My Minnesota Work Comp Claim Was Denied Because of a Prior Injury. Now What?

This is another of the common problems we often deal with when helping people who have been injured on the job across northern Minnesota.

Typical situation:  you have been working for several years without any physical problems, work restrictions, lost time or any other difficulties or limitations. Then one day at work, you are lifting or carrying something and suffer an injury to your back (or neck, shoulder, knee, elbow, etc.). You report the injury to your employer, explaining exactly what happened and you make an appointment to see your doctor or chiropractor.

Maybe you fill out some more paperwork for your employer or maybe you receive a call from a claims adjuster from the work comp insurance company, asking for more details about the injury and your medical history. Perhaps you are off work on doctor’s orders and receiving therapy or other treatment while you try to heal and get back to work.

One day in the mail you receive a notice from the work comp insurance company explaining that your work comp claim has been denied. DENIED?!?! Apparently, you had received medical treatment for a back injury 15 years ago and the insurance company has decided that your current problems are a pre-existing condition. Claim denied!

Claim Denied. Options?

At this point, you may have already lost several weeks of wages and run up hundreds, or thousands, of dollars in medical bills.  You had reasonably assumed that everything would be taken care of by work comp because your injury had occurred on the job. Now what do you do? Well, you basically have two options:

Option #1:  Walk away. If you have health insurance or are willing to go back to work and “tough it out”, you can simply let the matter drop and walk away from the claim. Your employer and the work comp insurance company would be very happy if you make that choice. In fact, insurance companies count on the fact that many people will simply walk away after a claim is denied, instead of even contacting an attorney for legal advice or a consultation. The downside of this option is that your claim will never be recorded as a work injury and you will have no protection if it turns out to be a long-term or serious problem. In addition, all claims have deadlines, also called statutes of limitation, which require you to formally file a work comp claim with the Minnesota Department of Labor and Industry, Workers’ Compensation Division, within a certain time frame. If you fail to legally file your claim before the deadline expires your claim will be barred forever. An experienced attorney can tell you when the deadline might be for your particular claim.

Option #2:  Fight the insurance company for the benefits to which you are entitled under Minnesota’s workers’ compensation laws. Your first step would be to contact an experienced work comp attorney for a consultation to see if you have a claim worth pursuing. After that, the attorney will pursue the claim by gathering medical records and reports, filing whatever claims you might have and fighting with the insurance company on your behalf until the claim is resolved.

Can My Claim Be Denied Because I Had a Prior Injury To the Same Body Part?

There are any number of reasons that the insurance company may use to deny a claim and this is one of them. Unfortunately, many people believe that a pre-existing condition or prior injury disqualifies them from a work comp claim if they later injure the same body part. Again, this is the type of misinformation the insurance company relies on when they deny claims and hope that the person simply walks away.

 

Aggravation of a Pre-existing Condition

The law in Minnesota does not disqualify you from work comp benefits if you have a prior injury or medical condition which has been reinjured at work. A pre-existing condition which has been substantially aggravated or accelerated by a work injury or even regular work activities, is still covered by workers’ compensation. It doesn’t matter if it is an injury to your back, neck, head, shoulder, knee or any other part of your body. It doesn’t matter if you need surgery or have previously had surgery. The issue is simply whether your work injury or activities have substantially contributed to your present condition. This is good news for people injured on the job but it usually still requires that you find an attorney to help you fight with the insurance company.

The burden of proof in a Minnesota work comp claim is on the employee. This means that, where a claim is denied or disputed, the employee must prove that the injury is covered under the work comp law. This is generally accomplished by filing a claim, obtaining a medical report which supports the connection between the work activities and the injury and then either taking the case to a hearing or reaching a settlement.

Conclusion

If this describes your situation or the situation of someone you know, then the initial step would be to consult with an attorney. Equally important is having a doctor who is willing to assist and support your claim in the dispute with an insurance company. Not every doctor is willing to take the time to review medical records and prepare a medical report at the request of your lawyer. That’s why it’s also very important to carefully select your treating physician in a work comp claim. For more information on this topic please see our previous post- Choosing a Doctor for Your Minnesota Workers’ Compensation Claim.

If you have been injured on the job and have questions about your claim or the Minnesota work comp system, please don’t hesitate to give us a call. You can contact us, anytime, with questions about your case or to arrange an absolutely free consultation. It won’t cost you anything and we will always give you our honest assessment about whether you need a lawyer to represent you. If you have questions about how much it costs to hire a lawyer for a Minnesota workers’ compensation case, you can check out this previous post.

Remember, you are dealing with an insurance company which handles hundreds or thousands of claims every day. They have experienced claims adjusters and attorneys managing their files. Even if you don’t need a lawyer at the moment, a little information about the work comp system can make a big difference for you in your dealings with the insurance company. At Bradt Law Offices, we have been providing assistance to injured workers all across northern Minnesota and the Iron Range for more than 33 years.

As always, thank you for visiting our blog and please spread the word that we are a good source of work comp information and assistance for workers injured in northern Minnesota and anywhere on the Iron Range.

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