Minnesota Workers’ Compensation Benefits Overview
Luke Smith represents Minnesota employees in workers' compensation litigation.
In Minnesota, a claim for workers’ compensation benefits is available where a personal injury arises out of and in the course and scope of employment. There are three salient requirements inherent in that definition:
1. An employer-employee relationship;
2. A work activity or component of the work environment must have caused the injury; and
3. The injury must have occurred while working during work hours.
The presence or absence of one of those requirements is very often disputed. Any Minnesota workers’ compensation attorney is likely to have litigated each of those three issues repeatedly.
Where a work-related injury impairs an employee’s ability to earn his or her normal wage, workers’ compensation insurance will replace 66.67% of the lost wages. There are three types of wage loss claims:
1. Temporary total disability occurs when an injured worker is not currently able to work due to the injury, but may be able to return to work in the future.. This may be due a physician restricting the employee from all work activity, or it may be due to a combination of some work restrictions and an inability to find work within those restrictions. Temporary total disability normally ends when the employee returns to work, but may also end for various other reasons.
2. Temporary partial disability occurs when the injured worker is working, but is earning a lower income as a result of the workplace injury. In those circumstances, the employee may make a claim for 66.67% of the difference between the preinjury wage and the current wage.
3. Permanent total disability occurs when an employee is permanently unable to earn anything more than sporadic employment leading to an insubstantial income. This benefit is normally paid through the presumptive age of retirement.
The validity of the discontinuance of wage loss benefits is another commonly disputed issue.
Workers’ compensation insurance provides coverage for medical treatment that is reasonable, necessary, and causally related to the occupational injury. The Commissioner of Labor and Industry developed a set of administrative rules (“Treatment Parameters”) that are intended to define the extent of medical treatment that is presumptively reasonable and necessary. However, case law on the issue is replete with examples of medical treatment that contravenes the Treatment Parameters but was held to be reasonable and necessary. Ultimately, if there is a reasonable expectation that treatment may improve the medical condition or its symptoms, that treatment is likely to be found reasonable and necessary.
The existence of a causal relationship between the treatment and the injury is commonly disputed. Insurers will often take the position that the need for treatment is caused by a pre-existing medical condition rather than the work-related injury. A pre-existing condition alone is not a defense to a claim for medical treatment. However, if the need treatment is caused only by the pre-existing condition and not by the work-related injury, then the workers’ compensation insurer is not required to pay for the treatment.
Injured workers in Minnesota may make claims for services that are intended to facilitate a return to gainful employment. A plan to facilitate a return to work is developed by a licensed vocational professional referred to as a QRC. Rehabilitation plans commonly include the following:
1. Medical Management: The QRC will commonly schedule and attend medical appointments with the injured worker. During those appointments, the QRC will seek clarification from the healthcare providers as to the extent of the employee’s ability to work. The QRC will then coordinate with the employer to identify opportunities to expedite a successful return to work. This may include transitional or modified positions.
2. Job Search: If a return to work with the date of injury employer is not likely, the QRC and other vocational professionals may assist with job search. This will often include skills assessment, resume creation, identification of job leads, and coaching with respect to interview techniques.
3. Retraining: Less commonly, an injured worker may require retraining in order to return to gainful employment. Retraining may range from a certification or license, to a college degree.
When retraining is recommended, the need for and appropriateness of recommended retraining program is often the subject of litigation.
Permanent Partial Disability
Parment Partial Disability is a percentage rating intended to translate the loss of function of a body part into a percentage. There exists a defined schedule of percentage ratings that are generally based on the treatment performed, and objective findings of loss of function. Once assigned a permanency rating, the injured worker may make a claim for lump sum benefit based on that permanency rating.
Attorney Fees and Litigation Costs
The Minnesota Workers’ Compensation Act proscribes the amount of attorney fees that may be charged to an injured worker, as well as the manner in which they may be charged. Attorney fees must be contingent fees based on the recovery of workers’ compensation benefits.
1. Indemnity Benefits (wage loss and permanency): A workers’ compensation attorney in Minnesota may charge no more than 20% of disputed benefits paid to the injured worker. Following the recovery of indemnity benefits, the injured worker can request reimbursement of 30% of attorney fees paid in excess of $250.
2. Medical and Rehabilitation Benefits: Where medical or rehabilitation benefits are recovered, the lawyer can make a claim against the employer and insurer for a reasonable attorney fee. What constitutes a reasonable attorney fee is often the subject of dispute. However, that dispute is between the employee’s attorney and the employer/insurer, as the employee is not required to pay attorney fees for the recovery of medical and rehabilitation benefits.
3. Costs: Likewise, litigation costs can be recovered from the employer and insurer following the recovery of workers’ compensation benefits.
As a result, injured workers in Minnesota are often able to obtain legal representation with no upfront expense and relatively low risk. Minnesota work injury lawyers are incentivized to assert claims for denied workers’ compensation benefits, and do not receive compensation unless and until those benefits are recovered.