Is My MN Workers' Comp. Claim Denied?

In our Minnesota workers’ compensation law practice, we regularly see even the most legitimate workers’ compensation claims being denied by workers’ compensation insurance companies. If primary liability is denied on your Minnesota workers’ compensation claim, you should strongly consider consulting with a Minnesota workers’ compensation lawyer. 

If you’ve sustained an on-the-job injury in Minnesota, your employer is supposed to report your injury to their workers’ compensation insurance company by filing a First Report of Injury form within 10 days of the date they had knowledge of your injury, or 10 days from the date that you reported your injury. If you miss more than three calendar days of work, the insurer is required to file the First Report of Injury form with the Minnesota Department of Labor and Industry.

The workers’ compensation insurance company has up to 14 days from the date your employer had notice of your injury within which to file a Notice of Primary Liability Determination in the event that the insurer is denying primary liability on your claim. In some cases, the insurance company may make initial payments on your case, and then after conducting an “investigation,” retroactively deny primary liability.

A Notice of Primary Liability Determination which denies liability requires a statement setting forth “a specific reason for the denial which must be in language easily readable and understandable…and a clear statement of the facts forming the basis for the denial.” If primary liability is denied on your Minnesota workers’ compensation case, it generally starts the running of a three-year Statute of Limitations. Unfortunately, not all employers or insurance companies follow these rules. Moreover, an insurer’s denial of primary liability on a workers’ compensation case is not always justified. In many cases, the basis for the denial is questionable or just plain wrong.

A Minnesota workers’ compensation attorney can help you contest a denial of primary liability on your workers’ compensation case. For a free, no-obligation case consultation, call Meuser & Associate at 877-746-5680 or click here to send us an email. 

Do I Need a MN Workers’ Comp. Lawyer?

Workers’ compensation insurance companies have lawyers to help them with questions and concerns. Many employers have direct access to legal advice about workers’ compensation claims. Why shouldn’t you have access to good legal advice, too? 

You can speak with a Minnesota workers’ compensation lawyer at no cost to you. Take advantage of a free, no-obligation legal consultation and learn about your Minnesota workers’ compensation rights. 

At Meuser & Associate, we have a long and well-deserved reputation for protecting the rights of Minnesota’s injured workers. Here are some things to consider in deciding whether to hire an attorney to assist you with your case:

• It is easy to make mistakes that can substantially hurt your entitlement to workers’ compensation benefits. Your employer and insurer aren’t going to warn you of these potential pitfalls, and in many instances, many injured workers are actively led by their employers and their insurers into these traps. These mistakes can cost you thousands of dollars’ worth of benefits. 
• Minnesota workers’ compensation is a complex area of law. It’s usually not an area of law where a general practice attorney can take on a workers’ compensation case once in a while. Minnesota workers’ compensation law is based on statute, rules, and case law. It’s constantly changing and developing. An inexperienced or inept lawyer can miss issues on your case, which can cost you thousands of dollars. Most injured workers are simply not capable of mastering all of the complex rules and regulations on their own. 
• If the insurance company denies your claim, a lawyer can help establish your right to benefits. If primary liability is denied on your case, virtually no amount of arguing or haggling with the workers’ compensation insurance company is going to get your claim admitted. Almost invariably, you will need a good Minnesota workers’ compensation lawyer to bring a claim on your behalf. 
• There are a lot of deadlines involved with workers’ compensation. If you miss a deadline for reporting your injury, filing a claim, disputing a denial of liability, or objecting to a discontinuance, in some instances, you may be foreclosed from making additional claims. Missing deadlines on your workers’ compensation case can, in some instances, permanently preclude you from claiming benefits for your work-related injury. 

Meuser & Associate has been fighting to protect the rights of Minnesota’s injured workers for over two decades. Arm yourself with the knowledge you need to protect your workers’ compensation rights. For a free, no-obligation workers’ compensation case consultation, call Meuser & Associate at 877-746-5680 or click here to send us an email. 

Pre-Existing Conditions and MN Workers’ Compensation

In Minnesota, if you re-injure or aggravate a pre-existing condition, it is covered by workers’ compensation. A person’s work activities or work injury need only be a substantial contributing factor to his or her current condition for it to be compensable under Minnesota workers’ compensation law.

While an employer is not obligated to cover a worker’s personal health, that employer take employees as they find them with whatever health conditions they bring to the job. Employers in Minnesota assume the risk that an employee’s non-work related pre-existing condition may be aggravated by a work injury or work activity.

In Minnesota, in order to be compensable workers’ compensation claim, it is not necessary that a work injury or an employees work activities be the only cause of the condition for which workers’ compensation benefits are sought. The work activities or the work injury need only be a substantial contributing factor to the cause aggravation or acceleration of a pre-existing condition.

In Vanda v. Minnesota Mining & Manufacturing Co., 27 W.C.D. 379, 218 N.W.2d 458 (1974), the Court explained that:

"[W]hen the usual tasks ordinary to an employee’s work substantially aggravate, accelerate, or combine with a pre-existing disease or latent condition to produce a disability, the entire disability is compensable, no apportionment being made on the basis of relative causal contribution of the pre-existing condition and the work activities."

A judge will consider several factors in determining whether an aggravation of a pre-existing condition is temporary or permanent, including (1) the nature and severity of the pre-existing condition and the extent of restrictions and disability resulting therefrom; (2) the nature of the symptoms and extent of medical treatment prior to the aggravating incident; (3) the nature and severity of the aggravating incident and the extent of the restrictions and disability resulting therefrom; (4) the nature of the symptoms and extent of medical treatment following the aggravating incident; (5) the nature and extent of the employee’s work duties and non-work activities during the relevant period; and (6) medical opinions on the issue.

Denials and disputes based on an actual or alleged pre-existing condition are some of the most common disputes we see in our Minnesota workers’ compensation law practice. For most workers hurt on the job, if there is any suggestion or evidence of a pre-existing condition, there is a strong probability that the workers’ compensation insurance company will deny or dispute the workers’ compensation claim. We fight these issues on a regular basis, and we win these fights on a regular basis. The key is having solid medical evidence evaluating the factors listed above.

I’ve seen workers’ compensation insurers deny a back injury claim based on the fact that the worker had a minor back injury 20 years ago. I’ve seen IME doctors characterize a disc herniation as “degenerative” and argue that it pre-dated the injury, even if the worker never had any back pain or medical care prior to the injury. I’ve seen a workers’ compensation back injury claim disputed because the worker had gone to a chiropractor a few times a couple years prior to the injury. I’ve seen a knee injury claim denied because an MRI revealed evidence of degenerative changes in addition to the claimed injury. Just because the insurance company says your injury is not covered, does not mean they’re right! 

In Minnesota workers’ compensation cases involving an actual or an alleged pre-existing condition, disputes with the workers’ compensation insurance company are almost inevitable. For a free, no-obligation Minnesota workers’ compensation case evaluation, call Meuser & Associate at 877-746-5680 or click here to send us an email. 

Degenerative Disc Disease and MN Workers’ Comp: Exercise and Physical Therapy for Pain Management

Degenerative disc disease is one of the most common causes of low back and neck pain, and it can significantly impact your ability to do your normal day to day activities, and your ability to work.

Degenerative disc disease refers to changes to the spinal discs from chronic wear and tear or injury. There are a variety of treatment options for degenerative disc disease, including exercise and physical therapy. For individuals suffering from degenerative disc disease, a regular routine of back or neck exercises can prevent neck or back pain and/or reduce the frequency, severity, and duration of flare-ups. Stretching exercises can improve range of motion, which in turn, can reduce neck or back pain. Strengthening exercises can help stabilize the spinal segments, and stronger muscles can help compensate for degenerated discs. Before beginning an exercise or therapy program, consult with your spinal specialist.

In the context of workers’ compensation, in many cases, degenerative disc disease is a condition that is covered for work comp benefits. The condition itself may be caused by an employee’s work activities, or an employee’s work activities may have substantially contributed to the condition.
Alternatively, an employee may suffer an aggravation of underlying degenerative disc disease, which is covered by workers’ compensation.

While the term “degenerative disc disease” refers to a medical condition, for workers’ compensation insurance adjusters, the term is also a legal defense to a claim for benefits. In plain language, what that means is that if you are injured at work, and you are diagnosed with degenerative disc disease, or there’s even a reference to degenerative disc disease in your medical records, be prepared for the work comp. adjuster to deny your claim on the basis that your condition is pre-existing.

Just because the workers’ compensation insurance company says your condition is pre-existing, doesn’t mean they’re right! 

In many cases, an individual’s work activities caused, or substantially contributed to, wear and tear on the spine over time, resulting in degenerative disc disease. That is a condition that IS covered by workers’ compensation, and is often referred to as a repetitive motion injury, or a Gillette-type injury.

In other cases, an individual’s work activities or an injury substantially aggravated or accelerated pre-existing degenerative disc disease. Again, in that instance, the injury IS covered by workers’ compensation.

If you are suffering from degenerative disc disease as a result of your work activities, you can expect that the workers’ compensation carrier will dispute your claim. It is important to speak with a Minnesota workers’ compensation lawyer to protect your rights. For a free, no-obligation consultation, contact Meuser & Associate at 877-746-5680 or click here to send us an email.

Will I Have to Undergo an Independent Medical Examination (IME) for My MN Workers’ Compensation Injury?

In our practice, I’d estimate at least 2/3 of my Minnesota workers’ compensation clients are required to undergo an “Independent” Medical Examination (IME) at least once during the duration of their claim. IME’s on disputed claims are almost inevitable.

We refer to so-called “Independent” Medical Examinations (IME) as adverse exams. They are not independent. The doctor you see will not offer treatment recommendations or advice. The doctor is hired by and paid for by the workers’ compensation insurance company.

The purpose of an IME is to provide an “independent” and “expert” opinion report regarding the nature and cause of your injuries for the insurance company. As you might imagine, very, very few of these reports are favorable to the Employee. Generally speaking, the IME doctor will opine that you weren’t hurt, that your injuries were pre-existing or unrelated to your work, that if you did have an injury, you’re completely healed, that your medical care has been unreasonable or unnecessary, that you’re not disabled, or that you’re simply faking it all together. The workers’ compensation insurance company then uses this so-called “expert” opinion as a basis to deny your claim.

Unfortunately, you are generally required to attend if the workers’ compensation insurance company decides to send you to one.

I ran across an interesting report from the MN Dept. of Labor and Industry analyzing what types of workers’ compensation claims involved an Independent Medical Examination. Claims that were closed in 2001 were included in the analysis, and a total of 1,197 of claims were reviewed to determine whether an IME had been performed and filed with the Department of Labor and Industry. Not all IME’s that are conducted are filed with DOLI, so some claims with no IME on file may have still had one conducted. Some claims fell into multiple categories. Not surprisingly, the analysis shows that claims where there was a dispute, or where the Employee’s disability lasted for an extended period were very likely to involve an IME.

• IME’s were filed on 9% of all claims involving indemnity benefits.
• IME’s were filed on 16% cases where claimants received temporary total disability (TTD) benefits for more than four weeks.
• IME’s were filed on 28% cases where a vocational rehabilitation plan was filed.
• IME’s were filed on 31% cases involving a primary denial of liability as well as a claim for indemnity benefits.
• IME’s were filed on 37% cases where a Rehabilitation Request for Assistance was filed.
• IME’s were filed on 56% cases where a Medical Request for Assistance was filed.
• IME’s were filed on 52% cases involving an Administrative Hearing Request, dealing with objections to discontinuances of wage loss benefits.
• IME’s were filed on 54% cases where a Stipulation for Settlement was filed.
• IME’s were filed on 63% cases where a Claim Petition was filed.
• IME’s were filed on 84% cases where a formal Objection to Discontinuance or Petition to Discontinue was filed.

If you’ve been scheduled for an Independent Medical Examination (IME) by your workers’ compensation insurance company, now is the time to speak with a workers’ compensation lawyer. It means that the workers’ compensation insurance company is going to try to stop your workers’ compensation benefits, and they’re seeking a so-called “expert” opinion to justify their reason for stopping your benefits.

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

Minnesota Workers' Compensation: What is a Claim Petition?

In Minnesota, a workers’ compensation claim is often initiated by filing a Claim Petition. A Claim Petition is a standard form that sets forth basic information about the employee’s claim for workers’ compensation benefits. The Claim Petition contains information about the employee, including his or her name, address, Social Security Number, date of birth, and date(s) of injury. It also lists the name of the employer(s) and insurer(s). The Claim Petition also sets forth the nature of the injury and the average weekly wage at the time of the injury. Finally, the Claim Petition lists the types of claims alleged, including Temporary Total Disability (TTD), Temporary Partial Disability (TPD), Permanent Total Disability (PTD), Permanent Partial Disability (PPD), Rehabilitation benefits, and/or medical benefits.

The Claim Petition is filed with the Department of Labor and Industry, and copies of the Claim Petition are served on the employee, the employer, the insurer, and any third-party payors, such as major medical insurers. Notice to Potential Intervenors is often served along with the Claim Petition to any medical providers and any third-party payors.

A Claim Petition is generally filed when the employer and/or insurer is denying primary liability, meaning that they admit no responsibility for the injury. A Claim Petition is also filed when there is a claim for monetary benefits, such as Temporary Total Disability, Temporary Partial Disability, and/or Permanent Total Disability, even if the insurer admits primary liability. If an injured worker has settled his or her case on a full, final complete basis, leaving open future medical benefits, a Claim Petition may be used in some instances where there is a dispute over medical expenses.

Once your Claim Petition has been filed, the employer and/or insurer is generally required to file an Answer to the Claim Petition within 20 days. The employer and/or insurer is required to serve specific responses to the allegations in the claim petition. If an answer is not filed in a timely matter and/or an extension of time to answer is not requested, the employee may request that the matter be scheduled for an expedited hearing.

Typically, after the Claim Petition has been filed, the matter is scheduled for a Settlement Conference at the Office of Administrative Hearings. Prior to the Settlement Conference, if appropriate, the employee’s attorney will often submit a settlement demand to the attorney for the employer and insurer. The purpose of the Settlement Conference is to attempt to discuss the possibility of settlement. Some cases settle at the Settlement Conference, and some do not. If it appears that the parties have reached an impasse, and that further negotiations will not facilitate a settlement, the case may be referred to the Office of Administrative Hearings for the scheduling of a hearing. If either side needs additional information, if the case is not ripe for settlement discussions, or if the sides need additional time to negotiate, the Compensation Judge may also reset a Settlement Conference for a month or two in the future.

If the parties are unable to reach a settlement, the case will proceed toward a Hearing. In Minnesota workers’ compensation, a Hearing is the equivalent of a trial. At the Hearing, both sides will present evidence in support of their respective positions, and the employee will generally provide testimony. After all evidence has been heard, the Compensation Judge issues a decision, which is final and binding on the parties.

The entire process from the filing of the Claim Petition through a Hearing can take anywhere from six months to a year or more. To see a blank copy of a claim petition, click here.

If you’ve been injured on the job, and the workers’ compensation insurance company is denying your claim, you should consult with an experienced workers’ compensation lawyer who can file a Claim Petition on your behalf to help you get the benefits you deserve. Meuser & Associates has been representing injured workers for over 20 years. To schedule a free, no-obligation consultation with one of our workers’ compensation lawyers, call Meuser & Associates at 877-746-568 or click here to send us an email.

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

Getting Medical Treatment When Your Workers' Compensation Claim Has Been Denied

One of the major problems with the Minnesota workers’ compensation system is how long it can take to resolve disputes over primary liability. When an insurer denies primary liability for a work-related injury, they will not pay any wage loss benefits, permanency benefits, rehabilitation benefits, and most problematic, medical expenses.

When a workers’ compensation insurer denies primary liability, meaning they do not believe they are responsible for paying for the injury, generally, a Claim Petition must be filed. It can take several months, or longer in some cases, for an employee’s Claim Petition to move through the workers’ compensation system. During that time period, the insurance company is not paying benefits. Workers’ compensation insurers deny primary liability for a variety of reasons, including, but definitely not limited to:

• The injury was not caused by the employee’s work activities
• The injury did not arise out the course and scope of an employee’s work activities
• The injury was caused by something other than work
• The employee had pre-existing injuries that are causing the current problem
• The employee did not sustain any injury at all
• The claimant was not an employee at the time of the injury
  

While there are certain rules an insurance company must follow when denying primary liability, in reality, they can deny a claim because it’s Tuesday, and they deny all claims on Tuesdays.

While a claim is pending, one of the major issues we see is the fact that it is difficult, if not impossible, for an employee with no health insurance to receive medical treatment if his or her claim is denied. If the workers’ compensation insurer is denying primary liability, an employee may submit the medical expenses through private insurance, MinnCare, or medical assistance. If bills related to a work-injury are submitted through private insurance, that insurance company has what’s known as a subrogation interest in the pending workers’ compensation claim. What this means is that the health insurance company has a right to seek reimbursement for the charges it covered from the workers’ compensation insurance company.

If that injured worker does not have private insurance or medical assistance, finding a health care provider that will provide services without some form of insurance can be extremely difficult. There are some health care providers who will agree to treat an injured worker without insurance until the claim is resolved. Your workers’ compensation lawyer can give you some ideas as to how to get the treatment you need while your claim is pending.

If you’ve been injured on the job and the workers’ compensation insurance company is denying primary liability, and you’re having trouble getting the medical treatment you need, call us at 877-746-5680 or click here to send us an email to schedule a free consultation.

Visit our website at MeuserLaw.com!

First Report of Injury - MN Work Comp

After you report your work-related injury to your employer, your employer is required to complete a First Report of Injury form. Your employer has 10 days to send this form to the workers’ compensation insurance company. If you miss three or more days, your employer and/or their insurer must file a copy of the First Report of Injury with the Department of Labor and Industry. Your employer or the insurer is required to provide you a copy of the First Report of Injury, as well as a copy of the Minnesota Workers’ Compensation System Employee Information Sheet.

Unfortunately, employers do not always follow the rules. It is not the responsibility of the employee to complete or file the First Report of Injury. However, if you need a blank copy of the form, it can be found here.

If you employer or their insurer did not provide you with a copy of the Minnesota Workers’ Compensation System Employee Information Sheet, or if you simply need some basic information about Minnesota Workers’ Comp., you can find a copy of the Information Sheet here.

If your employer refuses to report your injury, we can help. We can file the necessary paperwork to initiate a workers’ compensation claim on your behalf. Call us at 877-746-5680 or click here to send us an email to schedule a free consultation.

Visit our workers' compensation website at MeuserLaw.com!