The Nuances of Workers’ Compensation: The First Stages of the Process

As workers’ compensation attorneys, our first consultation with our clients often involves explaining the difference between a workers’ compensation claim and other more formal court processes. Often there is the misconception by our clients that they are “suing” their employer and many are surprised to learn, that typically, by the time they are consulting with us regarding their injury, a workers’ compensation claim is well on its way. While a civil suit typically begins with the serving of a complaint, a Minnesota’s workers’ compensation system begins with the First Report of Injury.

First Report of Injury

If an employee sustains an injury that, at a minimum, partially disables the employee from working for at least three days, the employer or its insurer must report the injury to the Commissioner of Department of Labor and Industry (DLI). Time limitations on employers and insurers to make this report vary depending on the severity of the injury and whether a death occurred.  However, this process is typically completed by filing a document entitled First Report of Injury, although in more severe cases an employer may initially report the injury by telephone. Employers and insurers face monetary penalties by the DLI for failing to make a timely report. Minn. Stat. §176.231.

Notice of Determination of Primary Liability

The insurer for an employer must then make an initial determination on whether or not the injured employee is entitled to worker’s compensation benefits. As a result, the insurer, or in some cases a self-insured employer, will file a document entitled the Notice of Determination of Primary Liability in which they either admit or deny that the injury suffered by the employee is work related.  This determination must be made within 14 days of the employer having notice or knowledge that an injury occurred.

Admitted Claims

If the employer admits the injury is work related, the employer through its insurer will begin to provide the injured employee the workers’ compensation benefits he or she is entitled to as required by Minnesota law. This includes wage loss, medical benefits, rehabilitation services and permanent partial disability benefits.  However, throughout the course of providing these benefits, often employers and insurers will attempt to discontinue wage loss benefits for numerous reasons. Employers and insurers will also at times refuse to pay for certain medical treatments or rehabilitation services.  When this occurs, there are formal processes available to help the employee maintain their wage loss and obtain the services they require to recover from their injuries.

Denied Claims

If the employer states the injury is not related to work, the employee may petition that the Office of Administrative Hearings review the case to determine whether the denial was appropriate. An employee may file an Employee’s Claim Petition with the DLI to initiate this process.

Clients contact us at all different stages of a worker’s compensation claim.  Whether it’s helping maintain the benefits already being provided or helping obtain the benefits that were denied, having an attorney represent the injured client is critical. Insurers have attorneys protecting their interests and injured employees should have the same. For more information or questions regarding a workers’ compensation injury, contact our office for a free consultation.