My Minnesota Work Comp Claim Was Denied Because of a Prior Injury. Now What?

This is another of the common problems we often deal with when helping people who have been injured on the job across northern Minnesota.

Typical situation:  you have been working for several years without any physical problems, work restrictions, lost time or any other difficulties or limitations. Then one day at work, you are lifting or carrying something and suffer an injury to your back (or neck, shoulder, knee, elbow, etc.). You report the injury to your employer, explaining exactly what happened and you make an appointment to see your doctor or chiropractor.

Maybe you fill out some more paperwork for your employer or maybe you receive a call from a claims adjuster from the work comp insurance company, asking for more details about the injury and your medical history. Perhaps you are off work on doctor’s orders and receiving therapy or other treatment while you try to heal and get back to work.

One day in the mail you receive a notice from the work comp insurance company explaining that your work comp claim has been denied. DENIED?!?! Apparently, you had received medical treatment for a back injury 15 years ago and the insurance company has decided that your current problems are a pre-existing condition. Claim denied!

Claim Denied. Options?

At this point, you may have already lost several weeks of wages and run up hundreds, or thousands, of dollars in medical bills.  You had reasonably assumed that everything would be taken care of by work comp because your injury had occurred on the job. Now what do you do? Well, you basically have two options:

Option #1:  Walk away. If you have health insurance or are willing to go back to work and “tough it out”, you can simply let the matter drop and walk away from the claim. Your employer and the work comp insurance company would be very happy if you make that choice. In fact, insurance companies count on the fact that many people will simply walk away after a claim is denied, instead of even contacting an attorney for legal advice or a consultation. The downside of this option is that your claim will never be recorded as a work injury and you will have no protection if it turns out to be a long-term or serious problem. In addition, all claims have deadlines, also called statutes of limitation, which require you to formally file a work comp claim with the Minnesota Department of Labor and Industry, Workers’ Compensation Division, within a certain time frame. If you fail to legally file your claim before the deadline expires your claim will be barred forever. An experienced attorney can tell you when the deadline might be for your particular claim.

Option #2:  Fight the insurance company for the benefits to which you are entitled under Minnesota’s workers’ compensation laws. Your first step would be to contact an experienced work comp attorney for a consultation to see if you have a claim worth pursuing. After that, the attorney will pursue the claim by gathering medical records and reports, filing whatever claims you might have and fighting with the insurance company on your behalf until the claim is resolved.

Can My Claim Be Denied Because I Had a Prior Injury To the Same Body Part?

There are any number of reasons that the insurance company may use to deny a claim and this is one of them. Unfortunately, many people believe that a pre-existing condition or prior injury disqualifies them from a work comp claim if they later injure the same body part. Again, this is the type of misinformation the insurance company relies on when they deny claims and hope that the person simply walks away.

 

Aggravation of a Pre-existing Condition

The law in Minnesota does not disqualify you from work comp benefits if you have a prior injury or medical condition which has been reinjured at work. A pre-existing condition which has been substantially aggravated or accelerated by a work injury or even regular work activities, is still covered by workers’ compensation. It doesn’t matter if it is an injury to your back, neck, head, shoulder, knee or any other part of your body. It doesn’t matter if you need surgery or have previously had surgery. The issue is simply whether your work injury or activities have substantially contributed to your present condition. This is good news for people injured on the job but it usually still requires that you find an attorney to help you fight with the insurance company.

The burden of proof in a Minnesota work comp claim is on the employee. This means that, where a claim is denied or disputed, the employee must prove that the injury is covered under the work comp law. This is generally accomplished by filing a claim, obtaining a medical report which supports the connection between the work activities and the injury and then either taking the case to a hearing or reaching a settlement.

Conclusion

If this describes your situation or the situation of someone you know, then the initial step would be to consult with an attorney. Equally important is having a doctor who is willing to assist and support your claim in the dispute with an insurance company. Not every doctor is willing to take the time to review medical records and prepare a medical report at the request of your lawyer. That’s why it’s also very important to carefully select your treating physician in a work comp claim. For more information on this topic please see our previous post- Choosing a Doctor for Your Minnesota Workers’ Compensation Claim.

If you have been injured on the job and have questions about your claim or 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 about how much it costs to hire a lawyer for a Minnesota workers’ compensation case, you can check out this previous post.

Remember, you are dealing with an insurance company which handles hundreds or thousands of claims every day. They have experienced claims adjusters and attorneys managing their files. Even if you don’t need a lawyer at the moment, a little information about the work comp system can make a big difference for you in your dealings with the insurance company. 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.

As always, thank you for visiting our blog and 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.

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.

Beware of a New Attack on Benefits for Injured Workers

It’s  bad enough that state legislatures, including ours right here in Minnesota, have chipped away at the rights and benefits of injured workers over the past 30 years. Now, some states are getting rid of workers’ compensation altogether and creating their own systems for compensating workers injured on the job. The argument made by business owners is, of course, that this is good for the injured working man or woman. Don’t believe it. If it’s being proposed by business you can bet that the motivation is strictly the bottom line – employers save money and the injured worker loses rights and benefits.

For more details about this scary prospect and how it is happening in other states, click on the link to read this excellent article : Inside Corporate America’s Campaign to Ditch Workers’ Comp.

As a work comp attorney representing injured workers for more than 30 years here in northern Minnesota, I find this to be a very scary development. If it is being pushed through in other states, you can be assured that it may eventually be tried here. Please feel free to share this article with anyone you feel might be interested.

Thank you for visiting our blog and please feel free to contact us at any time if you have questions about a work comp claim or would like to set up a free consultation to discuss your rights if you’ve been injured on the job in Minnesota.

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.

Boise Announces Layoffs at International Falls Plant

Boise Inc. recently announced plans to lay off 265 paper workers at its International Falls plant.  The company will permanently terminate the 265 employees by October and will shut down two production lines. No announcement has been made at this time as to how many of the workers to be laid off will be salaried or how many will be hourly.  Approximately 580 workers will remain employed at the plant following the layoffs.

This is another significant blow for working men and women in northern Minnesota, following layoffs and shutdowns in the past several years at LTV Steel, Blandin Paper, Georgia Pacific, Verso Paper and Potlatch, among others.  Following a layoff, it can be helpful to know that there are various resources available which might provide financial assistance or help transitioning to a new job.  Many workers are surprised to learn that they may be entitled to work comp benefits from an old injury, even if they had been back to work at full wage for several years up until the layoff.

While this doesn’t necessarily apply in every case, it is certainly worth investigating by checking with an experienced  work comp attorney.  After the devastating bad news of a layoff, you might be surprised to learn that you have wage loss, medical or vocational rehabilitation assistance available to you based upon an old work injury claim.

For more information about this topic please take a few moments to review this recent article on our blog, entitled “Can I Get Minnesota Work Comp Benefits after a Layoff?”.

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 and the Iron Range for nearly 30 years.  If you’ve been injured, we can help.

Thank you for visiting our blog.

Can I Get Minnesota Work Comp Benefits after a Layoff?

If you have ever been laid off from a job, either on a temporary basis or permanently, you know the gut-wrenching fear of suddenly being without a job and without income.  What will you do about house payments, truck payments, groceries, school expenses and tuition?  What about health insurance or other benefits that your employer may have provided?

Suddenly, you are scrambling to find other sources of income or ways to make ends meet. Obviously, you begin with a job search. You might also check into available benefits through unemployment or other sources.  At the end of the day, however, you are facing a major change in your life both personally and financially.  A possible benefit that most people tend to overlook might be workers’ compensation benefits.

Over the years, we have helped many people in northern Minnesota with work comp claims after they were permanently laid off following shutdowns or downsizing at LTV Steel, Potlatch and Blandin Paper, among other large employers.  Another large layoff has recently been announced for Boise Cascade in International Falls.

How Can I Get Work Comp Benefits after a Layoff?

There are several situations where you might be eligible for work comp benefits after you have been laid off from a job.  These situations might include if:

-You had a prior accepted work injury which resulted in surgery;

-You had work restrictions from a prior accepted work injury at the time of the layoff;

-You had a prior accepted work injury which requires additional medical care;

-You have a recent work injury that has not been reported;

-Your job duties right up until the date of the layoff have contributed to an injury or disabling condition;

The term “accepted work injury” means an injury that was reported to the employer and work comp insurer and was accepted, or admitted, by the work comp insurer as a work injury.  Typically, the insurance company would then pay medical bills or wage loss benefits depending upon the nature and extent of the injury.

If you had injuries during the years of your employment which were not reported or which were denied, the statute of limitations might prevent you from bringing claims at this time.  Consulting with an attorney would help you to establish whether it’s too late to file a claim.

You Had a Prior Accepted Work Injury Which Resulted in Surgery

If at some point during your employment you had a work injury and received work comp benefits, including surgery, you may have some ongoing claims.  If you had surgery, you may have been given a permanent partial disability rating (PPD), for which the insurance company paid you some money.  Or, maybe you have a PPD rating from a surgery and the insurance company never paid you – that claim is probably still available.

A prior surgery might also support a claim that you have ongoing restrictions related to the work injury, even if no formal restrictions were ever given to you by your treating physician.  Sometimes a friendly doctor will simply tell you to “take it easy” or “just do what you can”, without writing out specific restrictions on how much you can lift, how often you can bend, etc.  Your treating physician might be able to put some restrictions on you now, which would support a claim for wage loss benefits while you try to find a new job.  Under those circumstances, you may have a partial wage loss claim if you find another job which pays you less than you were earning when you were laid off.

You Had Work Restrictions from a Prior Accepted Work Injury at the Time of the Layoff

Even if you were working at full wage on the date of the layoff, if you had restrictions from a prior work injury, you might be able to claim partial wage loss benefits now if you find a new job that pays you less.  You may also be eligible for vocational rehabilitation services to help you find a new job.

You Had a Prior Accepted Work Injury Which Requires Additional Medical Care

In my twenty-nine years of experience handling work comp claims in northern Minnesota, I have seen many, many men and women who are “working hurt”.  These are people who suffered an admitted work injury and chose to go back to work without any formal work restrictions even though they were still suffering from back, neck, shoulder, knee, etc. pain and limitations.  Often, the work environment can be very intimidating for someone who claims an injury or needs work restrictions.  For that reason, many people simply tough it out and continue working to avoid being ridiculed by coworkers or supervisors.

However, if the medical records document that you had a legitimate work injury and there is current medical support for work restrictions, it may not be too late to file a claim for wage loss benefits now that you are laid off.  The key is to have solid medical support from a treating physician who will relate your ongoing difficulties to a work injury that was accepted at the time you reported it.

You Have a Recent Work Injury That Has Not Been Reported

If you have very recently suffered an injury at work but have not yet reported it to your employer, you should do so immediately. There are strict deadlines for actually reporting an injury once you are aware that it is related to your work activities.  If you fail to report the injury quickly enough, the claim might be barred forever.  Reporting an injury after a layoff will automatically be viewed suspiciously by the insurance company, but if you can prove that the injury is work related, you should definitely pursue it.

The notice of a work injury should be given in writing to a supervisor, human resources person or anyone else in a position of authority with the employer and should specifically state the nature of the injury and how it is related to your work.  You should also follow up right away with a doctor to document the nature of the injury and obtain treatment.

Your Job Duties Right up until the Date of the Layoff Have Contributed to an Injury or Disabling Condition

Not all work comp injuries are the result of one specific incident.  If you fall off a ladder and break your arm, that’s pretty clearly a work comp injury which occurred at a certain time on a certain date.  However, if your work activities over a period of time have gradually resulted in a painful or disabling medical condition, that can also be a work comp claim.  A good example might be someone who spends all day, everyday, bent over shoveling or lifting.  Eventually, that person develops back pain and requires medical care.  If his work activities contributed to the development of his disabling  back condition, that would be a repetitive injury work comp claim.  Another example might be someone who develops carpal tunnel syndrome from repetitive work activities involving the hands and wrists.  These types of claims are called repetitive, or Gillette injuries.  A Gillette injury can involve any body part which is subjected to repetitive stress in the course of employment.

The date of injury for a repetitive use  (Gillette)  injury, can be the first date you see a physician, the first day you become disabled or limited from the injury, or the last day you work, among other possible dates.  If you suspect that you have such a claim from your work activities, you should give written notice to your employer immediately, explaining that you have a medical condition which you believe is related to your work activities.  Again, follow-up with your physician right away and describe in detail what your job duties were and how they seemed to cause or increase your symptoms.

Deadlines and Other Limitations

As mentioned above, there are deadlines which apply to giving notice of an injury and there are additional deadlines for actually filing a work comp claim. If you had an injury at some point in the past that you didn’t report or which was denied, it may be too late to pursue any claims at this time. However, if you had an injury that was accepted by work comp, no matter how long ago, you may still have some benefits available to you, including wage loss, permanent impairment, medical or vocational rehabilitation and retraining.

There are also limitations or “caps” on certain types of benefits, so not all benefits would be available after a certain amount of time has gone by. Either way, it’s probably worth looking into now that you’ve  been laid off and will be looking for a new job.

Our Recommendation

If you have been laid off from a job and have a work related injury or disabling medical condition related to your work activities, consult with an experienced work comp attorney to see if you have any rights or claims available to you. You can be assured that the employer will not follow up with you after the layoff to remind you about any available work comp benefits.

We have been representing injured workers across all of northern Minnesota for nearly 30 years. You can contact us at any time for an absolutely free consultation.  We will always give you nothing but our honest opinion about your possible claims and will be happy to help you in any way that we can.  Call us with questions at any time.

Thank you for visiting our blog.