How Long Does a Minnesota Work Comp Claim Stay Open?

A few times each year I get calls from people with questions about an old Minnesota work comp claim. Most often, they have either had some type of flareup or progressively worsening symptoms from a work injury which had occurred several years in the past. The questions usually relate to whether the insurance company is still responsible to pay medical bills or other benefits.

There is no simple answer to this type of question but there are some general guidelines which might be helpful. The facts of each case are always different and whether your claim is still “open” will depend on some of these factors:

Was the Original Injury Reported to the Employer and Accepted by the Work Comp Insurer?  This is the starting point for determining whether the claim is still open or whether any ongoing benefits are available. When a work injury claim is reported to your employer’s work comp insurer, the insurer will decide whether to accept or deny the claim. Soon after reporting the injury you should receive a form from the insurance company entitled Notice of Insurer’s Primary Liability Determination. The form will tell you if the claim is accepted or denied and should also provide the basis for any denial.

If the claim is accepted, you may be eligible for various types of benefits under the work comp system, including wage loss, medical benefits and vocational rehabilitation services. The insurer can still fight with you or deny various types of benefits for any number of reasons, but if the claim is accepted a major battle is eliminated right at the beginning of your claim.

If the claim is denied by the insurer, you must formally file a Claim Petition with the Department of Labor and Industry-Workers’ Compensation Division before the statute of limitation (deadline) expires, or the claim is barred forever. If you have had a claim denied by a work comp insurer my recommendation would be to contact an experienced work comp attorney immediately to see what statute of limitation or deadline might apply to your case. If you wait too long, you will lose all workers’ compensation rights related to the injury.

Assuming that your claim has been accepted by the work comp insurer, these are some of the other issues which help determine whether you have any remaining benefits available:

Did You Make a Settlement?  Many work comp claims in Minnesota ultimately result in a settlement of some type. If you reached a settlement in your case, with or without an attorney, the settlement terms will generally be set forth in a document called a “Stipulation for Settlement” which is signed by the parties and approved by a workers’ compensation judge. A settlement can resolve some, or all claims related to an injury.

Frequently, a settlement will close out all future claims in exchange for a lump sum payment, but will leave open future medical expenses related to your injury. In other cases, a settlement closes all future claims, including future medical. Under the terms of that type of settlement you would not have any remaining benefits available to you from the original work injury. (For more information, see Types of Settlements in Minnesota Workers’ Compensation Claims)

Have You Been to a Hearing Before a Work Comp Judge?  If there were disputed issues in your case you may have ended up at a work comp hearing where the issues were decided by a judge. The judge’s decision may affect what benefits are available to you in the future. If you were represented by an attorney, he or she should be able to explain what potential benefits remain available to you.

How Long Ago Was Your Injury?  There have been significant changes to Minnesota’s work comp laws over the past 30 + years, particularly in 1984, 1992 and 1995. As a general rule, the law in effect on the date of your injury will control what benefits are available to you. Over the years, there have been limits or caps imposed on wage loss, medical and vocational rehabilitation, so the date of your injury is a very important factor to consider when evaluating what benefits may be available on your claim.

Were You Ever Given a Permanent Partial Disability (PPD) rating?  A PPD rating is usually given by your surgeon or treating physician upon completion of your treatment or recovery from your injury. If you qualify for a rating under the disability schedules, the doctor provides the applicable percentage (%) rating from the schedules and you are entitled to be compensated by the insurer based upon that percentage. Not every injury results in a ratable disability but if you had surgery or have permanent restrictions or symptoms, you may qualify. This benefit is often overlooked and not paid, particularly if the injured worker did not have an attorney providing guidance. (For more information on this subject, please check out our previous post explaining Permanent Partial Disability Ratings)

Have you had a new injury or aggravation? Let’s say you had a back injury in 1998 which was accepted by the work comp insurer and you received wage loss and medical benefits following the injury. Assuming you went back to work at some point and are now having low back problems again, the original insurer is not likely to resume payment of medical or other benefits without some updated information from you, such as:

-Do your current problems involve the same part of your back that was injured in 1998?

-Have you had any new back injuries since 1998 (work injuries, car accidents, slip and falls, etc)?

-Have your work activities since 1998 aggravated or accelerated your back problems?  (if so, you might have a new work comp claim  against your current employer. For more information about a gradual, repetitive injury claim see our previous article here)

-Have you been getting regular medical care over the years for your back and do the medical records support your claim that the problems are related to the 1998 injury?

There are many other factors which may affect whether you have any claims remaining from an old work comp injury. These are just a few of the considerations that might come into play. If you have questions about an old injury claim and were represented by an attorney, you should start by contacting the attorney’s office to see if they still have your file or could provide you with documents or information. If that’s not an option or if you did not have an attorney, we would be happy to offer a free consultation to answer your questions and provide whatever guidance that we can. Some helpful information for you to gather before any consultation would be the date of injury, name of the work comp insurer and copies of any settlements or other legal decisions relating to your claim.

Thank you for visiting our blog. 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. If you found this information helpful, 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.

Types of Settlements in Minnesota Workers’ Compensation Claims

Each day I take a few minutes to review the statistics for this blog to find out how many people are visiting and what type of search terms they are using to find us.  The overwhelming number of searches that bring people here involve questions regarding settlements.  I have previously written posts entitled:

When Do You Get a Work Comp Settlement in Minnesota, and

How Much Can I Receive for Minnesota Work Comp Settlement

Based upon what I have seen readers searching for, this seemed like a good time to write another post discussing the types of settlements you might receive in a Minnesota work comp claim.  I won’t go into details from the other posts regarding the timing of a settlement and how claims are valued for settlement purposes.  In this post, I will discuss the most common types of settlements that I have seen in my practice, handling work comp claims in northern Minnesota over the past 29 years.

To- Date  Settlement

A “to-date” settlement is just what it suggests.  It represents a settlement of disputed claims only through the date of the settlement agreement.  The dispute might involve medical issues, wage loss benefits, vocational rehabilitation issues or any combination of work comp benefits.  The claims might be disputed because the insurance company has denied primary liability or the dispute might revolve around differing opinions between treating physicians or the insurance company doctor. There are always plenty of things for an insurance company to fight about.

Regardless of the dispute, the parties agree to settle the claim only through the date that the agreement is reached.  The settlement may involve payment of some amount of disputed wage loss benefits or it might simply be an agreement to provide medical care or approve surgery.  A Stipulation for Settlement will be prepared, signed by the parties and submitted to a compensation judge for approval.  Once approved, the disputed issues are settled but no future claims are compromised, limited or surrendered.

In my experience, these types of settlements don’t occur all that often, primarily because the insurance company usually wants to close all claims completely when they make a settlement.  However, under certain circumstances a to-date settlement might be in everyone’s best interest.

Full, Final and Complete  Settlement with Future Medical Claims Left Open

This is probably the most common type of settlement.  Again, the dispute between you and the insurance company might involve one or many issues.  Perhaps the insurance company is attempting to discontinue your wage loss benefits, has denied your claim for vocational retraining or simply wants to pay you a lump sum to close your file and be done with you.  In its most common form, this type of settlement means that, for an agreed-upon lump sum payment, you have closed out, or given up, all future claims for any type of work comp benefits relating to your injury, except medical coverage or treatment.  If you can agree with the insurance company on a dollar amount and the appropriate terms, a Stipulation for Settlement is prepared, signed and submitted to a judge for approval.  The judge can refuse to approve the settlement for a number of reasons, although such refusal is extremely rare, particularly where both parties are represented by experienced attorneys.

It is also important to note that when we say you are closing out all claims, we are only speaking about claims related to the specific work injury you are presently claiming.  You cannot close out future claims related to injuries you haven’t had yet or don’t know about.

Full, Final and Complete  Settlement with Some Future Medical Claims Left Open, Some Closed

In this type of settlement, you would settle your claim on a lump sum basis and only limited future medical coverage would remain open with respect to the claimed injury.  Under the terms of this type of settlement, the parties will negotiate a closeout of certain, specific, future medical coverages.  A common example would be the insurance company’s request for a closeout of future acupuncture or acupressure expenses, health club memberships, massage therapy or other types of passive treatment.  The insurance company does not want to end up paying for this type of treatment after a settlement or, worse, fighting over this treatment with you and your lawyer and having to pay for the treatment and your lawyer’s attorney fees.

You would still be covered by the work comp insurance company for all other future medical treatment, such as doctor appointments, physical therapy, surgery, injections, MRIs, etc.  Basically, anything that is not specifically closed out remains available to you, subject to the work comp laws.  The insurance company can still challenge future medical bills and make you prove that the treatment is reasonable, necessary and related to your work injury.  Leaving future medical coverage “open” doesn’t  necessarily mean the insurance company has to pay every medical bill you ever submit for the rest of your life without challenge.

Some other common future medical benefits which are sometimes closed out are chiropractic expenses, pain clinic programs, psychological or psychiatric coverage.  All of these types of treatment or therapy are ordinarily covered under the work comp law and would be theoretically available to you after a settlement if you don’t specifically agree to close them out.  The insurance company cannot force you to close these future claims out, but often makes this a term of the settlement they are proposing.  In other words, they won’t pay the settlement money unless you agree to these terms.  Whether or not to close out any future medical benefits as part of a settlement is a decision you and your lawyer will have to make based upon all of the facts and circumstances of your particular claim and medical condition.

Full, Final and Complete  Settlement with All Future Medical Claims Closed

This is a rare type of settlement and most often occurs where the insurance company has denied the entire claim right from the beginning.  In other words, the insurance company has denied “primary liability”, and has raised one of many possible defenses to the claim.  They may be claiming that the injury is not covered by work comp, didn’t  happen on the job, is a pre-existing condition or was caused by your intoxication or horseplay.  For whatever reason, the insurer will not accept the claim or pay any benefits voluntarily.  Depending upon the medical or other evidence, the insurance company may still be willing to pay a settlement in order to avoid the risk of trial.  You may be willing to do the same.

Under those circumstances, an agreement might be reached for a lump sum payment which closes out all work comp claims relating to the injury, including future medical.  Like any other settlement, it must be approved by a compensation judge.  However, where there is a denial of primary liability and a possibility that you could end up with nothing if the case went to a trial, a compensation judge is generally going to approve such a settlement.

Structured  Settlements

While not very common, sometimes an insurance company will offer a structured settlement instead of a single lump sum. This more often occurs where the injured worker is a younger person and has a potentially large claim into the future.  The terms  would be the same as one of the settlements listed above, but instead of a single lump sum, the payment might be in the form of a structured settlement or an annuity, paid out over time in regular installments.

Summary

Every case is different and these are just the most common types of work comp settlements that I have negotiated over the years.  There are other, less common types of settlements, which might be negotiated depending on the circumstances of a particular case.  If you have a work injury claim and the insurance company wants to make a settlement, please take the time to contact an experienced attorney before you make a settlement. The insurance company hires attorneys and claims adjusters to protect their interests.  Why wouldn’t you do the same?

If you have any questions about a work comp claim, a settlement offer or any other issues relating to work comp,  please feel to contact me at any time with your questions.  I would be happy to arrange to meet with you for an absolutely free consultation at your convenience. You will always get my honest assessment of your claim and my advice as to whether you need a lawyer.

Thank you for visiting our blog.  At Bradt Law Offices, we have been representing injured workers all across beautiful northern Minnesota and the Iron Range for nearly 30 years.  If you have found this information helpful, please share this site with your friends or neighbors  who might have workers’ compensation questions or problems.