Minnesota has a no-fault system of workers’ compensation, where the insurance company should pay for your claim regardless of fault. However, sometimes insurance companies refuse to pay, and you have to go through the Department of Labor and the Office of Administrative Hearings to get what you need. Even then, you might have to take it to a higher authority.
Denial Process
When the insurance company denies your claim, you can file a petition with the Department of Labor, which will try to mediate your claim.
If it’s a simple case, the DOL will rule on it. If it is complex or concerns medical and rehabilitation issues, they will kick it straight to the Office of Administrative Hearings. There, you will attend a conference where a mediator will try to get all parties to settle their differences and write out an agreement called a Stipulation of Settlement. If no one is settling, the case goes before a a OAH judge for a OAH hearing.
There is no jury at OAH hearings; just a judge who will hear witnesses and expert testimony. This can take anywhere from a day to weeks.
An administrative judge has to sign off on these rulings, and sometimes these rulings don’t work for you.
Workers’ Compensation Appeals
Anybody can appeal a finding of the OAH and take his or her case to the Workers’ Compensation Court of Appeals. You have to act fast, however.
You or your lawyer have 30 days to file a Notice of Appeal, and you have to get the original filing fee check to the Office of Administrative Appeals within 10 business days after the appeal period ends. The Notice of Appeal is a written document covering the order appealed from and states specifically that you are appealing from the order to the Workers’ Compensation Court. All parties affected by the appeal need to receive a copy of this document. (The insurance can cross-appeal within 15 days of receiving the notice.) You must file the original notice to the chief administrative law judge and file a copy with the commissioner within the 30 day window, as well.
Reasons For Appeals
Minnesota law allows for 4 reasons that you can give to have an order appealed:
1. The compensation judge commits an error of law, and you can appeal on the grounds of the judge’s mistake.
2. The order doesn’t fit with the chapter on workers’ compensation in the Minnesota laws.
3. The findings and order aren’t supported by the facts of the case as a whole and are clearly wrong. The Notice of Appeal should detail which of the claims made in the order lack evidence.
4. The order and/or findings were procured by improper conduct such as fraud or coercion. The specifics of which findings you are reporting should go in the Notice of Appeal, just like any unsubstantiated finding.
Workers’ Compensation Court Process
Once you appeal, the case goes to the Workers’ Compensation Court of Appeals. This Court has the exclusive right to review workers’ compensation cases, but it does not work the way you see it on Law and Order.
The WCCA consists of 5 judges who work in groups of 3 to 5 to decide what to do with your appeal. They issue orders based on their findings, and their written decisions are published on-line and sent out to all the affected parties.
When you appeal, a judge will probably, with a few exceptions, have a transcription of the whole case written out. This will allow the compensation judges to catch up on the details. When that is done, the Court will do any of the following:
1. Examine the record given it.
2. Get your lawyer to present an oral argument based on the record before the compensation judge.
3. Substitute findings from their compensation judge for the findings from the last judge.
4. Remand or make an order
5. Change the award, order or disallowance of compensation based on facts, findings and law.
The court can make its own orders, but they might also let the old order stand, depending on what it finds.
The Court has 90 days from when it finishes getting all the information to make a decision. The Court can waive the 90 day limit, but it needs a good reason to delay. The Commissioner will have the proceedings recorded, and he or she is legally obligated to provide this transcript to anyone who requests it and pays the charge the Commissioner asks for.
The Supreme Court?
You have 60 days after the decision of the WCCA to appeal to the Minnesota Supreme Court. You will be covering the same ground that you did in the WCCA, and you will find the proceedings different once again.
With luck, you won’t have to take your case to the Supreme Court. To avoid that, and to make sure you get the benefits you are entitled to, you will need the help of expert legal advice. And if you do get all the way to the Appeals Court, you will definitely need a lawyer. So contact us when you start appealing your case.