Workers' Compensation Claims and Compensation Process
What should I expect?
For cases covered by the Minnesota Workers’ Compensation Act, employers must be insured through a private insurance company or be self-insured. Most government employers are self-insured for workers’ compensation. Note that federal government employees are not governed by the Minnesota workers’ compensation system, but are covered under federal laws. The persons who represent the employer/insurer are called claims administrators or representatives. If you believe that the claims administrator is delaying or denying your claim in whole or in part, or offering you a “settlement” which you think is unreasonable, schedule a free initial consultation with Krug & Zupke, P.C., by calling 651-645-7746.
Report the Injury
You must report your injury to your supervisor or human resources department. You will be asked questions about what body parts were hurt and how. Be certain that you are accurate and precise, and list all body parts injured. Ask for a copy of the First Report of Injury or Incident Report.
Primary Liability Determination Statement
The employer is required by Minnesota workers’ compensation law to send a copy of the First Report of Injury to its insurer. Then, the insurer is required by Minnesota workers’ compensation law to issue a Primary Liability Determination form, either accepting your claim, accepting the medical claim or wage loss claim, or denying the claim and providing an explanation. If you have not received a copy of the Primary Liability Determination form within 28 days, you should schedule a free initial consultation with Krug & Zupke, P.C., to discuss your claims and remedies.
Providing the Claims Administrators with a Statement
Usually the injured worker will be contacted to give a recorded or written statement. The claims examiner will imply that the case cannot be accepted until the injured worker provides a statement, suggesting it’s a mere formality. In fact, in many cases the statement is simply an investigation tool that precedes the insurer’s denial of the claim. This is also a good reason to schedule a free initial consultation with Krug & Zupke, P.C.
Filing a Workers’ Compensation Lawsuit
If all or part of your claim is wrongly denied, you will need to file a workers’ compensation lawsuit (called a claim petition). We will draft your claim petition documents for your review and signature. It will set forth your preliminary claims, which can later be modified. Your claims may include dependency death claims, wage loss, permanent partial disability, and medical and vocational rehabilitation injury claims.
Scheduling of Injured Workers’ Deposition
During the first 30 to 90 days, you may be required to provide a sworn statement before a court reporter, answering the insurer’s attorney’s questions about your background, your injury, and claims.
Attendance in an Adverse “Independent” Medical Exam
Within 30 to 60 days of your deposition, you will likely be required to attend a medical exam performed by a doctor who regularly examines workers for the benefit of insurance companies and their attorneys.
Usually within six to nine months from filing the claim petition, in an effort to resolve your case without hearing (trial), the court will require the parties to discuss potential settlement during a conference with a compensation judge.
In some more-complex cases, the parties hire a mediator—an independent third party well versed in workers’ compensation law—who encourages the parties to discuss settlement if the settlement conference fails.
Compensation judges hold workers’ compensation trials (called hearings), without a jury. The compensation judge reviews medical records and medical expert depositions, listens to live testimony including that of the injured worker, and issues a written decision within 60 days of the hearing.
A party who is dissatisfied with the compensation judge’s decision may appeal to the Minnesota Workers’ Compensation Court of Appeals (WCCA). A party dissatisfied with the WCCA’s decision has one final level of review—to the Minnesota Supreme Court. Appeals can delay resolution of the case for one year or more. There are limited grounds for a successful appeal, so the decision whether to appeal should be made after careful consultation with your attorney.
At Krug & Zupke, P.C., each case is unique and each client is treated with care and respect, with a goal of maximizing your financial recovery.