What Can I Expect to Receive in a Workers' Compensation Settlement?

A question often asked by clients when meeting for the first time is "how much is my claim worth?" While there is no hard and fast rule when it comes to estimating the value of a Minnesota workers' compensation claim, there are a variety of factors in every claim that help determine a fair settlement value or range.

1. How long have you been receiving wage loss benefits?

Most wage loss benefits in the workers' compensation system have temporal caps. For example, you can only receive 130 weeks of temporary total disability benefits (TTD) for injuries occurring on or after October 1, 2013. In addition, you can only receive 225 weeks of temporary partial wage loss benefits (TPD) or approximately four and a half years. Because these wage loss benefits are capped, the number of weeks you have received benefits will affect the value of a Minnesota workers' compensation claim.

2. Average weekly wage, i.e., how much were you earning on your date of injury?

If the injured person is a high wage earner, the value of the claim will be greater than someone earning a lower wage. The average weekly wage for a claim is calculated based upon average earnings for the six months preceding the date of injury. As such, it is important to have an accurate average weekly wage calculation and to be using the most recent date of injury to ensure the greatest possible settlement from workers' compensation is received.

3. Did the insurer accept or deny your workers' compensation claim?

When a workers' compensation claim is accepted by the insurer, you generally have a stronger position going into a settlement conference or mediation. This is true because many times the insurer is paying the employee ongoing benefits. If your claim is accepted, there will still be a dispute with the insurer with regard to the "nature and extent" of the injury and the amount of the benefits owed but the insurer has admitted responsibility for the injury when a claim is accepted.

On the other hand, if a claim is denied and litigation is pending, the insurance company knows that there is a chance that they will not have to pay anything for the claim. If you go to court, there is a chance the insurance company will win, and this is factored into the insurance company's exposure analysis for your claim. For example, let's say you have a 50% chance of winning your claim. The insurance company will typically look at the overall exposure for your claim, calculate how much you would receive if your case went to hearing and we won on each of the claims then reduce that amount by 50%, (i.e., the estimated chance of success for the claim).

4. Did you sustain a permanent or temporary injury? 

This concept is relatively straightforward. If you sustained a serious injury and are issued permanent restrictions, the insurance company will understand that you will likely collect most, if not all, of your wage loss benefits. In addition, you will likely be entitled to a benefit known as permanent partial disability (PPD) for the loss of use or functioning of the affected body part. This benefit is not available to employees that have sustained minor injuries. Conversely, if you sustained a relatively minor injury, the claim will likely have a limited settlement value because the injured person is expected to make a full recovery and return to the date of injury employer at full wage earnings.

5. How strong is your medical support?

If there is medical support from a treating physician, linking the injured individual's current condition to a work-injury, the claim tends to be stronger. This is especially true if the treating physician is an experienced, well-respected specialist, such as an orthopedic surgeon, in the relevant area. Remember, the burden of proof in a workers' compensation claim is on the employee. This means that the injured employee is responsible for providing medical evidence to support the claims if the matter goes before a judge. As such, if a claims adjuster or a defense attorney gets a persuasive narrative report from a treating physician that supports your claims, they will understand that you will be much more likely to be successful at hearing, which adds value to your claim.

6. Who is representing you?

If you choose to represent yourself, you will be at a serious disadvantage when it comes to settling your claims. Minnesota workers' compensation is a complex, confusing area of the law and you will not know whether you are getting all the benefits to which you are entitled unless you have an experienced workers' compensation attorney. In addition, your employer will be represented by a claims adjuster or attorney that has significant experience in the area and they will not be looking out for your best interests.

If you are thinking about settling your Minnesota workers' compensation claim, it is of utmost importance that you check with a workers' compensation attorney before you do. This is especially true if you are a police officer or firefighter and also entitled to PERA or MSRS benefits because there are certain, applicable offset provisions that will apply to any workers' compensation settlement. A wrong decision could cost you thousands of dollars. Contact Meuser Law Office, P.A. for a free no-obligation consultation and claim evaluation. At Meuser Law Office, P.A. we keep our clients informed of the process as well as what to expect each step of the way. Call us today at 1-877-746-5680.

by Ashley Biermann
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Will I Be Offered a Settlement on My Workers’ Compensation Case?

Individuals who suffer a work injury in Minnesota often wonder if or when they will receive a settlement. In fact, there are “work comp settlement calculators” on the Internet that mislead people into thinking that punching a few numbers into a form will give them a settlement estimate.

In Minnesota workers’ compensation is a “pay as you go” system, meaning that work comp benefits are paid on an ongoing basis, as long as you remain entitled to benefits. There is no such thing as an automatic “settlement” for your injuries.

That being said, settlement is a very common practice in Minnesota workers’ compensation cases, particularly where:

• There is a dispute over benefits
• The person will be eligible for ongoing work comp benefits for an extended period of time

An experienced Minnesota workers’ compensation attorney can help you decide whether a settlement of your case is in your best interest. With the guidance of an attorney, whether or not to settle your case is ultimately your decision. If you are considering settlement of your workers’ compensation case, you and your attorney will typically discuss the settlement process, which includes:

• Making a settlement demand
• Settlement negotiations
• Strengths and weaknesses of your case
• Approximate settlement value of your case

When calculating the settlement value of a Minnesota workers’ compensation case, there are several factors that are taken into consideration, including past owed wage loss, future estimated wage loss, rehabilitation and/or retraining benefits, permanent partial disability benefits, and outstanding medical expenses. Once the attorney has calculated a settlement demand, with client authorization to do so, the attorney will then send that demand to the defense attorney or the insurance adjuster. From there the defense attorney or adjuster will respond with an offer, and the parties negotiate back and forth, ultimately arriving at a number that is acceptable to both sides.

Beyond the numbers in a Minnesota workers’ compensation case, your lawyer will discuss the strengths and weaknesses of your case, and he or she will give you recommendations of the likelihood of success. The relative strength of a given case plays a huge role in the settlement value of the case. For example, if there is a case where the past and future wage loss is potentially worth $200,000, but the client only has a 25% chance of succeeding at trial, the case is worth far less than the potential past and future monetary value of the case.

Minnesota workers’ compensation settlement negotiations can take a variety of forms. Often, negotiating is an informal process of phone calls or emails back and forth. At times settlement discussions occur at a Settlement Conference at the Office of Administrative Hearings, and frequently, Meuser Law Office, P.A. utilizes a form of alternative dispute resolution called mediation in negotiating on a case. A mediation involves the services of an individual who is a third-party neutral to facilitate settlement discussions between the injured worker and the employer/insurer.

In addition to a dollar figure, the parties will also need to reach an agreement as to terms of the settlement. Is it a “to-date” settlement, meaning that the settlement only pertains to past owed benefits? Or is it on a full, final, complete basis, meaning that the settlement is for past and future benefits? Are future medical expenses open or closed – in other words, is the workers’ compensation insurer responsible for future medical expenses relative to the work injury? Who is responsible for paying any outstanding medical expenses or third party reimbursement claims, such as unemployment or short/long-term disability, the injured worker or the employer/insurer? These are all issues that need to be worked out in addition to the settlement amount.

Once you have reached a settlement on your workers’ compensation case, it typically takes a few weeks before things are finalized. You will ultimately sign a Stipulation for Settlement, which is a contract between you and the employer and their workers’ compensation insurer setting forth the terms of the settlement. Depending on the complexity of the case, it is not uncommon that it can take several weeks for this paperwork to be finalized. After the paperwork is signed by both sides, it is submitted to the Office of Administrative Hearings for approval. Once a judge has reviewed and signed off on the settlement, the Court will issue an Award on Stipulation, which is simply a Court Order approving the settlement. The workers’ compensation insurer has 14 days from the date of the Award on Stipulation to issue payment.

If you would like to discuss potential settlement of your Minnesota workers’ compensation case, contact Meuser Law Office, P.A. to schedule a free, no-obligation legal consultation. Our knowledgeable attorneys will help you understand the often-confusing Minnesota work comp law and ensure you receive the full benefits to which you are entitled. Call us today at 1-877-746-5680.

by Jen Yackley
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Employee Who Separates from Date of Injury Employer Due to PERA Duty Disability Remains Entitled to Wage Loss Benefits

Accepting an award of PERA Duty Disability Benefits does not prevent firefighters, police officers, deputy sheriffs, and corrections officers from receiving wage loss benefits, including temporary partial disability benefits under the Minnesota Workers’ Compensation Act.

A member approved for PERA Duty Disability benefits must separate from his or her position covered under the applicable plan, Police and Fire or Corrections, before receiving benefits. Members are encouraged to work in a different capacity. PERA Duty Disability benefits are not the same as PERA permanent and total disability benefits, members may work and still receive work comp benefits, PERA benefits, and income from a new employer. When the member begins working with a new employer and earns less than from the previous city or county employment, he or she will be eligible for temporary partial disability benefits from Minnesota workers’ compensation.

Temporary partial disability (TPD) benefits are wage loss benefits available to injured workers under the Minnesota Workers’ Compensation Act who are able to return to work, but at a reduced wage because of his or her work injury. TPD is available for a total of 225 weeks but no more than 450 weeks after the date of injury. TPD is paid out at a rate of 2/3 of the difference between what the employee was making at the time of the injury or average weekly wage and the reduced earnings. Like other work comp benefits, TPD benefits are non-taxable.

In order to receive TPD injured workers must:

(1) Suffer a work-related injury
(2) Experience a loss of earning capacity as a result of that injury
(3) Be able to work, subject to restrictions
(4) Experience an actual loss of earning capacity

It is well settled law that “[a]n injured worker is not forever bound to his employer in order to retain his entitlement to benefits.” Boutto v. U.S. Steel Corp., slip. Op., No. WC06-288 (W.C.C.A. July 18, 2007). This means that an injured employee does not have to continue to work for the date of injury employer as a prerequisite to receiving work comp benefits. Anything less would force injured workers to be at the mercy of the employer.

This is especially the case when injured workers leave the date of injury employer as a result of PERA awarding PERA Duty Disability benefits. “The fact that the employee accepted an early retirement incentive from his employer for reasons unrelated to his injury or that he remains physically able to perform his previous job is not relevant to the question of whether the employee’s actual loss of earning capacity is causally related to the work injury.” Id. “[I]t is well settled that termination from employment for reasons not connected to the work injury does not preclude an award of temporary partial disability benefits.” Id.

Employers and insurers hate having to pay employees wage loss benefits who separate due to his or her PERA Duty Disability and will look for any excuse to cut off the payment of such benefits. Attorneys may have to file claim petitions or send letters to demand payment.

Meuser Law Office, P.A. is one of the few workers’ compensation law firms in the state of Minnesota that also handles PERA and MSRS disability claims. We’ve successfully represented hundreds of State Patrol, police officers and firefighters throughout the state for both workers’ compensation and PERA/MSRS disability claims. Sitting down with us for a consultation to learn more about your potential claims is a lot like financial planning. We can explain what rights you have and make recommendations to you in terms of how to best protect your rights to those benefits. The knowledgeable attorneys at Meuser Law Office, P.A. can help make the process easier to navigate. Contact us today for a free, no-obligation consultation by calling 1-877-746-5680.

by Mary Beth
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Can I Move to Another State While Collecting Minnesota Workers’ Compensation Benefits?

I have been asked many times by injured employees, “Can I move out of state? Will this affect my Minnesota workers’ compensation benefits?” The answer I always give my clients is it depends. And, it truly does depend on a number of factors, including the location of the move and the type of benefits involved. But, we can typically find a way to make the out-of-state move work while still protecting all of the injured workers’ benefits.

Factor 1: Can you perform a diligent job search in your new location?

If an injured employee is completely off of work and collecting temporary total disability (TTD) benefits, he or she is required to conduct a diligent job search. There is no case law or statute that specifically defines “diligent job search” or specifies the number of job contacts that must be made or the geographic area within which jobs must be sought. Rather, whether a diligent job search has been conducted is a fact question for the judge.

The central question I ask my clients when assessing this factor is what is the new area like? Is it a city or a small town? Are there going to be job opportunities there? Will those job opportunities be similar to those that are available in the city they are currently living in? If my client is looking to move to a city that is similarly situated in terms of size and job opportunity then I’m typically confident that he or she will be able to perform a diligent job search in the new location. Of course, if you move to the new location for a job offer, this factor is largely moot unless the job does not come close to replacing your date of injury wages.

Factor 2: Would you be deemed to have withdrawn from the labor market in your new location?

Under Minnesota Statutes section 176.101, subd. 1(f), an employee’s temporary partial disability benefits shall cease if the employee withdraws from the labor market; however, moving to a new community does not preclude an employee from receiving wage loss benefits if there is a reasonable expectation of earning a reasonable livelihood in the town of destination. This is the proper test for determining whether your wage loss benefits will cease after moving to a new community.

If the injured worker moves to a new community where the employment prospects are substantially worse, or virtually non-existent, his or her wage loss benefits will be in jeopardy. The insurer will argue that the move is the reason why the employee cannot find work, not the work injury. An example I often use with clients is a move from the Twin Cities to a small town in Montana. It is fairly clear in this circumstance that the Twin Cities offers greater employment opportunities and the insurer may be able to make a colorable argument that the employee is effectively withdrawing from the labor market. It is a fine line though. The Workers’ Compensation Court of Appeals in Giles v. Minnesota Department of Transportation determined that a move from the Twin Cities to Albert Lea was not sufficient to cut off wage benefits under this theory. The court ruled that Albert Lea was not so sparsely populated to the point where job opportunities were virtually non-existent.

If an insurer does cut off your wage benefits because of a move, benefits can be restarted if you reenter the labor market prior to 90 days after reaching maximum medical improvement (MMI) and before receiving 130 weeks of TTD.

Factor 3: What impact does an out-of-state move have on my rehabilitation benefits?

If an employee voluntarily relocates to another city or town, the same analysis is used for rehabilitation benefits. You will still be able to seek rehabilitation services, including vocational rehabilitation services from your qualified rehabilitation consultant (QRC) as long as there is a reasonable expectation of earning a reasonable livelihood in the town of destination.

Don’t wait to get an attorney involved if you have a Minnesota workers’ compensation claim. The process can be complex and you want to be sure you receive the full benefits you are entitled. Contact Meuser Law Office, P.A. for a free no-obligation consultation and claim evaluation. At Meuser Law Office, P.A. we keep our clients informed of the process as well as what to expect each step of the way. Call us today at 1-877-746-5680.

by Ashley Biermann
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Narrative Request vs Narrative Report

A narrative request is a formal letter sent by your Minnesota workers’ compensation attorney to your treating physician requesting that he or she issue a “causation report” on your work-related condition. A causation report is issued by your attorney, asking your doctor to explain why in his or her medical opinion that he or she believe this condition arises out of the course and scope of your employment.

A narrative request will also ask the doctor to opine to any permanent partial disability (PPD) to which you are entitled. Your doctor will assign you a permanency rating under the Minnesota workers’ compensation PPD schedules based on lack of use or function due to your work-related condition. In his or her narrative report the doctor will also determine if you have reached maximum medical improvement (MMI). MMI signifies that you have reached a plateau in your treatment. You are not necessarily healed or restored to your pre-injury condition but you are not expected to decline or make a substantial improvement in your condition. A permanent partial disability rating cannot be assigned until you reach MMI since the PPD rating reflects a permanent loss of use or function. Once you have reached MMI as determined by the physician, you must be served with the report under Minnesota Statute §176.101, subdivision 3e.

A narrative request differs from a Healthcare Provider Report. A Healthcare Provider Report (HCPR) simply asks the doctor to assign a PPD rating and opine as to whether you have reached MMI. An insurance adjuster may also send your doctor a HCPR. The provider is also not allowed to charge for report pursuant to statute. While a provider will charge for the time associated with reviewing your case and writing a causation narrative report. This report may cost $500 to upwards of $3,000 depending on the complexity of the case. This cost will be paid up-front by your work comp attorney, who will then be reimbursed by the employer and insurer upon a successful resolution of the case.

The narrative request will include a summary of your pertinent medical history collected from your medical records. This summary will set forth the foundation or basis for which your physician had the evidence and information upon which to make a medical opinion. You should disclose to your workers’ compensation attorney every provider from which you have sought treatment for your condition, even pre-existing conditions. If this information is not included, the employer and insurer will have a basis on which to discredit your doctor’s medical opinion. The narrative request will further describe the mechanism of your injury and if necessary for a Gillette, or repetitive motion type injury, a detailed description of your job duties.

The narrative request will also include a set of questions for your doctor to answer, including PPD ratings and MMI determinations as discussed above. The doctor will also be asked to issue restrictions if appropriate, describe surgeries or recommended treatment and the basis for the recommendations, and if the past treatment was reasonable and necessary to cure or relieve the effects of the work-related injury.

Frequently, employees become frustrated at the length of time a workers’ compensation claim takes in the State of Minnesota. Unfortunately, providers take time to respond to requests for medical records, which need to be summarized before a narrative request is sent to the treating physicians. Additionally, it can take months for the doctors to respond to the narrative request due to the time involved in writing a report.

At Meuser Law Office, P.A. we’ve successfully represented hundreds of police officers, firefighters, deputy sheriffs, corrections officers, and State Patrol officers throughout the State of Minnesota for workers’ compensation, PERA/MSRS disability, healthcare continuation, and personal injury claims. We can explain what rights you have and make recommendations to you in terms of how to best protect your rights to those benefits. The knowledgeable attorneys at Meuser Law Office, P.A. will help make the process easier to navigate. Contact us today at 877-746-5680 for a free, no-obligation consultation.

by Mary Beth
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I Received a PPD Payment, Is My Minnesota Workers’ Compensation Case Closed?

Generally, no.

As a workers’ compensation attorney, I receive calls from injured workers in Minnesota at least a few times a month who have received a check in the mail from the workers’ compensation insurance company, and a Notice of Benefit Payment form which indicates that the payment is for Permanent Partial Disability (PPD) benefits. PPD is a Minnesota workers’ compensation benefit that is payable for the permanent functional loss of use of a body part due to a work-related injury.

Injured workers in Minnesota often mistakenly assume that this money is a “settlement” of their case, or that accepting this benefit somehow means that their case is now “closed.” That is not the case. Permanent partial disability (PPD) benefits are just one kind of benefit available under the Minnesota Workers’ Compensation Act. Receiving a permanent partial disability (PPD) payment on a Minnesota workers’ compensation case does not mean that your case is settled or closed. Cashing your PPD payment does not mean that you’ve accepted a settlement, or agreed to close your case.

Usually, a permanent partial disability (PPD) payment is based on a rating that your doctor assigned to your permanent injury. The percentage rating you are assigned is then multiplied by a dollar figure set by the Minnesota legislature to determine the amount of your permanent partial disability benefit. For example, if you’ve sustained a herniated disc in your lumbar spine, and you’ve been assigned a 10% permanent partial disability rating, the benefit owed to you would be $8,000.00. In some cases, insurance companies pay a minimum amount of PPD benefits if there’s any question as to whether the injured worker might qualify for a higher rating.

Many workers who receive PPD benefits are entitled to additional benefits, including, but not limited to:

• Additional PPD benefits
• Wage loss benefits, including temporary total disability (TTD), temporary partial disability (TPD), and/or permanent total disability (PTD) benefits
• Medical expense benefits or out of pocket expense reimbursement
• Rehabilitation and/or retraining benefits

It may be valuable to have a workers’ compensation lawyer review your case for errors. It is common for a work comp insurance company to dispute PPD benefits. If, for example, your doctor assigned a PPD rating of 15% but the insurance company takes the position that your PPD rating should only be 8%, they may begin paying the undisputed portion of your benefit - the 8% - and you may not realize that the checks are less than they should be.

I recently settled a work comp case involving a gentleman who had sustained low back injuries requiring surgery while employed at two different jobs several years ago. He did not return to work after his last injury. As a result of his work-related back condition, and several serious non-work related medical conditions, he was incapable of working in any capacity.

When I first met with this gentleman, he told me that he had settled his two Minnesota workers’ compensation cases. After I received his file from the Minnesota Department of Labor and Industry, I realized that he had in fact received some minimal permanent partial disability (PPD) payments from the workers’ compensation insurance company. However, he had not in fact, settled his cases. This gentleman assumed that he had settled his cases because he had received a permanent partial disability PPD) payment. We worked up his case, and ultimately procured a settlement for him for $150,000.00 in addition to the establishment of a professionally administered fund to cover his ongoing medical expenses.

If you’ve received payment for permanent partial disability (PPD) benefits on your Minnesota workers’ compensation case, a workers’ compensation attorney can evaluate whether the payment is appropriate and whether or not you have additional workers’ compensation claims. Meuser Law Office, P.A. is one of the few workers’ compensation law firms in the state of Minnesota that also handles PERA and MSRS disability claims. We’ve successfully represented hundreds of State Patrol, police officers and firefighters throughout the state for both workers’ compensation and PERA/MSRS disability claims. Sitting down with us for a consultation to learn more about your potential claims is a lot like financial planning. We can explain what rights you have and make recommendations to you in terms of how to best protect your rights to those benefits. The knowledgeable attorneys at Meuser Law Office, P.A. can help make the process easier to navigate. Contact us today for a free, no-obligation consultation by calling 1-877-746-5680.

by Jen Yackley
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