A guide to Minnesota s workers compensation system

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Godfrey Skinner
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1 What to do if you have a work-related injury: A guide to Minnesota s workers compensation system 1

2 About Center for Diagnostic Imaging (CDI) CDI is your Health Fund recommended medical imaging provider. Headquartered in St. Louis Park, CDI features a national network of outpatient centers with 20 locations in Minnesota alone. CDI consistently leads the way with diagnostic imaging and interventional pain management services, offering high-quality and cost-effective care close to home. We provide our patients and their physicians with a wide variety of imaging services to meet their needs, including: High-field MRI Open MRI Low-dose CT Nuclear Medicine X-ray Diagnostic Injections Pain Management Procedures With our outpatient imaging centers, along with partnerships and electronic connectivity to dozens of hospitals, physicians and specialists, we are dedicated to providing the best imaging experience possible for our patients. MINNESOTA LOCATIONS Over 600 employees 200,000 procedures in 2013 Patient satisfaction: 99% of patients surveyed had a positive experience at CDI Cost-effective: Up to 30% less than other providers Charity care: Partnering with La Clinica in West St. Paul providing 167 diagnostic procedures at no cost in

CDI consistently leads the way with diagnostic imaging and interventional pain management services, offering high-quality and cost-effective care close to home.

3 I have a work-related injury What should I do? Don t wait! Tell your employer immediately. Be sure to report your injury to your supervisor. If you need to seek emergency medical attention do that first, but then contact your employer as soon as possible. If you do not report the injury within a certain amount of time, you may lose your right to workers compensation benefits. Your employer will complete a First Report of Injury (FROI) form, so be sure to give your employer accurate and complete information about how you were hurt and about any injuries you sustained. Your employer or employer s insurer must give you a copy of the completed FROI. The employer must also send a copy to your union, if there is one. Your employer must give you the Minnesota Workers Compensation System Employee Information Sheet along with a copy of the FROI. Your employer has 10 days from first knowledge of a lost-time claim to report it to the employer s insurance company. If you are disabled for more than three calendar days, your employer must file the FROI with the Minnesota Department of Labor and Industry. The insurance company will investigate your claim to verify it was work-related. You should keep your employer informed of your medical condition and any work restrictions. You must notify the insurer of changes in your employment status and keep your employer and the insurer informed of your ability to work. Disclaimer: This information provides a general overview of the Minnesota s workers compensation system for educational purposes only. It is not a complete description of workers compensation law or of the topics discussed and should not be construed as offering or providing legal advice. Those with questions about workers compensation law are encouraged to contact the Department of Labor and Industry for more information or a lawyer for legal advice. 3

If you do not report the injury within a certain amount of time, you may lose your right to workers compensation benefits.

4 What types of injuries are covered by workers compensation? A work-related injury can be any condition that is caused, aggravated or accelerated by employment activities. This includes traumatic injuries, gradual injuries or occupational diseases. Treatment by certain unlicensed complementary and alternative health care providers is not paid. Prescriptions and reimbursement for mileage to medical appointments are payable. The insurer may designate a pharmacy or pharmacies you must use to obtain prescription medicine for your injury, if the pharmacy is within 15 miles of your home. You may choose your health care provider under most circumstances (see below). Make sure your health care provider sends all bills and supporting information to the insurer. The supporting information must explain how the treatments and charges relate to your work injury. Your health care provider must notify the insurer before you have any surgery or hospitalizations, except in an emergency. You or the insurer may ask for a second opinion for any surgery that is not an emergency. The insurer must pay for the second opinion. You cannot be forced to have surgery if you do not want it. Your health care provider cannot bill you for treatment unless the insurer determines the treatment was not related to an accepted workrelated injury. What medical treatment is covered by workers compensation? Minnesota workers compensation law entitles an employee to reasonable and necessary medical treatment or supplies to cure or relieve the effect of the work injury. The employer is required to furnish medical treatment as described by Minnesota Statutes , subd. 1, including psychological, chiropractic, podiatric, surgical and hospital treatment. 4

Prescriptions and reimbursement for mileage to medical appointments are payable.

5 May I seek treatment from my own physician? Minnesota workers compensation law gives employees the right to choose their own primary health care provider for treatment of a workrelated injury. Your employer may require you to see a designated primary care provider only in the following circumstances. 1. Employer has a certified managed care plan: An employer may require an employee to receive treatment and supplies from a provider participating in a managed care plan certified under Minnesota Statutes except as otherwise provided by that law and corresponding laws (Minnesota Rules Chapter 5218). 2. Employer is part of a collective bargaining agreement allowing the employer to specify exclusive providers: An employer that is part of a collective bargaining agreement, recognized and on file with the Minnesota Department of Labor and Industry, may include a provision specifying a list of health care providers who may be the exclusive providers of medical and related treatment and independent medical examinations (Minnesota Statutes ). 3. For prescription medications: An employer may require an employee to obtain outpatient prescription and nonprescription medications from a pharmacy or network of pharmacies as long as it is within 15 miles of the employee s residence (Minnesota Statutes , Subd. 1(g)). What if my primary treating provider refers me to a specialist, but the insurance company directs me to a different one? Remember, Minnesota workers compensation law gives employees the right to choose their own primary treating provider for a workrelated injury, except for those circumstances listed above. Your primary treating provider will direct and coordinate care for your work-related injury. You and your primary treating provider will choose which other providers or specialists you need to see. Except for those circumstances above, the insurance company cannot direct you to a different provider or specialist. 5

Employer has a certified managed care plan: An employer may require an employee to receive treatment and supplies from a provider participating in a managed care plan certified under Minnesota

6 If my primary treating provider refers me, will I end-up paying more out of my own pocket? Injured workers are entitled to select their own primary treating provider, except in the circumstances noted above. Employees cannot be charged more for selecting their own primary treating provider at the time of injury or for receiving services from someone to which the primary treating provider has referred them. Helpful hints Save copies of all claim-related documents, letters, forms, benefit checks and medical bills, especially the First Report of Injury (FROI) form. Keep track of your mileage and parking fees for your medical visits, vocational rehabilitation services and job-search visits. Save notes of phone conversations. Put your name, Social Security number or worker identification (WID) number, date of injury, employer and insurance company on all papers and forms you send to DLI s Workers Compensation Division. Keep your employer informed about your recovery and plans to return to work. Who can answer my questions? Your employer or your employer s insurance company can answer most questions about your workers compensation claim. If you need more help or if you feel you do not understand something about the workers compensation process, call DLI s ADR unit if you have any questions: (651) or toll-free between 8:00 a.m. and 4:30 p.m., Monday through Friday. You can also visit the DLI website at 6

Employees cannot be charged more for selecting their own primary treating provider at the time of injury or for receiving services from someone to which the primary treating provider has referred

7 Important Information for Your Claim Date of Injury Your Insurance Claim Number Your WID Number* (when assigned) Insurance Company Name Claim Adjuster s Name Claim Adjuster s Phone Number Managed Care Plan* (if applicable) Doctor s Name Doctor s Phone Number Qualified Rehabilitation Consultant (QRC) Name QRC s Phone Number Other Names and Phone Numbers 7

Phone Number Managed Care Plan* (if applicable) Doctor s Name Doctor s Phone Number

8 Twin Cities Blaine Burnsville Coon Rapids Eden Prairie Maple Grove Maplewood Mendota Heights North St. Paul St. Louis Park West St. Paul Woodbury Services High-field MRI Open MRI Low-dose CT Nuclear Medicine Central MN Alexandria St. Cloud Sartell Willmar Northern MN Duluth Deer River Grand Rapids X-ray Diagnostic Injections Pain Management Procedures CDI is your Health Fund recommended medical imaging provider. CDI s Dedicated Labor Line:

Paul Woodbury Services High-field MRI Open MRI Low-dose CT Nuclear Medicine Central MN Alexandria St.

A GUIDE TO MINNESOTA S WORKERS COMPENSATION SYSTEM

WHAT TO DO IF YOU HAVE A WORK-RELATED INJURY: A GUIDE TO MINNESOTA S WORKERS COMPENSATION SYSTEM 1 ABOUT CENTER FOR DIAGNOSTIC IMAGING (CDI) CDI is your Health Fund recommended medical imaging provider.