Minnesota Workers Compensation Claims: Eligibility, Filing and Appeals

Minnesota law requires mandatory Workers' Compensation coverage. With few exceptions, employers must provide workers' compensation insurance for their employees, either by a licensed insurance company or through self-insurance approved by the Minnesota Department of Commerce. Workers Compensation insurance protects employees injured or disabled while on the job by paying for medical treatment and lost wages. In 2007, there were approximately 94,200 reported injury and illness cases in Minnesota, with about 26,100 cases involving one or more days away from work.

Work Related Injuries

Work related injuries include accidental or traumatic injuries, injuries that are gradual and develop over time, as well as occupational diseases such as diseases caused by exposure to chemicals. Conditions that are caused, aggravated, or accelerated by workplace activities are covered. Employees are covered for injuries sustained while on the job, though not while traveling to and from work.

Filing a Minnesota Workers Compensation Claim

When an employee is injured, he or she should report the injury to their employer immediately in order to avoid delays in the claims process. The employer should then file a First Report of Injury (FROI) form with their insurance company within ten days. The employer should also file the FROI form with the Minnesota Department of Labor and Industry if the worker's disability lasts longer than three days. A worker should also seek medical care, and have a doctor fill out a Report of Work Ability (RWA) form. Copies of the form should be sent to the employer and insurer. The insurer will then file a Notice of Insurer's Primary Liability Determination (NOPLD) form with the state. The form will state whether the claim is accepted or denied, along with the compensation rate and when any benefits will start.

If a Claim is Denied

When an insurer denies a claim, they will do so by filing a Notice of Insurer's Primary Liability Determination (NOPLD) form explaining the reasons for the denial. Claims may be denied if the injury or illness was not sufficiently caused by a work related event or action, or if the worker submitted false or incomplete information. In some cases, an insurer may request that a worker see a specific doctor for an evaluation; if the worker refuses to do so, the claim may be denied.

Appealing a Minnesota Workers Compensation Denial

The first step to appealing a claim is to speak to the insurance adjuster and attempt to resolve the issue. If this doesn't work, a Benefit Management and Resolution specialist with Minnesota's Department of Labor and Industry should be contacted. The Department of Labor and Industry provides free mediation services, which can often lead to a resolution. If mediation does not resolve the issue, an employee may file an Employee's Claim Petition form to request a hearing with a judge.

Minnesota Workers Compensation Payments

Workers' Compensation Insurance pays medical, psychological, chiropractic, podiatric, surgical, and hospital benefits. Rehabilitation benefits may also be covered if necessary. Monetary benefits for wage loss are usually paid weekly, unless a settlement has been made for a lump sum. The amount paid will be a percentage of the employee's weekly wage, and the percentage is determined by the type of injury. Currently, the maximum weekly compensation payment is $850. Workers generally receive about 66% of their weekly wage.

Hiring a Minnesota Workers Compensation Lawyer

Hiring an attorney is recommended when disputing a denied compensation claim. The legal issues surrounding specific compensation laws are often complex, and an experienced attorney can help a worker make sure that forms are filled out correctly and all procedures are followed. Employees should also consider retaining the services of a lawyer to represent them in compensation hearings in order to achieve a positive outcome.

Minnesota Workers Compensation Office Locations

Minnesota Workers Compensation Division
443 Lafayette Road North
St. Paul, Minnesota 55155
1-800-342-5354

Minnesota Workers Compensation Court of Appeals
405 Minnesota Judicial Center
25 Dr. Martin Luther King Jr. Boulevard
St. Paul, Minnesota 55155
(651) 296-6526

Duluth Workers Compensation Office
525 Lake Ave. S., Suite 330
Duluth, MN 55802-2368
1-800-365-4584