Workers’ Compensation
Helping Injured Workers Secure Benefits.
Employees of all industries run the risk of workplace injuries and occupational disease which can threaten your health, career, and financial stability.
Workers’ compensation benefits can cover medical expenses, lost wages, rehabilitation costs, permanent partial disability and necessary work training if you cannot perform your pre-disability tasks. We represent all injured employees, including:
Construction workers, laborers, pipefitters, electricians, plumbers, carpenters, and all trade workers
- Nurses, nursing assistants, PCAs, CNAs, home health aides, doctors, dentists, physical therapists, occupational therapists, pharmacists, and all health care providers
- Office personnel, assistants, operations managers, project managers, security guards, compliance officer, customer service representatives, and other office workers
Miners and everyone who works in and around mines
- Housekeepers, cleaners, maintenance, and other service providers
Delivery drivers, truck drivers, and material movers
- Servers, bartenders, cooks, and other food service workers
- Professional athletes, coaches, fitness and sports instructors, and athletic trainers
- Bus drivers, taxi drivers, Uber and Lyft drivers, and other transportation providers
- Law enforcement, firefighters, dispatchers, and paramedics
Teachers, bus drivers, paraprofessionals, and other educators
Cashiers, salespersons, stockers, and all retail and service workers
- Landscaping specialists, groundskeepers, amusement and recreation attendants, and ski lift operators
Engineers, accountants, architects, real estate agents, and other professionals
- Mechanics, service technicians, snowplow drivers, and repair people
- Software and web developers, programmers, and all information technology workers
- Veterinarians, breeders, dog walkers, and animal trainers
Interpreters, translators, counselors, therapists, social worker, stylists, event planners, telemarketers, and many, many more
All Minnesota and Wisconsin employers are required to provide workers’ compensation benefits, which compensate individuals who have become injured in the workplace or developed disability as a result of work activities. Many workers are hesitant to “take legal action against their employer.” However, a workers’ compensation claim is not a lawsuit against your company; it serves as a type of insurance coverage. Workers’ compensation laws are safety nets for the injured worker AND employer who share the same objective: returning the injured worker to the workforce as quickly and safely as possible.
It is illegal for an employer to try to block a workers’ compensation claim or to retaliate against an injured worker.
Employers must pay for workers’ compensation insurance coverage regardless of whether claims are made.
Qualifying for Workers’ Comp Benefits
Unlike a typical personal injury claim, fault does not impact your benefit eligibility. Whether your actions, a piece of faulty equipment or dangerous conditions cause the injury, you may be eligible for benefits. Depending upon the circumstances of your injury, we can evaluate the possibility of filing a third-party lawsuit as well.
However, there is a statute of limitations within which you must file your claim, or you could forfeit your right to benefits. You must report the accident to your employer within 30 days of the accident. After that, state law dictates how long you have to officially file your claim and collect benefits.
Protecting Your Interests During “Independent” (Adverse) Medical Examinations
After you report an injury, your employer or their insurer may request that you attend an “Independent” (Adverse) Medical Examination or Evaluation (IME/AME). These “evaluations” are conducted by doctors who are typically hired by insurance companies for benefit eligibility evaluations, and their results may be biased in the company’s/insurer’s favor in an attempt to prevent the injured worker from receiving certain benefits.
Falsani, Balmer, Peterson & Balmer works with our clients to prepare them for their IME/AME so they know how to best protect their claim during an exam. We can also protest biased findings to protect your benefit eligibility.
You Only Pay Us if We Recover Compensation
We generally accept cases on a contingency basis. This means that we are paid a percentage of the compensation we are able to obtain (through settlement or verdict) for you. This means we are on the same team and can work together in order to maximize your recovery.
If we accept your case and it turns out that your condition does not qualify for compensation, or the insurance company successfully avoids responsibility for the harm it’s insured caused, you owe us nothing.
We believe that people of all means should have access to experienced legal representation to pursue the compensation they deserve. Everyone — rich or poor, employed or not, young or old — is on equal footing with the insurance companies when you hire us. When we take on a case, we invest our time and effort in helping you obtain a fair result regardless of who you are.
Frequently asked workers’ compensation questions
Maybe. If the workers’ compensation insurer is paying for all of your benefits, then there may be no need to have an attorney represent you in that process. But, you may want to make sure that you are getting all of the benefits to which you are entitled, and there may be a point where you need to plan ahead in order to protect your rights in the future. There are some red flags that may cause the need for a lawyer. Some examples are: cutting off benefits, failing to pay medical expenses or authorize needed medical care, scheduling an adverse medical exam, or demanding a full return to work without restrictions.
Not generally. Minnesota is an “exclusive remedy” state, which means that the only claim you have for a workplace injury is usually a workers’ compensation claim. Even if your employer was not insured for workers’ compensation benefits, there are funds available to pay for those benefits and your claim would still be limited to workers’ compensation benefits only.
Unlike a personal injury claim, your benefits are not generally affected by who did or did not cause the injury. It is a “no fault” system in that an injured worker is typically eligible for benefits regardless of the cause of the injury – faulty equipment, dangerous workplace conditions, or even your own mistake.
Depending upon the circumstances of your injury, we can sometimes make a third-party claim in addition to the workers’ compensation claim. A third-party claim involves an additional claim against an at-fault party (other than the employer) for causing the injury. The laws regarding who pays what to whom and when are very complicated and require attorneys who are experienced in both bodily injury and workers’ compensation claims, however. We are that law firm and are regularly referred such cases by other lawyers and firms due to their complexity.
After you report a workplace injury, your employer or their insurer may request an “Independent” (Adverse) Medical Examination (IME/AME) during which a doctor that they hire examines your claim. Since the doctor is chosen by and then paid by the insurance company, these doctors typically offer opinions that hurt your claim. They are NOT second opinions.
Falsani, Balmer, Peterson & Balmer know the rules for these examinations and use them to our clients’ full advantage. We are very familiar with many of these doctors and know how to best protect our clients’ claims before and during an exam as well as how to fight such biased findings to protect your benefit eligibility. Call us at 218-723-1990 or email us at lawfirm@falsanibalmer.com to find out what you can do to protect yourself.
If your injury resolves quickly and completely and you did not miss any work or incur any medical expense, then probably nothing.
The problem arises if you do not report your injury and then you need replacement wages, medical care, job protection, rehabilitation expenses, or other types of benefits. If you did not report the injury, then you may be unable to make a claim.
Some injured workers do not realize that their injury or condition was caused by work activity until much later than the 30-day initial deadline. A good example of this is a repetitive trauma injury that an employee did not realize was caused by work activities until their doctor mentioned it.
Regardless of when you realize you’ve suffered a work injury, the injury should be reported as soon as possible. If the workers’ compensation insurer denies you benefits on the grounds that your report was late, you should consult an attorney to make sure you are not giving up any rights. There are many situations in which a “late” report of injury can still qualify you for benefits.
If you have been told that you were too late in reporting an injury, don’t give up – call us at 218-723-1990 or email us at lawfirm@falsanibalmer.com to find out if that’s true.
Injured workers can receive wage loss (temporary partial, temporary total, and permanent total), medical treatment expenses, vocational/rehabilitation (job placement, medical treatment management, and/or retraining, amongst other services), permanent partial disability (payment for permanent loss of function), and dependency benefits. You can find out more about these types of benefits on the State of Minnesota Department of Labor and Industry website: https://www.dli.mn.gov/business/workers-compensation/work-comp-benefits-general-information.
If the work comp insurer tells you that you cannot have a benefit, or it tries to limit how much of a benefit you receive, contact us at 218-723-1990 or lawfirm@falsanibalmer.com to find out more about your rights under workers’ compensation laws.
The rate of pay from the workers’ compensation insurer is based upon what you were making at the time of your injury. It will not take into account raises, bonuses, or other changes that took place after your injury.
If your date-of-injury wage changed from week to week, then one way to figure out your average weekly wage is to calculate the average over the 26 or 52 weeks before your injury. Regular or frequent overtime pay should be included. There are specific rules for added compensation like commissions and bonuses.
Contact us at 218-723-1990 or lawfirm@falsanibalmer.com to make sure you’ve been paid the right amount of wage loss benefits.
No. You can see any doctor you like for your work injury. And, you can change your treating doctor for the work injury within 60 days. After 60 days, you can change treating doctors with consent of the insurance company, or by approval of a judge.
Some employers force their employees to see a certain doctor either on-site or at a nearby facility. Even if that happens, you can still see your own provider in addition to the employer’s.
Contact us at 218-723-1990 or lawfirm@falsanibalmer.com to make sure you’ve been paid the right amount of wage loss benefits.
An injured worker is supposed to follow the restrictions imposed by the treating doctor. If your doctor releases you without restrictions, or if the employer says they can accommodate the doctor’s restrictions, it’s usually best to try to return to work. Otherwise, the insurer will probably discontinue paying benefits.
If you have real concerns about getting injured, you should talk to your doctor again.
A Qualified Rehabilitation Consultant (QRC) should be assigned when an employee is unable to return to full work within a certain time after the injury, usually about 3 months. The injured worker has the right to select the QRC, and to change the QRC within 60 days of when the rehabilitation plan is filed. The QRC’s duties are spelled out in a rehabilitation plan signed by the employee, employer and insurer. Those duties may include assisting with medical appointments, communicating with the parties and doctors about restrictions and efforts to return to work, coordinating job search activities, developing a retraining plan or other vocational training, and other efforts to return the injured worker to a job that pays as close as possible to the pre-injury average weekly wage.
“Maximum medical improvement,” or “MMI,” is the point at which an injured worker has recovered to the best that he or she can get. It doesn’t mean the injured worker is totally healed, necessarily, but it means that the injured worker is not expected to get much better or worse. MMI is assigned by doctors.
According to Minn. Stat. § 176.011, subd. 13a:
“Maximum medical improvement” means the date after which no further significant recovery from or significant lasting improvement to a personal injury can reasonably be anticipated, based upon reasonable medical probability, irrespective and regardless of subjective complaints of pain. Except where an employee is medically unable to continue working under section 176.101, subdivision 1, paragraph (e), clause (2), once the date of maximum medical improvement has been determined, no further determinations of other dates of maximum medical improvement for that personal injury is permitted. The determination that an employee has reached maximum medical improvement shall not be rendered ineffective by the worsening of the employee’s medical condition and recovery therefrom.
(Emphasis added.)
Minn. Rule 5221.0410, subp. 3 also discusses how the doctor is supposed to determine whether an injured worker has reached MMI.
The only benefit that MMI affects are temporary total wage loss benefits. There is a lot of confusion over the impact of an injured worker reaching MMI.
MMI is meant to affect only temporary total disability (wage loss) benefits. An injured worker who has reached MMI is not eligible for temporary total benefits 90 days after the date of MMI. So, if an injured worker is receiving temporary total benefits at the time he/she is found to have reached MMI, then that worker can expect to be “cut off” from those benefits 90 days later.
Sometimes there is disagreement over whether an injured worker has or has not reached MMI. Confusion can arise if doctors disagree over whether an injured worker reached MMI. Some doctors don’t quite understand MMI. Sometimes doctors don’t have all of the information they need to determine whether someone has reached MMI.
Some people think that if an injured worker has reached MMI, then they can’t get any more medical care. That is not necessarily true. If someone has told you that you cannot receive a benefit because you’ve reached MMI, contact us.
Late wage loss payments, especially if they are very late or frequently late, can result in penalties assessed against the insurer. Generally the insurer has two weeks in which to send payment.
Yes. Minn. Stat. § 176.221, subp. 8 discusses what has to happen for an employee to receive wage loss payments by direct deposit.
Permanent partial disability (“PPD”) is one of the benefits available to an injured worker. There are disability “schedules” that provide a rating for almost every conceivable work injury (although the rating is sometimes zero percent). The schedules are set by law. The disability schedules have changed over the years, so a rating will depend on your date of injury as well as what your injury and treatment has been.
The purpose of the permanent partial disability benefit is to compensate the injured worker for a permanent loss of function due to the injury. It is the closest thing workers’ compensation has to pain and suffering.
Work comp percentage impairments are different from veteran’s disability percentage impairments.
No. The workers compensation chapter does not include benefits for pain and suffering, hardship, or the loss of fringe benefits like medical insurance or pensions. It is a limited benefit system that does not make an injured worker whole.
Many types of medical treatment are limited by the treatment parameters published by the Department of Labor and Industry. “Passive” treatment like chiropractic and physical therapy are limited to 12 weeks, for example, with some exceptions (called “departures” in the rules). Cases have carved out another exception for necessary chiropractic treatment, under which the treatment may be compensable up to 12 visits in a 12 month period.
If you have not settled your claim or lost at hearing, it doesn’t mean anything and is simply incorrect. Insurance adjusters frequently tell injured workers that their claims are “closed” which can trick an injured worker into not seeking any additional benefits (even though they may be entitled to them). There is no such thing as a “closed” claim if a judge has not denied your claim and you have not yet given up benefits in exchange for a lump sum. The insurer may refuse to pay, but you may be able to pursue recovery of those benefits through the workers’ compensation system. Contact us to help: 218-723-1990 or lawfirm@falsanibalmer.com.
When an injured worker files a claim with the State of Minnesota to recover workers’ compensation benefits, the employer/insurer typically takes that person’s deposition. The deposition usually involves an attorney for the employer/insurer asking the injured worker a lot of questions which the injured worker then has to answer under oath. We prepare our clients for their deposition so that they can do the best job that they can.
Minnesota workers’ compensation claims can be settled in two basic ways.
First, a “to date” settlement resolves the injured worker’s claims through the date of the settlement, typically. This type of settlement does not involve future benefits but is instead involves the employer/insurer paying money to resolve the injured worker’s claims through a certain date.
The other type of settlement are “full, final, and complete” settlements which involve the injured worker giving up a number of benefits permanently in exchange for money. Sometimes certain medical benefits are left “open,” which means the injured worker can ask the Employer/Insurer to pay for certain medical care, but the Employer/Insurer can still deny those claims for various reasons. Leaving medical “open” simply means that the injured worker can make the claim, but the Employer/Insurer can pay or deny it. If the Employer/Insurer denies future medical care, then the injured worker can file a claim against the Employer/Insurer. Hiring an attorney to help with such a claim does not require any attorney’s fees by the injured worker, as the attorney will claim fees against the Employer/Insurer (these are called “Roraff fees”).
The name of the settlement papers in a Minnesota workers’ compensation claim is a “Stipulation for Settlement.” A compensation judge must approve the settlement by issuing an “Award on Stipulation.” The Employer/Insurer have two (2) weeks from the date that the compensation judge issues the Award on Stipulation to send the settlement proceeds to the employee.
In most Minnesota workers’ compensation claims, the parties are required to seriously discuss settlement at some point. Most claims are scheduled for a settlement conference before the injured worker can have his or her claims decided by a judge. Nobody is required to settle their claim, but injured workers are required to send a settlement demand to the Employer/Insurer at least 7 days before a settlement conference. A settlement demand typically involves listing the injured workers’ claims and a discussion of what those claims are worth or might be worth.
A Notice of Intention to Discontinue Benefits, or “NOID,” is what the workers’ compensation insurer has to send before they stop paying an injured worker wage loss benefits. The NOID is supposed to say why benefits are being stopped.
If the injured worker disagrees with the NOID and wants his or her benefits to continue, then the injured worker should request a conference by calling the State of Minnesota number on the top of the NOID. As long as the injured worker makes that request within 12 days of receiving the NOID, the State of Minnesota should schedule a “.239 conference” to decide whether wage loss benefits should be stopped.
Even if the 12 day deadline is missed, an injured worker who has been cut off from benefits can file a claim for ongoing wage loss benefits, but it takes longer than the .239 conference process.
The .239 conference is typically conducted by phone. A State of Minnesota workers’ compensation judge will decide whether the insurer had reasonable grounds on which to stop paying the injured worker wage loss benefits. Exhibits can be submitted ahead of time and the judge will typically ask all of the parties to present their position.
If you have been cut off from workers’ compensation benefits, contact us at 218-723-1990 or lawfirm@falsanibalmer.com to get your benefits reinstated.
Work comp insurers are required to pay for all reasonable and necessary medical care that has arisen out of a work injury. But, sometimes work comp insurers do not pay for medical expenses because they do not believe the treatment was reasonable, necessary, or related to the work injury. Medical providers and work comp insurers can also have communication problems and other issues that make it difficult for the work comp insurer to receive and process a bill from the medical provider.
If you have medical expenses for a work injury, you should make sure that your medical providers (including pharmacies) have the billing information for your work comp insurer. This billing information should include your date(s) of injury, the claim number, the name of the work comp insurer, the name of the claims adjuster, the phone and fax numbers for the adjuster, and the adjuster’s email address.
If you find out that your medical provider did not bill the work comp insurer for work-related medical care, ask the medical provider to do it right way. Then, follow up with the work comp insurer to make sure they received all of the information they need.
If the work comp insurer refuses to pay for an injured worker’s medical care or related expenses, then the injured worker should file a claim with the State of Minnesota. An injured worker pays nothing to an attorney that he/she has to hire in order to get a medical bill paid. Instead, the attorney petitions the work comp insurer for fees once it’s determined that the work comp insurer is responsible for the bill. So, injured workers have nothing to lose in hiring an attorney to help them get medical and/or rehabilitation expenses paid for by the work comp insurer.
There are situations in which your personal or private insurance can pay for medical care while you are waiting for the work comp insurer to authorize it. But, this can be complicated, and it’s best to consult an attorney. Contact us at 218-723-1990 or lawfirm@falsanibalmer.com to find out what you need to do in order to keep treating without going into debt.
If the workers’ compensation insurer has not accepted primary liability (or responsibility) for your injury, then you should contact an attorney, because the insurer will not pay for any benefits unless and until they are required to do so by formal agreement or court order.
But, if the work comp insurer has accepted at least some responsibility for your injury, then they are responsible for paying for office visits, medications, physical therapy, durable medical equipment (i.e. canes, walkers, braces, etc.), surgeries, injections, chiropractic treatment, and various other types of treatment that are REASONABLE, NECESSARY, and CAUSALLY RELATED to your work injury.
There are limits on whether and/or when these medical treatments can be paid for. Those limits are the “treatment parameters.” The “treatment parameters” are a set of rules about how much of certain types of medical care you can receive. For example, a work comp insurer sometimes does not have to pay for more than 12 visits to a chiropractor per year unless there are special circumstances (the 12/12 rule) AND the chiropractor requests advance approval.
If you agreed to “close out” some of these benefits as part of a prior settlement, then you cannot ever ask the work comp insurer to pay for those types of treatments again.
If medical benefits are left open under a Stipulation for Settlement, this does not mean that the work comp insurer WILL pay for something; instead, it simply means that you can ask them to pay for it.
There are also special rules regarding narcotic medications which require the cooperation of your doctor.
Workers’ compensation hearings are administrative proceedings that are handled by an administrative law judge. These types of hearings are typically private (because medical information is discussed) and not as formal as a jury trial in state or federal court. The only people present at workers’ compensation hearings are the judge, the injured worker and his/her attorney, the attorney for the Employer/Insurer, a representative from the Employer (sometimes), and any live witnesses.
We take the time to prepare our clients for workers’ compensation hearings in an ethical and comprehensive manner. We do not tell you what to say at a hearing but will advise you on who says what when, what to expect from the judge and other attorney, how to give clear and concise testimony, and any matters specific to your claim.
If you think your injury might be work related, then yes, you should report it.
There are many types of injuries and/or disabilities that people can receive as a result of their work activities. We have represented not only individuals with obvious physical trauma, but people who have contracted diseases and cancers as a result of work-related exposures, developed debilitating arthritis as a result of repeated work activities, suffered cardiac events as a result of work stress, and many more.
Contact us for qualified legal representation.
If you have suffered a serious personal injury, deserve workers’ compensation benefits, need assistance with short- or long-term disability claims, or require help with the Social Security Disability claims process, Falsani, Balmer, Peterson & Balmer can serve as your trusted legal counsel. Schedule a free initial consultation with our qualified legal team and we will carefully evaluate your case and give you honest and expert legal advice.
