Frequently Asked Questions2024-03-29T14:26:05+00:00

Frequently Asked Questions

What is an “intervention” claim?2024-04-02T00:32:47+00:00

Medical providers (and other entities who have a financial interest in the injured worker’s claim) who have provided treatment to injured workers should receive a notice of their intervention rights at some point during a disputed claim. That notice typically includes basic information about the parties in the claim and what the provider should do in order to file an intervention claim in the matter. An intervention claim basically “piggy backs” on the injured worker’s claim and is the best way for a medical provider to recover outstanding expenses for the injured worker.

There are very specific deadlines for intervention claims as well as some basic rules, all of which can be found on the State of Minnesota Office of Administrative Hearings’ website:

If there is a balance after the medical provider receives payment from personal/private insurance (called the “Spaeth” balance), that balance can form the basis for an intervention claim.

Does my medical provider have to get prior approval for all of my work injury treatment?2024-04-02T00:31:35+00:00

Minnesota Rule 5221.6050 requires prior notification to the workers’ compensation insurer by the medical provider in some situations. In general, medical providers should request authorization from the workers’ compensation insurer at least seven (7) days before proposed medical treatment. That request can be made in writing or orally.

Regardless of the format, the medical provider should keep track of the request. The workers’ compensation insurer then has seven (7) days in which to respond (in writing or orally).

If the workers’ compensation insurer does not respond within seven (7) days, then the medical provider can assume that the proposed treatment is authorized and go ahead with the care.

If the workers’ compensation insurer requests additional information, requests a second opinion or an adverse medical examination, or simply denies the care, the medical provider should notify the injured worker and/or his/her attorney as soon as possible.

Is my medical provider allowed to send me bills for work comp medical care?2024-04-02T00:29:59+00:00

Medical providers are not allowed to attempt to collect payment by an injured worker for medical care related to the work injury. Minn. Stat. §§176.135, subd. 7; 176.83, subd. 5, paragraph (c); and, 176.136, subd. 2a. See also Minn. R. 5221.0500, subp. 3.

If a medical provider or someone acting on behalf of a medical provider collects or attempts to collect payment from an employee for charges on a bill for medical treatment or services related to a claimed workers’ compensation injury, then the provider may be subject to penalties assessed by the Minn. Dept. of Labor and Industry.

Please note that this prohibition applies to any co-pays or deductibles that the injured worker would owe if the medical care was NOT work-related. In other words, medical providers cannot bill injured workers for co-pays or deductibles if the personal/private health insurer pays for work-related medical care; instead, those balances should be pursued by the medical provider through an intervention claim.

Are there rules regarding how much work comp insurers have to pay for medical treatment?2024-04-01T18:11:16+00:00

Yes. Minnesota workers’ compensation laws have a “fee schedule” that controls how much medical providers are paid by workers’ compensation insurers. More information about fee schedules is available here:

Who is supposed to pay for my work-injury medical expenses? And, what happens if work comp denies?2024-04-01T18:08:10+00:00

The workers’ compensation insurer is primary. This means that medical providers should always bill the workers’ compensation insurer first, even if everyone knows that the workers’ compensation insurer will deny payment.

If the workers’ compensation insurer denies payment and/or delays too long, then the medical provider should document the delay and/or denial (as there may be a need for proof of that non-payment) and then bill the injured worker’s personal/private health insurer as soon as possible.

The personal/private health insurer may require proof that the workers’ compensation insurer has denied the medical care before they pay. That is why the medical provider should document its communications with the workers’ compensation insurer.

If the medical provider takes too long to the bill the personal/private health insurer, then Minnesota medical billing laws may prevent the medical provider from recovering any money from anyone for those bills.

If the personal/private health insurer refuses to pay for the work-related medical treatment, that is probably because it thinks the treatment is work-related. We may agree and will be sure to file a claim to force the workers’ compensation insurer to pay for the treatment. But, in the meantime, the personal/private health insurer is required to pay for medical care that has been denied by the workers’ compensation insurer. This is to prevent delay to the injured worker receiving necessary treatment and to make sure the medical provider is promptly paid.

The personal/private health insurer will be given the opportunity to file a claim to recover any payments it made on medical care that is later shown to be work-related. This is called a notice of intervention rights, and our office is responsible for sending those notices out to all entities (medical providers, insurers, etc.) who may have a financial interest in the injured worker’s claim. The personal/private health insurer can file an intervention claim to recover its payments.

The medical provider may receive less money from the personal/private insurer than it would from the workers’ compensation insurer. This is called a “Spaeth” balance and can be recovered through an intervention claim filed by the medical provider.

Find out more about intervention from the State of Minnesota here:

What are the rules on billing for medical care in Minnesota workers’ compensation claims?2024-04-01T18:02:06+00:00

When an injured worker receives medical care in Minnesota for a work-related injury, the medical provider should bill the workers’ compensation insurer for that medical care. Medical providers are required to comply with Minnesota workers’ compensation rules regarding billing for medical services. One of the most important rules on this is Minn. Rule 5221.0700, which requires medical providers to bill the workers’ compensation insurer within 60 days.


How does a negligence/motor vehicle collision claim work and how long does it take?2024-04-01T18:05:27+00:00

When someone has suffered injury and loss due to the negligence of another person or company, the injured person or their family may have a claim against the negligent party for the losses sustained because of that negligence. Those losses can include past and future medical expenses, past and future wage loss, and other “damages.”

The injured party can pursue a claim against the at-fault individual or company whose insurance frequently provides “coverage” for the claim. Individuals and companies have different types of insurance (automobile, homeowners, etc.) that are regulated by the insurance policies themselves as well as state and sometimes federal law.

A claim against an individual or a company is generally handled by that person or company’s insurance company. The insurer will frequently want information about the circumstances surrounding the injury as well as the nature and extent of the injured person’s damages. This can include accident/policy reports, photographs, medical records, bills, and other documents and information. Some claims also involve video footage (i.e. a security or surveillance camera), text messages, emails, and other types of electronic or digital data. Many insurance companies also try to take a statement from the injured party.

There are typically two parts to a negligence claim in which a person has been injured: liability and damages.

Liability involves the facts surrounding the injury-causing incident and whether the injured party can prove that someone was negligent. Determining liability in a case will involve the actions of the involved parties, any regulations and/or laws that apply, and many other factors that vary significantly.

Damages looks at whether the injuries were caused by the negligence (as opposed to some other cause) as well as how severe the injuries are and how much the losses cost (medical expenses and wage loss). Damages can also include the stress, emotional hardship, and other harms that an injured person suffers from an incident. Most injured people require the support of their medical providers to prove their damages.

An insurance company will not pay money more than once on a negligence claim. That money is paid either in a settlement or as a result of a judgment from a trial. As a result, it is important to have as much information as possible when discussing resolution of a negligence claim.

If a negligence claim does not settle, then under some circumstances it can be appropriate to file a lawsuit against the at-fault party. There are deadlines, or “statutes of limitations,” that apply to such a lawsuit that vary.

Timelines and procedures for a negligence claim in Minnesota vary. However, the sequence of events is typically as follows:

  • A claim is started by communicating with the at-fault party and/or that party’s insurance company. Generally, the at-fault party’s insurance company takes over and may request basic information regarding the claim which can include statements, executed authorizations, and other documentation and information.
  • The injured party (you) does as much as possible to recover from the injury. This generally involves receiving medical treatment and can take anywhere from a month to several years. (The reason there is a 6-year statute of limitations for most negligence claims is because of how long it can take to recover from some injuries. People are not expected to resolve their claims if they do not know what if any long-term effects will remain.)
  • Once you have recovered as much as possible, we will collect updated information and documentation to properly analyze the claim. Then, we will meet with you to review your claim and put together a settlement demand to send to the at-fault party’s insurance company.
  • The at-fault party’s insurance company can take anywhere from a couple of days to over a year to review and respond to a settlement demand.
  • At any point during the claims and settlement process but before the statute of limitations expires, we can file a lawsuit against the at-fault party. Lawsuits are generally filed if we are unable to agree upon settlement terms. They can also be filed if we do not want to wait for the at-fault party’s insurance company to respond to a demand or if there is some other good reason to commence litigation sooner rather than later. We file a lawsuit by serving the at-fault party with a Summons and Complaint.

You can find out more about civil lawsuits here:

What happens in a civil lawsuit in Minnesota?2024-04-01T17:58:52+00:00

In Minnesota state courts, a civil (instead of criminal, family, or probate) action begins with the complaining party (“Plaintiff”) serving a Summons and Complaint upon the responding party (“Defendant”). The Plaintiff then has to file the Summons and Complaint in state court within a year of the date on which they were served upon the Defendant.

In Minnesota federal court, a civil action begins with the Plaintiff filing a Summons and Complaint in federal court and making sure that the Defendant receives a copy.

There can be more than one Plaintiff and more than one Defendant. Plaintiffs and Defendants can be people OR entities such as businesses and agencies.

A Complaint is the legal document (typically created by an attorney) that identifies what the Plaintiff believes Defendant did wrong as well as the damages the Plaintiff claims to have suffered because of what the Defendant did or did not do.

After being served with the Complaint, the Defendant is required to issue an “Answer” within a certain time frame (usually 20-30 days). In the Answer, the Defendant should identify which parts of the Complaint with which the Defendant agrees and disagrees. The Answer is usually a form response that disagrees with everything the Plaintiff claims. The Answer is supposed to also include any affirmative defenses the Defendant has and whether the Defendant blames anyone else for Plaintiff’s losses.

Even though the lawsuit is against a person or business (the “at-fault party”), their insurance company will likely take over the claim on their insured’s behalf. In Minnesota,

If Defendant does not provide an Answer to Plaintiff’s Complaint (which is rare), then the Court can enter a default a judgment against the Defendant in Plaintiff’s favor.

Once the Complaint has been filed with the Court, there is usually a scheduling conference between the attorneys and the Court. A trial date is selected as well as a number of other important dates. A trial date can be anywhere from six months away to two years away. Trial dates can be postponed for various reasons – one or more parties request it, an attorney becomes unavailable, the judge becomes double-booked, etc.

Discovery and “Rule 35” Examinations

Discovery is the formal exchange of information and documentation between the parties to a lawsuit. Discovery generally includes sharing documents and other information as well as taking depositions of the Plaintiff, the Defendant, and other important witnesses. The discovery process can take anywhere from a few months to over a year or even longer, in some cases.

Depositions are formal statements under oath. They usually involve an attorney asking an individual a lot of questions while a court reporter records everything and then types everything up into a transcript. Both parties receive copies of deposition transcripts which are typically used to prepare for trial.

If a Plaintiff has alleged an injury, then the Defendant will likely ask the Plaintiff to sign various authorizations so that they can collect the Plaintiff’s medical records and other information. Defendant is also generally allowed to have the Plaintiff examined by one or more physicians hired by the Defendant to evaluate the Plaintiff’s injuries. These examinations are also called “Rule 35” examinations because Rule 35 of the Minnesota Rules of Civil Procedure governs how such evaluations are conducted. A medical examiner hired by Defendant, most of whom do such evaluations for insurance companies on a frequent basis, usually says that the Plaintiff may have been initially injured but has long since healed from the incident, and/or that the Plaintiff’s problems have nothing to do with the incident and are instead from other causes.

You can find more information about discovery from the American Bar Association here:

Alternative Dispute Resolution

Alternative dispute resolution, or “ADR,” is also typically required for all parties to a civil lawsuit in Minnesota. This is usually a mediation (see below) but can also be a binding arbitration which is like a mini-trial decided by one or more neutral attorneys that the parties agreed upon.

Mediation typically involves the partis agreeing upon a neutral third attorney to go back and forth between the parties during a set period in an effort to get the case settled. The parties will send the mediator information ahead of time so that he/she know enough about the case. Mediations used to be in person with the parties being in separate offices/conference rooms (and the mediator going back and forth between) but now they are also conducted via videoconference or even phone.

Mediations and other ADR solutions do not usually take place until close to trial. This is because the parties want to know everything and be totally prepared before they talk settlement. But, sometimes a case is settled sooner than that; it really depends.  If a case is settled, it generally involves ALL claims and issues between the parties; nothing is left for the Court to decide, and so the lawsuit is then dismissed.

Motions to Dismiss/Motions for Summary Judgment

Sometimes a party will make a motion to dismiss a lawsuit or part of a lawsuit. This can be because of certain facts in a case, a point of law, or both. A motion to dismiss asks the Court to dismiss an entire lawsuit because it is not supported by the law (even if the facts are accurate). A motion for summary judgment asks the Court to decide the case before trial, and typically happens when everyone agrees on the important facts but disagrees on what the law says about those facts.

Motions typically start with the parties filing briefs. All of the parties are given an opportunity to be heard in writing. The Court will also usually allow for a motion hearing where the parties can “argue” their positions and the judge can ask questions if necessary. Then, the Court will issue a decision.

If the case is dismissed, then the dismissed party has to decide whether it will appeal or not. If the case is not dismissed, then the case may proceed to trial.


In most civil lawsuits, one or more of the parties can opt for a jury trial. The other option is a “bench trial,” which has the judge deciding the case (instead of a jury). Both types of trials involve the parties presenting evidence, calling witnesses, and making arguments to the decisionmaker (judge or jury). Trials can take anywhere from a few hours to several months but they usually take 1-5 days.

Once the judge or jury decide the issues on which the parties could not agree (i.e. “reaches a verdict”), judgment is entered in the winning party’s favor. Many judgments also involve the Court awarding costs in the winning party’s favor (i.e. the Court orders the losing party to pay for the winning party’s costs).

The parties sometimes make post-trial motions which can involve disagreements over trial procedure, the verdict, the awarded damages, and/or other issues. The parties can also appeal the Court’s decision (or part of the decision) to a higher court.

You can find more information about civil actions in Minnesota (including definitions) on the Minnesota Judicial Branch’s website:

I don’t want to be “that guy” and sue my employer.2024-03-28T19:56:12+00:00

Many workers are hesitant to make a workers’ compensation claim against their employer because they don’t want a bad reputation or to get in trouble. But, workers’ compensation claims are legal safety nets that are required because everyone (the employer, the insurer, and the injured worker) shares the same objective in returning the injured worker to the workforce as soon as possible. The point of the law requiring businesses to have workers’ compensation insurance is to help to achieve that goal.

It is illegal for an employer to try to block a claim or retaliate against a worker who makes a claim.

All Minnesota and Wisconsin employers are required by law to provide workers’ compensation insurance for their employees. Employers pay for this coverage regardless of whether claims are made or whether those claims are accepted.