Saturday, September 26, 2009

I Was Injured At Work. Now Who Pays For My Medical Bills?


Under Minnesota's workers compensation laws, an employee sustaining a work related injury is entitled to reasonable and necessary medical treatment. Given this rule many injured workers assume that the Minnesota employer and workers’ compensation insurer will automatically pay for the injury and the related medical expenses. This is unfortunately often not the case.

Many injured workers then go without treatment which allows the same employer and workers compensation insurer to allege that the lack of treatment is an indication you were NOT injured or injured that bad. Given some cases can take anywhere from a few months or even up to a year before a judicial determination is made on the dispute, it is VERY important that you find some way to get the treatment you deserve and need.

If you have private health insurance and your workers compensation claim or treatment has been denied, Minnesota law requires the health insurer to provide coverage under their policy and seek reimbursement from the workers compensation insurer. Many of my clients have overlooked this right as nobody who works for the insurance company is willing to share this secret.

If, however, you are without health insurance you are not alone. Nearly 700,000 Minnesotans receive health care through the state’s three publicly funded basic health care programs — Medical Assistance (MA) — Minnesota’s Medicaid program, General Assistance Medical Care (GAMC) and MinnesotaCare. For more information click here. Even with these programs in place,over 453,000 Minnesotans go without health insurance according to the U.S Census Bureau.

The Minnesota Department of Human Services (DHS) administers these programs and pays all or part of enrollees’ medical bills for:

Medical Assistance (MA) (Minnesota’s Medicaid program) is the largest of the health care programs, providing health care coverage and prescription medication coverage for a monthly average of 507,000 low-income senior citizens, children and families, and people with disabilities in fiscal year (FY) 2007.

General Assistance Medical Care (GAMC) provides medical care for a monthly average of 33,000 (FY 2007) low-income Minnesotans who don’t qualify for MA or other state and federal programs — primarily low-income adults, ages 21 and 64, who do not have any dependent children.

MinnesotaCare is a publicly subsidized program for Minnesota residents who don’t have access to affordable health care coverage. In order to eligbile you must meet the following:

  • Have a Social Security number or be willing to apply for one (unless you have religious objections);
  • Live in Minnesota;
  • If you are an adult and do not have children living with you, or if your children are over age 21, you must have lived in Minnesota for six months;
  • Be a U.S. citizen or non-citizen lawfully residing in the U.S.;
  • Not have other health insurance now or have had health insurance (including Medicare), for at least four months except for Medical Assistance enrollees whose health insurance premium was paid for by Medical Assistance; and
  • Not be able to get health insurance through an employer who offers to pay at least half the monthly cost.

Assistance in applying can be found here.

The only way an injured worker can get back to work is to get the necessary medical treatment. If you find yourself without medical insurance and the workers’ compensation insurer refuses to pay for your medical treatment, look into contacting the state and/or county for assistance. MinnesotaHelp.info is another great resource for help.

If you have been injured at work, attorney Tom Atkinson is more than willing to discuss your claim. There is NO obligation and he is willing to review your case to ensure you are properly receiving all the benefits you have coming to you. Contact him directly at 651-324-9514 or visit his web site at www.mndisability.com


Saturday, July 18, 2009

I Just Received a Notice of Intent To Discontinue Benefits In The Mail, What Should I Do Now?


I was reminded about the importance of having an attorney review Notices of Intent to Discontinue benefits (NOIDs) after meeting with a new client this afternoon. An attorney who has been handling workers compensation cases as long as myself can look at a NOID and usually find a deficiency or mistake that can help avoid the IMMEDIATE cessation of benefits. If you receive wage loss benefits YOU WILL RECEIVE A NOID at some point in your claim if the insurer is compliant with Minnesota’s Workers Compensation Laws.

When you receive a Notice of Intent to Discontinue Benefits (NOID), you should probably contact an attorney to simply have them review it to ensure you don’t have any defenses. At Minnesota Disability, attorney Tom Atkinson will review your NOID for FREE! The Notice of Intent to Discontinue benefits should be sent to you by mail, along with any supporting documents with which they are relying to stop you benefit payments. The document must also state in clear and concise language the basis for which they intend to discontinue your wage loss benefits.

Insurers often attempt to discontinue temporary total and temporary partial disability benefits for a variety of reasons. The most usual reasons are: reaching Maximum Medical Improvement, your return to work at full or reduced wages, release from work restrictions, or failure to cooperate with rehabilitation efforts. As in the case with my client today, the insurance company’s basis to discontinue benefits was improper on its face. In this instance the medical information referenced in the NOID was not attached by the inexperienced out of state claims handler. This error was compounded by other errors that will allow for additional defenses in the future.

As with most employee’s, you will receive no warning of the receipt of Notice of Intent to Discontinue your benefits. You simply find a letter from your workers compensation insurer along with a two page NOID with a sentence or two attempting to explain why your benefits are terminated. You have a right to immediately object to discontinuance. Though there are some exceptions, if you are not represented, you should IMMEDIATELY call the Minnesota Department of Labor and Industry at 1-800-342-5354 to object by telephone. Next, immediately contact an attorney to review the Notice of Intention to Discontinue benefits. If you do not prevail at the conference, it is a long road to appeal the decision and have the matter heard by a workers compensation judge. Though the time frame can vary, if you do not appeal the NOID within 12 days, you will need to retain an attorney to file an Objection to Discontinue benefits or file a Claim Petition.

Failure to object to a Notice of Intent to Discontinue Benefits can significantly delay your receipt of temporary total or temporary partial disability benefits. I strongly urge you take allow an attorney to provide a FREE review of your NOID to discuss options to the termination of you benefits. Attorney Tom Atkinson with MN Disability will directly take your call at 651-324-9514 EVERY DAY of the week. Don’t wait until Monday morning, call him today.

Welcome to the State of Minnesota Injured Worker Legal Help Center

The State Workers' Compensation Program is a self-insured, self-administered program that covers approximately 54,000 employees of the executive, legislative and judicial branches of state government; along with employees of some quasi-state agencies such as the State Fair and the Minnesota Historical Society. The program provides or coordinates claims management, disability management and managed health care for state workers who are injured on the job; and offers workers' compensation legal services for state agencies.