Can You be Denied Workers’ Compensation Benefits Because of a Prior Injury?

Many injured workers are denied Minnesota workers’ compensation benefits because of prior injuries. For example, a workers’ compensation insurer may see that you filed a workers’ compensation claim with a former employer for the same body part and deny your claim, alleging that your current symptoms are the result of the prior injury. Or, an insurer may review your medical records and discover that you sustained an injury while playing basketball fifteen years earlier. This can be true even if you have been working full-duty for several years without any physical issues.

What do you do when your claim is denied?

Dealing with a denied workers’ compensation claim can be very frustrating. Many injured workers reasonably assume that because they were injured at work, everything will be taken care of by their employer and its insurance company. Unfortunately, for many injured workers, this is not the case and they find themselves incurring thousands of dollars in wage loss and medical bills, the employee has lost several weeks of wages and run up hundreds, or thousands, of dollars in medical bills.

In this situation, you have a couple of options. The insurance company hopes that you will simply walk away. If you have health insurance or are willing to go back to work despite your injury (and many times, against your treating doctor’s advice), you can simply avoid the fight and walk away from the claim. Many insurance companies count on the fact that employees will do this instead of contacting an attorney and taking definitive steps to prove their claim. The choice to not make a workers’ compensation claim can have dire consequences if the injury turns out to be a serious or long-term issue. Under the Workers’ Compensation Act, employees must file their workers’ compensation claims with the state within a prescribed period of time or they will be forever barred from bringing their claims. It is important that you discuss these deadlines (or statute of limitations) with an experienced attorney so you can make an informed choice about whether to proceed with a claim.

The second option is to fight the insurance company for the wage loss and medical benefits that you are entitled to under the Minnesota Workers’ Compensation Act. The first thing you will want to do is call an attorney experienced in the area of workers’ compensation to determine whether you have a viable claim. If the attorney believes that you have a compensable claim, they will work on your behalf to establish your claims by gathering medical evidence, including records and reports; filing your claim with the Department of Labor and Industry; and advocate on your behalf with the insurance company and its representatives.

What if I had a prior injury to the same body part?

When I first speak to clients, I often hear that they do not want to bring a claim because of a prior injury to the same body part. Many people falsely believe that a prior injury will disqualify them from receiving workers’ compensation benefits. This is categorically untrue. Prior injuries can make your claim more complicated in some circumstances; however, the Minnesota workers’ compensation laws do not require that your work injury be the sole cause of your current injury or disability. The law only requires that the work injury be a substantial contributing cause or factor to the underlying condition or disability. In other words, your prior injury and your work injury may have combined to create your current condition—and that’s completely fine. You are still able to bring a workers’ compensation claim, collect wage loss and have your medical bills covered.

In Minnesota, the workers’ compensation laws actually go even a step further. If you have a pre-existing injury that is substantially re-aggravated or accelerated by a work injury or your work duties, you are eligible to receive workers’ compensation benefits. An example the attorneys at Meuser Law Office, P.A. frequently encounter is police officers that develop PTSD on the job relating to his or her job duties. Many police officers have served in the military prior to going into law enforcement and may have experienced traumatic events as a police officer and as a service member. This does not preclude them from receiving workers’ compensation benefits relating to his or her PTSD condition. This is true even if the police officer had been diagnosed with PTSD through the Veteran’s Administration and is collecting disability benefits.

The burden of proof in a Minnesota workers’ compensation claim is on the employee. This is significant because it means that when a claim is denied or disputed, an employee must prove that his or her work injury or duties was a substantial contributing cause or factor to his or her current condition. An employee can establish this by filing a claim with the Department of Labor and Industry, obtaining a medical report (or a “narrative report”) that supports the causal connection between the condition and the work duties, and resolving the claims through settlement or a hearing.

If you or someone you know has sustained an injury on the job and the workers’ compensation insurer has denied your claim, do not panic. As explained in this article, you are able to fight this determination, even if you have a pre-existing condition or prior injury. It is important that you contact the experienced attorneys at Meuser Law Office, P.A., they will provide valuable guidance on the Minnesota workers’ compensation system and help you navigate through what can be a very stressful process. Contact us today for a free, no-obligation consultation by calling 1-877-746-5680.

by Ashley Biermann
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If I am a Veteran Can I Still Make a Work Comp Claim and Apply for PERA Duty Disability Benefits as a Result of My Work-Related PTSD?

If you are a veteran and develop post-traumatic stress disorder (PTSD) as a result of being exposed to traumatic event(s) during the course and scope of your employment, you can absolutely bring a workers’ compensation claim under the Minnesota Workers’ Compensation Act as well as obtain Duty Disability benefits from the Public Employee Retirement Association (PERA). In fact, many of our police officer, firefighter, State Patrol, and corrections officer clients at Meuser Law Office, P.A. who have developed work-related PTSD have served in the military, including service in combat roles. Veteran status does not preclude an injured worker with PTSD from obtaining wage loss benefits, medical benefits, and rehabilitation benefits under the Minnesota Workers’ Compensation Act as well as Duty Disability benefits from PERA.

Even the exposure to past traumatic events as the result of military service does not preclude police officers or corrections officers from bringing a workers’ compensation claim or obtaining PERA Duty Disability benefits. Minnesota Workers’ Compensation law does not require that the work-related injury be the sole cause of a condition. Past traumatic events not related to work activities can still contribute towards the development of an injured workers’ PTSD and his or her condition may still be compensable.

Minnesota Workers’ Compensation law requires only that the work injury be a substantial contributing cause or factor to the employee’s condition.  Swanson v. Medtronics, 443 N.W. 2d 534 (1989).  Moreover, an injury is compensable where it aggravates or accelerates a pre-existing condition.  Wallace v. Hanson Silo Co., 235 N.W. 2d 363 (Minn. 1975). In these cases, medical experts must document that an employee’s work activities aggravated, accelerated, and/or combined with a pre-existing condition to result in his or her new injury sustained in the course and scope of his or her employment.

When determining if a condition is compensable, judges consider factors such as:

• The nature and severity of the pre-existing condition and the extent of restrictions and disability resulting there from.
• The nature of the symptoms and extent of medical treatment prior to the aggravating incident.
• The nature and severity of the aggravating incident and the extent of the restrictions and disability resulting there from.
• The nature of the symptoms and the extent of medical treatment following the aggravating incident.
• The nature and extent of the employee’s work duties and non-work activities during the relevant period.
• Medical opinions on the issue.  McClellan v. Up North Plastics, slip. Op. (W.C.C.A. October 18, 1994).

PERA Duty Disability law does not have as much extensive case law surrounding the issue of pre-existing conditions. The definition of “Duty Disability” as set forth in Minnesota Statutes § 353.01, subdivision 41 (2013), requires only that the individual suffer from “a condition” that “is the direct result of an injury” (emphasis added). Like in the work comp system, claimants need expert medical opinions explaining the relationship between the work exposures and the subsequent PTSD. Moreover, PERA, unlike work comp, is a technically a neutral agency where the work comp system is an adversarial process.

If you have been diagnosed with post-traumatic stress disorder (PTSD) as a result of traumatic work exposures contact Meuser Law Office, P.A. for a free no-obligation consultation. The attorneys at Meuser Law Office, P.A. are experienced and knowledgeable in this unique area of the law and can help you obtain the benefits to which you are entitled under the Minnesota Workers’ Compensation Act as well as PERA Duty Disability benefits. You may also be entitled to wage loss benefits under Minnesota Statute §299A.475 in conjunction with your other claims.
Call us today at 1-877-746-5680.

by Mary Beth
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