing in front of an impartial judge who does not have a financial interest in your case.
How to Appeal a Workers' Compensation Denial
There are two potential places where you can file a workers' compensation appeal:
- In front of an administrative law judge at the Office of Administrative Hearings
- To the Workers' Compensation Division at the Department of Labor and Industry
A judge will hold a hearing where your lawyer will present evidence that can show that you have suffered a work-related injury. They may offer witness testimony and even call you to testify.
If your appeal is unsuccessful at this first level of review, you can take your case to the Minnesota Workers' Compensation Court of Appeals (MWCCA). The MWCCA has the authority to review decisions made by both forums listed above, and the judges can overturn the decision at the lower level of review. If you do not get the desired result in front of the MWCCA, you can take your case to the Minnesota Supreme Court.
You have a reasonable chance of winning your case on appeal or negotiating a settlement with the insurance company. Studies show that roughly 65-70 percent of workers' compensation denials can turn to benefits. In some cases, you may even end up with more money after you go through the appeals process. Either way, it pays to push back and fight when the insurance company has wrongfully denied your workers' compensation claim. Always contact an attorney to see if you have grounds to appeal the decision.
You May Have Continued Legal Issues with the Insurance Company
Even when you receive workers' compensation benefits, it may not be the end of the legal issues that you may encounter. Insurance companies will need to pay your benefits over time. At some point, they may ask you to attend an independent medical examination with a doctor of their choosing. The doctor may say that you are ready to return to work, and usually, you will need to return to your job (even with light work duties), or you will risk losing your benefits. You can always get a second opinion or file an appeal if the insurance company wrongly terminates your benefits.
You may also have issues when the insurance company refuses to pay for specific treatments. Even when insurance companies admit liability, they may not always want to pay for what is necessary. You may need to continue dealing with them, even after receiving benefits. An attorney may need to speak with the insurance company and file an appeal on your behalf.
Workers' Compensation Lawyers Cost You Nothing Upfront
If you are wondering how to afford a workers' compensation attorney when you are not earning money, you can put that worry behind you. You do not need to pay an attorney out of your pocket. A workers' compensation attorney gets paid on a contingency basis, meaning they only receive money if you win your case. You do not have to pay a retainer or hourly bills during your case. If you do not receive benefits, you will not pay an attorney anything for their time and services. Thus, you have no downside in hiring a workers' compensation attorney. You risk much more if you do not get the benefits you critically need.
Not only will a workers' compensation lawyer fight for your rights, but they will also handle all the legal aspects of your claim. From gathering evidence to negotiating with insurance companies and representing you in court if necessary, they will be your advocate every step of the way. Their experience in workers' compensation law ensures that you have the best chance of a successful outcome in your case.
If you have suffered an injury at work, do not hesitate to contact Minnetonka personal injury lawyers. Remember, they cost you nothing upfront, and their experience and dedication can make all the difference in getting the compensation you deserve. Focus on your recovery while they handle the legalities and fight for your rights.
Steve Fields
Founder | CEO | Principal | Attorney
Steve Fields founded Fields Law in 2001 and quickly established a reputation with his Personal Injury clients for being a lawyer who truly cares. After more than 20 years, those clients continue to refer their friends and family whenever they have been injured or become disabled.
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