The answer to this question is not always an easy one. First, you need to get your health care provider to forward the request to your insurance company. Then, according to Minnesota Workers Compensation Rule 5221.6050, the insurer must respond orally or in writing to the health care provider’s request within seven working days. If the health care provider does not receive a response from the insurer within the seven working days, authorization is deemed to have been given. See Minnesota Workers Compensation Rule 5221.6050 subp. 9c(1).  There are several ways that the insurance company can delay this further.

The insurance company can approve the request, deny the request, request additional information, request a second opinion, or request an Independent Medical Exam (IME). Depending on the response, the insurance company could have additional time to make a decision. For instance, if the insurance company requests additional information, they will have an additional seven business days to make a decision after the additional information has been received. The more common response is to request and IME.

If the insurer notifies the health care provider of the IME within seven working days, the proposed non-emergency surgery may not be provided pending the examination. However, after 45 days following the insurer’s request for an examination, the health care provider may elect to go ahead with the procedure and if the procedure is ultimately determined to be compensable by a judge, they will be paid.

Minnesota work comp has many rules and regulations. Insurance companies know these rules like the back of their hand. If left unchecked, these rules can be used to delay your case, or worse prevent you from getting benefits. However, if you know what the rules are and how to use them, they can made to work for you, not against you.  

Over the years I have had clients ranging from medical doctors to high school cashiers. Regardless of their age, background, experience, or education, they all get bogged down by the complexities of the workers’ compensation system. With this in mind, there are certain steps you can do early on to help preserve your benefits for the future.

• Report the accident/incident to your employer immediately.
• Seek medical attention as soon as possible.
• Inform the doctor that you were injured at work, and what body part(s) hurts.
• Be open and honest with your doctor at all times.
• Have your doctor write work restrictions and provide it to your employer.
• Follow your doctor’s recommendations.
• Keep track of your mileage to and from the doctor, along with parking costs.
• Keep track of your time off of work
• Keep receipts
• If you are not returning to your date of injury employer, but are still able to work, you must do a job search.
• Get a QRC.

Do you have to treat with a company doctor? In most cases, an injured worker is free to choose their own doctor. What you are not allowed to do is jump from doctor to doctor, which makes choosing the right doctor early on very important. Choosing the right doctor is an important part of your claim. Like anything else, there are good and bad doctors. First and foremost, you want to choose a doctor that is going to help you get better. You also want to choose a doctor that is willing to provide information in the form of reports or testimony. After the injured worker has been seen by the same physician (3) times, that physician is considered to be a primary care provider. You are entitled to second opinions and/or change of physician, if there are good reasons to do so.

What happens if the insurer denies your benefits? There are many reasons why an insurer may deny your benefits. The insurer may deny the entire injury, or various benefits like wage loss benefits or medical treatment. Do not abandon your claim simply because the insurance company has denied it. You are entitled to these benefits and with help can re-claim them.

There are many injuries covered under the workers compensation system. Essentially, any injury arising out of or in the course of your employment is potentially covered. In most cases it does not matter whose fault it is, you’re covered.

Injuries include: acute injuries, aggravations of a pre-existing condition, a gradual onset of symptoms, such as carpal tunnel, or an illness. 

Some examples of injuries that occur at work may include sprains, strains, lacerations, contusions, herniation, tears, fractures, falling, lifting, running machines, bending, standing, typing, using vibrating tools, car accident, or injuries while getting medical treatment for work injuries.  

An employee can even have a long standing condition that was made worse due to their work activities.  Some common conditions that may be aggravated by work include: degenerative disc disease, herniated disc, hearing loss, prior shoulder injuries and prior knee injuries.  This is commonly seen in repetitive jobs where the employee lifts frequently or uses the same repetitive motions in assembly or packing, resulting in the onset of pain over time. 

The bottom line is, if you have an injury, and it is in anyway related to your work, it is likely covered under Minnesota workers’ compensation laws.

In 1995 the American Bar Association funded Temple University to conduct a study of the differences between satisfied and dissatisfied clients. “Report on the Legal Needs of the Low- and Moderate-Income Public,” Study conducted by the Institute for Survey Research at Temple University for the consortium on Legal Services and the Public (ABA, 1995). It is no surprise that the biggest complaint, among dissatisfied clients, was lack of communication.

 Attorneys are required, under Rule 1.4 of the Rules of Professional Conduct, to keep clients informed about the status of their case and to promptly comply with reasonable requests for information. With today’s technology (i.e. internet, cell phone, email, voicemail, fax, and text) there is absolutely no excuse for lack of communication between attorney and client. 

With that said, communication is a two way street. Attorneys have many clients, but clients generally only have one attorney. It is easier for a client to call their attorney with questions, then for their attorney to call each client every time a letter is draft or received.  Clients should also make sure they call their attorney with any updates on their contact information. There is nothing more frustrating than calling a client only to find out they have moved and their number has been disconnected.

Attorneys, when your client calls, RETURN THE CALL. I will admit to having gone 30 plus days without speaking to a client if there is nothing new on their case. However, if a client calls, emails, or writes, I do my best to responds in a timely fashion, if I am unable to do so, I make sure someone from my office does.

 If a client has made all reasonable efforts to communicate with their attorney and gets nothing but radio silence, a client has the unquestionable right to fire that attorney at any time.  The process is simple, find a new attorney and let them contact your attorney to let them know their services are no longer required. 

However, I don’t advise firing your attorney until you contact a new attorney.  If your case is close to hearing or a major event, it may be difficult to get a new attorney to take your case on such short notice.  A new attorney can explain this further and any other potential consequence of firing your attorney. 

The goal of the Minnesota Workers’ Compensation system is to successfully return injured workers to the work force. To this end, Minnesota uses a vocational rehabilitation system that utilizes qualified rehabilitation consultants (QRC), job placement vendors, and when appropriate retraining plans, to insure that injured workers not only return to work, but are successful when they do.

Vocational rehabilitation services are planned by you, the employer/insurer and a qualified rehabilitation consultant (QRC). These services are:

· Modifying job duties to fit abilities;

· Finding work with a different employer if yours does not have suitable;

· Training for a new job.

A QRC conducts a vocational rehabilitation consultation to determine whether you are eligible for rehabilitation services. If you are eligible, the QRC will write a rehabilitation plan and coordinate rehabilitation services. The QRC will work with you, your employer and the insurer to plan the serviced you need to return to suitable gainful employment.

Currently the Commissioner of the Department of Labor and Industry is trying to pass legislation that could seriously undermine the ability of s QRC’s to do their job. The substantive points are as follows:

1. QRC’s will be required to file a plan progress report 18 months after filing a rehab plan and every 6 months thereafter (presumably to better allow DOLI to monitor rehab plans that continue beyond 18 months);

2. DOLI will be given express authority to schedule a rehab conference under 176.106 (presumably to deal with what they perceive to be excessive or inappropriate rehab services);

3. The maximum hourly rates paid to QRC’s will be reduced by 15% after 39 weeks or $3,500, and by 25% after 52 weeks or $5,200 (the previously proposed reduction by 50% after 104 weeks or $10,500 has been withdrawn);

4. The maximum hourly rates paid to QRC’s will be reduced by 50% for all QRC’s for medical management services;

5. The maximum hourly rates paid to QRC’s will be reduced by 50% for all QRC’s and all services if:

a. The QRC does not consult with, or make a good faith effort to consult with, the date of injury (DOI) employer regarding whether the employee can be expected to return to suitable gainful employment with the DOI employer;

b. The DOI employer tells the QRC they will offer the employee suitable gainful employment; or

c. The rehab plan provides for a return to work with the DOI employer;

6. The mandatory rehab conference after 70 weeks of services has been withdrawn;

7. The bonus for securing suitable gainful employment within 52 weeks has been withdrawn.

The danger in the Commissioner’s proposed changes is that QRC’s will be forced to place injured workers to work before they are ready and possibly in positions that are not suitable for their injuries. This will be setting injured workers up for failure and ultimately undermining the ultimate goal of the entire system.

Thousands of Minnesotans are injured on the job annually. With the current economy, it is imperative that any proposed changes to the Workers’ Compensation be focused on providing access to the best vocational rehabilitation care available and not limiting the vocational rehabilitation that we currently have.

I get this question a lot; “Do I really need to hire an attorney?” The answer is always the same, YES! Even if I was not an attorney, knowing what I know, the answer would still be emphatically YES. Whether it’s Heimerl & Lammers, LLC or somebody else, get an attorney.

Workers’ compensation laws in Minnesota can be extremely complicated. Riddled with rules, cessation events, time limits and exceptions to all of the above, it is easy for an injured worker to get lost in a procedural maze. Unfortunately, if you do not follow the proper procedures, you can miss out on key benefits you are rightfully entitled to and possibly forfeit those benefits forever.

In addition to the risk of missing out on benefits, injured employees are taken a little more seriously when they are backed by a competent attorney. You will find that your wage loss and medical bills get paid just a little bit quicker when you have an attorney on your side. Attorneys are also able to negotiate higher overall compensation than an employee can do on their own.

For those of you who are still not convinced and think they will save some money by not hiring an attorney, I saved the best part for last. A Minnesota workers’ compensation attorney is FREE unless one of two things happen:

1. there is a dispute over benefits
2. said attorney recovers money for you

If a dispute arises, there is already a problem with your case and in most cases you are not receiving benefits you are rightfully entitled to. It is unlikely you will recover those benefits on your own, which means without an attorney you will likely receive nothing. With an attorney in your back pocket, they can quickly spring to action and get some if not all those benefits back. If there is no dispute, you don’t pay anything. You get free help and advice whenever you want at no cost. Where is the down side in that?

With today’s economy many workers’ are hesitant to file a workers’ compensation claim for fear of losing their job. In a time when jobs are hard to come by, and there are hundreds of able bodied workers to take your place, who can blame you. However, you have an unquestionable legal right to file a workers’ compensation claim if you are injured on the job. There are many laws which protect an injured employee from being terminated.

Under Minnesota Law, an employer may not retaliate against an employee for filing a workers’ compensation claim. This includes terminating the employee or obstructing their right to file a workers’ compensation claim. Additionally, an employer who unreasonably fails to offer continued employment may be subject to civil damages. However, filing a workers’ compensation claim does not provide an employee a shield behind which they cannot be touched.

Often times employees who have filed workers’ compensation claims feel as though they are under a microscope, and the truth is they often are. An employer may terminate an employee for behavior which violates the reasonable standards of behavior the employer has the right to expect, and which rises to the level the law would consider to be misconduct. In other words if you are doing something which one would ordinarily expect to get fired for then the law will not protect you.

So, why take the risk? Many injures which go untreated will undoubtedly get worse over time. Some injuries may progress to the point where the employee will have no choice but to remove themselves from the work force. To file a workers’ compensation claim months or years after the injury has happened could, at best make it more difficult to prove your claim, and worst bar your claim completely. It is always better to get treatment and the rest you need right away and could possibly prevent a two week injury from turning into a two year injury.

It is the intent of workers’ compensation to assure the quick and efficient delivery of wage loss and medical benefits to injured workers. The goal is to get injured employees the medical treatment they need and return them to the work force as quickly and safely as possible. If you are still unsure if you should file a claim or even whether you have a claim you should contact an attorney immediately.

What exactly are you entitled to when it comes to workers compensation? Under the state of Minnesota workers compensation laws, any injured worker is entitled to the following medical benefits:

• Reasonable medical care
• Hospital services
• Your choice of doctor in most instances
• Physical therapy
• Chiropractic
• Medication and pain relief
• Crutches
• Eye glasses
• Artificial limbs
• Wheelchairs
• Other appliance that can help relieve the effects of a work injury

One problem with Minnesota workers compensation is that workers are not always given the proper compensation for all of these medical needs. While on workers compensation, you may notice that you are paying a lot of the bills yourself.

Furthermore, there will be additional expenses incurred that are not originally covered by the insurance company. You can still claim these back through out of pocket reimbursements. Here are some tips to make this process as smooth as possible

• Keep all your receipts for any out of pocket expenses such as prescriptions. Store all receipts in a file and make copies just in case they fade
• Keep track of all mileage used going to medical appointments
• Double check that the doctor and the insurance company are corresponding and that the paperwork is being sent to the insurer
• Provide your employer with regular updates about your progress, your medical treatments and your restrictions at work.

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