Tag Archives: wage loss

Injured at Work

Why You Should Know If Your Employer is Self-Insured

Minnesota requires employers to carry worker’s compensation insurance, which also means that your employer is the one who pays for the coverage.

Because your employer has to pay for workers’ compensation insurance, which operates much like any other insurance does with premiums, your employer has an unavoidable conflict: taking care of employees vs. keeping its costs low.

Self-Insured Employers

Not all conflicts of interests are equal though. It is important to discuss how this conflict can be even more amplified if your employer is self-insured.

Minnesota gives employers two ways to comply with the state’s workers’ compensation laws. It allows employers to get workers’ compensation insurance through:

  1. private insurance
  2. self-insuring

So what does it mean to be self-insured? If your employer is self-insured, it means that your employer acts as its own insurer. Instead of paying a traditional third party insurer, the company has set up a system in which it pays workers’ compensation claims directly out of the company’s own pocket.

Your employer is directly responsible for paying any wage loss benefits, medical benefits, permanent disability benefits, or rehabilitation benefits you are entitled to as a result of your workplace injury. This can add up to be a significant cost to your employer, especially if a lot of workers’ compensation claims are being made.

What kind of employer is self-insured? Minnesota requires that any employer who is self-insured prove that it has enough funds to pay workers’ compensation claims for self-insuring to be permissible. This means that self-insured employers are often large, corporate businesses. And, these employers have a significant interest in keeping their costs low by minimizing the workman’s comp claims it has to pay. Since they are paying out-of-pocket, the conflict of interest is emphasized. And, this may impact how hard your employer is willing to fight to avoid paying for your claim.

How to Find Out How My Employer Is Insured

It is not always easy to tell if your employer is privately or self-insured. Some self-insured employers pay third party administrators to handle the day-to-day aspects of its workers comp claims. These third party administrators are usually also private insurers, so it may initially appear that your employer is insured through the administrator. Look at your paperwork and see if any reference to the insurer says “administered by” or a similar variation. This is a good indicator that your employer is self-insured.

Next Steps: Make a Plan of Action

As an injured employee, it is important that you take steps to make sure you are getting the help you need to recover. Whether you would describe your relationship with your employer as good or bad, it is important that you understand the conflict of interest they have and how it can impact their decision making. An employer can’t have only your best interest at heart when it has so many other factors it is trying to balance. As workers’ compensation lawyers, we have seen many employees with both good and bad relationships with their employer run into difficulty getting their claims paid. The facts are this: if you were injured at work and are a qualifying employee, not only do you deserve coverage, you may be entitled to it.

If this “red flag” has brought concerns to your attention about your workers’ compensation claim or you believe you are not receiving the workers comp benefits you should be receiving, we encourage you to speak with an attorney as soon as possible. Our attorneys have extensive experience in handling workman’s compensation claims and are available to discuss your case. To speak with an attorney on the workers’ compensation team at Heimerl & Lammers, contact us at 612.294.2200.

Why Am I Not Getting Paid All of My Wages?

Under Minnesota’s workman’s compensation law, injured employees who receive wage replacement benefits do not get 100% of their income replaced. In other words, if you are receiving wage loss benefits and you were paid $12.00/hr on the job, your workers’ compensation will not pay the full amount.

Your benefit check will be 66 2/3% of your “average weekly wage.” There are two things about this an injured employee is likely to discover very quickly:

  1. Your average weekly wage is not necessarily what it sounds like (aka the wage you earn each week). Your average weekly wage (also known as “AWW”) is a technical calculation unique to workman’s compensation.
  2. You only get 66 2/3% of your income replaced by workers’ compensation.

Why is This?

First, the worker’s compensation AWW calculation is used to account for any variances in your work schedule, such as part time or seasonal work. This is especially important now that there are about 18.2% part-time workers. The AWW calculation also makes sure to properly account for any overtime.

Second, you get paid only 66 2/3% of your wages for a few reasons. Workman’s compensation is designed to get injured employees medical benefits and wage replacement as soon as possible. This means that traditional litigation, which may take years, is not a good fit. To create a system that worked quickly and efficiently, both employees and employers had to compromise. Getting paid less than you normally make is part of this.

Another reason is that your workers’ compensation benefits are not taxed. So, if you were making $12/hr before your work injury, that was not the amount you were bringing home after taxes. The idea is that employees should not make more money after getting hurt on the job than they were before. Some insurers also view the 66 2/3% rule as a way to motivate employees to return to work as soon as possible.

The good news for you if you are an injured worker is that the workman’s compensation system tries to work quickly. You may see a wage replacement check within a matter of a week or two after your workplace injury. When you are injured, that is exactly when you need the money. Not a year later.

What Can Workers’ Compensation Do For Me?

If you are an injured employee, I suggest you make a plan of action. First, arm yourself with knowledge. Second, communicate with your employer about your injury. Third, assess whether you will need a work comp lawyer.

A worker’s compensation attorney not only helps keep your employer and its insurer from dragging their feet, but he or she will take care of the paperwork and most communications on your behalf. Not all workers’ compensation claims will require the assistance of an attorney, but if you were injured on the job and do not have a workers’ compensation lawyer, make sure you are extra cautious and know your rights. Often, your claims adjuster will not tell you about all of the available benefits.

Our attorneys have extensive experience in handling workman’s compensation claims and are available to discuss your case. To speak with a Minneapolis attorney on the workers’ compensation team at Heimerl & Lammers, contact us at 612.294.2200.

Wage Loss & Wage Replacement Benefits

If you are an injured worker, you may find yourself unable to continue working or performing the same job after your injury. This can result in you losing income. Fortunately, workman’s compensation can pay you a portion of your lost wages.

Wage loss or wage replacement benefits are payments made to you if you lose all or part of your income because of a workplace injury.

The Minnesota workman’s comp laws use a lot of legal jargon, such as “temporary total disability” or “permanent total disability” to explain whether you are eligible for wage loss benefits. Despite the complicated terminology, injured employees who are eligible for wage benefits generally fall into one of three simple situations.

1. You have lost all of your income because your work injury keeps you from working.

Many injured employees experience a period immediately after a work injury when they cannot work but may return after a few days or weeks. This is called Temporary Total Disability. You are temporarily unable to work.

For some employees, their work injury is so severe it keeps them from ever working again. This is called Permanent Total Disability. You are permanently unable to work.

In both circumstances, workman’s compensation may pay you a portion of what your income should have been had you been working.

2. You lose income because your work injury stops you from working a full shift.

If you are an injured employee, your doctor may give you work restrictions that cap how many hours you can work a day, your employer doesn’t have enough work for your restriction-type, or you may simply be unable to tolerate your normal hours because of your work injury.

This is called Temporary Partial Disability. You are temporarily only able to do part of your job or earn part of your wages.

Generally, an employer does not have to pay the injured employee for the hours he or she did not work, so the injured employee can take a huge wage loss. And unfortunately, while your income has decreased, your monthly bills and living expenses probably did not. The good news is that workers’ compensation’s wage loss benefits kick in and help make up for those lost wages.

3. You are not getting paid as much after your work injury.

Wage loss can also occur when you work your regular hours but cannot continue to do your old job either permanently or temporarily. Our clients who find themselves in this situation often have to take a new job that pays less. Here, wage loss benefits may be available to make up for the income difference of your old and new position. This is also referred to as Temporary Partial Disability.

Plan of Action: What Are Your Next Steps?

If you fit into one of the categories above, you may be eligible for wage replacement workers’ compensation benefits. Your next step is to take some time to learn more about the workers’ compensation. You may want to check out our “Basics” blog series for a general understanding of workman’s comp or you simply may want to speak with a Minnesota work comp attorney to get more information about your specific case.

Minnesota Work Comp Attorneys

If this information has brought concerns to your attention, we encourage you to speak with an workman’s compensation attorney as soon as possible. Our Minneapolis attorneys have extensive experience in handling workman’s compensation claims and are available to discuss your case. To speak with an attorney on the workers’ compensation team at Heimerl & Lammers, contact us at 612.294.2200.

Regular Overtime Workers – Often Overlooked Wage Loss

If you are like many Minnesota workers, you regularly work overtime and rely on those earnings in order to pay your bills and support yourself or your family. It can be a really good thing if your employer has overtime work available, and pays at overtime rates. However, wage loss benefits are often overlooked for overtime workers that suffer a work injury.

Lost Wages

If an employee suffers a work injury, but can still work as a result (under work restrictions), most Minnesota employers that can accommodate the employee to continue working with those restrictions only allow employees to work up to 40 hours per week on light duty. This caps the employee’s wage at 40 hours per week, rather than the 40-plus-overtime hours they may have been earning before the injury.

As a result, the employee will often suffer wage loss if he or she consequently works that light duty job. This is because they are no longer able to work those overtime hours that help them get by, and it is that “overtime” wage loss that often gets overlooked. Whether intentional or not, insurers often do not pay those wage loss benefits to injured workers who are able to work 40 hours per week. However, if the overtime employee is earning less wages in working (capped at 40 hours per week), they are still entitled to wage loss benefits.

Average Weekly Wages

A worker is entitled to wage loss benefits of 2/3 the difference between their average weekly wage (AWW) prior to the accident and their weekly earnings after the accident. AWW does not depend on just what the worker earns per hour, but is rather an average of earnings grossed per week prior to the accident.

Therefore, if you suffer a work injury and you were a regular overtime employee before the accident, be aware that you may be entitled to wage loss benefits if you are not able to work those same overtime hours.

Workers’ Comp issues are very complex in the state of Minnesota. If you have any questions about a workers’ comp issue, contact a skilled MN workers’ comp attorney.

Wage Loss Benefits

What to do if the Insurance Company Stops Paying your Wage Loss Benefits

If you receive a Notice of Intention to Discontinue (NOID) from the insurance company paying your wage loss benefits you need to take action immediately to make sure you continue to get the benefits you deserve. A NOID can mean many things. It could mean one type of benefit has ended and another has begun, or it could mean that all wage loss benefits from the date of the NOID forward will be denied.

There are countless possible reasons why the insurance company may decide to stop paying you. If you feel they have unjustly cut you off, what you do next is extremely important. Here are some tips on what to do next:

Contact an attorney. This should be the first thing you do. An attorney is your best chance of getting your benefits reinstated quickly.

Request an Administrative Conference by calling the number on the NOID. It is important that you request an Admin Conference within 12 days of the date the NOID was served. You can find the service date of the NOID on the second page in the bottom right hand corner. If you request an Admin Conference within 12 days you will be granted an audience with a judge within two to four weeks.

If you do not request a conference within the 12 days you will have no choice but to file an Objection to Discontinuance. An Objection to Discontinuance can take up to 60 days before you are able to get in front of a judge, another 30 days for a judge to render a decision, and another 14 days before you start getting paid again.

Obviously, the quicker you can get in front of a judge the quicker you can start getting paid again. These Admin Conferences are only Band-Aids and are appealable by either side. Even if you are able to reinstate your benefits the fight for your benefits has just begun.