0513c.indd
FOR WORKERS' COMPENSATION PROFESSIONALS
WORKERS' COMPENSATION BILL PASSES
Enhanced benefi t, cost containment, housekeeping items
The Minnesota Legislature passed a workers' compensation law that contains the most signi icant changes to the workers' compensation
Testing begins for new
system in almost 20 years. The bill was negotiated by the AFL-CIO
EDI trading partners
and the Minnesota Chamber of Commerce and approved by the Workers' Compensation Advisory Council. The governor sign the bill
In preparation for the Jan. 1, 2014,
on May 16, 2013.
mandatory EDI/eFROI implementation, the Department of Article 1 of the law contains several housekeeping provisions
Labor and Industry (DLI) has begun proposed by the department. Article 2 contains enhanced bene its
testing with new EDI trading
for injured workers and several cost containment measures for
partners, using the standards
employers. For example, coverage will now be provided for post-
outlined in the Electronic Filing of
traumatic stress disorder (PTSD) when diagnosed by a licensed
First Report of Injury
psychologist or psychiatrist according to the Diagnostic and
Implementation Guide. The guide
Statistical Manual of Mental Disorders and the maximum bene it for
may be found on the DLI website at injured workers was increased from $850 a week to 102 percent of
the statewide weekly average wage. In addition, the cap on cost of living adjustment (COLA) increases was raised from 2 percent to 3
To become a new EDI trading
percent and the waiting period for COLA increases was reduced
partner, see Section 4 of the
from four to three years. The law also directs the commissioner of
implementation guide for the
the Department of Labor and Industry to implement a two-year
necessary steps to follow. The revised Minnesota electronic
patient advocate program for workers with back injuries who are
trading partner profile became
considering spinal fusion surgery.
available on the department's
With respect to cost containment, limits were placed on certain job
website May 3, 2013.
development services, and employers and insurers will no longer be required to reimburse workers for a percentage of attorneys' fees if
More information regarding the mandatory EDI/eFROI
the employee did not actually pay any such fees. In addition, the
implementation, including
commissioner was given authority to adopt rules to require injured
frequently asked questions, can be workers who are prescribed narcotics to enter into pain contracts found on the department's website with their physicians. The commissioner is also directed to conduct at www.dli.mn.gov/WC/Edi.asp.
a study of the effects of potential reforms and barriers on workers' compensation medical and administrative costs, and make a report
Questions, comments or concerns
to the Workers' Compensation Advisory Council by Dec. 31, 2013.
regarding implementation can be directed to the DLI EDI/eFROI
The law is available on the Of ice of the Revisor of Statutes website as
Implementation Team at
Session Law 70 at www.revisor.mn.gov/laws/?id=70&year=2013&type=0.
Stay informed
Subscribe to the trading partners
email list on the DLI website at
www.dli.mn.gov/EmailLists.asp.
Department of Labor and Industry • 443 Lafayette Road N. • St. Paul, MN 55155 • (651) 284-5005 • 1-800-342-5354 • www.dli.mn.gov
FACTS ABOUT FUSION
The Department of Labor and Industry, in collaboration with the Medical Services Review Board, has prepared a Spinal Fusion Information Fact Sheet. The fact sheet is intended to provide basic information about the potential risks and bene its of spinal fusion surgery. Physicians, surgeons, quali ied rehabilitation consultants (QRCs), insurers and others are encouraged to share the fact sheet with injured workers who are considering lumbar fusion surgery.
The fact sheet is available on the department's website at www.dli.mn.gov/WC/Pdf/fact_sheet_lumbar_fusion.pdf.
Anyone with questions about the fact sheet or its use should contact Lisa Wichterman, DLI's medical policy specialist, at (651) 284-5173 or [email protected].
New online process streamlines submission of Medical, Rehabilitation Request/Response forms
The Department of Labor and Industry (DLI) has launched a new online process enabling employees, insurers, attorneys, rehabilitation providers and medical providers to complete and submit Medical Request, Medical Response, Rehabilitation Request and Rehabilitation Response forms electronically to the department. The process is intended to reduce delays caused by manually processing paper requests and responses. Use of this online iling process is optional; parties can continue to ile these forms with the department in the conventional paper format.
According to the most recent Minnesota Workers'
Compensation System Report, during calendar-year 2011, almost 5,000 Medical and Rehabilitation Request forms were iled. The system report also indicates that from 1997 to 2010, the overall dispute rate for Medical and Rehabilitation Request forms increased 92 percent and 69 percent, respectively.
The process became available April 19. All applicable statutes and rules regarding the iling of Medical and Rehabilitation Request forms apply to the forms available electronically from DLI's website. Data submitted electronically will be accepted as received only during regular DLI business hours, 8 a.m. to 4:30 p.m. (Central Time), Monday through Friday (excluding holidays). Data received after 4:30 p.m. or on a Saturday, Sunday or state holiday will be electronically date-stamped for the next business day DLI is open for business.
The form can be accessed at https://secure.doli.state.mn.us/adrforms/main.aspx. General instructions and directions for completion and submission of Medical and Rehabilitation Request forms can be accessed at www.dli.mn.gov/WC/PDF/mq03.pdf and www.dli.mn.gov/WC/PDF/rq03.pdf. If you have questions regarding the submission of these forms, call the DLI Alternative Dispute Resolution unit at (651) 284-5032 or 1-800-342-5354.
2 • COMPACT • May 2013
100 years of workers' compensation in Minnesota
100 years of helping injured workers get back to work
Prior to passage of the workers' compensation law in 1913, employees who became injured or ill at work often had little support and few options. Employers were not required to pay for medical help or to make concessions for those who needed to be off the job for a few days, inde initely or permanently.
"Until 1913, when Minnesota passed its irst workmen's compensation law, the injured industrial worker had four options," according to The Origins of Workmen's Compensation in Minnesota author Robert Asher. "He could sue his employer for damages; he could hope his employer would tender
inancial aid; he could fall back on an insurance policy if he had one; or he could turn for help to
private and governmental [charitable] institutions."
"Industrial accidents were so common," he reports, "that in 1909 a manager of a manufacturing plant could tell investigators in an unemotional manner that 'When a man applies to us for work and says he has 10 years experience on, say a punch press, we ask him to show us his hands. We expect to ind a few ingers off.'"
Employers, workers, labor groups and insurers were all in favor of some kind of workers' compensation system, but disagreed with the particulars of what should be enacted. Proposals to the 1911 Legislature failed, but the ideas resurfaced before the 1913 Legislature.
The 1913 Senate debated various amendments, compromises and objections to a bill proposing workers' compensation. One such objection was from the Minneapolis Trades and Labor Assembly "which called the Senate bill 'the most outrageous piece of legislation attempted to be passed against the interests of the working people in the state,'" according to How Minnesota Adopted Workers' Compensation by Shawn Everett Kantor and Price V. Fishback. "The Senate ignored the opposition to the bill and passed it unanimously."
When the bill passed to the House, more debate and compromise was underway. "For six hours," said Kantor and Fishback, "Representative Ernest Lundeen, a Republican and avid supporter of labor issues, proposed a litany of labor-supported amendments that effectively served as a ilibuster."
After adoption of some, but not all, of the proposed amendments, the House passed the bill 102 to 6.
Within the workmen's compensation law, the labor commissioner was given the duty to advise employees of their rights, adjust "so far as possible" differences between the employee and employer, "observe in detail the operation of the act throughout the state" and report to the Legislature, including any suggestions or recommendations.
The original statute is about a dozen pages in length. Among other bene its for injured workers, an injury producing temporary total disability requires payment of: 50 percent of the wages received at the time of injury, subject to a maximum compensation of $10 a week and a minimum of $6 a week, paid for as many as 300 weeks.
Today, 100 years later, the Minnesota Department of Labor and Industry (DLI) oversees the workers' compensation system to assure it quickly and ef iciently delivers indemnity and medical bene its to injured workers at a reasonable cost to the employers who are subject to the provisions of the law.
3 • COMPACT • May 2013
Examples of the schedule of compensation – 1913 and 2013
Type of disability
50 percent of wages – maximum $10 a week and 66-2/3 percent of wages – maximum $850 a minimum $6 a week; 100 percent of wages if
week and minimum $130 a week or the injured
Temporary total disability
making less than $6 a week; for up to 300 weeks
employee's actual wage; for up to 130 weeks
50 percent of the diff erence between the
66-2/3 percent of the diff erence between the
before-injury wage earned and the wage that
before-injury wage earned and the wage that
can be earned in a partially disabled condition –
can be earned in a partially disabled condition
Temporary partial disability
same minimum and maximum as above; for up
– same maximum as above; for up to 225 weeks
or, after 450 weeks after the date of injury, whichever comes fi rst
Compensation based on extent of such
Compensation based on a percentage of the
disability, from loss of a toe other than the great
whole body – from less than 5.5 percent to 95.5-
(or big) toe – 50 percent of daily wages for 10
100 percent – multiplied by a dollar amount
Permanent partial disability
weeks, to the loss of an arm – 50 percent of daily – ranging from $75,000 to $515,000; employee wages for 200 weeks
can request a lump-sum payment
50 percent of wages – maximum $10 a week and 66-2/3 percent of wages – maximum $850 a minimum $6 a week; 100 percent of wages if
week and minimum weekly compensation equal
making less than $6 a week; for up to 400 weeks
to 65 percent of the statewide average weekly
Permanent total disability
wage; ceases at age 67; coordinated with other government disability and retirement benefi ts
As of 2012, Minnesota Statutes Chapter 17, Workers' Compensation, stretches from 176.001 to 176.862 – covering everything from Appeals to Zero Ratings. An available PDF ile is 142 pages in length.
Current bene its, which are paid regardless of any fault of either the employer or employee, include: • medical care related to the injury, as long as it is reasonable and necessary; • wage-loss bene its for part of the income loss; • bene its for permanent damage to a body function; • bene its to dependents in fatality cases; • vocational rehabilitation services if the employee cannot return to the job or employer; and • reimbursement for mileage to obtain medical treatment and certain vocational rehabilitation activities.
The Department of Labor and Industry's Safety and Workers' Compensation Division comprises four work units to oversee various areas of assistance for employers, insurers, injured workers and other stakeholders (see page 6 for more information about each unit).
In addition, DLI added an Of ice of Workers' Compensation Ombudsman a few years ago, tasked with informing, assisting and empowering injured workers and small businesses having dif iculty navigating the workers' compensation system and recommending improvements to the effectiveness of the system.
The system continues to evolve and change, but the basic foundation of workers' compensation remains the same as it was 100 years ago – helping injured workers get back to work.
Information from The Origins of Workmen's Compensation in Minnesota was used with permission of the Minnesota Historical Society's Minnesota History magazine (Winter 1974). The complete text is online at www.mnhs.org/market/mhspress/minnesotahistory/index.html.
How Minnesota Adopted Workers' Compensation, published in the Independent Review (Spring 1998), is online at www.independent.org/publications/tir/article.asp?a=372.
4 • COMPACT • May 2013
Save the date: 2013 Workers' Compensation Summit
Looking Back, Moving Forward: 100 Years of Workers' Compensation in Minnesota
– Sept. 12, 2013 a
Cr wne Plaza Hot
Registration will open soon for the 2013 Workers' Compensation Summit! Join the Minnesota
Department of Labor and Industry on Thursday, Sept. 12, at the Crowne Plaza Hotel in St. Paul, Minn.,
for this one-day event packed with great information.
The conference will feature general sessions and breakout sessions that focus on current issues affecting the workers' compensation system and ways to improve processes and services that affect employers and injured workers. Topic to be addressed may include: recent changes to workers' compensation law; head injuries and traumatic brain injuries; alternative dispute-resolution options; workplace violence prevention; Medicare; chemical dependency; sleep deprivation; and more.
In previous years, the Workers' Compensation Summits in northern Minnesota attracted nearly 300 stakeholders, including employers, insurers, providers, employee representatives, public of icials and others. An even bigger crowd is expected this year with the conference in the metropolitan area.
The complete schedule, with topics and speakers listed, plus registration information, will soon be online at www.dli.mn.gov/Summit.
Exhibitor and Sponsor Opportunities
The Department of Labor and Industry and the Workers' Compensation Advisory Council are excited
to offer organizations two ways to showcase their company and support this important event.
• The Exhibitor's Package includes: an 8' x 10' booth with 8' skirted table, two chairs,
electrical access and Wi-Fi connectivity; as well as two complimentary all-access passes
to the conference, all conference materials and meals (additional exhibitor staff
members must register and pay the conference fee); plus company description, contact
information and logo listed in the conference program, with name/logo featured on
signage throughout the conference area.
• The Sponsor's Package includes: the company's name/logo on signage throughout the
conference area and in the conference program.
This opportunity closes at the end of business on Friday, Aug. 2, 2013. To become an exhibitor or sponsor contact Lisa Wichterman at [email protected] or (651) 284-5173.
Co-sponsored by the Minnesota Department of Labor and Industry and the Workers' Compensation Advisory Council. No taxpayer dollars will be used to fund this event.
5 • COMPACT • May 2013
Directors bring experience, knowledge to Workers' Compensation Division
Alternative Dispute Resolution
(ADR) unit
The ADR unit seeks early
intervention in workers'
compensation disputes through
conference and mediation. It
handles calls from the workers'
compensation hotline and
responds to questions from
injured workers and their
employers.
ADR Director Chris Leifeld
Leifeld joined DLI in April 2011,
serving as the director of the
Vocational Rehabilitation unit
for six months, until taking
on the position of Alternative
Dispute Resolution unit director.
Prior to coming to DLI, he
was the executive director
of the Minnesota Catholic
Conference for nine years.
Leifeld has a master's degree in
education from the University of
Minnesota. He lives in St. Paul,
Minn., with his two teenaged
children. Besides the constant
worrying about his children,
his hobbies include biking,
Back row: Chris Leifeld, Charles McKinstry-Luepke
remodeling his 1920s house
Front row: Jessica Stimac, Karen Kask-Meinke
and reading mystery novels and historical non iction.
Compliance, Records and Training (CRT) unit
The CRT unit creates and maintains workers' compensation claim iles. It ensures compliance with
bene it provisions of workers' compensation law by auditing workers' compensation claims, penalizing
insurers for late payment and providing educational outreach. It also certi ies QRCs and provides analysis
of medical and rehabilitation issues. Upon request, CRT mails the state's required workplace posters
without charge.
CRT Director Jessica Stimac
Stimac's primary area of practice since 2004 has been workers' compensation. She started in the ield
as a defense attorney, representing insurers, self-insured employers and medical intervenors. She
has been with the Department of Labor and Industry for six years. In that time, she has made bene it
determinations and mediated disputes in the Alternative Dispute and Resolution unit; supervised the
special claims of the Special Compensation Fund unit; and, since February 2012, has overseen operations
as director of the Compliance, Records and Training unit. Stimac has a bachelor's degree in biological
6 • COMPACT • May 2013
sciences from the University of Notre Dame and graduated with honors from the University of St. Thomas School of Law. Her hobbies include trail running with her Great Dane, reading, watching Notre Dame football and spending time with family and friends.
Special Compensation Fund (SCF) unit
This work unit administers the
workers' compensation claims of
injured employees who worked
for employers that did not carry
workers' compensation insurance or
that declared bankruptcy. SCF also
administers the asbestosis program and
the supplementary and second-injury
reimbursement programs. It enforces
the requirement that all state employers
carry workers' compensation insurance.
SCF Director Karen Kask-Meinke
Kask-Meinke joined the Department of
Labor and Industry (DLI) in 1989 as
a claims administrator in the Special
Compensation Fund unit, administering
second-injury and supplemental bene it
claims. Since then, she has gained valuable experience managing uninsured and bankrupt self-insured
claims, and supervising all functions of the fund, including the mandatory-coverage investigation
and penalty program. She is a St. Olaf College alumna and lifelong Green Bay Packers and Wisconsin
Badgers fan.
Vocational Rehabilitation unit (VRU)
This work unit provides vocational rehabilitation services to help injured workers return to work. Its staff
consists of quali ied rehabilitation consultants (QRCs), placement specialists and placement assistants.
Injured workers eligible for services include: those whose workers' compensation claims were denied;
those whose rehabilitation services were suspended; those who qualify for services paid by insurance
carriers or self-insured employers; and those who are awaiting a decision on eligibility for workers'
compensation bene its.
VRU Director Charles McKinstry-Luepke
McKinstry-Luepke has been with DLI for almost 24 years. During that time, he has worked as a
rehabilitation and medical specialist, rehabilitation policy analyst, mediator/arbitrator, quali ied
rehabilitation consultant (QRC) and QRC supervisor. He comes to the Vocational Rehabilitation unit with
30 years of experience in vocational rehabilitation, as well as experience in trucking and warehouse
management prior to that. He has a master's degree in rehabilitation counseling from the University of
Iowa and has maintained his Certi ied Rehabilitation Counselor certi ication since 1984. His hobbies
include long-distance biking, reading and playing music.
7 • COMPACT • May 2013
Vocational rehabilitation utilization
By Brian Zaidman, Research and Statistics
Vocational rehabilitation utilization measures
Figure 1. Percentage of paid indemnity claims with a VR plan filed, injury years 2001-2011
the percentage of indemnity claims with a vocational rehabilitation plan fi led. The fi rst
fi gure, based on developed numbers of claims and vocational rehabilitation plan fi lings,
shows the estimated percentage of injured
workers that are or will receive vocational
rehabilitation services by their year of injury.
The estimated rate for workers injured in 2011
was 23.8 percent, compared to estimated rates
of 23.7 percent for 2010 and 2009. The 2001
rate was 20.3 percent.
The second fi gure shows the estimated number
of injured workers who are receiving or will
Injury year
receive vocational rehabilitation services by
Figure 2. Number of paid indemnity claims with a VR plan filed, injury years 2001-2011
their year of injury. For 2011, 4,960 workers are estimated to receive vocational
rehabilitation services, compared to 5,110
workers injured in 2010 and 6,470 workers injured in 2001.
Figure 3 shows the utilization rate for workers
injured during 2008, 2009 and 2010, based on
ith
w 3,000
reported plans and claims, by the length of
temporary total disability (TTD) benefi ts paid.
This fi gure shows vocational rehabilitation
services are being provided to nearly all of the
injured workers who have received more than
six months of TTD benefi ts. For injured
workers with up to three months of TTD
Injury year
benefi t payments, 13 percent have received vocational rehabilitation services. For injured
Figure 3 Percentage of paid indemnity claims with a VR plan filed by TTD
duration, injury years 2008-2010 combined
workers with more than 12 months of TTD
benefi t payments, 95 percent have received vocational rehabilitation services.
n
la
p
ith 40%
w
e
g
ta
n 20%
Duration of TTD benefits
8 • COMPACT • May 2013
Coverage requirements highlighted for businesses, organizations
By Dave Horning, Special Compensation Fund Outreach Project Manager
Minnesota workers' compensation law states all employers are required to purchase workers' compensation insurance or become self-insured, with some limited exceptions.
To bring awareness of the workers' compensation requirement to organizations and businesses, the Special Compensation Fund (SCF) unit of the Department of Labor and Industry (DLI) has initiated a workers' compensation outreach program.
SCF is collaborating with state licensing and permitting boards to provide current workers' compensation information and standardized forms to verify license applicants aer in compliance with workers' compensation insurance requirements. Current information about workers' compensation coverage and who needs it is available on the DLI website at www.dli.mn.gov/WC/AboutCov.asp.
SCF's mandatory coverage enforcement team is providing support to state licensing personnel in determining workers' compensation coverage issues with license/permit holders.
Included in the outreach program is a 2013 revision to DLI's insurance veri ication lookup tool. The revised tool provides licensing personnel the opportunity to obtain – in real time – workers' compensation coverage information (if any) for a license/permit applicant.
The SCF outreach initiative is a irst step in expanding and coordinating state government workers' compensation education and compliance efforts.
Open an account with workers' compensation fi le review
Those who use the services offered by the department's Workers' Compensation Division File Review section, such as obtaining copies of workers' compensation records, may want to consider opening an account with File Review.
Opening an account is as easy as contacting File Review to register the business and then sending a check or money order payable to the Department of Labor and Industry with "Financial Services/Workers' Comp File Review" on the memo line. The recommended starting amount depends on business needs; a File Review staff member can help estimate this amount.
Opening an account allows File Review to provide a client's copies in a more timely manner, because the account eliminates the need to invoice the business and receive payment before making copies available. Account holders have the
bene it of copy availability immediately after preparation, with copy charges simply deducted from the account balance. The account holder will receive noti ication when the account needs to be replenished, to continue uninterrupted service.
For more information about this service, call File Review at (651) 284-5200.
9 • COMPACT • May 2013
Ask the ADR pro
DLI's Alternative Dispute Resolution unit
answers frequently asked questions
Editor's note: The Alternative Dispute Resolution (ADR) unit at the Minnesota Department of Labor and Industry seeks early intervention in workers' compensation disputes through conference and mediation. It handles calls from the workers' compensation hotline and responds to questions from injured workers and their employers.
Q. What can be done to ensure that medical bills incurred immediately after the claimed injury
are properly processed in the workers' compensation system?
A. Medical bills incurred immediately after a work injury often seem to fall through the cracks. In part
this is because the employer has up to 10 days to report a claim with disability exceeding three calendar-days to their workers' compensation insurer. "Medical only" claims are handled even less formally. In either case, a workers' compensation insurer will typically not have knowledge of a claimed work injury when an injured worker is irst treated and there will be no workers' compensation claim number or adjuster yet assigned.
Because the only thing that triggers the workers' compensation insurer's responsibility to pay medical bills (or to deny them, ask for additional information or schedule an independent medical examination) is the actual receipt of the itemized bills, the importance of making sure the medical provider has the information about where to send the bills cannot be overstated. A medical provider may have dif iculty obtaining this information from anyone other than the injured worker/patient due to data privacy laws.
Both employers and insurers can be helpful by reminding an injured worker of the need to furnish their medical providers with the workers' compensation insurance company contact information and the claim number as soon as it is available to make sure the providers send the medical bills directly to the workers' compensation insurer.
Employers and insurers should also feel free to give an injured worker DLI's Alternative Dispute Resolution hotline phone number (see below). Specialists are available to help explain this process to injured workers and how they play a critical role in ensuring the workers' compensation insurer will promptly process their medical bills.
Q. As an employee attorney, what can I do to expedite the certiϐication of dispute process
regarding medical bills?
A. When you ile a request for certi ication, provide as many details as you can about the matter in
dispute. For example: the bills or at least the amounts and dates of service; the explanations of review (EORs) or documentation showing denial of bills. Serving the insurer with the request for certi ication, although not required, is very helpful. ADR can then quickly contact the insurer and ascertain the current adjuster with some con idence they will be already aware of the issue being raised. Remember, the division iles contain virtually no information about what bills were submitted, when and to whom. DLI relies on the information the parties provide in the certi ication process to determine whether a dispute is ripe for certi ication.
Do you have a question for DLI's ADR unit?
Contact ADR at (651) 284-5032, 1-800-342-5354 or [email protected] if you have a question
for DLI's ADR professionals. The question and answer may also be featured here at a later date.
10 • COMPACT • May 2013
From the State Register
Provider participation list available
Minnesota Statutes § 256B.0644 and Minnesota Rules parts 5221.0500, subp. 1, and 9505.5200 to 9505.5240, also known as the Department of Human Services (DHS) "Rule 101," require health care providers to provide medical services to an injured worker under the workers' compensation law to participate in the Medical Assistance Program, the General Assistance Medical Care Program and the MinnesotaCare Program.
Notice is hereby given that the Minnesota Health Care Programs provider participation list for April 2013 is now available. The provider participation list is a compilation of health care providers that are in compliance with DHS Rule 101. If a provider's name is not on the list, DHS considers the provider noncompliant.
The list of providers is separated by provider type, each section is in alphabetical order by provider name and there is no additional information on the list other than the provider's name. This list is distributed on a quarterly basis to Minnesota Management and Budget, the Department of Labor and Industry, and the Department of Commerce. To obtain the list, call the DHS Provider Call Center at (651) 431-2700 or 1-800-366-5411. Requests may also be faxed to (651) 431-7462 or mailed to the Department of Human Services, P.O. Box 64987, St. Paul, MN 55164-0987.
More resources from DLI: newsletters, specialty and rulemaking email lists
The Minnesota Department of Labor and Industry (DLI) offers three quarterly publications in addition to COMPACT: Apprenticeship Works, CCLD Review and Safety Lines.
• Apprenticeship Works is the newsletter from DLI's Apprenticeship
unit. Its purpose is to inform the public of the goals, plans and progress
of the Apprenticeship unit. Learn more or subscribe online at
www.dli.mn.gov/Appr/Works.asp.
• CCLD Review is the newsletter from DLI's Construction Codes and
Licensing Division. Its purpose is to promote safe, healthy work and
living environments in Minnesota and to inform construction and code
professionals about the purpose, plans and progress of the division.
Learn more or subscribe online at www.dli.mn.gov/CCLDReview.asp.
• Safety Lines, from Minnesota OSHA, promotes occupational safety and
health, and informs readers of the purpose, plans and progress of
DLI also maintains ive specialty email lists and 11 rulemaking email lists to which interested parties may subscribe. The specialty email lists are: prevailing-wage information; workers' compensation adjuster information; workers' compensation EDI trading partners; workers' compensation medical providers information; and workers' compensation rehabilitation information. Learn more about DLI's specialty email lists, subscribe or review previously sent messages online at www.dli.mn.gov/EmailLists.asp.
The rulemaking lists are required to be maintained for people who have registered with the agency to receive notices of agency rule proceedings. The rulemaking lists topic areas are: apprenticeship; boats/boats-for-hire; electrical; ire code; high-pressure piping; independent contractor; labor standards/prevailing wage; Minnesota OSHA; plumbing; state building code; and workers' compensation. Learn more or subscrite at www.dli.mn.gov/Rulemaking.asp.
11 • COMPACT • May 2013
Updated brochures available:
Part of body
Work comp claim characteristics;
Head 3% (except eyes)
general industry, logging industry
The Department of Labor and Industry's Research and
Statistics unit has updated its annual Minnesota workers'
compensation claims characteristics brochures for general
industry and for the logging industry.
The general industry brochure provides statistics at a
glance about injury, illness and fatality claims for 2011, such
as the number of claims, nature of injury or disease,
occupation of injured workers and other injured worker characteristics. The brochure also provides resources for
Multiple parts 12%
further workers' compensation statistical information.
Body systems 3%and internal organs
The second brochure includes statistics about workers' compensation indemnity claims in the logging industry from 2006 through 2011.
There were 71 indemnity claims (claims with more than three days of disability) in the logging industry during this six-year period. Falls were the most common injury-causing event, with 30 percent, and fractures were the most common injury type, with 29 percent.
Both brochures are available on the department's website at www.dli.mn.gov/RS/ClaimCharac.asp. For more information, contact the Research and Statistics unit at [email protected] or (651) 284-5025.
Watch the website: Fall 2013 possible out-of-state training opportunities
The Minnesota Department of Labor and Industry (DLI) is looking into providing training to adjusters in the Chicago, Kansas City and Wausau, Wis. areas.
Each location will have a full day of condensed basic adjuster's training, followed by a half day for questions and answers. At each location, participants can attend either session or both sessions.
• Waiting period
• Forms/ iling refresher
• Liability determination
• Denials of liability
• Indemnity bene its
• Communication with DLI
• How/when to ile forms
• Resolving disputes
• Participants questions
• And more .
• And more .
Watch www.dli.mn.gov/WC/TrainingIns.asp for further details.
12 • COMPACT • May 2013
minnesota department of
labor & industry
workers' compensation division
June 13 and 14 • Oct. 17 and 18
8:30 a.m. to 4 p.m.
Recommended for claim adjusters who have less than one
year of experience in Minnesota workers' compensaƟ on
• Overview of Minnesota workers' compensation• Rehabilitation benefits and issues• Medical benefits and issues• Waiting period• Liability determination• Indemnity benefits• Penalties• Dispute resolution• How to file forms
t regis er and pay online
CEU credits
This educa onal off ering is recognized by the Minnesota commissioner of commerce as sa sfying 10.5 hours of credit toward con nuing insurance educa on requirements.
LocaƟ on
Minnesota Department of Labor and Industry, 443 Lafaye e Road N., St. Paul, MN 55155
$150 for the two-day session (includes lunch)
Early registra on is encouraged. The session is limited to 28 people. Classes will be fi lled on a fi rst-come, fi rst-served basis. The Department of Labor and Industry reserves the right to cancel a session if there are not enough par cipants registered.
Take the pre-test
Do you administer Minnesota workers' compensa on claims? Not sure if you need training?
Take the pre-test at www.dli.mn.gov/WC/PDF/quiz.pdf and see how you do.
If you need special accommodaƟ ons to enable you to parƟ cipate or have quesƟ ons about this training, call Jim Vogel at
(651) 284-5265, toll-free at 1-800-342-5354 or TTY (651) 297-4198.
• Judicial •
Workers' Com pen sa tion
Court of Ap peals
January through March 2013
Summaries of
Case summaries pub lished are
those pre pared by the WCCA
Majerus vs. Rochester City Lines Co., January 2, 2013
Evidence – Admission
Compensation judges are afforded considerable latitude in conducting evidentiary hearings, and they are trained in the law and presumed to properly weigh evidence admitted at hearing. Absent any indication that the compensation judge actually relied upon portions of exhibits or testimony containing allegedly prejudicial or irrelevant evidence, this court will not reverse or remand indings that have substantial support in the other relevant and material evidence of record.
Causation – Substantial Evidence
Even though the injury was not witnessed, and the employee could not corroborate the exact date of injury, substantial evidence, including medical records and the employee's testimony, supported the compensation judge's decision that the employee injured his low back at work as claimed.
Paskett vs. Imation Corp., Jan. 3, 2013
Arising Out Of and In The Course Of – Recreational Activities
The compensation judge properly concluded that the employee's injury during a charitable fundraising
lag-football game sponsored by the employer quali ied for the exclusion for injuries occurring during
voluntary employer-sponsored recreational activities pursuant to Minnesota Statutes § 176.021, subd. 9.
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DeMarais vs. United Parcel Servs., Inc., Jan. 3, 2013
Penalties – Substantial Evidence
Substantial evidence, including credible witnesses' testimony, supported the compensation judge's determination that the employer and insurer did not unreasonably or vexatiously delay payment of bene its due under an Award on Stipulation, and were not liable for a penalty under Minn. Stat. § 176.225.
Mohamed vs. Viracon, Inc., Jan. 4, 2013
Permanent Partial Disability – Psychological Condition
Substantial evidence supports the compensation judge's award of a 27 percent permanent partial disability for the employee's psychological condition based on the employee's treating psychologist's rating pursuant to Weber v. City of Inver Grove Heights, 461 N.W.2d 918, 43 W.C.D. 471 (Minn. 1990) by analogy to Minnesota Rules 5223.0360, subp. 7.D., items (2) and (3).
Permanent Total Disability – Substantial Evidence
Substantial evidence, including the adequately founded opinion of the employee's treating psychologist, a licensed psychologist who conducted vocational psychometric testing, and a quali ied rehabilitation consultant, supports the compensation judge's inding that the employee has been permanently and totally disabled since his work-related accident Dec. 18, 2008.
Af irmed in part and reversed in part.
Wittstock vs. Mcphillips Bros., Roofi ng Co., Jan. 9, 2013
Causation – Gillette Injury
Gillette Injury – Date of Injury
Substantial evidence supports the compensation judge's decision that the employee sustained a Gillette injury to his low back from his job as a roofer that culminated on the last day of his employment.
Apportionment – Equitable
Substantial evidence in the form of a medical expert opinion with adequate foundation supports the compensation judge's apportionment of liability.
DeNoma vs. City of St. Paul, Jan. 14, 2013
Causation – Substantial Evidence
Substantial evidence, including expert medical opinion, supports the compensation judge's inding that the employee sustained a low back injury as a result of a 1976 work injury.
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Permanent Partial Disability – Weber Rating
Permanent Partial Disability – Substantial Evidence
Where there is no rating listed for the employee's condition under the permanent partial disability schedules in effect at the time of the injury, a Weber rating is appropriate, and need not be based on ratings listed in the schedule. Substantial evidence, including adequately founded medical opinion, supports the compensation judge's award of permanent partial disability bene its, excepting the award of permanent partial disability for a right foot injury, which is vacated since the record does not support the injury was claimed before the statute of limitations ran. Calculation of award of permanent partial disability for hearing loss is modi ied as agreed by the parties.
Medical Treatment and Expense – Substantial Evidence
Substantial evidence, including expert medical opinion, supports the compensation judge's inding that the claimed medical expenses, except those for the right foot injury, were causally related to the employee's work injuries.
Af irmed as modi ied in part and vacated in part.
Miller vs. Brambleberry Farm, Jan. 15, 2013
Causation – Temporary Aggravation
Substantial evidence, including expert medical opinion, supported the compensation judge's decision that the employee's work-related shoulder injuries temporarily aggravated the employee's underlying degenerative condition and did not contribute to the employee's need for shoulder replacement surgery.
Fries vs. Independent Sch. Dist., #47 – Sauk Rapids, Jan. 17, 2013
Medical Treatment and Expense – Reasonable and Necessary
The judge properly considered factors relevant to the issue of the reasonableness and necessity of fusion surgery proposed by the employee's treating orthopedic surgeon, and substantial evidence supports the compensation judge's inding that the proposed decompression and fusion from T11 to L4 was reasonable and necessary.
Causation – Substantial Evidence
Substantial evidence, including medical expert testimony, supported the compensation judge's determination that the proposed surgery was causally related to the employee's April 25, 2002, work-related low back injury.
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Hansen vs. Dayton Hudson/Marshall Fields/Macy's, Jan. 22, 2013
Where the intervenor was not advised that a settlement was being discussed, there were no settlement discussions or negotiations with the intervenor, and no settlement offer was made to the intervenor, it was reasonable for the compensation judge to conclude that the intervenor was effectively excluded from settlement negotiations and that the intervenor is entitled to full reimbursement without a hearing on the merits, pursuant to Brooks v. A.M.F., Inc., 278 N.W.2d 310, 31 W.C.D. 521 (Minn. 1979).
Gilbert (deceased) vs. Independent Sch. Dist. 615, Jan. 23, 2013
Arising Out Of and In The Course Of
Where the employee's cause of death was unexplained and substantial evidence supports the compensation judge's determination that the employee was not in the course of his employment at the time of his death, the compensation judge's denial of the claim for bene its is af irmed.
House vs. Heartland Homecare, Jan. 28, 2013
Causation – Substantial Evidence
Substantial evidence supports the compensation judge's determination that the employee's current condition and need for treatment are related to the Feb. 10, 2010 injury.
Medical Treatment and Expense – Treatment Parameters
A party must speci ically identify which treatment parameters it claims to be applicable and must raise these speci ic arguments at the trial level to the compensation judge.
Medical Treatment and Expense – Reasonable and Necessary
Where the treatment at issue had been prescribed by the employee's physicians for symptom management, the employee had not required any extensive medical care since the medication was prescribed, and the medication allowed the employee to manage her condition and to improve to a point where she was "fairly stable," substantial evidence supports compensation judge's inding that the employee's treatment, including prescription medications, was in compliance with Minnesota Rules 5221.6300, subp. 10, and had been reasonable and necessary to treat the employee's condition.
Practice and Procedure – Matters at Issue
Where the compensation judge was asked at hearing to address whether the treatment at issue was reasonable, necessary and causally related to the initial injury, it was not error for the compensation
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judge to conclude that the employee's current condition and need for treatment is related to the initial injury and subsequent "overuse" as a result of continued work activities, and this conclusion did not result in the inding of a new Gillette-type injury.
Kanable vs. Service Master of Rochester, Jan. 31, 2013
Arising Out Of and In The Course Of – Substantial Evidence
Substantial evidence supports the compensation judge's inding that the characteristics of the location of the employee's worksite placed her at an increased risk for injury from highway traf ic and that her work injury accordingly arose out of her employment.
Murschel vs. B.F. Nelson Folding Cartons, Inc., Feb. 2, 2013
Causation – Substantial Evidence
Evidence – Expert Medical Opinion
Substantial evidence, including expert medical opinion, supports the compensation judge's indings that the employee did not sustain a right shoulder injury, left carpal tunnel syndrome or a brain injury as a result of a work-related accident on Jan. 21, 2010.
Todd vs. West Wind Village, Feb. 5, 2013
Causation – Substantial Evidence
Calculation of Bene its
Where substantial evidence supports the compensation judge's conclusion as to the injury responsible for the employee's disability, the compensation judge's inding that the employer and insurer had used the correct wage for the calculation of bene its and had not underpaid bene its is af irmed.
Bogdanowicz vs. Target Corp., Feb. 12, 2013
Causation – Medical Treatment
Causation – Temporary Aggravation
Causation – Pre-existing Condition
Despite the lack of a speci ic anatomical diagnosis and the employee's pre-existing multiple sclerosis, there is substantial evidence, including medical opinions, to support the compensation judge's conclusion that the medical treatment at issue is reasonable, necessary and causally related to the employee's work injury.
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Janikowski vs. Ryan Janikowski, Feb. 14, 2013
Attorney Feeds – Irwin Fees
The compensation judge properly applied the factors in Irwin v. Surdyk's Liquor, 599 N.W.2d 132, 59 W.C.D. 319 (Minn. 1999) to the facts in this case, and the compensation judge's award of attorney's fees for representation of the employee in recovering medical and rehabilitation bene its, in an amount less than that claimed by the employee's attorney, but greater than the contingent fees awarded, was reasonable and therefore is af irmed.
Benedict vs. Polar Fab, Inc., Feb. 19, 2013
Causation – Gillette Injury
Substantial evidence, including the expert opinion, supported the compensation judge's decision that the employee's work activities did not aggravate the employee's pre-existing arthritis and that the employee did not sustain the claimed Gillette injuries to her ingers.
Gunderson vs. Center for Diagnostic Imaging, Feb. 19, 2013
Causation – Substantial Evidence
Given the length of time before back pain was noted in the employee's treatment records, inconsistencies as to the onset of the employee's symptoms, as well as con licting expert opinions, substantial evidence supported the compensation judge's conclusion that the employee did not injure her low back in a fall at work.
Polzin vs. Canterbury Park, Feb. 20, 2013
Temporary Partial Disability – Work Restrictions
Substantial evidence, including medical records and expert medical opinion, supported the compensation judge's determination that the employee was able to work with no restrictions due to the work injury during the period in question.
Medical Treatment and Expense – Surgery
Substantial evidence, including medical records and expert medical opinion, supported the compensation judge's inding that diagnostic arthroscopy was not reasonable or necessary.
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Miller vs. Greyhound Lines, Inc., Feb. 22, 2013
Where the employee believed that she had provided medical information to the employer referring to the wrist injury and a irst report of injury had been iled listing "multiple body parts" as part of the injury, and where the employer has not been prejudiced by any delay, the compensation judge could reasonably conclude that the employee's delay in speci ically reporting a wrist injury was due to mistake or inadvertence and that the employee had given adequate notice under Minnesota Statutes § 176.141.
Causation – Substantial Evidence
Substantial evidence, including the employee's testimony and expert medical opinions, supports the compensation judge's inding that the employee sustained a right wrist injury as a result of a work incident.
Temporary Total Disability – Substantial Evidence
Where the employee was being treated for a wrist injury and had work restrictions related to that injury, substantial evidence supports the compensation judge's inding that the employee was temporarily totally disabled until she was released to work without restrictions.
Moore vs. Big Timber Wood-Premier Resources, Feb. 28, 2013
Practice and Procedure – Matters at Issue
Where the compensation judge was presented with an overall dispute regarding mental health treatment provided by Primary Behavioral Health Clinic, which would have included a prescription for BuSpar, and said prescription was addressed in the IME doctor's opinions and the employer and insurer's closing arguments, the compensation judge did not err in determining that the BuSpar prescription was at issue as a part of the treatment provided by Primary Behavioral Health Clinic.
Evidence – Burden of Proof
Evidence – Expert Medical Opinion
The compensation judge did not apply an incorrect burden of proof or foundation standard where he considered all of the medical opinions presented along with the employee's testimony and found that a preponderance of the evidence established that the employee's August 2003 injury was a substantial contributing factor in his mental health condition.
McCarney vs. Malt-O-Meal Co., March 5, 2013
Causation – Temporary Aggravation
Evidence – Expert Medical Opinion
When the expert relied on by the compensation judge seemingly held an erroneous view as to what constitutes an injury under Minnesota workers' compensation law, and where the compensation judge
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failed to make other indings bearing on the issue of whether the employee sustained a compensable injury, the matter was remanded for reconsideration and further explanation.
Reversed and remanded.
Lann vs. Stan Koch & Sons Trucking, Inc., March 6, 2013
Attorney Fees – Subd. 7 Fees
The provision in Minnesota Statutes § 176.081, subd. 7, stating that the award to the employee is 30 percent of attorney fees after the fee is reduced by $250 is applied only to the irst award of fees arising out of an injury.
Larson vs. Herberger's, March 6, 2013
Causation – Substantial Evidence
Substantial evidence supports the compensation judge's conclusions and determination that the employee's work injuries did not result in temporary total disability or ongoing medical care.
Jaynes vs. Golden Crest Nursing Home, March 13, 2013
Evidence – Expert Medical Opinion
The employee's objections regarding a medical expert's quali ications concern the weight to be given to that expert's opinions, which is a question for the compensation judge. Where an expert's opinions have suf icient foundation, this court will not disturb the compensation judge's decision with regard to the weight assigned to that expert's opinion.
Practice and Procedure – Matters at Issue
The compensation judge did not impermissably expand the issues to include causation. The employee bears the burden of showing that medical treatment is not only reasonable and necessary but causally related to the injury as well, and although the compensation judge does include some implicit discussion of the causal relationship between the ongoing medical treatment at issue and the work injury, his decision may be upheld where it was based primarily on the reasonableness and necessity of the treatment at issue.
Appeals – Record
Where pharmacy records were available to the employee at the time of the hearing but were not presented to the compensation judge, those records will not be considered on appeal.
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Sammarco vs. Ford Motor Co., March 14, 2013
Vacation of Award
The supreme court's summary af irmance of this court's prior decision, af irming the compensation judge's determination that the employee failed to ile her claim within the time prescribed by the statute of limitations, is inal and conclusive, and this court has no authority to void or vacate the decision of this court or that of the compensation judge in this matter.
Petition to vacate dismissed.
Reinhard vs. Federal Cartridge Corp., March 18, 2013
Caustion – Substantial Evidence
Evidence – Medical Expert Opinion
Substantial evidence, including adequately founded medical opinion, supported the compensation judge's determination that the employee did not sustain a Gillette-type injury in the nature of epididymitis. The compensation judge did not err in inding the opinion of the independent medical examiner more persuasive than the opinions of the employee's treating physicians where the opinions of all the medical experts were adequately founded.
Morgan vs. Minnesota Wild Hockey Club, March 25, 2013
Wages – Calculation
The compensation judge did not err in accepting the calculations presented by the employer and insurer at the hearing to be a reasonable determination of the employee's earning capacity at the time of his injury.
Temporary Partial Disability – Earning Capacity
Substantial evidence, in the form of testimony by the employee found credible by the compensation judge, supports the determination by the compensation judge that the employee had sustained a loss in earning capacity as the result of his work injury.
Permanent Partial Disability – Substantial Evidence
The well-founded opinion of an evaluating doctor, in combination with the employee's testimony, provides substantial evidentiary support for the compensation judge's award of permanent partial disability bene its.
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Olson Husain vs. Paul A. Schmitt Music Co., March 28, 2013
Notice of Injury – Actual Knowledge
Substantial evidence, including the testimony of the employer's bene its administrator, supported the compensation judge's conclusion that the employer did not have timely notice or actual knowledge of the employee's injury as speci ied by Minnesota Statutes § 176.141.
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Source: http://www.doli.state.mn.us/wc/Pdf/0513c.pdf
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