Who Pays For My Medical Bills After A Work Injury?

Under Minnesota's workers compensation laws, an employee sustaining a work related injury is entitled to reasonable and necessary medical treatment. Given this rule many injured workers assume that the Minnesota employer and workers’ compensation insurer will automatically pay for the injury and the related medical expenses. This is unfortunately often not the case.

Many injured workers then go without treatment which allows the same employer and workers compensation insurer to allege that the lack of treatment is an indication you were NOT injured or injured that bad. Given some cases can take anywhere from a few months or even up to a year before a judicial determination is made on the dispute, it is VERY important that you find some way to get the treatment you deserve and need.

If you have private health insurance and your workers compensation claim or treatment has been denied, Minnesota law requires the health insurer to provide coverage under their policy and seek reimbursement from the workers compensation insurer. Many of my clients have overlooked this right as nobody who works for the insurance company is willing to share this secret.

If, however, you are without health insurance you are not alone. Nearly 700,000 Minnesotans receive health care through the state’s three publicly funded basic health care programs — Medical Assistance (MA) — Minnesota’s Medicaid program, General Assistance Medical Care (GAMC) and MinnesotaCare. For more information click here. Even with these programs in place,over 453,000 Minnesotans go without health insurance according to the U.S Census Bureau.

The Minnesota Department of Human Services (DHS) administers these programs and pays all or part of enrollees’ medical bills for:

Medical Assistance (MA) (Minnesota’s Medicaid program) is the largest of the health care programs, providing health care coverage and prescription medication coverage for a monthly average of 507,000 low-income senior citizens, children and families, and people with disabilities in fiscal year (FY) 2007.

General Assistance Medical Care (GAMC) provides medical care for a monthly average of 33,000 (FY 2007) low-income Minnesotans who don’t qualify for MA or other state and federal programs — primarily low-income adults, ages 21 and 64, who do not have any dependent children.

MinnesotaCare is a publicly subsidized program for Minnesota residents who don’t have access to affordable health care coverage. In order to eligbile you must meet the following:

• Have a Social Security number or be willing to apply for one (unless you have religious objections);
• Live in Minnesota;
• If you are an adult and do not have children living with you, or if your children are over age 21, you must have lived in Minnesota for six months;
• Be a U.S. citizen or non-citizen lawfully residing in the U.S.;
• Not have other health insurance now or have had health insurance (including Medicare), for at least four months except for Medical Assistance enrollees whose health insurance premium was paid for by Medical Assistance; and
• Not be able to get health insurance through an employer who offers to pay at least half the monthly cost.

Assistance in applying can be found here.

The only way an injured worker can get back to work is to get the necessary medical treatment. If you find yourself without medical insurance and the workers’ compensation insurer refuses to pay for your medical treatment, look into contacting the state and/or county for assistance. MinnesotaHelp.info is another great resource for help.

If you have been injured at work, attorney Tom Atkinson is more than willing to discuss your claim. There is NO obligation and he is willing to review your case to ensure you are properly receiving all the benefits you have coming to you. Contact him directly at 651-324-9514 or visit his web site at www.mndisability.com

Your Workers Compensation Claim Was Denied. Is There Anything I Can Do Now?

YES, hire an EXPERIENCED workers compensation attorney. The same fee is paid to every attorney under Minnesota law so why would you hire someone who only dabbles in work comp or has only been out of law school for a few years? It makes no sense!

At Atkinson Law Office and Minnesota Disability Attorney Tom Atkinson will personally oversee your claim, puncutually returning your calls! When your claim is denied the ONLY way to get benefits paid is to initiate a claim by filing a Claim Petition.

A Claim Petition is a standard form that sets forth basic information about the employee’s claim for workers’ compensation benefits. The Claim Petition contains information about the employee, including his or her name, address, Social Security Number, date of birth, and date(s) of injury. It also lists the name of the employer(s) and insurer(s). The Claim Petition also sets forth the nature of the injury and the average weekly wage at the time of the injury. Finally, the Claim Petition lists the types of claims alleged, including Temporary Total Disability (TTD), Temporary Partial Disability (TPD), Permanent Total Disability (PTD), Permanent Partial Disability (PPD), Rehabilitation Benefits, and/or medical benefits.

The Claim Petition is filed with the Department of Labor and Industry, and copies of the Claim Petition are served on the employee, the employer, the insurer, and any third-party payors, such as major medical insurers. Notice to Potential Intervenors are often served along with the Claim Petition to any medical providers and any third-party payors.

A Claim Petition is generally filed when the employer and/or insurer is denying primary liability, meaning that they admit no responsibility for the injury. A Claim Petition is also filed when there is a claim for monetary benefits, such as Temporary Total Disability (TTD), Temporary Partial Disability (TPD), and/or Permanent Partial Disaiblity (PTD), even if the insurer admits primary liability. If an injured worker has settled his or her case on a full, final complete basis, leaving open future medical benefits, a Claim Petition may be used in some instances where there is a dispute over medical expenses.

Once your Claim Petition has been filed, the employer and/or insurer is generally required to file an Answer to the Claim Petition within 20 days. The employer and/or insurer is required to serve specific responses to the allegations in the claim petition. If an answer is not filed in a timely matter and/or an extension of time to answer is not requested, the employee may request that the matter be scheduled for an expedited hearing.

Typically, after the Claim Petition has been filed, the matter is scheduled for a Settlement Conference at the Office of Administrative Hearings. Prior to the Settlement Conference, if appropriate, the employee’s attorney will often submit a settlement demand to the attorney for the employer and insurer. The purpose of the Settlement Conference is to attempt to discuss the possibility of settlement. Some cases settle at the Settlement Conference, and some do not. If it appears that the parties have reached an impasse, and that further negotiations will not facilitate a settlement, the case may be referred to the Office of Administrative Hearings for the scheduling of a hearing. If either side needs additional information, if the case is not ripe for settlement discussions, or if the sides need additional time to negotiate, the Compensation Judge may also reset a Settlement Conference for a month or two in the future.

If the parties are unable to reach a settlement, the case will proceed toward a Hearing. In Minnesota workers’ compensation, a Hearing is the equivalent of a trial. At the Hearing, both sides will present evidence in support of their respective positions, and the employee will generally provide testimony. After all evidence has been heard, the Compensation Judge issues a decision, which is final and binding on the parties.

The entire process from the filing of the Claim Petition through a Hearing can take anywhere from six months to a year or more. In some instances your case can be expedited due to financial hardship. Let an attorney like Tom Atkinson personally assist you in determining whether your case could possibly qualify. You may reach him directly at 651-324-9514 or email at tom@mndisability. Also be sure to check our the Minnesota Disability and Atkinson Law Office web site at www.mndisability.com

Remembering The Sacrafices Made To Unionize Minnesota Labor 75 Years Ago.

Reporting
Pat Kessler MINNEAPOLIS (WCCO) ―

On a train platform at the end of the line in downtown Minneapolis, hundreds of people every day pass by a bloody battle site. It is the only place in Minnesota that publicly recognizes the Minneapolis trucker's strike -- a bloody, 2-day labor battle.

For many, it's an all-but-forgotten footnote of history. But what happened there 75 years ago -- July 20, 1934 -- may have changed the course of American history.

The trucker's strike was born in the Depression; 1934 was America's darkest Depression year. The unemployment rate in Minnesota was 25 to 30 percent.

Unions were rare or non-existent, but truckers in the Minneapolis Warehouse District tried to organize one. Labor historians say local businesses went to extraordinary lengths to stop it.

"It was ideological," said Hy Berman, professor emeritus of History at the University of Minnesota.

Business leaders opposed unions because "it's our business. It's ours to control. It's none of your business. Workers are to work, and to not question," said Berman.

In Minneapolis, according to Berman, local business leaders created the Citizen's Alliance with its own militia. Working with the Minneapolis police, they were determined to keep the trucks moving.

And on what came to be known as "Bloody Friday," thousands of striking truckers were just as determined to stop them.

Tensions were so high, WCCO Radio was broadcasting from the roof of a nearby building.

A "blow by blow account of what went on," according to Berman.

In the unusual live broadcast of the clash, the announcer sounds urgent: "Lines of pickets march up! They're going to stop the convoy of trucks! But police are ready with shotguns! They're chasing the pickets!"

News accounts reported Minneapolis Police and the Citizens Alliance fired on the crowd. Two were killed and more than 200 wounded.

But the bloody conflict on in that hot summer of 1934 on that Minneapolis street. In fact, for some union leaders it was just the beginning of several years of terror.

The 1937 murder of Tom Dooher's grandfather in Minneapolis has never been solved. Patrick Corcoran was a leader of the trucker's strike and a Teamsters Union organizer, back when union organizing was a dangerous job.

"He was found two houses down, laying facedown in the snow," said Dooher, Corcoran's grandson. "They slowed him with a blow to the head and then shot him in the back of the head."

As many as six union leaders were murdered after the truckers strike, according to Berman.

That included Corcoran, who lived with his family in the Bryn Mawr neighborhood of Minneapolis and who was targeted by anti-union thugs.

"They would literally go through the front door, go into the dining room and pull him out yelling while my mother and her siblings and my grandmother were there," said Dooher. "Take him out, drive him around, beat him up and throw him back here on this curb and tell him to knock it off. And if he didn't, there would be more. "

Minnesotans were horrified by the violence in Minneapolis, which sparked widespread reforms we take for granted. Collective bargaining that led to 40-hour weeks and paid vacations, Social Security and the Depression-era work programs.

"This transformed the whole social politics and economic politics of the United States," said Berman. "And created the America that we know today."

In 1937, thousands of people attended Corcoran's funeral, spilling into the street outside the Basilica of St. Mary. Even though his family will likely never know who killed him, there's a legacy he might never have expected.

Dooher is now the president of Education Minnesota. With 70,000 members, it's the largest labor union in the state.

"His spirit lives on in me, and his spirit lives on in others," said Dooher. "They thought they were going to end the labor movement by killing the leaders, but someone else took his place."

MN Union Construction Facilliation Program - Does it work?

Over the years I worked as attorney representing construction and insurance companies participating in the Minnesota Union Construction Workers Compensation Program.

The stated goal of the MN UCWCP is as follows:

"OUR MISSION: Eliminate the adversarial culture of workers' compensation claim administration; improve the delivery of wage-replacement benefits and the quality of medical care to injured union members; return injured workers to their pre-injury job quickly; reduce the costs of insurance for union contractors thereby increasing their competitiveness."

I now represent ONLY injured employee's before the MN UCWCP and feel compelled to share my experience and commentary.

Does the MN UCWCP fulfill their mission statement? When it comes to "reducing costs of insurance for construction companies the answer is clearly YES. When it comes to fairly looking out for the injured worker the answer is "NOT in many cases". In my opinion the biggest problem is the alleged "neutral" panel of physicians which is LAUGHABLE. In fact, many in the legal community on both sides snicker and giggle at the use of the term "neutral" with some of the medical providers listed. Are there good physicians listed - yes. But the question is whether they are neutral and the answer is not always. The majority of the physicians on the list are the same one's used by insurance companies day in and day out for adverse examinations or so called "independent medical examinations". These doctors make MILLIONS upon MILLIONS of dollars performing IMEs in offices across Minnesota.

I urge labor and union members to contact their leadership and stewards and ask that this panel of physicians be replaced with truly neutral examiners. Those who perform IMEs or Adverse Examinations more than once a month should be EXCLUDED from the panel! Do you really want a doctor who performs hundreds of IMEs a year for insurance companies every year to be the decision maker on your MN UCWCP case? The answer should be a resounding NO!

If you have questions regarding the Minnesota Union Construction Facillitation Program please contact Thomas Atkinson at 651-324-9514 or visit my web site at www.mndisability.com

Minnesota Workers Compensation Tools, Rules and Guidelines

Have you ever been puzzled by the abbreviations and acronyms used by your attorneys discussing your workers compensation benefits? Below I have listed some common workers’ compensation abbreviations and the meanings:

TTD: TEMPORARY TOTAL DISABILITY’. Workers compensation wage loss benefits available to injured workers who are off work completely due to their injuries.

TPD: TEMPORARY TOTAL DISABILITY. Workers’ compensation wage loss benefits available to injured workers who are working at a wage loss due to their injuries.

PTD: PERMANENT TOTAL DISABILITY. Workers’ compensation wage loss benefits available to injured workers who are completely and totally disabled from returning to substantial gainful employment as the result of their work injuries. This term does not necessarily mean FOREVER, just for an indefinite period of time.

PPD: PERMANENT PARTIAL DISABILITY. Workers’ compensation monetary benefits available to workers who have suffered a permanent injury.

MMI: MAXIMUM MEDICAL IMPROVEMENT. 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

QRC: QUALIFIED REHABILIATION COUNSELOR. A QRC provides rehabilitation services to workers who are unable to return to their pre-injury employment.

NOID: NOTICE OF INTENT TO DISCONTINUE. A specific form filed by an insurer or employer when they intend to discontinue an injured workers’ benefits. YOU ARE STRONGLY URGED TO CONTACT AN ATTORNEY AS SOON AS YOU RECEIVE THIS NOTICE IN THE MAIL!

NOPLD: Notice of Primary Liability Determination. A specific form filed by an insurer or employer indicating its initial decision regarding its liability for an injured workers’ claim.

FROI: First Report of Injury. A specific form that an employer must fill out following an injury.

RCD: Request for Certification of Dispute. A specific form filed by an employee or their attorney to certify a dispute regarding medical or rehabilitation services.

SOAF: Statement of Attorney Fees. A petition filed by an employee’s attorney for approval of attorney’s fees in some cases.

NOA: Notice of Appearance of Attorney. Notice filed with the Department of Labor and Industry notifying the Department that an attorney is involved with a workers’ compensation case.

NOBP: Notice of Benefit Payment. A form filed by the workers’ compensation insurance company indicating payment of benefits.

WC: Workers’ Compensation.

WCCA: Workers’ Compensation Court of Appeals.

WID: Worker ID Number. New in 2008, the Minnesota Department of Labor begins replacing social security numbers with WID numbers. A WID number is assigned to workers in lieu of using the worker’s Social Security Number for purposes of identification.

AWW: AVERAGE WEEKLY WAGE. Used to calculate the amount of wage loss benefits an injured worker is entitled to.

SAWW: Statewide Average Weekly Wage. Used to calculate the maximum compensation rate.

EE: Employee.

EER or ER: Employer.

IR: Insurer.

TPA: Third-Party Administrator. Work comp. insurers frequently use TPA’s to administer their workers’ compensation programs.

FCE: Functional Capacity Evaluation or Examination. An evaluation to determine an injured workers’ capacity for physical activities.

IVE: Independent Vocational Evaluation or Examination. An evaluation to determine an injured workers’ vocational abilities.

RTW: Return to work.

PT: Physical Therapy.

ROM: Range of Motion.

TBD: To be determined.

DOI: Date of injury.

DOL: Date of loss.

OAH: Office of Administrative Hearings. In Minnesota the main offices are in St. Paul and Duluth.

DOLI: Department of Labor and Industry.

SSDI: Social Security Disability Insurance.

IME: INDEPENDENT MEDICAL EXAMINATION. An examination conducted by a doctor hired by the employer or workers’ compensation insurance company. The examination should actually be called an ADVERSE EXAMINATION given there is nothing independent about it. This doctor is NOT your treating doctor and is a hired “gun” by the employer and insurance company.

ADR: Alternative Dispute Resolution, including mediation or arbitration.

At Minnesota Disability and Atkinson Law Offices, Attorney Thomas Atkinson will gladly answer any of your workers compensation questions. With nearly two decades of workers compensation experience, including years an attorney for the same insurance companies denying your benefits, he can help you maneuver the system to your advantage. Contact him at 651-324-9514 or visit www.mndisability.com

I'm A Union Member Who Was Injured On The Job, What Are My Rights?

Attorney Thomas Atkinson has authored numerous articles on the subject of the receipt of Notices of Intent to Discontinue (NOID) Workers Compensation benefits by injured workers in articles published in my blog and national publications such as The American Bar Association Journal and US Law Blog. More importantly he has experience representing MINNESOTA LABOR in workers compensation matters through Minnesota, including in the specialized Union Construction Facilitation Program.

An injured worker usually searches for an attorney when they have a denied claim OR upon receipt of a "Notice of Intent to Discontinue" workers compensation benefits. A NOID signals the single most important time for injured workers to contact an attorney. You will NEVER be charged a fee for merely discussing this document. If you are an injured LABOR employee currently receiving wage loss benefits YOU WILL RECEIVE a NOID in your mailbox within the next few months guaranteed! When you receive the NOID you have very little time to act to preserve your right to receive ongoing wage loss benefits. These documents usual follow an “independent medical examination” or return to work slip obtained by pressuring a treating physician to return you work.

Remember that release you signed allowing the insurer to contact your health care providers, well the “nurse case manager” employed by the insurance company earns his/her job by getting you released finished with treatment and returned to work as fast as they can. You should NEVER allow a nurse case manager to assist with your file. They have no right to interfere with your doctor/patient relationship.

As soon as the Notice of Intent to Discontinue Benefits arrives in your mailbox you need to contact an experienced workers compensation attorney who limits their practice to workers compensation matters. Tom Atkinson has the number of the Minnesota Department of Labor employee who sets conferences to contest NOIDs on the speed dial of his phone! Tom will arrange for an expedited conference to your discontinuance action immediately. Contact Tom Atkinson at 651-324-9514 or email me at tom@mndisability.com Feel free to visit my website at www.mndisability.com