Common Questions About Workers’ Compensation
What types of injuries are covered in a workers’ compensation claim?
Personal injury or occupational illness or disease arising out of and in the course and scope of employment, including:
- Traumatic injuries
- Non-traumatic injuries resulting from repetitive movements or over-use of a body part from work activities
- Pre-existing conditions or prior injuries that are substantially aggravated or accelerated by work activities
- Employer or employee’s fault in causing the injury (with limited exceptions) has no relation on the work injury claim; in other words, your fault in causing your injury cannot be used to deny or limit your claim
Do I need an attorney and what will it cost?
Yes. Regardless of whether your work injury claim has been accepted or denied, you will need an attorney to assist you in navigating the claim process. Attorney Andrea B. Niesen will advocate on your behalf for your legal rights. Workers’ compensation laws are complex and frequently change. You need an attorney to best represent your interests and maximize the benefits you are entitled to under the law.
Attorney fees in workers’ compensation claims are paid on a contingent fee basis, meaning fees are only paid if you receive an award of denied benefits or negotiated settlement of benefits. Attorney fees are paid on genuinely disputed benefits or settlements. Attorneys representing injured employees in a workers’ compensation claim cannot charge hourly fees or require a monetary retainer. A court may order the employer or insurance company to pay the employee’s attorney’s fee in disputes involving medical or vocational rehabilitation benefits.
What do I do when the insurance company tells me it closed my file and will not pay for any more medical treatment for my injury?
You are entitled to claim medical benefits under work comp as long as the treatment is “reasonable and necessary and casually related to your injury.” There is no cut-off in an admitted claim for medical benefits. Even if the insurance company claims to close your file, your rights under the law allow you to claim these expenses and challenge any denial by the insurance company. Contact our workers’ compensation attorney to discuss challenging the insurance company’s denial of medical treatment for your injury.
What workers’ compensation benefits can I receive?
I. WAGE LOSS – “INDEMNITY” BENEFITS
- Temporary Total Disability (TTD)
Treater takes off of work completely; or has restrictions that ER will not accommodate; restrictions and layoff; restrictions and terminated
2/3 of average weekly wage = compensation rate
Duration: 130 weeks (post 10/08 DOI)
Cut-off: MMI – 90 days post
- Temporary Partial Disability (TPD)
Working at a wage loss (less hours; less pay) with same or new ER
2/3 difference of post-injury earnings and DOI earnings = TP benefit
Duration: 275 weeks (approx. 5 years 4 months) (225 weeks for pre 01/01/19 DOI)
Cut-off: 450 weeks (approx. 8 years 6 months)
- Permanent Partial Disability (PPD)
Percentage of functional loss of the injured body part
Assessment made according to MN Work Comp disability schedule
Percentage multiplied by schedule factor
One time monetary payment
- Permanent Total Disability (PTD)
Employee found to be vocationally and medical unable to perform meaningful work with no potential earning capacity.
Weekly payment of full compensation rate (2/3 of average weekly wage)
Duration: paid until the presumed age of retirement, age 67; or possibly shorter or longer time period as long as employee remains permanent and totally disabled
PPD Thresholds must be met to be PTD:
a. at least 17 %
b. at least 15% and is 50 y.o. at DOI
c. at least 13% and 55 y.o. at DOI and no HS degree or GED
II. MEDICAL BENEFITS
Duration: no cut off date; as long as treatment is reasonable and necessary to cure and relieve the effects of the work injury
Prescription, medical device, nursing, home health care, transportation expenses
Mileage reimbursement round trip to medical appointments
III. VOCATIONAL REHABILITATION
- Qualified rehabilitation consultant (QRC)
- Job placement services