The Claim Process - UNIVERSAL CARE CLINICS

Disclaimer: The information on this Web page provides a general overview of the Minnesota workers’ compensation system for educational purposes only. It is not a complete description of workers’ compensation law or of the topics discussed and should not be construed as offering or providing legal advice. Those with questions about workers’ compensation law are encouraged to contact the Department of Labor and Industry for more information or a lawyer for legal advice.

1. What happens when I get injured at my job?

Tell your employer immediately. Be sure to report your injury to your supervisor. If you need to seek emergency medical attention do that first, but then contact your employer as soon as possible. Your employer will complete a First Report of Injury (FROI) form, so be sure to give your employer accurate and complete information about how your were hurt and about any injuries you sustained.

2. What types of injuries are covered by workers’ compensation?

A work-related injury can be any condition that is caused, aggravated or accelerated by employment activities. This includes traumatic injuries, gradual injuries or occupational diseases.

3. Does my employer have to carry workers’ compensation insurance?

Minnesota Statutes 176.181, subd. 2, requires every employer to provide workers’ compensation insurance for their employees, either through a policy with a licensed insurance company or through self-insurance approved through the Minnesota Department of Commerce. There are some exceptions, which can be found in Minnesota Statutes 176.041.

4. What benefits might I be entitled to if my claim is accepted?

Some benefits you might receive include wage-loss benefits, compensation for loss of use of a part of the body, medical benefits, vocational rehabilitation and retraining. Click on the links in the flow chart to learn more about each benefit type.

5. What medical treatment is covered by workers’ compensation?

The Minnesota workers’ compensation statutes entitle an employee to reasonable and necessary medical treatment or supplies to cure or relieve the effect of the work injury. The employer is required to furnish medical treatment as described by Minnesota Statutes 176.135, subd. 1, including psychological, chiropractic, podiatric, surgical and hospital treatment.

6. Can I treat with my own physician?

In most cases employees may choose their health care provider for treatment of a work-related injury. Under certain circumstances an employer may require an employee to see a designated health care provider for treatment or evaluation.

7. What is an independent medical examination (IME) and do I have to attend?

An independent medical examination (IME) is an evaluation performed by a doctor selected by the employer or insurer who is not involved in the employee’s care. The purpose of the IME is to provide an opinion about a variety of medical and job-related issues. The workers’ compensation insurance carrier or self-insured employer has a legal right to request an IME with a doctor it selects, at reasonable times and places. Failure to attend the examination could result in an interruption of benefits to the injured worker.

8. How does my workers’ compensation claim affect the Family Medical Leave Act (FMLA), sick time, vacation time, paid time off (PTO), etc.?

The work or non-work status of the injury or disability has no bearing upon the employer’s obligations under the Family Medical Leave Act (FMLA). The employee’s eligibility for the protections of FMLA is governed entirely by whether the employee’s injury or medical condition brings the employee within the coverage of FMLA. If the employee qualifies for FMLA leave, the employer will not be able to terminate the employee for absenteeism or take any other actions prohibited by FMLA until the employee’s entitlement to FMLA leave has been exhausted. Sick leave, vacation leave or paid time off (PTO) cannot be used to pay workers’ compensation benefits. However, accrual of these benefits may be affected by being off of work due to an injury.

9. What happens if I am unable to return to the work I did before I was injured?

You may be eligible for wage-loss benefits as discussed in question four. You may also be eligible for vocational rehabilitation services, at no cost to you, to help you return to work. Services may include vocational counseling, transferable skills analysis, job-seeking skills, job placement and formal retraining.

10. Where can I find Minnesota laws and statutes regarding workers’ compensation?

Minnesota Statutes Chapter 176 contains the Minnesota Workers’ Compensation Act, which allows employees to receive compensation for injuries or occupational diseases that arise out of or in the course of employment. Various Minnesota Rules, some of which are found in Chapters 5220, 5221 and 5223, also relate to Minnesota workers’ compensation.

11. What do I do if my workers’ compensation claim or wage-loss/monetary benefits are denied?

If the insurer has denied primary liability for your claimed injury (has never paid any benefits) call the insurance claims adjuster. Write down the date, time and adjuster’s name for your records. Explain the problem and try to work it out. Many problems can be fixed with a telephone call.

If a conversation with the claims adjuster does not resolve the matter, you may discuss your problem with a Alternative Dispute Resolution specialist at the Department of Labor and Industry (DLI). The Alternative Dispute Resolution specialist will try to help resolve your problems.