Workers’ compensation is a vital resource that protects employees who suffer injuries or illnesses on the job. It provides wage replacement, medical coverage, and support during recovery, saving workers from financial burdens. Unfortunately, receiving it is not always straightforward.
Some may end up with work comp and denied treatment woes, which can be deeply unfair and discouraging. If you are in this situation, know that a denial is not the end of the road. Let us share the right knowledge on workers’ compensation settlements in Minneapolis.
Common Reasons for Work Comp and Denied Treatment Issues
Ideally, an injured employee reports an incident, receives medical care, and is promptly granted benefits. However, this outcome does not always work, usually because of the following:
- Lack of Timely Reporting: The insurance company may deny the claim if you do not report an injury within the required timeframe.
- Disputes About Whether the Injury Is Work-Related: If there is uncertainty or disagreement about whether the injury occurred on the job, the insurer may deny responsibility.
- Insufficient Medical Documentation: A lack of clear medical records linking the injury to the workplace can lead to denial.
- Inconsistencies in Statements: Discrepancies between your report and medical or employer documentation can raise red flags.
- Non-Compliance With Treatment: Your claim may be rejected if you do not follow prescribed treatment plans or attend scheduled appointments.
The Process for Workers’ Compensation Settlements in Minneapolis
When presented with work comp and denied treatment problems, keep in mind that you still have options. Here is an overview of workers’ compensation settlements in Minneapolis.
Step 1: Find Work Injury Attorneys in Minnesota
First and foremost, you need legal representation. A lawyer will journey through the complexities of the appeals process with you, ensure your protection, and increase your chances of a favorable outcome.
Osterbauer Law Firm is a trusted team of work injury attorneys in Minnesota. We have extensive experience helping injured employees build solid cases, communicate effectively with insurers, and fight claim denials in court if necessary.
Step 2: Call the Insurance Claims Adjuster
Contact the insurance claims adjuster assigned to your case. Clearly explain the issue with your claim and try to resolve it over the phone. Take note of the date and time of your call, along with the adjuster’s full name.
Step 3: Discuss With an Alternative Dispute Resolution Specialist
If your discussion with the claims adjuster does not lead to a resolution, you could speak with an Alternative Dispute Resolution (ADR) specialist from the Minnesota Department of Labor and Industry (DLI). Should the issue remain unresolved after, the ADR specialist will explain the formal dispute-resolution process and share resources and insights to guide your next steps.
Step 4: Enter Mediation
The DLI offers mediation services where a neutral third party facilitates negotiations between you and the insurance company. It is not mandatory, but it can be valuable for reaching a financial agreement outside of court.
Step 5: File an Appeal
If other efforts fail, you have the right to formally appeal the denial of your workers’ compensation claim. This step involves submitting an Employee’s Claim Petition form with your lawyer’s aid, which includes the following and more:
- Your name and employment details
- Information about your employer
- The date and time of the injury
- A description of the workplace incident
- Details about the medical treatment you have received
Step 6: Go Through Pre-Hearing Proceedings
The insurance company might request a preliminary determination hearing to try and resolve the issue again without a full hearing. If the decision is not in your favor, you can contest it and proceed.
Both parties shall share relevant case information, and attorneys may file motions or other paperwork before the hearing. There may be opportunities for settlement discussions before the hearing.
If you still fail to reach an agreement during the pre-hearing phase, your lawyer will prepare to present your case in court.
Step 7: Attend the Appeal Hearing
Your lawyer will submit a pre-trial statement summarizing the major points of your case. During the hearing, they can call medical and vocational experts to testify, present recorded depositions, cross-examine the insurance company’s witnesses, submit evidence, documents, and argue for your entitlement to compensation, and submit a post-hearing memorandum if necessary.
After your hearing, a judge will issue a ruling. A successful appeal will result in the reinstatement of your benefits, while an unsuccessful one may require you to file another appeal or seek alternative legal action.
Take the First Step Now
A denied workers’ compensation claim is overwhelming, but having legal experts by your side will give you peace of mind. From disputing the initial denial to presenting a case in court, a qualified lawyer will help you understand your rights and advocate for what you deserve.
At Osterbauer Law Firm, our work injury attorneys in Minnesota are ready to make all the difference in your life after a workplace accident. Trust us never to let injustice turn your recovery into an ordeal. Call (612) 334-3434 or contact us online today to schedule a free consultation.