Minnesota Workers' Compensation Claims: Eligibility, Filing, and Appeals
Find out whether you're eligible for workers' comp benefits in Minnesota.
Workers’ compensation in Minnesota is a mandatory insurance program designed to compensate injured workers for medical care, lost wages, and permanent disabilities. Employees who are involved in workplace accidents, who sustain repetitive motion injuries (such as carpal tunnel from years of typing), or who develop occupational diseases (such as asbestosis, a lung disease caused by exposure to asbestos), are eligible for benefits.
In Minnesota, virtually all private businesses must provide workers’ compensation insurance for their employees. Any business with at least one part-time employee is subject to this requirement. However, certain employees are exempt from coverage, including:
- certain interstate trucking and railroad company workers
- casual employees (those performing occasional or temporary work not related to the type of business normally conducted by the employer)
- certain household domestic workers (such as house cleaners and gardeners), who earn less than $1,000 cash in a three month period from a single household
- workers at nonprofit associations who do not receive more than $1,000 in salary or wages per year
- a spouse, parent or child of a sole proprietor, executive officer of a closely-held corporation, or manager of a small limited liability company (LLC)
- certain farming employees, and
- state and federal government employees.
Independent contractors are also not entitled to workers’ compensation benefits. Minnesota has a multi-factor test for determining whether a worker is an independent contractor or an employee for purposes of workers’ comp. For more information, see the Minnesota Department of Labor & Industry (MDLI) page on determining independent contractor status.
Filing Your Claim
In Minnesota, you must report any workplace accident or occupational disease to your employer within 14 days of the date of your injury. For occupational diseases, your date of injury is the first day that you knew or should have known that your injuries were work-related. In general, though, you will still be eligible for workers’ comp benefits if you file your claim within 30 days of your injury, as long as your employer wasn’t harmed by the delay. To avoid any negative impact on your benefits, the best practice is to report your injury to your supervisor as soon as possible.
Once you have reported your injury, your employer must complete and file a form (a "First Report of Injury" form) with its insurance company and send a copy to you. The insurance company must file a report with the Minnesota Department of Labor & Industry (MDLI) within ten days. The insurance company then has 14 days to investigate your claim and decide whether to accept or deny it.
Obtaining Medical Treatment
In the event of an emergency, you should seek medical care immediately and tell the provider that you have sustained a job-related injury. In emergency situations, you can choose any health care provider you wish for treatment.
You may also select your health care providers for non-emergency care, unless your employer has a state-certified managed care plan. Your employer is required to give you written notice if you’re covered under a managed care plan. If your employer has given you the proper notice, you must typically see a doctor within the plan. However, if there is no provider within 30 to 50 miles from your home or work, you may choose your own doctor.
The workers’ compensation insurer is responsible for covering all reasonable and necessary medical care related to your workplace injury. In some cases, you will need to notify the insurer prior to receiving treatment. For example, you or your doctor must notify the insurer before you undergo any non-emergency surgery or hospitalization.
Disability benefits are available to workers who are unable to return to work, either temporarily or permanently, due to their injuries. When it comes to disability benefits, Minnesota law has changed several times during the past 25 years. As a result, there are different sets of rules depending on the date of injury. This article focuses on benefits that are available for injuries occurring on or after October 1, 2013.
Temporary Total Disability
If your doctor determines that you are completely unable to work while you’re recovering, you are eligible for temporary total disability (TTD) payments. There is a three-day waiting period for temporary disability benefits. No TTD payments will be paid for the first three days after your injury, unless your disability lasts for at least ten calendar days. For example, if your disability lasted from Monday through Friday of a typical work week, you would only be entitled to TTD payments for the last two days of the week (because the waiting period applies). However, if your disability lasted for several weeks, the waiting period would not apply and you would receive TTD payments from the first day of your disability.
Temporary total disability benefits are two-thirds of your average weekly wage, subject to a maximum of $1,046.52 (as of October 1, 2016).TTD benefits are paid during the time your doctor finds that you cannot return to work but have not yet reached maximum medical improvement (MMI). MMI is the point where your doctor does not expect your condition to improve with additional medical treatment. However, TTD benefits are not paid for more than 130 weeks.
TTD benefits may, however, be extended beyond the 130 weeks if you are in an approved retraining (vocational rehabilitation) program. You may request retraining from the workers’ comp insurer, which will normally appoint a Qualified Rehabilitation Consultant (QRC) to verify your eligibility for retraining and develop your vocational rehabilitation plan. You are eligible for retraining if you cannot return to your former job because of your injury, if your employer doesn’t have another suitable position for you, and if retraining will increase your ability to find work elsewhere.
Temporary Partial Disability
Your doctor may allow you to return to part-time or modified work while you are still recovering. For example, your doctor may clear you for “light duty” work, which places restrictions on the type or amount of work that you can perform based on your medical condition.
If your earnings for part-time or modified work are lower than what you previously made, you will usually be entitled to temporary partial disability (TPD) benefits. TPD payments are two-thirds of the difference in your earnings. TPD benefits are generally available until your doctor finds that you’ve reached maximum medical improvement, up to a maximum of 225 weeks.
Permanent Partial Disability
If you have a permanent loss of function from your injuries, you are entitled to permanent disability benefits. For example, if you can no longer use your right hand to write or grip, you have a loss of function. However, if there is no loss of function, you will not qualify for permanent disability benefits. For example, if you have regained full use of your right hand, you will not be entitled to benefits. In general, workers cannot receive payments for scarring or disfigurement, unless there is also a loss of use to that body part.
The amount of your permanent disability benefits and how long you will receive them depends on the nature and severity of your permanent disability. Once you have reached maximum medical improvement, your doctor will determine the level of your permanent impairment and assign a percentage of disability to your body as a whole, based on a published state schedule.
The impairment rating is then multiplied by a specific dollar amount (set by the state schedule) to determine the permanent disability payments. For example, suppose you have a 10% impairment rating and your gross pay was $500 per week before your injury. According to the current schedule, a 10% impairment would be multiplied by $80,000, to yield a total PPD payment of $8,000. PPD benefits are paid at the same intervals as your temporary disability benefits (for example, weekly or monthly). You can also request to receive the payments in a lump sum (which will be discounted to its present value).
Permanent Total Disability
For a permanent total disability (PTD), where you cannot return to your former job or obtain any gainful employment, you will receive two-thirds of your average weekly wage, subject to a maximum of $1,046.52 (as of October 1, 2016). Your PTD benefits may be increased after four years to adjust for inflation.
PTD benefits are paid until you reach the age of 67, when retirement is presumed. Also, after the insurer has paid $25,000 in PTD, your benefits may be reduced to take into account other sources of income. For example, your PTD benefits may be reduced by the amount you receive in Social Security disability benefits.
If your claim is denied, you may file a formal appeal with the MDLI. In general, you have three years from the date of your injury to file this petition, which starts the appeal process. Your appeal will then be assigned to a compensation judge at the Minnesota Office of Administrative Hearings.
For more information on filing an appeal, see our article Appealing a Minnesota Workers’ Comp Denial.