Money Benefits in a Minnesota Work Comp Case

Individuals who are hurt at work in Minnesota may be eligible for workers' compensation benefits, which, in addition to medical expense benefits and rehabilitation benefits, can include significant monetary benefits.

I often meet with potential Minnesota workers’ compensation clients who tell me that they just want to get the medical care they need and get on with their lives. They tell me they don’t want any money, they just want to get back to work, and they don’t want their employer to think poorly of them if they hire a lawyer. While this is an admirable attitude to have, all injured workers should know a few things about monetary benefits available under Minnesota workers’ compensation benefits.  

• The amount of your wage loss benefits is usually dependent on how much money you earned in the 26 weeks preceding your date of injury.  This calculation method is used to determine your Average Weekly Wage (AWW). Your AWW is used to calculate wage loss benefits, including temporary total disability (TTD) benefits, temporary partial (TPD) disability benefits, and permanent total disability (PTD) benefits. In some cases, a different calculation rule may apply. Determining an injured workers’ correct AWW is important to determining the appropriate compensation rate for wage loss benefits. Calculation errors or under-calculations can cost an injured worker hundreds or even thousands of dollars. 

• There is no pain and suffering compensation available in a Minnesota workers’ compensation case. Compensation paid on a work injury claim is based strictly on the benefits available under the law. “Pain and suffering” or “loss of enjoyment of life” are money damages awarded by judges or juries in personal injury cases, not workers’ compensation cases. Even the most horribly painful injury will not warrant any compensation for pain and suffering if it is a workers’ compensation injury in Minnesota. In some workers’ compensation cases, however, there may be what’s known as a third-party liability claim, or a personal injury claim, against someone other than an injured workers’ employer or a co-worker, which can include damages for pain and suffering. 

• Permanent partial disability awards are available only to injured workers whose injuries are permanent. Permanent partial disability (PPD) benefits are available to injured workers in Minnesota who have suffered a permanent injury. A worker in Minnesota who sustains a serious, but temporary injury, is not eligible for permanent partial disability benefits. For workers who have sustained a permanent injury, your doctor should assign a permanent partial disability rating based on the Minnesota PPD schedules once you have reached Maximum Medical Improvement (MMI). This rating is often a source of disagreement in workers’ compensation cases. In some cases, five different doctors might come up with five different ratings. 

• Insurers sometimes “close” a Minnesota workers’ compensation case without obtaining a permanent partial disability (PPD) rating from the injured worker's treating physician. On occasion, this may be because the primary treating physician simply isn’t familiar with the workers’ compensation PPD schedules or the rules governing timing of assigning a PPD rating. In other cases, the doctor, unfortunately, simply doesn’t want to be bothered. In yet other cases, the insurer never requests a rating from the doctor, and a rating is never issued, even though the worker clearly has a permanent injury. We routinely see cases that were supposedly “closed” by the insurance company, where the worker was clearly entitled to several thousand dollars’ worth of permanent partial disability benefits.

• It may be difficult, if not impossible, to predict how much money an injured worker will get for a Permanent Partial Disability (PPD) award at the outset of the claim. When an injured worker comes for a consultation at the beginning of his or her claim, I may not be able to predict how much money will be awarded for PPD, because we don’t know the extent, if any, of any permanent injuries that individual may have until that worker has gone through a course of medical treatment. For some types of injuries, I can give a ballpark estimate on the permanent partial disability, but others depend on loss of range of motion, review of MRI’s or operative reports, or neurological testing. Aside from the value of a claim for permanent partial disability benefits, an injured worker’s case may have additional monetary value for wage loss benefits and other workers’ compensation benefits. 

• The workers’ compensation insurance company is not required under the law to offer you a settlement on your workers’ compensation case. One of the most common questions I hear is: “when does the insurer have to offer me a settlement?” The answer is: They don’t. That being said, in many, many cases, we are able to secure a settlement on behalf of our clients. There are a variety of different types of Minnesota workers’ compensation settlements. An injured worker is extremely well advised to speak with an experienced workers’ compensation lawyer before attempting to settle his or her case. There’s simply too much at stake to try to “wing it” when you’re looking at settling your workers’ compensation case, particularly if your injuries are serious, or if you’ve missed significant time from work. 

Even if you have an “admitted” Minnesota workers’ compensation claim, meaning that the insurer is paying your benefits, as a rule, it’s not a matter of IF there will be a dispute on your case—it’s a matter of when. At every turn, the workers’ compensation insurer is looking for ways to minimize the amount of benefits they have to pay on your claim. You need to look out for your best interests!

To learn more about the benefits available to workers’ hurt on the job in Minnesota, call Meuser & Associate at 877-746-5680 or click here to send us an email to schedule a free, no-obligation consultation. 

I Received a PPD Payment, Is My Case Closed? Minnesota Workers’ Compensation Permanent Partial Disability

I get calls from injured workers in Minnesota a couple times a month who’ve received a check in the mail from the workers’ compensation insurance company and a Notice of Benefit Payment which indicates that they’re receiving payment for Permanent Partial Disability (PPD) benefits. These folks often have questions about what exactly this payment is for, and how it may affect their rights. 

Usually, the permanent partial disability (PPD) payment is based on a rating that your doctor assigned to your permanent injury. In some cases, insurance companies pay a minimum amount of permanent partial disability benefits if there’s a question as to whether the injured worker may be eligible for a higher rating.

Receiving a permanent partial disability (PPD) payment on a Minnesota workers’ compensation case does not mean that your case is settled or closed. Cashing your PPD payment does not mean that you’ve accepted a settlement, or agreed to close your case. 

Many workers who receive a PPD payment are eligible for additional workers’ compensation benefits. When I speak with injured workers who have questions about a PPD payment they’ve received, I typically try to evaluate:

• Whether the amount of PPD is correct. 
• Whether a maximum medical improvement (MMI) determination is premature. 
• And, whether they may be eligible for additional workers’ compensation benefits. 

A while back, I met with an injured worker for an initial consultation. He had a couple back injuries over the years, and had undergone back surgery. He had been off work due to his back problems for a couple years, which had resulted in progressively worsening neurological problems in one of his legs. He told me that he had settled the monetary benefits on his back injury claims. In the meantime, we decided to pursue a claim for payment of his outstanding medical expenses.

As part of investigation his claim, I obtained copies of his workers’ compensation file from the Department of Labor and Industry. While I found documentation that this gentleman had been paid permanent partial disability benefits for some of his back injuries, I couldn’t locate any documentation of any settlements. The attorneys for the insurance companies involved were also unable to locate any documentation of any settlements. I realized that this gentlemen ASSUMED that he had settled his cases because he had received permanent partial disability payments for his injuries.

In fact, because he hadn’t settled his cases, this gentleman has a substantial claim for wage loss benefits, in addition to his claims for payment of his medical expenses.

The moral of the story is that a permanent partial disability (PPD) payment on a Minnesota workers’ compensation case is not a settlement or a close out of other claims. 

If you’ve received a permanent partial disability (PPD) payment on your Minnesota workers’ compensation case, a workers’ compensation attorney can evaluate whether the payment is appropriate and whether or not you have additional workers’ compensation claims. For a free, no-obligation Minnesota workers’ compensation case consultation, call Meuser & Associate at 877-746-5680 or click here to send us an email. 

Calculating a MN Work Comp Settlement

Under Minnesota workers’ compensation law, there is no automatic right to a lump sum settlement. That means that neither side can force the other side to settle the case. That being said, in the majority of cases, the parties can, and do, reach some kind of settlement.

There are a variety of different kinds of settlements of workers’ compensation cases, but generally, they are either full, final, complete settlements, or to-date settlements. When people want to settle their Minnesota workers’ compensation case in exchange for a lump sum payment, they are usually thinking of what is known as a full, final, complete settlement, which is a lump sum settlement of all past and future claims, which sometimes closes out an employee’s right to future medical expense benefits, or sometimes leaves open an employee’s right to future medical expense benefits.

While there are literally dozens of factors that need to be evaluated in every case before attempting to put a monetary value on the claim, generally speaking, there are several things that we calculate in every Minnesota workers’ compensation demand. The best way to get an accurate valuation of your Minnesota workers’ compensation claim is to consult with a Minnesota workers’ compensation lawyer.

Past wage loss claims: We calculate claims for any past wage loss to-date, if the workers’ compensation insurer owes any past wage loss benefits. This can include temporary total disability benefits, if the employee has been completely off work, or temporary partial disability benefits, if the employee has been working, but earning less money. In some cases, it can include past permanent total disability benefits. It can also include underpayment claims if the insurer has been paying benefits at an incorrect rate. Factors that play into this calculation include the employee’s average weekly wage and compensation rate at the time of the injury, whether or not the employee has reached maximum medical improvement or not, whether the employee has consistently had work restrictions during the relevant time periods, whether the employee has conducted a diligent job search during the relevant time periods, and whether any third parties have paid wage loss benefits during the same time periods.

Future wage loss claims: For a full, final, complete settlement demand, which contemplates a close out of future wage loss benefits, we also calculate what the employee will realistically incur in future wage losses as well. Several factors come into play in this calculation, including how many weeks of wage loss benefits the employee remains entitled to, whether or not the employee has reached maximum medical improvement, whether the employee is currently working or not working, how much longer it is anticipated that the employee will be off work, whether the employee has permanent work restrictions and the nature of those restrictions, the employee’s anticipated future earning capacity, the employee’s average weekly wage and compensation rate at the time of the injury, and whether the employee is eligible for any other wage loss benefits, such as PERA disability benefits, retirement pension benefits, or social security disability benefits.

Permanent partial disability claims: Based on the type and severity of the injury, we determine whether the employee may have claims for permanent partial disability benefits. Factors that come into play in estimating the value of permanent partial disability benefits, include the nature and extent of the injury, whether or not any permanent partial disability has already been paid, the nature and extent of any pre-existing conditions, and whether a doctor has assigned a permanent partial disability rating.

Out of pocket expenses/medical mileage: If the injured worker has incurred out of pocket expenses or medical mileage, we typically include a claim for reimbursement of these expenses.

Close out of rehabilitation/retraining benefits. Often, a full, final complete settlement also includes a close out of entitlement to rehabilitation and/or retraining benefits. While an injured worker doesn’t actually receive money for rehabilitation benefits, this is a benefit that has monetary value to the insurance company, because they pay for this benefit. If an employee is a strong candidate for retraining, which can be a costly benefit, the value of closing out this type of benefit may be higher.

Payment of outstanding medical expenses/third party intervenors. In addition to the monetary benefits claimed, normally a settlement demand directs that the insurer will also be obligated to satisfy any outstanding medical expenses, and reimburse any third party payors, such as a person's private health insurance, if any of the medical expenses have been paid by a third party. 

Close out of future medical care. In some cases, it may be appropriate to consider a close out of an employee's rights to future medical care in exchange for a monetary payment. In some cases, consideration of a close out of future care is not appropriate. This depends on a variety of factors, such as whether the underlying claim is admitted or denied, the nature and extent of the employee's injury, and the nature, extent, and expense of any anticipated future medical care.

In addition to the actual hard numbers in valuing a Minnesota workers’ compensation claim, obviously, the strengths and weaknesses of any claims or defenses must be taken into account. For example, on a workers’ compensation case where the insurer doesn’t have strong defenses to the claims, it is much more likely that an injured worker will get a settlement that is closer to the demand amount. For cases where the insurer has strong defenses to the claims, or stronger defenses on liability for the underlying injury, while the potential value of the case may be high, that must be weighed against the higher risk that the insurer will successfully defend against those claims.

Crunching the numbers on a Minnesota workers’ compensation claim can be complicated, but coming up with the numbers is actually the easy part. The harder part is determining the true value of a claim to ensure that you’re getting a fair deal on a settlement of your workers’ compensation claim. Workers that try to settle their cases on their own usually undervalue their claims, or unknowingly give up rights to valuable future benefits. Do not trust the workers’ compensation insurance company to give you a fair valuation of your claim!

The best way to ensure that you’re getting a fair deal in settling your claim is to have a Minnesota workers’ compensation lawyer assist you with the process. For a FREE, NO-OBLIGATION case consultation call Meuser & Associate at 877-746-5680, or click here to send us an email. We’ve been helping injured workers for over 20 years, and have recovered millions of dollars in workers' compensation benefits for our clients. We can help you get a fair settlement of your Minnesota workers’ compensation claim. 

Maximum Medical Improvement (MMI) and MN Work Comp: A Double-Edged Sword

If you’re an injured worker in Minnesota, at some point in time, you will probably be sent a letter from the workers’ compensation insurance company notifying you that you’ve reached Maximum Medical Improvement (MMI). On the upside, Maximum Medical Improvement often means you may qualify for Permanent Partial Disability (PPD) benefits. On the downside, it means the insurer can stop paying you temporary total disability benefits (TTD) even if you are not fully recovered or back to work.

Maximum Medical Improvement (MMI) is an important concept in Minnesota workers’ compensation law. It is 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.” In plain language, it essentially means that from an objective perspective, your condition has improved as much as it is going to. It doesn’t mean that you’re healed. It doesn’t mean that you’re not entitled to additional medical care. It doesn’t mean that your case is over. And it doesn’t mean that you’re no longer suffering from the effects of your injury.

What it does mean, however, is that the workers’ compensation insurance company will stop you temporary total disability (TTD) benefits 90 days after sending you notice of reaching Maximum Medical Improvement (MMI), regardless of whether you’ve fully recovered from your injuries, and regardless of whether you’ve found a new job.

Often, the insurance company secures an MMI determination by sending you to attend an Independent Medical Examination (IME).

This is one of the hardest concepts for my clients to deal with. If you lost your job because of your injury, and you have yet to find a new job, if you have reached Maximum Medical Improvement (MMI), the insurance company will discontinue temporary total disability benefits.

The upside is that if you’ve reached Maximum Medical Improvement (MMI), it is appropriate for your doctor to make a determination as to any permanent impairment you’ve sustained, which may entitle you to Permanent Partial Disability (PPD) benefits.

The other good news is that if you believe that you have not in fact reached Maximum Medical Improvement (MMI), in many circumstances, we can dispute that determination. For example, if the MMI determination was issued by an IME doctor, and your doctor disagrees, you may not actually be at Maximum Medical Improvement. Or, if your doctor has recommended additional diagnostic testing, surgery, or other treatment, you may not have reached Maximum Medical Improvement yet.

Workers’ compensation insurance companies often seek a pre-mature determination of Maximum Medical Improvement (MMI) to try to limit their potential liability for ongoing temporary total disability (TTD) benefits.

If you’ve sustained a Minnesota work-related injury, the workers’ compensation insurance company will almost invariably try to discontinue your benefits prematurely. Unfortunately, injured workers are a liability in the eyes of the insurance company, and they will often go to surprising means to keep their costs as low as possible, regardless of what is right or fair.

For a free, no-obligation consultation to learn more about your workers’ compensation rights, call us at 877-746-5680, or click here to send us an email to speak with one of our Minnesota workers’ compensation lawyers.

Visit us at MeuserLaw.com!

MN Workers’ Compensation Benefits: Types of Benefits Available for Injured Workers in Minnesota

There are four main types of workers’ compensation benefits available to injured workers under the Minnesota Workers’ Compensation Act.

Medical Expense Benefits

If you’ve sustained a work-related injury in Minnesota, the employer and insurer are responsible for payment of “reasonable and necessary” medical care and treatment to cure and/or relieve the effects of the work injury. Covered treatments include, but are not limited to: hospitalization, prescriptions, medical mileage reimbursement, nursing services, chiropractic care, physical therapy, assistive devices, MRI’s, CT scans, EMG’s, counseling, injections, chronic pain management, psychological care, and occupational therapy.

Wage Loss Benefits

Temporary total disability benefits (TTD): Temporary total disability benefits are wage loss benefits available to injured workers who are completely unable to work, or who are released to return to work with restrictions, but are unable to find work within those restrictions. TTD is calculated at 2/3 of an injured worker’s average weekly wage (AWW) at the time of the injury. This benefit is current capped at a maximum of $850 per week, for a maximum of up to 130 weeks. An injured workers’ entitlement to temporary total disability (TTD) also ends 90 days after reaching maximum medical improvement (MMI), if the employee fails to conduct a diligent job search, if the employee is released to work without restrictions, or if the employee is terminated for misconduct.

Temporary partial disability benefits (TPD): Temporary partial disability benefits are wage loss benefits available to an injured worker who is back at work but is earning less than they were at the date of injury due to his or her work restrictions. TPD benefits are calculated by subtracting a worker’s post-injury earnings from their average weekly wage (AWW) at the time of the injury. The difference is then multiplied by 2/3 to determine the amount of temporary partial disability benefits. This benefit is limited to 225 weeks and is not payable more than 450 weeks after the date of the injury.

Permanent total disability benefits (PTD): Permanent total disability benefits are available for injured workers who are permanently prevented from performing any substantial gainful employment. This wage loss benefits is payable as 2/3 of the worker’s average weekly wage (AWW) through age 67. As of October 1, 1995, in order to qualify for permanent total disability (PTD) benefits, an injured worker must meet certain thresholds in addition to showing he or she is physically incapable of substantial gainful employment.

Permanent Partial Disability Benefits

Permanent partial disability (PPD) or permanency benefits is a payment for the loss of use of a body function. PPD benefits are paid in accordance with the permanent partial disability schedules set forth by the Department of Labor and Industry. These benefits are payable weekly or as a lump sum.

Rehabilitation Benefits

Rehabilitation benefits are available to injured workers that are having difficulty returning to their former job due to their work injury. Vocational rehabilitation services are provided by a Qualified Rehabilitation Consultant (QRC). You have the right to choose your own QRC. A QRC will provide you with an initial consultation to determine whether you're entitled to rehabilitation services. Rehabilitation services can include medical management, return to work services, job search and placement services, or formal retraining.

For a free, no-obligation consultation regarding your Minnesota workers’ compensation rights, contact Meuser & Associates at 877-746-5680, or click here to send us an email.

Minnesota Workers' Comp PPD % Rating: How Much Is It Worth?

Under Minnesota Workers’ compensation law, Permanent Partial Disability (PPD) benefits are payable for the permanent functional loss of use of the body based upon a disability schedule. Often, once an injured worker has reached Maximum Medical Improvement (MMI), his or her doctor will assign a permanency rating.

If the search statistics are any indication, folks are curious as to the dollar value associated with their permanency ratings.

In Minnesota, since 1984, Permanent Partial Disability (PPD) has been determined using the PPD schedules. Under the schedules, specific types of impairments to each body part are assigned a percentage rating. These ratings are meant to assign a permanent partial disability to the body as a whole based on the specific type of permanent impairment. This percentage is then multiplied times a dollar amount to determine the amount of the PPD benefits. A higher permanency rating is multiplied by a higher dollar amount. Here’s a look at the schedule that applies to injuries that occurred on or after October 1, 2000:

PPD % Amount 

0-5        $75,000
6-10       $80,000
11-15     $85,000
16-20     $90,000
21-25     $95,000
26-30     $100,000
31-35     $110,000
36-40     $120,000
41-45     $130,000
46-50     $140,000
51-55     $165,000
56-60     $190,000
61-65     $215,000
66-70     $240,000
71-75     $265,000
76-80     $315,000
81-85     $365,000
86-90     $415,000
91-95     $465,000
96-100   $515,000

The compensation schedule at the Minnesota Department of Labor and Industry website can be somewhat confusing for folks trying to figure this out on their own what the insurance company owes them. For example, I’ve had people inquire as to why the insurance company wasn’t going to pay $80,000.00 for their 10% PPD rating.

Reading the schedule this way makes it seem like PPD ratings between 6-10% result in a benefit of $80,000.00. Unfortunately, this is not the case. Ratings between 6-10% are multiplied by $80,0000.00 to determine the permanency benefit.

Here’s a couple examples of how this math works:

3% PPD (x) $75,000.00 = $2,250.00

5% PPD (x) $75,000.00 = $3,750.00

9% PPD (x) $80,000.00 = $7,200.00

16% PPD (x) $90,000.00 = $14,400.00

24% PPD (x) $95,000.00 = $22,800.00

36% PPD (x) $120,000.00 = $42,200.00

50% PPD (x) $140,000.00 = $70,000.00

75% PPD (x) $265,000.00 = $198,750.00

100% PPD (x) $515,000.00 = $515,000.00

Sometimes, determining permanency is relatively straightforward under the schedules. Other times, however, such as when the type of injury is not specifically addressed in the schedules, if there is disagreement as to the precise diagnosis, if there is a question as to whether the individual had a pre-existing condition, or where multiple body parts are injured, determining permanency may be more complex. As a rule, Minnesota workers’ compensation insurance companies adopt the lowest possible rating.

Our office frequently reviews files of injured workers who don’t think they have any workers’ compensation benefits available, only to discover that the work comp. insurer either did not pay PPD benefits, or underpaid those benefits.

For more information about Permanent Partial Disability (PPD) benefits in Minnesota, check out these previous posts:

MN Work Comp and Permanent Partial Disability (PPD) Benefits

Calculating Permanent Partial Disability (PPD): MN Work Comp

For a free, no-obligation consultation to learn more about Minnesota workers’ compensation benefits, call Meuser & Associates at 877-746-5680 or click here to send us an email to speak with one of our Minnesota workers’ compensation lawyers.

MN Work Comp and Permanent Partial Disability (PPD) Benefits

Permanent partial disability (PPD) benefits are payable for the permanent functional loss of use of a body part due to a work-related injury.

Once you have reached Maximum Medical Improvement (MMI), if you have a permanent injury, your doctor may assign you what is known as a permanency rating. This is stated as a percentage. For example, following recovery from a back surgery, your doctor may indicate that you’ve sustained permanent partial disability of 12% to the body as a whole.

This percentage is then multiplied by a dollar amount, which is set by the legislature. The higher your permanency percentage, the higher the dollar amount used for purposes of calculating the amount of permanent partial disability (PPD) benefits you are owed.

Permanency (PPD) benefits are payable on the same schedule that you had received temporary total disability (TTD) benefits, or at the same time that you receive temporary partial disability (TPD) benefits.

If your doctor has indicated that you have reached Maximum Medical Improvement (MMI), but doesn’t specify your PPD rating, the workers’ compensation insurer is supposed to request an assessment of PPD from your doctor.

If everyone agrees as to the amount of your PPD benefit, the insurer is supposed to make a minimum lump sum payment or begin periodic payments. If there is a disagreement as to the correct amount of your permanency benefit, the insurer is still supposed to make at least a minimum lump sum payment or begin periodic payments, at least to the extent of the undisputed benefit.

You have the right to request permanent partial disability (PPD) benefits be paid to you as a lump sum, as opposed to being paid these benefits on a weekly or bi-weekly basis. Keep in mind that if you request a lump sum payment, the insurer can discount the lump sum by up to 5 percent of the present value.

Under Minnesota workers’ compensation law, permanent disabilities are rated according to a set of rules known as the Permanent Partial Disability Schedules. Each injury is rated according to the body part involved, and the type of impairment affecting that body part.

As you can imagine, even on a case where a workers’ compensation insurer admits responsibility for your work injury, there is a lot of room for dispute as to the amount of permanent partial disability (PPD) benefits you are entitled to.

For example, the insurer may try to reduce your PPD rating by suggesting that part of your injury is pre-existing, they may suggest that your doctor’s rating is too high and that a lower rating applies, they may suggest that your injury is not actually permanent, or they may improperly combine ratings if you have multiple body parts that are injured, or they may just simply never pay you PPD if your doctor does not complete a healthcare provider report specifically assigning you a permanency rating.

If you have a permanent injury, make sure you get all the workers’ compensation benefits you are entitled to. Contact Meuser & Associates at 877-746-5680 for a free, no-obligation consultation with one of our workers’ compensation lawyers, or click here to send us an email.

Visit Minnesota Workers' Compensation and Personal Injury Law Firm, Meuser & Associates, P.A., at MeuserLaw.com

Calculating Permanent Partial Disability (PPD): MN Work Comp

One of the workers’ compensation benefits available to injured workers in Minnesota is Permanent Partial Disability (PPD).

If your doctor determines that you’ve suffered a permanent injury, your doctor may issue what’s known as a “permanency rating.” Minnesota law sets forth a schedule for assigning permanency ratings to almost any type of permanent injury imaginable. This percentage is then multiplied by a dollar figure to determine the amount of the PPD benefit you are entitled to.

Generally, doctors do not assign permanency ratings until you have been placed at Maximum Medical Improvement (MMI). PPD may be paid weekly, or it may be paid in a lump sum. PPD is generally not payable while you are still receiving Temporary Total Disability (TTD) benefits, but you may receive PPD while you are receiving Temporary Partial Disability (TPD) or Permanent Total Disability (PTD) benefits.

Let’s look at an example:

Let’s assume you suffered a low back injury on the job and the workers’ compensation insurance company has admitted liability. Let’s also assume you underwent an MRI that shows a disc herniation at L4-5 that does not appear to be impinging on nerve roots or on the spinal canal. About a year after your injury, you are still experiencing back pain, and symptoms into your buttocks and leg. Your doctor concludes that you still need ongoing occasional treatment, but that your condition is permanent and you’re not likely to see major improvement with any kind of medical procedure.

Based on these facts, you would probably qualify for Permanent Partial Disability benefits. Specifically, your injury would probably qualify for a 7% rating based on Minnesota Rule 5223.0390, Subpart 4(C)(1).

This 7% rating is then multiplied by a dollar amount. Impairment ratings between 6-10 percent are multiplied by $80,000.00 which equals $5,600.00.

Seems simple, right? Determining the amount of PPD benefits you are entitled to should be relatively straight-forward. Unfortunately, insurance companies frequently underpay injured workers the amount of permanency benefits they are entitled to. If you have a permanent work injury, it’s wise to speak with a workers’ compensation lawyer to make sure the insurance company pays you the PPD benefits you are entitled to.

Doctors don’t always automatically issue permanency ratings. If your doctor never issues a permanency rating for your injury, the insurance company will probably never pay you permanency benefits. Even if your doctor does issue a permanency rating, the insurance company might simply ignore it and never pay you the benefits you are entitled to.

While the schedules are intended to be fairly straightforward, in many cases, the level of permanency benefits you are entitled to may fall somewhere between ratings. For example, if a worker has a back injury and an MRI shows a herniation, and that worker is experiencing radicular symptoms, there may be a question as to whether that herniation impinges on a nerve root or not. There are different levels of permanency depending on whether an MRI evidences nerve root impingment. As a rule, the insurance company will always pay the lower permanency level.

Another situation that frequently comes up is where there are multiple body parts injured in one accident. For example, if you sustain an injury to both your neck and shoulder, you may be entitled to permanency benefits for both your shoulder and your neck. There is a specific way to combine these ratings and insurance companies often miscalculate the rating.

If there is any suggestion that your injury may have been pre-existing, or that part of your condition existed prior to your work injury, the insurance company will almost inevitably try to either avoid paying PPD benefits altogether, or they will try to take a deduction for whatever alleged “pre-existing” condition you may have. This scenario comes up very frequently with back and neck injuries.

For more information on calculating your PPD benefits, check out the following:

Minnesota Permanency Schedules
PPD Benefit Table

While calculating Minnesota workers’ compensation Permanent Partial Disability (PPD) benefits should be relatively straightforward, the insurance company will rarely voluntarily pay the full level of benefits you are entitled to. Make sure you’re paid all the PPD benefits you’re entitled to. Call Meuser & Associate at 877-746-5680 or click here to send us an email to schedule a free, no-obligation consultation with one of our lawyers.

Visit Minnesota Workers' Compensation and Personal Injury Law Firm, Meuser & Associates, P.A., at MeuserLaw.com

Audit of MN Work Comp System Reveals Underpayment by Insurance Companies

A new report released by the Minnesota Office of the Legislative Auditor reveals the results of a recent audit of the Minnesota workers' compensation system. Among other things, the report reveals that insurance companies underpaid work comp claims by over $3 million in each of the last few fiscal years. While those of us who practice workers' compensation frequently see underpayments by insurance companies or questionable denials of claims, unfortunately, errors in calculating benefits even when there is literally no question as to an employee's entitlement to certain benefits occurs more often than it should.

The reported underpayments represent less than 1% of the total amount of indemnity payments made each year. However, the underpayments reported in the audit represented only those underpayments caught when a claim was reviewed by staff at the Department of Labor and Industry. Not every case is audited, and not every error is caught. Moreover, the amount of underpayments does not include instances where there is a dispute over the amount of the benefit the injured workers is entitled to.

Benefit calculation errors often occur when an adjuster is unfamiliar with Minnesota Workers' Compensation rules and calculation methods, when someone makes a careless calculation error, or when an insurance company simply fails to recognize an employee's entitlement to a particular benefit.

The vast majority of underpayments occurred as the result of errors in calculating the amount of permanent partial disability (PPD) benefits owed to an injured worker. The next most common error was in miscalculating the number of weeks of wage loss benefits due to an injured worker. In our practice, errors in determining the amount of permanent partial disability benefits available to an injured worker occur very frequently, even when there is no dispute over the extent of an employee's injuries. Where there is a dispute over the extent of an employee's injuries, an insurer will almost never voluntarily pay the full extent of permanent partial disability benefits potentially available to the employee.

If there is a dispute regarding the extent of the benefits to which you are entitled, it is a good idea to consult with a workers' compensation attorney. Even if there is no dispute regarding your entitlement to benefits, keep in mind that insurance companies frequently make errors in calculating your entitlement to benefits. We're happy to provide a free evaluation of your case to determine if you are entitled to additional benefits. Call us today at 877-746-5680 or click here to send us an email.

Visit our workers' compensation website at MeuserLaw.com!