If you suffer a job-related injury, workers’ compensation insurance could provide some benefits that can assist with your medical expenses and the time you miss from work.
However, there are strict eligibility rules, and navigating the claims process can be frustrating. Understandably, many injured workers are left trying to figure out, What does workers’ comp cover?
If you have questions about pursuing a workers’ compensation claim, contact an experienced Minnesota workers’ compensation attorney.
What Does Workers’ Compensation Insurance Cover?
If you are eligible, your workers’ compensation benefits can cover:
- Medical treatment,
- Loss of earnings,
- Any ongoing care costs, and
- Funeral expenses.
Some workers’ compensation claims are not related to a single accident or traumatic event. Instead, they develop over time. Some illnesses would qualify for benefits if you suffered exposure to harmful substances or chemicals.
If a medical doctor diagnoses you with a condition connected to your work-related activities, workers’ compensation benefits would likely provide some assistance with your treatment and time off work.
Repetitive injury claims also fall under workers’ compensation.
For example, carpal tunnel syndrome can take years to develop in some cases. If your job involves a lot of typing, workers’ compensation may pay for some of your treatment costs.
In some cases, injuries or illness are severe enough that you are temporarily disabled. In that case, workers’ compensation could potentially pay for some of your missed wages during your disability period as well as your treatment.
What Does Workers’ Compensation Not Cover?
Workers’ comp benefits won’t cover you for injuries you sustain outside of work. Additionally, benefits won’t apply if you:
- Were intoxicated or using illegal drugs at the time;
- Intentionally hurt yourself;
- Were injured during the commission of a crime;
- Started a fight; or
- Violated company policy.
If you are worried about a denial, it’s better to be honest upfront. If you try to cover up your actions and someone figures it out, you could be facing a coverage denial even if your claim was valid.
Who Gets Workers’ Comp?
In general, Minnesota Workers’ compensation laws state that employers must purchase applicable coverage or be self-insured.
However, some employers may be exempt from carrying coverage. Federal government employees are also not covered under state-run benefits programs. Instead, federal employees have benefits under federal workers’ comp.
Minnesota law excludes specific categories of workers from workers’ comp benefits as well. The exclusions can apply to people who are associated with the following business types, depending on their role in the company, their relationship to the company owners, and the size of the company:
- Family farm corporations,
- Sole proprietors and partnerships,
- Closely held corporations, and
- Limited liability companies.
In some cases, employers who wish to include categories of workers excluded from workers’ comp can take steps to have them listed as eligible for benefits. Some employers elect to do this if they have independent contractors, seasonal workers, domestic workers, etc.
If you fall under one of these categories and suffer a job-related injury, ask about potential coverage.
How Does the Workers’ Compensation Coverage Process Work in MN?
You must report your accident or condition to your employer within 14 days of the injury.
For repetitive injuries or occupational diseases, your date of injury is when you knew or should’ve learned that you had work-related injuries. Once you have reported the information, your employer will fill out a form and send it to the insurance company.
Provided your injury wasn’t severe and required immediate transport to the hospital, the insurance company will advise whether you are approved for benefits and provide a list of doctors within the plan.
Typically, you are expected to see a doctor covered under the plan, unless there is no listed medical provider within 30 to 50 miles from your home.
If your benefits are denied, you have the right to file a formal appeal with the Minnesota Department of Labor and Industry.
I Wasn’t Injured at My Workplace; What Does Workers’ Comp Cover?
There may be coverage for someone who wasn’t injured at their place of employment in some cases.
Were you still in the course and scope of your employment but somewhere else?
If so, then your employer’s workers’ compensation insurance should provide coverage. Maybe you were out at a training session, speaking at an event, or driving a company vehicle on your way to the office after visiting a job site.
Injuries occurring during any of these events could potentially trigger workers’ compensation benefits.
Why Would I Need a Workers’ Comp Attorney?
Unfortunately, it’s common to have a legitimate claim for benefits denied by the insurance company.
The appeals process can be complicated. You want an experienced Minnesota workers’ compensation benefits attorney on your side who can help you through the process.
If you need assistance with a workers’ compensation claim, contact the Law Offices of Arechigo & Stokka.
We have decades of experience handling workers’ compensation denials.
Let us put our experience to work for you and help you get the benefits you’re entitled to after a work-related injury.