One of the many questions I get asked by injured workers is “What am I going to get for my injury?” Unlike most civil cases, the Minnesota workers compensation  system offers certain benefits when you are injured. The employer and insurer may not tell you what is available and when it might be available to you.  Consequently, you may be losing out on benefits you deserve.

Benefits available under MN work comp includes:

• Wage loss benefits which may incude Temporary total, Temporary partial or Permanent and total disability/dependency benefits
• Permanent partial disability benefits if your injury is permanent and meets certain legal requirements
• Medical benefits
• Rehabilitation assistance

Temporary total disability benefits

If you are completely off of work due to an occupational injury, you may be entitled to temporary total disability (“TTD”) benefits for that period of time you are disabled. Temporary total disability is paid based on two-thirds of your average weekly wage.

There are various limits to when and to how long you may be able to receive TTD benefits based on your date of injury.

You are also required to conduct a “diligent” job search during that period of time unless the job search would be futile and/or the employer is planning on returning you to the date of injury employment. I always instruct my clients to perform a job search within their restrictions and limitations. I typically provide them with job logs to help document their job search efforts.

Also, you are responsible to cooperate with rehabilitation and make reasonable efforts to participate with medical care and treatment.

The employer and insurer may either deny or seek to discontinue temporary total disability benefits on the basis of:

• Maximum Medical Improvement “MMI”
• Your injury has resolved
• No restrictions
• Return to work
• Misconduct
• Job search
• Withdrawal from the labor market
• Your refusal of a “suitable” job offer
• 104 weeks/134 weeks of TTD benefits have been paid out

If you have been denied benefits, I would recommend you contact an attorney right away as the denial from the insurance company could have an impact on your entitlement to future benefits.

Temporary partial disability benefits

If you are working half days or only a few hours a day instead of your previous work schedule, you may be entitled to Temporary Partial Disability (“TPD”) benefits. TPD benefits are paid similar to TTD benefits whereby they are calculated based upon two-thirds of the difference between your average weekly wage on the date of injury and your actual earnings.

Once again, the employer and insurer may seek to discontinue TPD on the basis of:

• Loss of earning capacity is not caused or substantially contributed by the work related injury
• Your current earnings are not reflective of your actual earnings
• No diligent job search
• Past 225 weeks/450 week post injury

Permanent and total disability benefits/dependency benefits

If you are unable to work at all in the indefinite future, you may be entitled to Permanent and Total Disability (“PTD”) benefts. Permanent total disability is defined by statute as follows:

Any other injury which totally and permanently incapacitates the employee from working at an occupation which brings the employee an income, provided that the employee must also meet the criteria of one of the following clauses:

• the employee has at least a 17 percent permanent partial disability rating of the whole body; or
• the employee has a permanent partial disability rating of the whole body of at least 15 percent and the employee is at least 50 years old at the time of injury; or
• the employee has a permanent partial disability rating of the whole body of at least 13 percent and the employee is at least 55 years old at the time of the injury, and has not completed grade 12 or obtained a GED certificate.

If after meeting one of the above criteria and you are “unable to secure anything more than sporadic employment resulting in an insubstantial income”, you may be entitled to PTD benefits.  The court will look at your age, education, training and experience when determining whether you are permanently and totally disabled.

An employer and insurer may attempt to deny or discontinue PTD benefits on the basis of:

• Retirement
• You are not totally and permanently disabled

Also, if you have a loved one who died as a result of a work related injury, you may also be entitled to dependency benefits and burial expenses.

Permanent partial disability benefits

If you sustained a permanent injury, you may be entitled to permanent partial disability benefits (“PPD”). PPD is payable for the functional loss of use of the injured body part or permanent impairment caused or substantially contributed to by a work related injury.

PPD benefits are typically governed by the Minnesota Workers’ Compensation Permanency Schedule. In cases where there is no specific schedule for that injury, the courts have allowed what is called a “Weber” rating whereby a doctor may provide an alternative permanent disability rating.

Payment of PPD benefits may only be paid upon stopping of TTD benefits. The benefits are payable in installments at the same intervals and in the same amounts as the TTD benefits. PPD is not payable at the same time as TTD.  PPD benefits, if requested, may be paid in a lump sum.

Rehabilitation

As noted above, sometimes the workers’ compensation system can be confusing and difficult to manage through. Rehabilitation services are offered for the purpose to assist you in returning to work quickly and reduce the overall cost to the employer and insurer.

Rehabilitation services can include the use of a Qualified Rehabilitation Consultant (“QRC”) to help you with medical management, return to work, and job placement. The Minnesota Workers’ Compensation Statutes provides the following:

Rehabilitation is intended to restore the injured employee so the employee may return to a job related to the employee’s former employment or to a job in another work area which produces an economic status as close as possible to that the employee would have enjoyed without disability. Rehabilitation to a job with a higher economic status than would have occurred without disability is permitted if it can be demonstrated that this rehabilitation is necessary to increase the likelihood of reemployment. Economic status is to be measured not only by opportunity for immediate income but also by opportunity for future income.

In order to be eligible for rehab assistance, and you must be a “qualified employee” under the law. A qualifed employee is an employee who, because of the effects of the work related injury or disease, whether or not combined with the effects of a prior injury or disability:

1. Is permanently precluded from returning to their usual occupation or prior job;
2. Is with no reasonable expectation of a return to suitable, gainful employment with the date of injury employer; and
3. The services will reasonable result in a return to suitable gainful employment.

If you request rehab services, the employer and insurer must provide a rehabilaition consultation within 14 days. This consultation must occur within 50 miles of your residence. This is mandatory unless the employer and insurer obtain a “waiver.”

You may also make your own selection of a QRC once before a referral by the employer and insurer for the first in person meeting with the employee. Otherwise, the injured worker may select a QRC within 60 days of the filing of the rehabilitation plan.

Through the assistance of a QRC  yoiu may receive assistance with medical management, job search and even possibly retraining.

Medical Benefits

Again, every employer is liable for work comp benefits, including medical benefits.. The employer and insurer are required to provide for medical treatment to “cure and relieve” you from the effects of the work injury.

You have the right to choose your treating medical provider. You may be able to change treating physicians if

1. You have lost faith in the doctor’s skill,
2. You  have a lack of improvement in your condition, or
3. A communication breakdown between you and the physician.

Although you may have a right to choose your treating physician, not all treatment recommended is allowed under the Minnesota Workers’ Compensation Act. The Minnesota Workers’ Compensation Act has limits to the type, the amount and the frequency of treatment you may receive.

A lawyer may be necessary to represent you to insure that you receive the necessary and proper medical care.

(photo: Full Circle)

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