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.

How Much Is a Permanent Partial Disability Rating Worth in a Minnesota Work Comp Claim?

This is a very common question for someone who is in the work comp system and has been assigned a disability rating by a physician. The rating might come from your own doctor or from a doctor you have seen for an Independent Medical Examination (IME)  at the request of the insurance company. Either way, the dollar value will be the same. In most cases, however, you can pretty much assume that the insurance company doctor will give you the lowest possible rating he can find under the disability schedules.

As we have explained in some previous posts, the Minnesota work comp laws have changed pretty dramatically over the past 30+ years. The date of your injury controls most of the benefits to which you may be entitled, so if you have an older injury your benefits will be based upon the older laws which were in effect on the date  you were injured. In order to keep this post relatively short and to provide a basic understanding of the issue, we are discussing  injuries which have occurred since about 1995.

What is a disability rating?

A disability rating (sometimes also called an impairmant rating) is a percentage (%) rating given under the disability schedules which is intended to compensate you for some loss of the permanent use of a specific body part. It is referred to as a Permanent Partial Disability (PPD) rating or an Impairment rating. It is not intended to represent “pain and suffering”, nor does it necessarily reflect how the permanent impairment has negatively affected your life or your ability to perform certain activities. In other words,  a 10% disability does not necessarily mean you can still do 90% of everything you could do before, which is a common misconception. In fact, there are some fairly serious injuries which don’t have any disability rating at all.

Where do disability ratings come from?

A disability rating comes from the Minnesota Department of Labor and Industry Worker’s Compensation Disability Schedules. The actual schedules are in the Minnesota administrative rules, chapter 5223, and can be found here.   (The schedules for injuries occurring on or after July 1, 1993 begin at 5223.0300)  A doctor will look at the specific portion of the disability schedules which relates to your affected body part and find the category or categories which best describes your condition. There will be a percentage listed for each category and that is where the rating comes from.

How much do I get paid for a disability rating?

This has changed somewhat over the years, but the current compensation system for disability ratings has been in place for all injuries occurring on or after October 1, 2000. It is a schedule which multiplies your disability/ impairment rating (a percentage) by a particular dollar amount. It is not tied to your average weekly wage, so a 10% rating is the same for everyone, regardless of whether you are a high wage earner or a part-time minimum wage employee.

For example:  a 10% disability rating is multiplied by $80,000, resulting in a payment of $8000.

Higher disability ratings are multiplied by higher dollar amounts to reflect more serious disabilities.

Therefore, in another example:  a 25% disability rating is multiplied by $95,000, resulting in a payment of $23,750.

You can find the chart which explains these dollar values here (see Subd. 2a.)

 

Do I have to accept a disability rating from the insurance company doctor?

No. If the insurance company is not disputing your claim, they are required to pay you, as a minimum, whatever rating their doctor gives. However, you can file a claim for any additional rating which is supported by another doctor. So if your own doctor or surgeon gives a higher rating, you can file a claim for that percentage and take the issue before a compensation judge for determination. The ratings can be very complicated and are open to some amount of interpretation, so the insurance company’s doctor will always give the lowest possible rating. That is, after all, what the insurance company is paying him for.

Conclusion

There can be a number of other issues which arise relating to disability ratings and compensation, particularly with older claims or injuries to multiple body parts. This was only intended to give a general overview of the issue and answer some fairly common questions.

If you have any questions about a disability rating or any other aspect of your claim, please feel free to contact us.  We provide an absolutely free consultation for any injury claim. We will always give you our honest opinion about whether you need a lawyer or whether there is anything we might be able to do for you. Insurance companies have experienced claims adjusters and attorneys working for them and they are not interested in paying you any more than they have to. In a work comp claim against a huge insurance company, it can be very helpful for you to have a good understanding of the benefits available to you and your rights within the work comp system.

If you found this post to be helpful, please share this site with your friends and co-workers as a good source of work comp information for the working men and women of northern Minnesota and the Iron Range.

Thank you for visiting our blog.