WHAT IS WORKER’S COMPENSATION?
Workers’ compensation benefits are laws that are dedicated to providing money and medical benefits to an employee who has an injury as a result of an accident, injury or occupational disease incurred at work. The laws are specifically designed to protect workers and their dependents against the hardships from injury or death arising out of the work environment. The Worker’s Compensation laws benefit both the employee and employer. The employee receives money (usually on a weekly or biweekly basis) and medical benefits in exchange for forfeiting the common law right to sue the employer. By contrast, the employer benefits by receiving immunity from court actions against them by the employee in exchange for accepting liability that is limited and determined.
WHO PAYS WORKER’S COMPENSATION BENEFITS?
All employers are required by Minnesota Statutes, section 176.181, subdivision 2, to either purchase workers’ compensation insurance to provide benefits to their employees for work-related injuries or to obtain approval from the Minnesota Department of Commerce permitting self-insurance upon proof of the employer’s financial ability to do so.
Employers can be self insured. However, in most instances, employers purchase workers’ compensation policies from insurance companies.
Benefits that are paid may include compensation to injured workers for wage-loss and permanent loss of use of body functions, medical and vocational rehabilitation costs, and out of pocket medical expenses such as mileage and prescriptions.
State law sets the benefit levels.
ARE INDEPENDENT CONTRACTORS COVERED BY WORKER’S COMPENSATION?
No. This issue comes up quite often in the context of construction law and in the IT industry where employees are contracted out to third party employers. Individuals who are independent contractors with no employees are not covered by workers’ compensation insurance unless the entity contracting with the independent contractor elects to purchase insurance for that individual or the independent contractor chooses to purchase coverage for him or herself. The workers’ compensation statute does not contain a definition of “independent contractor.”
When a question arises as to whether a particular relationship is that of employer-employee or that of two entities contracting independently, a five-factor test has developed through case law that generally allows an employer or employee to make some judgments concerning the appropriate characterization. This test involves analyzing the following five factors:
- the right to control the means and manner of performance;
- the mode of payment;
- the furnishing of tools and materials;
- control over the premises where the work was done; and
- the right of discharge. Guhlke v. Roberts Truck Lines, 128 N.W.2d 324 (1964)
The degree of control one party has the right to exert over another has become the primary factor to consider. One party’s right to control over another’s job duties is an indication that the first is an employer. Hunter v. Crawford Door Sales 501 NW2d 623 (1993).
HOW CAN WORKER PREPARE FOR A WORKER’S COMP. CLAIM?
- Save copies of all worker’s compensation claim-related documents, letters, forms, benefit checks and medical bills, especially the First Report of Injury form.
- Keep track of your mileage and parking fees for medical visits, vocational rehabilitation services and job-search visits.
- Save notes of phone conversations.
- Put your name, Social Security number, date of injury, employer and insurance company on all papers and forms you send to the Workers’ Compensation Division.
- Keep your employer informed about your recovery and plans to return to work.
CAN A WORKER BE DENIED WORKERS’ COMPENSATION BENEFITS?
Unfortunately, it is fairly common for an insurer to file a “Notice of Denial.” When a Notice of Denial is filed, it means the employer and insurer are disputing part or all of the worker’s compensation claim that has been made. A workers’ compensation insurer must notify the worker in writing within twenty-one (21) days after receipt of the petition for benefits that a claim denial has occurred. That Notice of Denial will also set forth the reasons for the denial of benefits. If a denial of benefits does occur, you should immediately contact an workman’s compensation attorney.
It is important to remember that if an insurer does not provide a notice within 21 days of the Petition for benefits, the worker may be awarded penalties, interest and attorney’s fees.
IS A WORKER ENTITLED TO A WORKERS’ COMPENSATION HEARING?
Yes. In fact, there are several types of hearings possible in any worker’s compensation case. The first hearing is generally a pretrial hearing. This is the best chance that you will have to resolve your case without a trial. At a pretrial hearing, your attorney will discuss the case and possible settlement options with counsel for the insurer and employer. If the parties are able to resolve the matter, that settlement may be recorded before the court. If they are unable to settle, the matter will be heard before a Workers’ Compensation Judge. If the issues cannot be resolved, the parties appear before a judge to schedule future court dates.
Similar to other civil cases, there may also be motion hearings. A motion hearing may be scheduled by any party to address procedural issues or substantive issues that are in dispute. Typical Motions may consist of motions to:
- produce discovery;
- to determine the case or parts of the case based on a summary judgement;
- motions for protective orders; and
- motions to compel production of discovery.
If you are unable to resolve your worker’s compensation issues, you are entitled to a trial before an administrative law Judge.
Beware, very often, insurance companies will hire investigators armed with cameras to conduct surveillance on the worker to determine if the claimed physical limitations are being exceeded in everyday activities.