What Should I Do If I Receive a Notice of Intention to Discontinue Benefits on My Minnesota Work Comp Claim?

At some point in almost any work comp claim where you are paid wage loss benefits, you will receive a Notice of Intention to Discontinue benefits, commonly referred to as an NOID. An NOID is simply a form which the insurer is required to serve and file whenever they will be discontinuing wage loss benefits. The form provides you with notice that your benefits will be ending at a certain time and explains the reason why.

Some reasons why you might receive an NOID form

1. You have returned to work. If you have been off work and receiving wage loss benefits from work comp, you have been receiving Temporary Total Disability (TTD) benefits. These benefits are paid at the rate of 2/3 of your average weekly wage on the date of injury. (For more information on TTD benefits, see our blog post here)

The notice tells you that the insurance company will be discontinuing those benefits because you are back to work and no longer entitled to TTD benefits. If you are returning to work, with restrictions from your injury but earning less than your preinjury wage, you may be entitled to partial wage loss benefits (TPD) and the NOID form should reflect that you will be paid TPD benefits upon returning to work. It doesn’t matter whether you are going back to work for the same employer or whether you have found a new job since the injury.

2. You have exhausted your TTD benefits. For dates of injury between 10/1/95 and 9/30/08, you are limited to 104 weeks of TTD benefits. This means that even if you are still out of work because of the injury, you cannot receive more than 104 weeks of TTD and your benefits will end. For injuries on or after 10/1/08, the maximum number of TTD benefits was increased from 104 to 130 weeks.

3. Your weekly earnings have reached or exceeded your preinjury wage. If you have been working at a wage loss and receiving TPD benefits, those benefits will end once you get back to your preinjury wage, because you no longer have a wage loss.

4. You have reached Maximum Medical Improvement (MMI). If you are receiving TTD benefits, those benefits will end 90 days after you are provided with notice that you have reached MMI. An MMI opinion can come from one of your treating physicians or from a doctor who has examined you for the insurance company (this is called an Independent Medical Exam (IME), more information about an IME can be found here). The explanation for why your benefits are being discontinued must be included on the NOID form.

5. You no longer have work restrictions. If your treating physician, or the IME doctor, gives an opinion that you have no work restrictions as a result of the work injury, you are no longer eligible for wage loss benefits. Most often, this occurs following an IME where the insurance company doctor writes a report and gives the opinion that you have fully recovered from the work injury or that any restrictions you have are not related to the work injury. Sometimes, your own doctor may lift all restrictions without fully understanding how this might affect your claim. (For more information about choosing a physician for a work comp claim, click here).

What you can do if you receive an NOID

Your options after receiving an NOID are explained on the form and will depend upon the reasons for the discontinuance. If you disagree with the discontinuance of benefits or the reasons given, you can request a telephone conference with a work comp judge to argue your position. The time frame to dispute a discontinuance if you want an immediate conference is generally 12 days. The NOID form provides you with a phone number and address and explains how to request the conference.

If you have an attorney, you should obviously make sure that he or she has received a copy of the NOID form and will be requesting a conference on your behalf if you disagree with the discontinuance of your benefits. If you don’t have an attorney, this would be a very good time to contact one. At the discontinuance conference, the insurance company will be represented by either a claims adjuster or an attorney. The discontinuance of your benefits is a serious matter and you should have an experienced work comp attorney representing you at that conference.

If you win at the conference and the judge agrees that your benefits should not be discontinued, the insurance company may appeal but they will have to continue paying your benefits until a formal hearing is scheduled. However, if you lose at the conference, you may appeal but you will not receive any benefits while you wait for the formal hearing and a decision. Having an attorney represent you at the initial conference will generally give you a much better chance to win.

There are some other reasons why your benefits might be discontinued, but these are the most common situations that we typically see.

Contact Us If You Have Questions about Your Claim

If you have been injured on the job and have questions about 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 or concerns about the cost of hiring an attorney, you can check out this previous post- How much does it cost to hire a workers’ compensation lawyer in Minnesota?

At Bradt Law Offices, we have been providing assistance to injured workers all across northern Minnesota and the Iron Range for more than 32 years.

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

What Is the Difference Between a Settlement Conference and Mediation in a Minnesota Work Comp Case?

Over the past several years we have seen the increasing use of mediation to settle work comp cases in Minnesota. If you have a work comp claim, you may wonder why a settlement conference was scheduled on your case but a mediation has then been proposed or scheduled. What’s the difference, and is one better than the other?

Settlement Conferences

Settlement conferences are automatically scheduled by the workers’ compensation Office of Administrative Hearings after a claim is filed.

In every work comp case where a Claim Petition is filed, a settlement conference is automatically scheduled for approximately 6 months later. Depending upon where you live, these conferences may be scheduled by telephone or may take place in person with a work comp settlement judge in St. Paul. A settlement conferences is an informal opportunity for the parties to attempt to settle any disputed issues and sometimes the entire claim.

Settlement conferences are scheduled to last one hour and a work comp judge presides over the conference to help the parties reach a settlement. It is not a trial and the judge does not have any authority to order the parties to agree to any particular terms, nor does the judge have authority to make any decisions about the disputed issues. If the claim does not settle, it will be put on the trial calendar for a hearing a few months later with a different judge.

Frequently, settlement conferences are either postponed or canceled altogether. A conference may be postponed because it is too early in the case to discuss settlement, possibly because of pending surgeries or ongoing medical care which needs to be completed. In other cases, the parties may agree that there is no possibility of settlement and ask that the case be put on the trial calendar for hearing. This may occur in cases where the insurance company has denied liability for the claim or where there is a dispute over a proposed surgery or medical procedure. In these types of cases, there may be no room for compromise and the disputed issues need to be decided by a judge.

If a case is settled at a conference, the defense attorney will prepare a Stipulation for Settlement, which sets forth the terms of the agreement. All necessary parties must sign the Stipulation and it is then submitted to a compensation judge for approval before the insurance company makes payment.

Mediation

A mediation is also a method to get the case settled but it is more formal and involved than a simple one hour settlement conference. Typically, the parties agree to mediate cases that are more complicated or have more value. The parties will choose a mutually agreeable mediator who is experienced in Minnesota workers’ compensation matters. The mediation may take place at the mediator’s office, at one of the attorneys’ office or at a neutral site depending upon the availability of conference rooms and where all the parties live or work.

Prior to the mediation, the employee or her attorney will submit a detailed case evaluation and settlement proposal to the insurance company. Both parties will also submit confidential background information to the mediator before the mediation so the mediator understands the issues, the claim values and the relative position of each party.

Once the mediation begins, the parties will usually be in separate conference rooms and the mediator will visit back and forth between the rooms with settlement offers and counter offers. The process may take part or all of the day until the parties either come to an agreement or determine that they cannot agree on a settlement amount or terms. Most mediations will probably be completed in 2-4 hours.

If no settlement is reached the case simply continues toward a hearing on the disputed issues and all discussions, offers or counter offers remain confidential and cannot be discussed or used at any later hearings. Essentially, there is no risk in pursuing a mediation and it is often a good way to find out how each party is valuing the case, even if a settlement is not reached. If nothing else, you will find out what the insurance company is willing to pay to settle your claim at that time. The value of any claim might increase or decrease after the mediation, depending upon medical, employment or other factors.

If a settlement is reached at the mediation, the process is the same as for any other work comp settlement. A Stipulation for Settlement is prepared, signed by the parties and submitted to a work comp judge for approval.

Do I Need an Attorney for a Mediation or Settlement Conference?

Technically, any employee may represent himself in a work comp claim at a settlement conference, mediation or even at a trial. However, keep in mind that the insurance company has experienced claims adjusters and attorneys looking out for their interests. Also, the insurance company’s interests are not the same as yours, so it is not reasonable to expect that they will voluntarily pay you a fair settlement if you are not represented by an experienced attorney.

In any type of work comp case, particularly where there are discussions about settlement or disputed issues, it is a good idea to consult with an experienced attorney to make sure you understand your rights and are being treated fairly by the insurance company.

If you have been injured on the job and have questions about 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 or concerns about the cost of hiring an attorney, you can check out this previous post- How much does it cost to hire a workers’ compensation lawyer in Minnesota?

At Bradt Law Offices, we have been providing assistance to injured workers all across northern Minnesota and the Iron Range for more than 30 years.

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

Can the Insurance Company Deny My Minnesota Work Comp Claim Because of a Pre-existing Condition?

Unfortunately, the work comp insurance company can deny a claim on almost any basis, no matter how flimsy. This is how insurance companies avoid paying claims, because they know that a certain percentage of people will never hire a lawyer or pursue a claim if it has been denied. This is particularly true where the injured worker has health insurance or other benefits available – many people are simply afraid to call a lawyer or don’t know where to begin when their claim has been denied.

However, getting back to the original question: Can the insurance company deny your claim because of a pre-existing condition? The answer is “maybe”. A pre-existing condition may have some impact on whether you have a legitimate work comp claim. However, the simple fact that you have had some prior back problems, for example, does not necessarily disqualify you from bringing a claim for current back problems related to a work injury or your work activities. The issue is more complicated than that.

Example: Prior Back Problems

The real question is whether your prior back problems were affecting your ability to work or limiting your physical or other activities prior to the work incident. Many people have back problems or other physical ailments which intermittently give them some problems but “come and go”. They are able to continue working and enjoying their usual and regular physical activities with only occasional flareups of symptoms. If a work injury or your regular work activities significantly aggravates or accelerates a pre-existing condition to the point where you now need medical care and may need some physical restrictions or limitations, then you probably have a work comp claim.

Prior Work Comp Claims Involving the Same Body Part

Another common issue arises where a person has had a prior work comp claim involving the same body part. We’ll continue with the example of a bad back. Let’s say you had a back injury 10 years ago which was treated as work comp. The insurance company paid you wage loss and medical benefits but you were able to return to work. Now, you have had a new back injury or your work activities have gradually caused an increase or return of your back problems. The claim could be against the same or a new employer, but there will probably be a different work comp insurance company involved since your claim from 10 years ago.

This is a work comp claim, but you can almost be assured there will be a dispute between the current work comp insurance company and the company that provided coverage 10 years ago when you filed your prior claim. In all likelihood, the claim will be covered by one insurance company or the other, but there may be a delay in obtaining benefits while the insurance companies slug it out between themselves.

When in Doubt —  Contact an Attorney

If you find yourself in a situation where your claim has been denied because the insurance company says you have a pre-existing condition, or if two insurance companies are each arguing that the other is responsible, it’s time to contact an attorney. The insurance companies have lawyers and other experts protecting their interests and they are not looking out for yours. An experienced work comp attorney should be able to review your medical records and any prior work comp records and give you an opinion as to what type of claim you have. If the insurance company wants to fight, make sure you have an attorney who is willing to go to bat for you and get you the benefits to which you are entitled.

At Bradt Law Offices, we have been representing your friends and neighbors in work comp and other injury claims for over 30 years. Our clients come from all over northern Minnesota and we are happy to discuss any claim, with anyone, at any time. Whether you just have some questions over the phone or would like to make an appointment to come in for a free consultation, don’t hesitate to call and let us help you. You will always get our honest opinion and there is never any fee unless we recover benefits for you.

Thank you for visiting our blog.

 

Laid off Boise Cascade Employees May Have Workers’ Compensation Claims

If you are an employee of Boise Cascade in International Falls who recently lost your job due to the layoffs, you may be surprised to learn that you have work comp claims. We have represented people in similar situations over the years following major layoffs at Blandin Paper Company and LTV Mining, to name a couple of examples.

In our experience,  employer’s generally do not notify employees about potential work comp claims following a layoff. The simple reason for this is that it would cost your employer money if it had to pay ongoing work comp claims. For this reason, many laid off employees simply collect unemployment compensation and then move on to another job without any idea that they may be eligible for work comp benefits.

Under what circumstances might you have a work comp claim following a layoff?  These are a few examples:

1. You suffered a work related injury at some time during your employment before the layoff;

2. The injury was accepted by the work comp insurer and medical or wage loss benefits were paid;

3. At the time of the layoff, you still had some limitations or restrictions as a result of the work injury (even if you were working at full wage at the time of the layoff);

4. Your previous work injury resulted in a permanent impairment under the work comp disability schedules, but the disability was never rated by your physician or paid by the insurance company;

5. You have a gradual or repetitive type injury which you haven’t yet reported but which is related to your work activities up to the time of the layoff;

6. Depending upon how much time has passed since your injury, you may be entitled to vocational rehabilitation assistance or retraining;

What type of benefits might be available? Again, some examples:

1. Partial wage loss benefits if you find a new job which pays you less than you were earning before the layoff;

2. Compensation for a disability rating;

3. Total wage loss benefits if you were off work and receiving work comp benefits at the time of the layoff;

4. Wage loss and vocational rehabilitation benefits if you have what amounts to a “new” injury which has not yet been reported;

What should I do now?

1. If you have an old work comp claim and were represented by an attorney, contact the attorney to find out if you have any claims which remain available to you after the layoff;

2. If you have an old work comp claim but never had an attorney, contact an experienced work comp attorney to see about your options;

3. If you believe that you have suffered a gradual or repetitive type injury as a result of your work activities which you haven’t reported to the employer, contact an experienced work comp attorney immediately. Work comp claims in Minnesota have notice and filing deadlines – if you miss one of these deadlines your claim will be barred forever.

Our Recommendation

If you have an old claim, think that you have a new claim, or just have questions about work comp benefits following a layoff, contact an experienced work comp attorney for consultation. At Bradt Law Offices, there is no charge for an initial consultation over the phone, in your home or at our office. A layoff is a traumatic, life-changing event. While you may be entitled to unemployment benefits in the near term, you may be surprised to find that you have claims for work comp benefits to help you through this transition in your life. Feel free to contact us at any time with your questions – you will always get our honest opinion and we will help you in any way that we can.

We have been helping your friends and neighbors with work injury claims across all of northern Minnesota for 30 years. Let us help you.

Thank you for visiting our blog and/or our website.

What is Maximum Medical Improvement (MMI) in a Minnesota Work Comp Case?

At some point in your work comp claim, you will almost certainly receive a letter or notice from the insurance company advising you that you have reached Maximum Medical Improvement (MMI).   After receiving such a notice, these are some of the questions you may have:

What is MMI?

Will it have an effect on my benefits?

Can I dispute a finding of MMI?

What is Maximum Medical Improvement (MMI)?  The concept of MMI was added to Minnesota work comp law in 1984. It applies only to injuries which occur on or after October 1, 1984, which basically means pretty much all claims that are ongoing these days.  The most recent definition contained in the work comp statutes (subdivision 13a.) states:

“Maximum medical improvement” means the date after which no further significant recovery from or significant lasting improvement to a personal injury can reasonably be anticipated, based upon reasonable medical probability, irrespective and regardless of subjective complaints of pain.”

Simply put, it means that you are not expected to get any better, even though you may have ongoing pain or work restrictions related to your injury.  If there are no additional treatment recommendations, no pending surgeries and no reasonable expectation of significant improvement, then you have probably reached MMI.  The fact that you may get worse does not mean you haven’t reached MMI.

What effect will a finding of MMI have on your work comp benefits?  The most direct affect will be on your receipt of weekly wage loss benefits, specifically, Temporary Total Disability benefits (TTD). The law provides that TTD benefits will cease 90 days after you have been provided with notice of MMI.  “Notice” means that the insurance company must provide you with a written report or documentation of MMI. Typically, this means that the insurance company mails you a copy of a medical note or report which gives the opinion that you have reached MMI.  This opinion can come from your own physician or from a doctor which the insurance company sends you to for an Independent Medical Exam (IME).

Can my TTD benefits be discontinued based upon MMI even if I remain out of work and still have restrictions?  Unfortunately, yes.

Does a finding of MMI affect my temporary partial disability benefits (TPD)?  No.  If you still have restrictions from the work injury and are working but earning less than your pre-injury wage, a finding of MMI does not affect your partial wage loss benefits.

Will a  finding of MMI affect my entitlement to ongoing medical care for the work injury?  Technically no, but some insurance companies will take the position that if you have reached MMI you don’t need any additional medical care.  You may need to hire a lawyer or fight with the insurance company for payment of additional medical bills or authorization for medical care.

Can I dispute or fight a finding of MMI?  Yes you can.  If an insurance company doctor says you have reached MMI but your treating physician disagrees, you may have a good chance at a hearing to overturn the MMI finding.  The insurance company doctor will almost always give the insurance company the opinion they want (and are paying for) but it isn’t always consistent with the medical evidence or the opinions of your treating doctor. If you are fortunate enough to have a treating doctor who is supportive of your claim and willing to write a report, you have a very good chance of winning at a hearing. That’s why it’s very important to choose your physician carefully when you have a work comp claim.

Our Recommendation

The concept of MMI can be confusing and can have a significant  impact on your work comp claim.  It is important to know that you have the right to contest an MMI finding and to fight the insurance company if you disagree with any determination they make on your claim.  It’s a good idea to consult an experienced work comp attorney anytime the issue of MMI arises on your claim.  Most attorneys will be happy to provide you with information or a free consultation about your claim and whether you need legal assistance.  At Bradt Law Offices, we have been providing work comp help to injured workers throughout northern Minnesota for 30 years. Please feel free to contact us at any time with questions about your claim or the work comp system.  Your initial consultation is always free and you will always get an honest opinion about your case and whether you need a lawyer.

Thank you for visiting our blog and please read through some of our other blog posts for more information on a variety of work comp topics.

My Minnesota Work Comp Claim Was Denied. Now What?

So, you were injured on the job, filed an injury report and the claim has been denied by the work comp insurance company. What do you do next?

Simple. You should contact an attorney in your area who has experience in Minnesota work comp claims.  Why wouldn’t you? Most attorneys will not charge you to discuss the claim, answer your questions or even meet to review the facts and determine whether you have a case.  If you are in northern Minnesota and call us, I can promise you for certain that we won’t charge you for any of these things – ever.

There are a number of reasons the insurance company might give for denying your injury claim, including:

  • The injury didn’t  happen at work or in the course and scope of your employment;
  • You waited too long to report the injury or file a claim;
  • Your medical or physical problems are the result of a pre-existing problem;
  • You were not an “employee” as defined by the work comp laws in Minnesota;
  • There is no medical proof or support for your claimed injury;
  • Your injury was the result of your own intoxication;

There are many other defenses to a work comp claim but these are some common examples.  Sometimes the defense is valid and you don’t have a claim, but many other times the defense is bogus.  The insurance industry counts on the fact that a certain percentage of people will not pursue a claim after it has been denied.  Many people simply do not want to hire a lawyer or “make waves” with their employer.  Other people assume that if the claim is denied, the insurance company must be correct and there is no claim to pursue.  Or, it might just seem easier to let your health insurance company pay the medical bills and continue to work in pain every day.

None of these are good options if you truly believe that you were hurt on the job. Choosing to walk away from a potential work injury claim is simply a bad idea.  It benefits the insurance company by saving them money.  It hurts you if you have a legitimate claim that should be paid by work comp, not only now, but if you continue to have problems down the road with your current or a new employer. It only gets more difficult to prove a claim the longer you wait.

At the very least, it’s a good idea to consult with an attorney to see if you have a claim. Over the past 29 years handling work comp claims, I have spoken with hundreds, if not thousands, of people in your situation.  Their claim has been denied and they are intimidated by the insurance company or afraid to fight back.  Or, they are afraid that hiring a lawyer will cost them a lot of money that they don’t have. Sometimes my honest opinion is that there is no claim.  More often than not, however, people I speak with have legitimate claims that are definitely worth pursuing.

The insurance company has lawyers and experienced claims adjusters handling their cases.  They are well aware that many of the claims they deny are probably legitimate claims but the people will not pursue them.  They win, you lose.

Our Recommendation

If you have been injured on the job, or if you have a medical condition or disability which you believe was caused or aggravated by your work activities, immediately file a report of injury with your employer. If the claim is then denied or if you have any questions or concerns, contact us for an absolutely free consultation to discuss your rights and options.  You will always get our honest assessment and opinion about any possible claims.  If you decide to hire us, we only get paid if we win the case or recover benefits for you.

If you would like more information about how we get paid in a work comp case, or when you should consider hiring a lawyer, please see these earlier posts:

How much does it cost to hire a workers’ compensation lawyer in Minnesota?

When should I hire a lawyer for my Minnesota workers’ compensation claim?

We hope that you have found this information helpful. Please don’t hesitate to contact us if we can be of assistance or answer any questions for you.  Attorney Steve Bradt has been representing injured workers all across northeastern Minnesota for nearly 30 years.  If you’ve been injured, we can help.