Reopening Minnesota Workers’ Compensation Claims

A Minnesota worker lifts a box and feels low back pain with tingling down his leg. The next day he can barely walk. He tells his boss and goes into the doctor. The doctor assigns light duty restrictions and recommends physical therapy. Workers’ compensation insurance approves the physical therapy. The physical therapy helps. The worker is released to return to work without restrictions, but his back still hurts and leg still tingles. He returns to the doctor a year later. The doctor recommends an MRI. The workers’ compensation insurance company says “sorry, your case is closed.”

That type of scenario, or some variant of it, plays out far too often. Unless an admitted Minnesota workers’ compensation case was closed by a judge, it is open, regardless of any insurance adjuster’s claims to the contrary.

How Long Can a Workers’ Comp Claim Stay Open?

Once an employer or insurance company provides medical treatment, a workers' compensation claim can stay open indefinitely. As long as the medical treatment is still caused by the work-related injury, the insurance company is required to pay for it.

What Happens When You Reopen a Workers' Comp Case?

Once a workers' compensation case is reopened, it should function as normal. Workers' compensation benefits include wage loss benefits, medical benefits, rehabilitation, and permanent partial disability.

• Wage loss benefits: Injured workers may be entitled to payment for time missed from work or reduced income caused by a work-related injury.

• Medical benefits: Workers’ compensation covers medical treatment that is reasonable and necessary to cure or relieve the effects of a work-related injury.

• Rehabilitation benefits: Injured workers may be entitled assistance from a vocational professional, retraining, or other services to assist in the return to work.

• Permanent partial disability benefits: The treating physician may assign a percentage rating that corresponds to a lump sum benefit paid to the injured worker.

How Long Do I Have to Reopen a Workers' Comp Case?

If the insurance company has paid for medical expenses, or the employer has provided medical treatment, then there is no time limit. Otherwise, the time limit may be as short as three years.

Was the Case Closed by a Judge or an Insurance Company?

Workers' compensation insurance companies often "close" claims internally. This basically just means that the insurance adjuster has come to the conclusion that the claim has ended, and is no longer monitoring it. However, this action has no impact on workers compensation laws.

On the other hand, a workers' compensation case can legally be closed by a judge. This can happen in two ways:

1) Findings and Order: After a hearing, a workers' compensation judge may find that the work-related injury has resolved. This action does close a workers' compensation claim.

2) Award on Stipulation (Settlement): An injured worker and an insurance company may agree to close the workers' compensation claim in exchange for a lump sum. This type of agreement must be approved by a workers' compensation judge. This action does close a workers' compensation claim.

Workers’ Comp Closed My Case

From an injured worker's perspective, it is not legally meaningful that the insurance company has "closed" its file. If an insurance company is refusing to pay expenses because the "claim is closed," the worker might consider contacting a workers' compensation attorney. This usually comes up in two scenarios:

Workers' comp case closed but still in pain:

If an injured worker still has ongoing pain issues that have not been addressed medically, he or she can request medical treatment. The insurance company cannot deny treatment simply because it closed its file.

Old workers' comp injury:

It is sometimes the case that old injuries get worse with time. Even if a long time has passed since the insurance company covered medical treatment, the worker may be entitled to additional benefits.

Can I Reopen a Workers’ Comp Case After Settlement?

Reopening a workers' compensation claim is much less common if it was closed by a judge. To reopen the claim, an injured worker must submit a petition showing one of the following:

1) A mutual mistake of fact;

2) Newly discovered evidence;

3) Fraud; or

4) An unforeseeable substantial change in medical condition.

Successful petitions usually are based on a substantial change in medical condition. The Workers' Compensation Court of Appeals evaluates those petitions based on the following factors:

1) A change in diagnosis;

2) A change in the employee's ability to work;

3) Additional permanent partial disability;

4) The necessity of more costly and extensive medical care than initially anticipated;

5) Causation; and

6) The contemplation of the parties at the time of the settlement.

Conclusion

Reopening Minnesota workers' compensation claims requires a clear understanding of how cases are managed and the rights of injured workers. The misconception that a claim is definitively closed simply because an insurance company says so can be detrimental to those still suffering from work-related injuries. As outlined, unless a case has been officially closed by a judge through a formal order or a settlement agreement, the claim remains open. This critical distinction means that workers have ongoing rights to medical treatment and other benefits as long as their condition relates to the original work injury.

For injured workers facing persistent pain or new symptoms, reopening a workers' compensation claim is a viable option, especially if the initial case was not resolved by a judicial order. If closed by judicial order, the process of reopening a claim usually hinges on demonstrating significant changes in medical condition that warrant further review. Understanding these processes can empower workers to advocate effectively for their rights.

If faced with the situation where a workers' compensation claim appears to be unjustly closed, seeking legal advice from a workers' compensation attorney is likely a good choice. An attorney can help clarify the legal standing of the case, assist in reopening a claim, and ensure that workers receive the benefits and treatment they are entitled to. Ultimately, the goal is to ensure that every worker receives fair and just compensation for their injuries, reflecting both their current medical needs and their long-term well-being.

LawSmith PLLC is a Minnesota legal practice that represents injured employees in workers' compensation cases. A free consultation with an experienced workers comp attorney is available to Minnesota injured workers on request. Feel free to reach out with any questions about workers' compensation benefits.