Bradt Law Offices Case Report: Permanent total disability benefits awarded following trial

Type of Case:   Workers’ Compensation

Legal Issue or Dispute:   Permanent total disability  (even though our client was still working part-time).

Facts:   Our client was 57 years old when she went to work on a part-time basis for the employer. She had some history of low back problems but did not have any restrictions at the time she was hired and was not receiving any medical treatment for her low back. Unfortunately, within a few months after she was hired, she suffered a new low back injury which significantly limited her ability to do the job. She was eventually released to work only 6 hours per week by her treating doctor, and was restricted from  any lifting or other physical activities.

The insurance company sent her for an independent medical exam (IME), and the insurance company doctor said that her back problems were pre-existing and that she didn’t need any work restrictions from the new injury. The employer created a “job” for her, which basically only required that she show up for 6 hours per week, even if she didn’t actually perform any work activities while there. We filed a claim for permanent total disability (PTD), which was denied by the insurance company.  (see this previous post for more information about permanent total disability claims)

At the trial, our vocational experts testified that the job created for our client was not competitive employment, but was only a position created by the employer to avoid responsibility for permanent total disability benefits. We argued that our client met the definition of permanently and totally disabled, because she was “unable to secure anything more than sporadic employment resulting in an insubstantial income.” (The definition of permanent total disability in the work comp statute – see subdivision 5)

Result:   The judge rejected the opinions of the insurance company’s doctor, accepted our medical and vocational evidence and declared our client permanently and totally disabled.

If you have questions about any aspect of your northern 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. We have been representing your friends and neighbors on their work comp claims all across northeastern Minnesota and the Iron Range for nearly 30 years. If you’ve been injured, we can help.

Thank you for visiting our blog.

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.

How Much Can I Receive for a Minnesota Work Comp Settlement?

Although there is no single or simple answer to this question, I have posted it because this is one of the most common search requests I see from people visiting our blog.  Every day, I see search requests which involve some form of the question:  how much is a work comp settlement in Minnesota?

It is perfectly understandable to wonder if you will receive a settlement for your claim and how much it might be.  After all, we all know someone who has settled a work comp claim, or we have heard rumors about how much someone received for an injury claim.  Now that you have been injured and are “in the system”, you probably have the same questions and concerns.

In a previous blog post, I discussed when, or if, you might get a settlement in a Minnesota work comp case.  I explained that a “settlement” is not a guaranteed part of every claim.  (See this previous post, When Do You Get a Work Comp Settlement in Minnesota?)  In today’s  post, I will discuss how a claim is valued for settlement purposes.

As I pointed out in my earlier post, not every case results in a settlement.   In addition, every settlement is different, based upon a variety of factors which will be different in every case.  The only way to put a value on your individual case, is to look at all of the factors which affect how much the insurance company might be willing to pay to settle your claim.  Some of the factors considered are:

Average Weekly Wage and Compensation Rate.  Every claim starts with the basic determination of your average weekly wage on the date of injury. Any wage loss benefits you are paid after that are based upon the average weekly wage.  The higher your average weekly wage, the more value your claim will probably have.  It stands to reason that if the insurance company is paying you wage loss benefits at the maximum rate of $850 per week, your claim has more value than someone who was working part-time at minimum wage and is receiving work comp benefits of $175 per week.

How Many Weeks Have You Been Paid and How Many Do You Have Remaining?  There are limits on the number of weeks that you can receive certain benefits.  Temporary Total Disability (TTD) benefits are limited to 130 weeks (104 weeks for injuries occurring before 10/1/08). Temporary Partial Disability (TPD) benefits are limited to 225 weeks and are not available if more than 450 weeks have elapsed since your date of injury.

Keep in mind that these are not guaranteed weeks of wage loss benefits.  Your benefits might end long before 130 or 225 weeks, for a variety of reasons – these are simply the maximum number of weeks you can receive.  So, if the insurance company has already paid you most of the available weeks of benefits you can receive, they don’t have much exposure in terms of future benefits.  Or, if your weekly wage loss benefits are about to end for some other reason, your claim may have limited value for settlement purposes.

On the other hand, if you have only been paid a few weeks and it appears that you will be eligible for long-term, ongoing wage loss benefits, then your claim would have significantly more value.

How Serious Was Your Injury and What Are Your Restrictions?  If you are permanently unable to return to a high-paying job, your claim has more value.  The insurance company will likely be paying you weekly wage loss benefits for many months.  Or, they may realize that you need vocational retraining, which can also be very expensive.  Your claim would have more value under those circumstances.

On the other hand, if your injury is only temporary and you can return to your previous job at your regular wage, the insurance company may not consider the claim as having long-term financial exposure.  They may simply wait for you to return to work at full wage and just pay future medical expenses related to your injury, without wanting to make any type of settlement.

How Strong or Weak Is Your Claim?  Has your entire claim been denied by the work comp insurance company?  If so, they may be willing to take their chances at a hearing.  If the insurance company wins, they don’t have to pay you anything.

In a medical dispute, the strength or weakness of the medical evidence is a key factor.  If you have a strong, supportive medical report from your doctor, your claim will have more value than if you have weak medical evidence.

What Issues Are Being Disputed?  If the only dispute is over a small medical bill or a few weeks of wage loss benefits, the claim probably won’t have much value.  If the dispute involves Permanent Total Disability (PTD) or retraining, the insurance company is looking at a lot more exposure for future benefits and the claim will have more value, assuming you have a strong claim based upon solid medical and vocational evidence.

How Old Are You, How Disabled Are You and What Are Your Plans for the Future?   If you are a younger person with a serious injury, a high wage  and plans to work for many more years, you might have a claim that could cost the insurance company a lot of money.  Those types of claims, if supported by strong medical evidence, can result in significant settlements.  On the other hand, if you are near retirement age, are only temporarily disabled or have a minor injury, your claim will be valued much differently.

These are only some of the factors that are considered when trying to put a value on a claim if the insurance company wants to make a settlement. There can be other factors that come into play, including previous injuries or pre-existing conditions, credibility issues, your cooperation with vocational rehabilitation, the quality of any job search you might have done and many others.

What We Recommend

If the insurance company proposes a settlement of your work comp claim, you should immediately contact an experienced attorney for advice or representation.  A claims adjuster or defense attorney will have far more experience than you in evaluating the claim.  Obviously, they will try to settle your claim as cheaply as possible.  Even though a settlement must be approved by a work comp judge, the judge does not represent you and cannot give you any advice about whether it is a fair settlement.

If you have any questions about your work injury claim, whether it involves a settlement or anything else, feel free to contact me at Bradt Law Offices anytime, with any questions.  We can talk about your claim on the phone or we can make an appointment to meet – either way it is an absolutely free consultation.  We can meet in my Grand Rapids office or wherever it would be convenient for you.

I  have been representing your friends and neighbors in their work comp claims all across northeastern Minnesota for nearly 30 years.  If you’ve been injured, we can help.

Thank you for visiting our blog.

When Do You Get a Work Comp Settlement in Minnesota?

We probably all know someone who was hurt on the job,  filed a workers’ compensation claim and eventually received a settlement.  In the 28 years that I have been handling work comp claims,  I have come to learn that most people assume  a “settlement” is a standard, guaranteed and inevitable result in a Minnesota work comp claim.   It isn’t.

What, no settlement?

Let me explain.  In the majority of cases where a lawyer is involved or there are disputes,  there will eventually be a settlement  –  but not always. There is no guarantee or entitlement to a “settlement” in a Minnesota workers’ compensation claim.  Instead,  settlements occur at some point in a claim because the parties mutually agree to settle their disputes in exchange for a certain amount of money.  In that regard, it’s no different than any other type of legal action where the parties agree to compromise and end their dispute.

Many claims  just run their natural course and will end,  without any type of  “settlement”.   For example,  let’s assume that you injured your shoulder at work, had successful arthroscopic surgery and missed 3 months of work.  The work comp insurance company  voluntarily paid your wage loss benefits and  all medical and vocational rehabilitation expenses.  You return to your previous job at your previous wage.  Your surgeon then gives you a 6% Permanent Partial disability (PPD) disability rating and the insurance company pays that.  The claim would end at that point without any additional payment of benefits and no “settlement”.   If you need additional medical care or lose more time from work at some point down the road,  your claim could be reopened and additional benefits paid at that time.

When, how and why do work comp settlements happen?

To understand why a case might end with a settlement,  you’ll need at least a basic understanding of the benefits available in a Minnesota work comp claim.  As I explain to my clients during our first meeting, there are only four basic types of monetary benefits that you might receive under  Minnesota workers’ compensation laws (these are very brief descriptions, you can find more details in some of our other blog posts or here).

Temporary Total Disability benefits (TTD).  These are benefits paid to someone who is off work completely because of a work injury.  (I won’t go into more detail  about TTD benefits for the purposes of this article – this topic will be a separate future post).

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 his or her pre-injury wage.

Permanent Total Disability (TTD).  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 details)

Permanent Partial Disability (PPD).   This is compensation paid if you have suffered a permanent impairment which can be rated (as a percentage) under the workers’ compensation disability schedules.

Every case and every injury is different,  so some or all of the available types of benefits might be payable in any given case.  There are limits on the number of weeks you may receive TTD and TPD  benefits and there are also triggering factors and events which  might allow the insurance company to discontinue wage loss benefits.   (That’s also the subject for another post.)

In addition to these monetary benefits,  an injured worker can also be reimbursed for certain travel expenses related to medical treatment or vocational rehabilitation and job search,  including retraining.  There is no payment or compensation for pain and suffering in a Minnesota workers’ compensation claim.  The benefits mentioned above are set by law and strictly limited.  So, with that basic benefit explanation,  here are some situations where settlements frequently occur:

Shortly before a workers’ compensation hearing

In my experience, this is the most common time for a case to settle.   If there is a hearing scheduled before a compensation judge,  it means that there are disputed issues.  The disputes might involve compensation benefits, medical issues, vocational rehabilitation issues or a combination of many issues.  If a judge decides the case, someone will win and someone will lose.  In a work comp case, because the available benefits are clearly defined, the value of most claims can be relatively easy to calculate.  Therefore, both the employee’s attorney and the insurance company attorney will usually have a pretty good idea as to what the “best case” and “worst case” outcomes might be.  Obviously, everyone likes to win and nobody wants to lose.  A compromise settlement at that point often makes sense for both parties.

At a settlement conference or mediation

If there are disputed issues and the case is proceeding toward a hearing, the Office of Administrative Hearings will usually schedule a  settlement conference.  A settlement conference involves the attorneys, the employee and a workers’ compensation settlement judge.  The conference may be held in person or by telephone, depending upon where the parties and attorneys reside.  Participation is voluntary and the settlement judge will assist and encourage the parties to reach a settlement of the disputed claims.  If they are able to do so, the claim (or at least the claim in dispute at that point) is settled.

A mediation is simply a different format for attempting to resolve disputed claims.  The parties will usually select an experienced workers’ compensation attorney to serve as a mediator.  A meeting is held, typically at the mediator’s office, and the parties exchange settlement proposals and offers back and forth through the mediator.  Again, if the parties can agree to reasonable terms, the case is settled.

While an appeal is pending

Sometimes the parties are unable to resolve the disputed claims and the case proceeds to a hearing.  After a compensation judge issues his or her decision, the losing party might file an appeal to the Worker’s Compensation Court of Appeals.  Cases are sometimes settled while the appeal is pending but before a decision is made by the Court of Appeals.

After an injured employee has returned to work

Many cases are settled after the injured worker has completed medical care and treatment and returned to work.  At that point, the parties may be able to project the potential future and ongoing wage loss benefits that might be payable to the employee.  If the employee has returned to work, with physical restrictions, but at a job which pays less than he was earning when injured, the insurance company may have to pay partial wage loss benefits into the future.  In this situation, the insurance company is often interested in paying a lump sum to settle out potential future benefits.

These are only some of the many situations where a settlement might be reached in a workers’ compensation claim.  Every settlement will have its unique terms and conditions, depending upon what the issues are and what claims are in dispute.  There are also many factors which affect the amount and terms  of a settlement, including:

  •  The employee’s average weekly wage on the date of injury
  •  How many weeks of benefits have been paid and how many weeks are potentially remaining?
  •  How strong or weak are the insurance company’s defenses?
  •  How strong or weak is the medical or vocational evidence?
  •  How old is the employee and what are his or her employment plans?
  •  And many other factors and circumstances specific to an individual case

Summary

This post was not intended to discuss how much your claim might be worth or whether you should settle it.  As mentioned above, every case must be evaluated based on its particular facts.  An experienced attorney would need to evaluate the medical evidence, the history of the claim, the nature of any disputed issues, your credibility and a number of other factors before coming up with a fair settlement value.

If you have been offered a settlement of your work comp claim,  I would strongly recommend that you contact an experienced attorney before you ever agree to settle.  A claims adjuster or insurance company attorney is far more knowledgeable than you are about the value of a workers’ compensation claim.  Even though any settlement has to be approved by a work comp judge, you should always consult with an attorney regarding the possible settlement of any  portion of your claim.

If you have questions about a settlement or any other aspect of your northern Minnesota work comp claim,  please feel free to contact me at Bradt Law Offices  with any questions.  I am happy to speak with you anytime about your claim or make an appointment for a free consultation in our Grand Rapids office or wherever it would be convenient for you.

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What Is Permanent Total Disability in Minnesota Work Comp?

In a Minnesota worker’s compensation claim, Permanent Total Disability (abbreviated as PTD) is a wage loss benefit paid to someone who is determined to be permanently unemployable as the result of a work injury.  It is one of three main types of wage loss benefits payable to someone injured on the job in Minnesota. The other two types of benefits are Temporary Total Disability (TTD) and Temporary Partial Disability (TPD).  This article deals only with Permanent Total Disability benefits.

For the purposes of this article, we will first assume that the injury or disability occurred on the job and that the injury claim has been accepted by the employer and its workers’ compensation insurer.  This article is not intended to cover every possible situation or all of the possible claims or defenses involved in a PTD claim.  Rather, this is a brief summary of what PTD benefits are and how they may be obtained.

There are two ways by which a person can be determined to be Permanently Totally Disabled:  By agreement or by a judge.

By Agreement:  If the medical and vocational evidence is strong and the insurance company doesn’t have any good defenses, they may simply agree that a person is permanently and totally disabled and begin paying benefits.

By a Judge:  In most cases, because the financial exposure for the insurance company is so high, the issue of whether an injured worker is PTD will be submitted to a workers’ compensation judge at a formal hearing.  The insurance company usually decides that they will take their chances at a hearing,  rather than voluntarily agree to pay PTD benefits.  At a hearing, the judge will listen to testimony from the employee, the medical and vocational witnesses, review all of the relevant medical and other documents and make a decision based upon Minnesota law.  Either party can appeal the judge’s decision.
How do you prove that you are “permanently totally disabled”?

Under Minnesota law, there are certain medical conditions that automatically qualify someone for permanent  total disability  (permanent loss of sight in both eyes, loss of both arms at the shoulder, loss of both legs close to the hips , paralysis, total and permanent loss of mental faculties).

If one of these automatically qualifying conditions is not present,  you would then need to prove that:

-Your work injury has resulted in permanent physical restrictions;
-You are unable to return to the job you were performing on the date of your injury;
-You have searched for other work unsuccessfully;
-You are not a suitable candidate to be retrained;
-and that you therefore meet the definition of “permanently and totally disabled” set forth in the workers’ compensation statutes (see Subd. 4 & 5), also taking into account your age, education, physical disability, training and experience.

One Final Requirement.  The Minnesota Legislature added an additional threshold requirement for Permanent Total Disability for injuries occurring on or after October 1, 1995.  If your work injury occurred on or after that date, you must also have a minimum Permanent Partial Disability (PPD) rating in order to receive PTD benefits.  A PPD rating is a percentage, taken from the Workers’ Compensation Disability Schedules, which is intended to compensate for a permanent functional impairment from a work injury.  If you don’t have the minimum rating required, you cannot receive Permanent Total Disability benefits, no matter how truly disabled you might be.

The minimum rating is 13%,  15% or 17%, depending upon factors such as your age and education. The unfairness of this threshold PPD rating has been demonstrated by many cases in the years since the law was passed, but it remains on the books and prevents many injured workers from being able to receive Permanent Total Disability benefits.

As in any legal proceeding, the facts of every case are unique and a workers’ compensation judge makes a decision on the basis of all  the evidence and in light of the law and previously decided cases.  This is only a general summary.  If you have questions about a Permanent Total Disability claim or other work comp issues, contact me anytime at Bradt Law Offices for a free consultation.

Other common questions related to Permanent Total Disability claims, which will be addressed in later articles:
How much would I receive for Permanent Total Disability benefits?

How long can I get Permanent Total Disability benefits?

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