Being injured on the job creates enough of a challenge. Getting compensation for your medical bills, lost wages and possible retraining often becomes a bigger challenge as you’re left to deal with the bureaucracy behind the workers’ compensation system.
Understanding the Minnesota workers’ compensation laws and systems can give you a better chance of getting all the benefits you are due.
What is Workers’ Comp?
Workers’ compensation is a state-mandated insurance program to provide benefits to workers who are injured as a result of any employment-related injury or disease.
Minnesota uses a no-fault system, so employees do not need to prove their injury was a result of negligence on the company’s part. Reversely, insurers cannot deny a workers’ comp claim because of an employee’s negligence.
Minnesota laws require worker’s compensation companies to provide three types of benefits:
• Wage-loss benefits: These cover either temporary or permanent losses and total or partial loss of wages. We’ll get into more details in the Knowing Your Benefits section below.
• Medical benefits: Medical benefits are paid for diagnostic services, treatment, rehabilitation and medical products, such as crutches, wheel chairs, eyeglasses, etc.
• Vocational rehabilitation benefits: Rehab payments are made if you need to be retrained to return to your old job or if you need to be trained for a new job at a similar economic scale that accommodates your disability.
How Do Claims Get Paid Out?
Claims are paid in different ways, depending upon the injury and the timeline of your return to work.
• Wage-loss benefits: In Minnesota, you do not receive wage-loss benefits until you have missed 10 days of work. After the 10-day waiting period, you will be paid for all days on disability. Wage-loss benefits are paid weekly and generally amount to about two-thirds of your gross wages the week you were injured. You normally will be paid as temporary, either total or partial, until the total days you are eligible for temporary status, then switch over to permanent, unless other factors have changed your eligibility.
• Medical benefits: Medical benefits are paid directly to the service provider, and they are responsible for providing billing statements to the workers’ comp insurer. Charges can be denied if they are deemed non-compensable or excessive. If you have to get a lawyer involved in a dispute over medical fees, the lawyer’s fees can be covered if the insurer is deemed wrong to deny the fees.
• Vocational rehabilitation benefits: Minnesota law outlines a rigorous review process for determining whether an injured worker is eligible for vocational rehabilitation if there is disagreement among the parties. If your claim for rehabilitation is approved, you will work with a qualified rehabilitation consultant (QRC), who will be paid by the insurer.
Who Is Covered and Who Isn’t?
Minnesota Statutes, section 176.181, subdivision 2, requires all employers in the state to provide workers’ compensation insurance. Companies that wish to self-insure for workers’ comp must get permission from the Minnesota Commerce Department and prove they have the financial resources to self-insure. Minnesota has no minimum number of employees to require workers’ compensation coverage, so even an employer with only one part-time employee is required to have coverage. An employee is defined as anyone who works full-time or part-time, even if a minor or non-citizen.
Limited exceptions are included in the Minnesota statutes, such as a family member who works limited hours for a sole proprietor, a family member of an executive officer of a closely held company, persons who meet the regulations to be defined as an independent contractor, and household workers who work in a private home and earn less than $1,000 every three months.
Chances are pretty good, if you’re working in Minnesota, you’re covered by workers’ compensation insurance.
Occupational diseases, repetitive-type injuries and qualifying mental injuries (such as post-traumatic stress disorder) are covered under Minnesota’s workers’ compensation laws. Workers will need to show their employment contributed substantially to the disability and/or need for medical care. Prescriptions needed to treat occupational diseases, repetitive-type injuries and mental injuries are included in your coverage.
The Minnesota Legislature in April 2020 passed legislation requiring worker’s compensation to cover COVID-19 primarily for workers in the front line battling the outbreak, but other workers who can prove they became infected with the coronavirus while at work, also can apply for worker’s comp.
Knowing Your Benefits
While medical coverage for workers injured on the job should be rather clear-cut, and vocational rehabilitation coverage could be a drawn-out process you will need professional help to wend your way through, knowing the benefits you should receive for wage loss might be your greatest concern.
Wage-loss coverage will fall into four general categories:
• Temporary Total Disability (TTD): Once your pass your 10-day waiting period, if you are unable to work, you quality for TTD. The benefits paid during TTD normally will be two-thirds of your gross weekly pay at the time of your injury. If your injury occurred between Oct. 1, 1995, and Sept. 30, 2008, you are eligible up to 104 weeks of TTD. If the injury occurred on or after Oct. 1, 2008, that eligibility jumps up to 130 weeks.
• Temporary Partial Disability (TPD): If you are able to return to work, either part-time or at a position that pays less than the position you held when you were injured, you qualify for TPD. TPD typically pays two-thirds of the difference between your current income and your income prior to the disability. TPD is available for 225 weeks within 450 weeks of your injury. If your earnings are inconsistent during the time on TPD, you may need to verify your income before you receive payout.
• Permanent Total Disability (PTD): If you are never able to return to employment, you qualify for PTD. Qualification for PTD requires extreme physical or mental injury that incapacitates you from working in any normal employment. After an insurer has paid out $25,000 in PTD, your benefit may be reduced by the amount of disability benefits being paid by Social Security Disability Insurance.
• Permanent Partial Disability (PPD): PPD is paid based on a formula that calculates the percentage of disability to the body as a whole based on the permanent loss of functional use of certain parts of the body. PPD can be paid in conjunction with TPD and PTD, but typically begins at the conclusion of TTD and when the employee has reached maximum medical improvement.
Timeline of a Case
Each workers’ compensation case is going to vary depending upon the nature and severity of the injury, your ability or inability to return to work in your previous position or some new capacity, the response of your medical care providers and the workers’ comp insurance company.
The only real givens on a timeline is you must wait 10 days before you qualify for workers’ compensation for wage loss, as it’s expected anything shorter than that can be covered by your sick leave.
But fighting for your rights to workers’ compensation while simultaneously dealing with your injuries and the stress of loss of income and medical bills, could become overwhelming. Contact our professional workers’ comp litigators today if you feel you are being denied any of the benefits you deserve following your workplace injury.