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 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.

How Long Do Work Comp Wage Loss Benefits Last in Minnesota?

This seems like a pretty simple question and it is.  However, the answer is not so simple, because it depends upon a lot of different factors and possibilities.  In this post, I will try to offer some general information on how long your wage loss benefits might last, by providing some basic guidelines.

Please understand that this is a basic summary of general Minnesota Worker’s Compensation principles and is not intended as legal advice or to cover all possible situations.  Minnesota work comp laws have changed a great deal over the years and the benefits available to an injured worker are governed by the date of injury.  Limitations and “caps” on benefits really began with drastic legislative changes in 1992 and again in 1995.  For the purposes of this article, we are only addressing benefits for injuries which occurred after 1992.  If you have an older injury claim, your best bet would be to contact an experienced work comp attorney who has been around for a few years.

Wage loss benefits available to injured Minnesota workers

There are three basic types of wage loss benefits available under Minnesota Worker’s Compensation. We have discussed them in some previous posts and they are:

Temporary Total Disability benefits (TTD) – These are benefits paid to someone who is off work completely because of a work injury.
Temporary Partial Disability benefits (TPD) – These are partial wage loss benefits paid to someone who is working after an injury,with physical restrictions, but earning less than on the date of injury.
Permanent Total Disability benefits (PTD) – These are benefits paid to someone who is off work completely because of a work injury and is permanently unemployable.       (See this previous post for more information on Permanent Total Disability)

How long do Temporary Total Disability (TTD) benefits last?

To begin with, for any injury which occurred on or after October 1, 1995, you are limited to a maximum number of weeks of TTD benefits.  If your injury occurred between 10/1/95 and 9/30/08, the maximum number of weeks of TTD you can receive is 104.  The maximum was increased to 130 weeks for injuries occurring on or after 10/1/08.  For injuries prior to 10/1/95, there are a variety of other laws and limitations which apply and which we won’t go into for the purposes of this post.  There are exceptions to these maximums if you are in an approved retraining program.

Does that mean I am guaranteed 104 or 130 weeks of TTD?

No.  Those are only the maximum number of weeks you can receive. Your TTD benefits may end long before 104 or 130 weeks if one of these things occurs (there are others, but these are the most common):

  • You return to work, for any employer, at the wage you were earning when you were hurt.  At that point, the benefits would and because you are no longer losing wages.
  • You are released to work without any restrictions.  This issue is the subject of many work comp disputes and hearings.  A work comp judge must often decide whether you still have restrictions, based upon competing medical opinions from the insurance company’s doctor and yours.  Unfortunately, if it is determined that you have no restrictions, your TTD benefits will end even if you are not back to work or your job is no longer available.
  • You reach Maximum Medical Improvement (MMI) +90 days.  Maximum Medical Improvement means that you are not expected to make any additional or significant improvement, even if you are not completely recovered.  Your TTD benefits will end 90 days after the insurance company serves you with notice of MMI, even if you are still not back to work and have permanent restrictions from your injury.  Yes, this is as unfair as it sounds.
  • You return to work but at a lower wage than what you were earning when you got hurt.  At this point, assuming you still have restrictions from your injury, in most cases your benefits would be switched from Temporary Total to Temporary Partial (TPD) benefits.

How long do Temporary Partial Disability (TPD) benefits last ?

For injuries occurring prior to October 1, 1992, there was no weekly limit on TPD benefits.  However, anyone injured on or after October 1, 1992, is limited to a maximum of 225 weeks of TPD benefits.

Does that mean that I am guaranteed at least 225 weeks of TPD benefits?

No.  Again, 225 weeks is the maximum you can receive, but not a guarantee.  Your TPD benefits may end for one of these reasons (there are others, but these are the most common):

  • You return to work, for any employer, at the wage you were earning when you were hurt.  Just like with TTD, the benefits end because you are no longer losing wages.
  • You are released to work without any restrictions.  Again, this is the same issue which arises for TTD benefits, and is often the main issue in litigation. You must have restrictions from your work injury in order to receive wage loss benefits.

How long do Permanent Total Disability (PTD) benefits last?

Unfortunately, permanent does not really mean permanent – at least in Minnesota work comp.  There have been a number of changes to PTD benefits over the years, but the most recent and significant relates to injuries occurring on or after October 1, 1995.  For those injuries, there is now a retirement presumption at age 67.  This means that the insurance company will stop paying your PTD benefits when you reach age 67 and force you to prove that you would not have retired at that age.  This will require you to file a claim and try to persuade a work comp judge that you would not have retired at age 67.  If you win your case, the insurance company will have to continue paying your PTD benefits beyond age 67.

Summary

I hope you have found this post helpful for  general questions about how long your benefits might last or how they might end.  There are many variables in every case that will affect the length of your benefits.  If you have questions about any aspect of your Minnesota work comp claim, please feel free to contact me at Bradt Law Offices at any time.  I am happy to speak with you about your claim or make an appointment for an absolutely free consultation in our Grand Rapids office or wherever it would be convenient for you.

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