Whether or not you hire an attorney to represent you in a workers’ compensation proceeding is up to you. Most employees do so. The attorney is familiar with the laws and the procedures and is trained in advocating for your rights in the legal system. If you choose not to hire an attorney or are unable to find an attorney to represent you, you may still file a claim. The Office of Administrative Hearings (OAH) and the Department of Labor and Industry (DLI) can provide some basic information to assist you, but cannot act as your advocate. It will be your responsibility to serve and file the appropriate forms, gather the necessary documents and other evidence needed to prove your case, and present that information in the proceeding.
Word of mouth is often the best way to obtain a referral. If you or your personal contacts cannot recommend an attorney practicing in the area of workers’ compensation, your county or state bar association has referral services available. Visit the statewide referral system by computer at this website: http://www.mnfindalawyer.com/. In Hennepin County, call 612-752-6666, or visit the website at http://www.hcba.org/. In Ramsey County, call 651-224-1775, or visit the website at http://www.ramseybar.org/. In Dakota County, call 952-431-3200.
If you are claiming benefits to replace lost wages or payment for permanent disability (temporary total benefits, temporary partial benefits, permanent total benefits, or permanent partial benefits), attorney fees are paid as a percentage of the benefits obtained for you by the attorney. Generally, the fee is 25% of the first $4,000 in benefits and 20% of the remaining benefits for a maximum of $13,000 in attorney fees. In an especially complicated or lengthy case, the attorney may claim fees in excess of $13,000. Customarily, the insurance company withholds the attorney’s portion of the benefit that is owed to you and pays that portion directly to the attorney. Before a fee is paid to the attorney, the judge must approve the requested fee. In some cases, you are also entitled to reimbursement for a portion of the attorney fees, typically 30% of the fees after the first $250 in attorney fees.
If the disputed benefits are medical or rehabilitation services only, the attorney is paid by the insurance company after the attorney helps you obtain the services. The attorney fees are fully paid by the insurance company after the attorney obtains payment for the medical or rehabilitation services.
If you are unsuccessful in proving entitlement to benefits, the attorney does not receive a fee. You may, however, be required to reimburse the attorney’s costs (such as a charge from the doctor for a medical opinion). The terms of the agreement between you and the attorney are spelled out in a retainer agreement that you would be asked to sign when you hire the attorney.
In disputes between multiple employers or insurers, the attorney fees may be fully paid by the insurer. This occurs when the dispute is primarily about which insurer is liable for payment rather than whether benefits are owed to you.
There are different types of workers’ compensation proceedings. Some disputes are more informal. In these informal disputes, an administrative conference is held. For example, if you need assistance in resolving a dispute concerning only rehabilitation or medical services where the insurer admits you had a work injury, you may file a form called a Rehabilitation Request or Medical Request. The forms are available from the DLI website. Instructions for completing the forms are included with the form.
Another type of informal administrative conference is a discontinuance of benefits conference (often referred to as a 239 conference because the procedures are contained in Minnesota Statutes § 176.239). If the insurer stops your wage replacement benefits, you should receive a form called a Notice of Intention to Discontinue Benefits (NOID). The NOID form includes instructions on how to request a conference concerning your benefits. You may request a conference by calling OAH within the time deadline given on the form (usually within 12 days after the NOID is received by the state). If your benefits have stopped and you did not receive the NOID form, you may contact OAH to request a conference, or DLI for advice.
If the insurer denies that there was a work injury or has denied benefits for another reason and an administrative conference is not an option for you, you must file a petition for benefits. This initiates a more formal proceeding that ends with a hearing if your case is not settled by agreement. There are different petition forms for different circumstances. The most common petition forms for employees are the Employee’s Claim Petition and the Employee’s Objection to Discontinuance. These forms are available on the DLI website. Instructions for filing the forms are included on the form. If you need help understanding the form or how to complete it, please contact DLI or a staff attorney at OAH.
You will receive a notice in the mail of the date, time, and place that a proceeding is scheduled to occur. An administrative conference regarding discontinued temporary total or temporary partial benefits is typically held several weeks after the request for conference. An administrative conference following a Medical or Rehabilitation Request (that is not consolidated with a petition) is typically held two to three months after the Medical or Rehabilitation Request is filed. A settlement conference is usually held within six months after an Employee’s Claim Petition is filed. If a petition is not resolved by settlement, it is referred for a hearing at OAH. The petition is typically scheduled for a hearing within six months. Some cases are scheduled for a pretrial conference before a hearing.
Certain issues or cases are expedited for an early hearing. Cases involving a request for approval of urgent medical treatment (such as surgery) are advanced on the calendar. If the treatment has already been provided and the remaining dispute is over the payment of the bills, the case is not expedited. Cases involving a recent discontinuance of wage loss benefits are also expedited for hearing. An employee may also file an Affidavit of Significant Financial Hardship (a statement documenting the employee’s very urgent financial situation) to request that a petition be scheduled earlier than usual. You will find the Affidavit of Hardship form on the DLI website. Some employees apply for public assistance benefits while waiting for a workers’ compensation dispute to be heard and decided. You may also want to contact DLI to request mediation services. If the insurance company is willing to meet with you to try to resolve your case by agreement, the state mediator would assist you and the insurer in that process. A mediation session may be requested and scheduled at any time the parties and the mediator are able to do so. Mediation is a voluntary process; there is only a binding outcome if you reach an agreement.
An administrative conference is a meeting between the parties (the employee and the insurance company and/or their attorneys) to a workers’ compensation case and the judge. The judge starts the conference by explaining the issues to be addressed in the conference. Each party has an opportunity to state its position on the issues. In some cases there are others included in the conference such as a rehabilitation services provider or representatives of the employer. It is a meeting around a table, not a hearing in a courtroom. There is no formal testimony. The parties summarize the relevant facts and make legal arguments. If you offer written information for the judge to also consider, the judge will decide if it may be considered or not. You are expected to bring copies for the opposing party of any documents you want the judge to consider. Some administrative conferences also include settlement discussions if the judge and the parties think that would be beneficial. If the issues are not resolved by settlement, the judge will issue a written decision after the conference. An administrative conference usually lasts between 15 and 60 minutes.
The judge may schedule a pretrial conference before a hearing is held. The pretrial conference is a short meeting between the parties or their attorneys to clarify issues and procedures related to the hearing. By the date of the pretrial conference, you need to know all of the benefits you are claiming, the witnesses you plan to call at the hearing, and the documents and other evidence you expect to present at the hearing. Pretrial statements are due by the date of the pretrial conference (if one is scheduled), or 30 days before a hearing if a pretrial is not scheduled. On the OAH web site, you will find a Standing Order on Pretrials. This Order lists all the questions you are expected to answer in a written pretrial statement. Pretrial statements are not required in cases that are expedited unless a judge issues an order requiring a pretrial statement. (See “What if I can’t wait that long for my case to be resolved?” above regarding expedited cases.) The pretrial conference helps the judge know if the case is ready for a hearing. It is also an opportunity for you to ask questions about hearing procedures.
If you live more than 50 miles from the location of the conference, you may “attend” an administrative conference or a pretrial conference by telephone. Please contact the OAH at (651) 361-7900 if you want to be contacted by telephone before the conference date. The judge will call you at about the time the conference is scheduled to occur. If you have documents needed by the other party or the judge, they should be sent to that person before the conference. Hearings must be attended in person.
The hearing is a more formal proceeding, usually in a courtroom. Workers’ compensation hearings are subject to Minnesota Rules, chapter 1420, particularly part 1420.2900. Chapter 1415 also contains a portion of the litigation procedures. The hearing is digitally recorded or recorded by a court reporter. The judge typically allows an opening and closing statement at the beginning and end of the hearing. Exhibits are often documents related to employment, and medical records. Witnesses supply testimony related to the claim. The length of the hearing depends on the issues and the number of witnesses. Hearings are frequently scheduled for several hours. For more information about preparing for a hearing and what to expect in the hearing, please see Workers’ Compensation Hearing Preparation.
Some basic information about workers’ compensation benefits is provided on the DLI website. You may also call the customer assistance office at DLI. DLI will be able to give you some general advice, but its employees do not represent you in court or prepare the case for you. Links to the workers’ compensation rules and statutes are on both the DLI and OAH websites. The DLI website also has a resource guide that gives phone numbers to call for more information on a variety of workers’ compensation topics. Workers’ Compensation Court of Appeals decisions in recent years and some Mn. Supreme Court decisions in workers’ compensation cases are available at http://www.workerscomp.state.mn.us/.
Generally, information related to your workers’ compensation case is available by making a written demand for the information from the entity or person possessing the information. See Minnesota Rules, part 1420.2200 concerning “discovery”, the information gathering stage of the claim. Disputes about whether a party to the claim (the injured worker, the employer, the workers’ compensation insurer) must release information to another party are resolved by motion. The party seeking the information files a Motion to Compel. The opposing party may file a written objection within 10 days. The judge will make a decision about whether or not the information must be supplied. Sometimes the judge will schedule a conference to allow the parties an opportunity to present arguments about whether or not the information should be supplied, and then make a decision. Motion procedures are contained in Minn. R. 1420.2250. Motions are filed with OAH and a copy must be sent to the opposing party (the insurance company or their attorney if they have one).
One of the parties, usually the attorney for the insurer, drafts a settlement agreement called a Stipulation for Settlement. The agreement is then signed by the parties and sent to the judge for review. If the judge approves the agreement as fair and reasonable, an Award on Stipulation is signed and sent to the parties. Payment by the insurer according to the terms of the settlement must be sent to the employee no later than 14 days after the Award on Stipulation is sent to the parties. If the judge needs more information before deciding to approve or disapprove the settlement agreement, the judge will schedule a Special Term Conference to discuss the settlement agreement. At the conference, the judge may ask the parties questions about the claim and the settlement agreement, and answer questions from the parties as well. It is helpful to bring any medical reports you have regarding the injury and any other information that may assist the judge in determining if your agreement is fair. After the conference, the judge will issue an order either approving or disapproving the agreement. If the agreement is disapproved, you may choose to re-negotiate a different agreement, or file a request or petition for benefits to seek a decision regarding benefits due. If months have passed and a settlement agreement has not been filed, OAH may schedule a Stipulation Status Conference to talk to the parties about why the settlement agreement is delayed. If the Stipulation for Settlement is received by OAH before the date of the Stipulation Status Conference, the conference will be cancelled.
It depends upon the nature of the proceeding. A decision following a discontinuance of benefits conference is due five working days later. Once the judge has all the information that will be considered, the judge’s deadline to send a decision to you is usually a week later. After an administrative conference regarding rehabilitation or medical services, the decision is due 30 days after the judge has all the information that will be considered. After a hearing, the decision is usually due 60 days later. If the case is expedited, the decision is due 30 days after the evidence has all been received.
First, determine if the order is final. If an Award on Stipulation (approving a written settlement agreement) was issued more than 30 days ago, the matters settled are final. If you had a hearing and the judge issued a Findings and Order more than 30 days ago and no one filed an appeal, the matters litigated and decided are final. If you’re not sure if the order is final, talk to one of our staff attorneys. If there is no final order concerning the current claim, you are free to make a new claim. If the matter has been finally decided, you may make a further claim only after the decision or order is vacated by the Workers’ Compensation Court of Appeals (WCCA).
Although it is difficult to vacate a settlement agreement or final order, the WCCA occasionally does so. You would have to show one of the following:
a mutual mistake of fact (opposing parties both misunderstood some important fact regarding the intended settlement);
fraud (the party representing facts before the settlement or order knew that the facts represented were false);
newly discovered evidence (evidence was in existence at the time of the settlement or hearing but could not be obtained after reasonable and due diligence and the evidence affects the outcome of the dispute); or
a substantial change in the employee’s medical condition that could not have been reasonably anticipated at the time the settlement was approved (factors considered: change in the employee’s diagnosis or in the ability to work or engage in daily activities, change in the extent of permanent partial disability, or the necessity of more costly and extensive medical treatment than anticipated; there must be a causal relationship between the employee’s condition and the injury that is the subject of the settlement or order).
A settlement or final order may only be reopened if one or more of the above criteria are met. A change in a party’s financial situation is not a basis to vacate a settlement agreement. Economic stress or personal financial problems at the time of settlement does not render the employee’s consent to a settlement ineffective.
To request that a Stipulation for Settlement or final order be vacated, you would need to file an Application to Set Aside Award with the WCCA. The application is a legal document that must be accompanied by supporting affidavits (a legal document that is a written statement under oath), medical reports, other evidence, and a memorandum of law. A copy of the application is sent to the other parties also, and a proof of service document showing this was done is also filed with the WCCA.
The rules of procedure for the WCCA are located in chapter 9800 of Minnesota Rules. You may locate them on the internet at www.workerscomp.mn.us/rulestext. The phone number for the Workers' Compensation Court of Appeals is 651-296-6526. You may also call the customer assistance line at the Minnesota Department of Labor and Industry.
A workers’ compensation decision generally has an appeal paragraph telling you the time limit for filing an appeal, and the form that needs to be filed to appeal the decision. In an appeal, you cannot re-try your case. The Workers’ Compensation Court of Appeals decides if the judge’s decision was clearly erroneous and not supported by substantial evidence, or whether a legal error was made. Decisions made by OAH Judges after administrative conferences are not “appealable” to the WCCA. However, there is an avenue to present the case again in a hearing at OAH if you file a Request for Formal Hearing or Objection to Discontinuance within the appropriate time period. If you do not request a formal hearing after an administrative conference decision, the decision becomes final regarding the issues decided. The Request for Formal Hearing and Employee Objection to Discontinuance forms are available from DLI.
To appeal a decision, you must take all the required actions within the appeal time period. This includes (a) filing a Notice of Appeal with OAH and DLI, (b) sending a copy of the Notice of Appeal to the other parties, and (c) making a $25.00 payment to OAH. The Notice of Appeal form is available on the OAH website. The Notice of Appeal must include a proof of service on the other parties showing where and when the notice was sent and the name of the person who sent the copies to the other parties. After that, the appealing party must pay for the cost of a written transcript of the hearing. If the party filing the appeal is unable to pay the cost of a transcript, he or she may apply to OAH for a free transcript. The form for requesting a free transcript is available on the OAH website. Requests are occasionally granted in cases of severe financial hardship.
The rules concerning appeals to the Workers’ Compensation Court of Appeals are available on the court’s website at http://www.workerscomp.mn.us./
Appeals from decisions of the WCCA are to the Minnesota Supreme Court.
Throughout this document, there are instances where you are referred to the websites of the Minnesota Department of Labor and Industry (DLI) or the Minnesota Office of Administrative Hearings (OAH) for forms or additional information, or are given the option of contacting DLI or OAH for advice.
|Contact Information for the Minnesota Department of Labor and Industry:|
|Telephone:||651-284-5030 or 1-800-342-5354 (1-800-DIAL-DLI)|
|Mailing Address:||P.O. Box 64221, St. Paul, MN 55164-0221|
|Location:||443 Lafayette Road N., St. Paul, MN 55155|
|Contact Information for the Minnesota Office of Administrative Hearings:|
|Mailing Address:||P.O. Box 64620, St. Paul, MN 55164-0620|
|Location:||600 North Robert Street, St. Paul, MN 55101|
|Contact Information for the Worker’s Compensation Court of Appeals (WCCA):|
|Location:||405 Minnesota Judicial Center, 25 Rev. Dr. Martin Luther King Jr. Blvd., St. Paul, Minnesota 55155|