What is Worker's Compensation?
Workers’ compensation is a no-fault system designed to provide benefits to employees injured as a result of their employment activities and to limit the liability of employers. Because it is a no-fault system, the employee does not need to prove negligence on the part of the employer to establish liability. It also means the employer cannot use negligence on the part of the employee as a defense to a claim.
A work-related injury can be any condition that is caused, aggravated or accelerated by the employment activities. This includes traumatic injuries, gradual injuries or occupational diseases. The employee needs to show only that the employment activities were a substantial contributing factor to the disability and/or need for medical care.
Minnesota workers’ compensation law states all employers are required to purchase workers’ compensation insurance or become self-insured. The workers’ compensation system provides benefits if you become injured or ill from your job. Workers’ compensation covers injuries or illnesses caused or made worse by work or the workplace. Workers’ compensation benefits are paid regardless of any fault of either the employer or employee. Your employer pays the cost of the insurance.
A work-related injury can be any condition that is caused, aggravated or accelerated by the employment activities. This includes traumatic injuries, gradual injuries or occupational diseases. The employee needs to show only that the employment activities were a substantial contributing factor to the disability and/or need for medical care.
Minnesota workers’ compensation law states all employers are required to purchase workers’ compensation insurance or become self-insured. The workers’ compensation system provides benefits if you become injured or ill from your job. Workers’ compensation covers injuries or illnesses caused or made worse by work or the workplace. Workers’ compensation benefits are paid regardless of any fault of either the employer or employee. Your employer pays the cost of the insurance.
What does my worker's compensation pay for?
- Medical care related to the injury, as long as it is reasonable and necessary;
- Benefits for permanent damage to a body function;
- Benefits to your dependents if you die of a work injury;
- Vocational rehabilitation services if you cannot return to your job or to the employer you had before your injury; and
- Travel mileage to obtain medical treatment and/or for certain vocational rehabilitation activities.
What happens when I am injured on the job?
- Don’t wait. Report your injury to you supervisor as soon as possible. You may lose the right to workers’ compensation benefits if you do not report the injury within the time frames set by law.
- Your employer must complete the First Report of Injury form.
- The employer has 10 days from its knowledge of a lost-time claims to report it to the employer’s insurance company.
- If your disability lasts for more than three days, the insurer must file the First Report of Injury form with the Department of Labor and Industry.
- Your employer or its insurer must provide you with a copy of the First Report of Injury. A copy of the First Report of Injury in a lost-time claim must also be sent to your union, if there is one.
- The employer must give you the Minnesota Workers’ Compensation System Employee Information Sheet at the time you are given a copy of the First Report of Injury.
- After you have reported the injury, the insurer will investigate your claim to verify it was work-related.
- You should keep your employer informed of your medical condition and any work restrictions.
Wage Loss/Monetary Benefits from Worker's Compensation?
The employee may request in writing that benefit payments be sent directly to the employee’s bank or other financial institution. The written request should include the name and address of the institution, and the account number to which the payments should be credited. The self-insured employer or insurer must comply with this request.
Temporary Total Disability (TTD)
Temporary total disability (TTD) benefits are paid if you are totally disabled from any work due to a work injury or if you cannot return to work because your employer cannot accommodate the work restrictions from your doctor. The first payment of these benefits should be issued within 14 days of the date of your employer first had knowledge of your disability. After these payments are started, they should be paid at the same interval as your wages were paid.
Temporary Partial Disability (TPD)
Temporary partial disability (TPD) benefits are paid if because of a work injury, you earn a lower weekly wage than you earned at the time of the injury. They are paid at the same interval that your wages were paid. However, if your wage varies, TPD benefit payments are due 10 calendar-days after the date on which documentation of your wage loss is sent to the insurance company by either you or your employer. Ultimately, it is your responsibility to make sure wage-loss documentation is sent to the insurer.
Permanent Partial Disability (PPD)
Permanent partial disability (PPD) benefits compensate you for loss of permanent use of a specific body part.
Dependency Rights
Dependency rights benefits could be due to the surviving dependents of an employee if the employee dies because of a work-related accident or occupational illness.
Cost-of-living Adjustments (COLAs)
Cost-of-living adjustments (COLAs) are used to adjust the rate at which ongoing benefits are paid to the employee and/or dependents. Employees injured on or after October 1, 2013, are eligible for cost-of-living adjustments starting three years after the injury date, with a maximum increase of 3 percent. No adjustment shall be less than zero percent.
What health care benefits are available?
- If your claim is accepted, payment will be made for the cost of all reasonable and necessary health care treatment related to your work injury.
- Treatment by certain unlicensed complementary and alternative health care providers is not paid.
- Prescriptions and reimbursement for mileage to medical appointments are also payable.
- The insurer may designate a pharmacy or pharmacies that you must use to obtain medicine for your injury, if the pharmacy is within 15 miles of your home.
- You may choose your own health care provider under most circumstances.
- Make sure your health care provider sends all bills and supporting information to the insurer. The supporting information must explain how the treatments and charges relate to your work injury.
- Your health care provider must notify the insurer before you have any surgery or hospitalizations, except in an emergency. You or the insurer may ask for a second opinion for any surgery that is not an emergency. The insurer must pay for the second opinion. You cannot be forced to have surgery if you do not want it.
- Your health care provider cannot bill you for treatment unless the insurer determines the treatment was not related to an accepted work injury.
Medical Benefits
The Minnesota workers’ compensation statutes entitle an employee to reasonable and necessary medical treatment or supplies to cure or relieve the effect of the work injury. The employer is required to furnish medical treatment as described in Minnesota Statutes 176.135, subd. 1, which may include psychological, chiropractic, podiatric, surgical and hospital treatment.
Rehabilitation Benefits
Vocational rehabilitation
You may be eligible for vocational rehabilitation services if you need to help returning to work because of your injury and your employer is unable to offer you suitable gainful employment within your work restrictions. At any time, you may request a rehabilitation consultation to determine if you are eligible for rehabilitation services. Submit your request for a rehabilitation consultation in writing to your insurer.
Retraining
This benefit is a formal course of study designed to return an injured worker to suitable gainful employment.
You may be eligible for vocational rehabilitation services if you need to help returning to work because of your injury and your employer is unable to offer you suitable gainful employment within your work restrictions. At any time, you may request a rehabilitation consultation to determine if you are eligible for rehabilitation services. Submit your request for a rehabilitation consultation in writing to your insurer.
Retraining
This benefit is a formal course of study designed to return an injured worker to suitable gainful employment.
- Before 80 weeks of wage-loss benefits have been paid, the insurer must notify you or your right to request retraining.
- If your date of injury is from October 1, 1995, through September 30, 2000, you must file your request for retraining benefits before 104 weeks of wage-loss benefits have been paid to you.
- If your date of injury is from October 1, 2000, through September 30,2008, you must file your request retraining benefits before 156 weeks of wage-loss benefits have been paid to you.
- If you were injured on or after October 1, 2008, you must file your request for retraining before 208 weeks of wage-loss benefits have been paid to you.
What is Qualified Rehabilitation Consultant (QRC)?
A Qualified Rehabilitation Consultant (QRC) will assist you with planning vocational rehabilitation services. The insurer may refer you to a QRC for a rehabilitation consultation, but you may also choose your own QRC. If you do not choose the QRC for the consultation, you may select one to provide the services. You have up to 60 days after a rehabilitation plan is filed to request a different QRC. Under certain circumstances, you may be entitled to a different QRC after the 60-day period. You may obtain a list of QRC’s in your area at www.dli.mn.gov/WC/QrcData.asp.
Disability Case Management; Vocational Rehabilitation Services
If an insurer has been granted a waiver for vocational rehabilitation services of if you are not qualified for statutory rehabilitation services, your employer or insurer may assign a disability case manager (DCM), sometimes just referred to as a case manager, to work with you instead of a QRC. The employer or insurer might ask the DCM to communicate with you, your health care provider(s), your employer and the insurer to help you successfully return to work and/or coordinate medical treatment.
A DCM is not a rehabilitation provider, as defined by rule, and is not necessarily bound by all of the statutes and rules pertaining to QRC’s. To avoid confusion and understand the role of the individual you are working with, clarify whether you are working with a QRC or a DCM. Although there is no law that requires you to work with a DCM, a DCM can be a helpful resource in coordinating medical treatment or assisting your return to work. As noted in the previous section, you may ask for a vocational rehabilitation consultation with a QRC at any time, even if you are working a DCM. A person who worked with you as a DCM may not be your QRC. If you disagree about your eligibility for rehabilitation services or have questions about a DCM, call DLI’s ADR unit for additional information and assistance at (651)284-5032 or 1-800-342-5354.
A DCM is not a rehabilitation provider, as defined by rule, and is not necessarily bound by all of the statutes and rules pertaining to QRC’s. To avoid confusion and understand the role of the individual you are working with, clarify whether you are working with a QRC or a DCM. Although there is no law that requires you to work with a DCM, a DCM can be a helpful resource in coordinating medical treatment or assisting your return to work. As noted in the previous section, you may ask for a vocational rehabilitation consultation with a QRC at any time, even if you are working a DCM. A person who worked with you as a DCM may not be your QRC. If you disagree about your eligibility for rehabilitation services or have questions about a DCM, call DLI’s ADR unit for additional information and assistance at (651)284-5032 or 1-800-342-5354.
What about death/dependency benefits?
- The spouse, children and/or other dependents of a worker who dies because of a work-related accident or occupational illness are eligible for dependency benefits.
- Workers’ compensation insurance also pays burial expenses. For date of injury on or after April 28, 2000, the maximum payment amount is $15,000.
- For injuries on or after April 28, 2000, payment is made to the estate, if the deceased has no dependents.
What is an Independent Medical Examination (IME)?
The insurer may ask you to be examined by a health care provider of its choice. The examination is often called an independent medical examination (IME). The insurer may suspend your benefits if you refuse to be examined by that doctor. The insurer must reimburse you for mileage and other costs for attending the examination.
How to file a worker's compensation claim?
Schedule a free consultation, contact us today!
How to know if you're eligible for worker's compensation benefits?
Schedule a free consultation, contact us today!
Basic Benefits of Worker's Compensation?
Workers’ compensation provides four basic types of benefits:
- wage loss/monetary benefits;
- compensation for the loss of use of a part of the body;
- medical benefits; and
- vocational rehabilitation services.
Workers' Compensation Forms
Visit the MN Department of Labor and Industry's forms page to download worker's compensation forms.
Visit the MN Department of Labor and Industry's forms page to download worker's compensation forms.
|
Schedule a free consultation!
Schedule your appointment for a massage today. |