Minnesota Workers’ Compensation Benefits Stopped? What to Do After an NOID

Minnesota Workers’ Compensation Benefits Stopped? What to Do After an NOID

If you are receiving Minnesota workers’ compensation wage-loss benefits and the insurance company sends you a Notice of Intention to Discontinue Workers’ Compensation Benefits, commonly called an NOID, you should take it seriously.

An NOID means the insurer is seeking to reduce or stop wage-loss benefits that you have been receiving.

Most importantly, there may be a short deadline to challenge the discontinuance.

If you disagree with the insurer’s decision, acting quickly can be critical.

What Is an NOID in Minnesota Workers’ Compensation?

Once an employer or workers’ compensation insurer has begun paying wage-loss benefits, Minnesota law generally does not allow those benefits simply to be stopped without notice.

The insurer ordinarily must provide the injured worker with written notice stating:

• the benefit it intends to discontinue or reduce;
• the date of the proposed discontinuance;
• the reason for stopping or reducing benefits; and
• the facts supporting that decision.

If the insurer is relying on medical reports or other written information to support the discontinuance, those materials may also become important in evaluating whether the insurer has a sufficient basis to stop benefits.

The discontinuance process is governed primarily by Minnesota Statutes §§ 176.238 and 176.239.

Why Might the Insurance Company Try to Stop My Benefits?

There are many possible reasons.

For example, an insurer may claim that:

• you have returned to work;
• you are capable of returning to work;
• your work injury has resolved;
• your current disability is no longer related to the work injury;
• you no longer have work restrictions;
• you have reached maximum medical improvement;
• you have failed to cooperate with rehabilitation;
• your current wage loss is not caused by the work injury; or
• an independent medical examiner has concluded that you can return to work.

The fact that the insurer gives one of these reasons does not necessarily mean the insurer is correct.

The insurer’s position may conflict with the opinions of your treating physician, your actual physical limitations, your QRC’s recommendations, or other evidence concerning your ability to work.

What Should I Look for When I Receive an NOID?

Read the entire document carefully.

In particular, look at:

1. What benefit is being stopped or reduced?
2. What date does the insurer say the change will take effect?
3. What reason does the insurer give?
4. What medical or other evidence does the insurer rely on?
5. What does the NOID say about your right to request an administrative conference?

Do not assume that receiving an NOID means the insurer has already proven that your benefits should end.

An NOID is often the beginning of a dispute over whether the insurer has a legal basis to discontinue benefits.

How Long Do I Have to Challenge an NOID?

The deadlines can be very short and may depend on the reason benefits are being discontinued.

In many discontinuance situations, an employee who disagrees with the NOID can request an expedited administrative conference.

Because the applicable deadline can depend on the circumstances, you should not wait until the deadline is approaching before seeking advice.

The NOID should include information explaining how to challenge the discontinuance.

If you have received an NOID and disagree with it, contact an attorney promptly.

What Is a Minnesota Workers’ Compensation Discontinuance Conference?

If an injured worker timely challenges an NOID, the dispute may proceed to an expedited administrative conference.

The purpose of the conference is to obtain an interim decision about whether wage-loss benefits may be discontinued.

A compensation judge conducts the conference.

This is not the same as a full workers’ compensation trial, but the result can have an immediate effect on whether benefits continue.

Because the employee may be relying on those weekly benefits for basic living expenses, discontinuance conferences can be extremely important.

What Does the Insurance Company Have to Show?

At a discontinuance conference, the compensation judge considers whether the employer and insurer have a legally sufficient basis to stop the benefits.

The specific reason stated in the NOID matters.

For example, if the insurer says benefits should stop because its independent medical examiner believes the work injury has resolved, the dispute may focus heavily on the competing medical evidence.

If the insurer claims the employee can return to work, the employee’s restrictions, job duties, earning capacity, rehabilitation evidence, and actual ability to work may become important.

The insurer’s stated basis for discontinuance should be evaluated carefully rather than accepted at face value.

What Happens at the Conference?

A discontinuance conference is generally less formal than a full workers’ compensation hearing.

The compensation judge may consider information such as:

• medical records;
• work restrictions;
• reports from treating physicians;
• an independent medical examination report;
• wage records;
• rehabilitation records;
• QRC reports;
• job-search information; and
• statements from the employee and attorneys.

The central issue is usually whether the employer and insurer have a sufficient legal basis to discontinue benefits at that time.

Although the proceeding is expedited, preparation still matters.

What Happens After the Conference?

The compensation judge issues an interim administrative decision.

The judge may permit the discontinuance or may determine that the insurer does not have sufficient grounds to stop the benefits.

Either side may have additional rights to challenge the interim decision.

A discontinuance dispute can therefore continue beyond the administrative conference and may ultimately proceed to a more formal hearing before a compensation judge.

What If My Benefits Suddenly Stopped and I Never Received an NOID?

If you were receiving wage-loss benefits and your checks suddenly stopped, first determine whether an NOID was actually issued.

You may want to confirm:

• whether the insurer issued a payment;
• whether the insurer changed your mailing address;
• whether an NOID was filed;
• what reason the insurer claims supports the discontinuance; and
• whether the insurer followed the required procedure.

An improper discontinuance does not mean you should wait indefinitely.

If benefits unexpectedly stop, investigate immediately.

What If the IME Doctor Says I Can Work but My Treating Doctor Disagrees?

This is a common workers’ compensation dispute.

The insurance company may rely on an independent medical examination to argue that:

• you no longer need restrictions;
• your work injury has resolved;
• your ongoing symptoms are unrelated to the work injury; or
• you are capable of returning to unrestricted employment.

Your treating physician may strongly disagree.

An IME report does not automatically control the outcome simply because the insurance company obtained it.

The competing medical opinions, the foundation for those opinions, your medical history, your work restrictions, and the other evidence in the case all matter.

In some cases, your treating physician may need to prepare a detailed response addressing the IME doctor’s conclusions.

What If I Tried to Return to Work but Could Not Continue?

A failed return to work can create additional issues.

For example, an injured worker may attempt to return to work but discover that the job exceeds the employee’s restrictions or causes a significant increase in symptoms.

The insurer may nevertheless claim that the employee is capable of working and attempt to discontinue benefits.

In those situations, evidence concerning:

• the actual job duties;
• physical restrictions;
• why the work attempt failed;
• medical treatment after the attempted return;
• the employer’s ability to accommodate restrictions; and
• vocational rehabilitation

may become important.

If you attempted to return to work and your benefits were stopped, do not assume that the failed work attempt permanently ends your entitlement to wage-loss benefits.

Does Reaching Maximum Medical Improvement Automatically End My Benefits?

No.

Maximum medical improvement, commonly called MMI, is an important concept in Minnesota workers’ compensation, but it does not mean that every workers’ compensation benefit immediately ends.

MMI can affect entitlement to temporary total disability benefits.

But other issues may remain, including:

• temporary partial disability;
• permanent partial disability;
• medical treatment;
• rehabilitation;
• work restrictions;
• retraining; and
• settlement.

An employee may be at MMI and still have substantial workers’ compensation rights.

What If I Am Working but Earning Less?

If you return to work but earn less because of your work injury, you may have a claim for temporary partial disability, or TPD.

An insurer may dispute whether the wage loss is actually caused by the work injury.

Important questions may include:

• whether you have work restrictions;
• whether your current job is suitable;
• whether the reduced earnings accurately reflect your earning capacity;
• whether you are working enough hours;
• whether you are conducting an appropriate job search when required; and
• whether the insurer claims some non-work reason explains the wage loss.

A discontinuance involving TPD can be just as financially significant as termination of TTD.

Can an Employer Offer Me a Job and Stop My Benefits?

An employer may offer an injured worker a job that it believes fits the employee’s restrictions.

Whether refusing that job affects benefits depends on the circumstances.

Important questions include:

• Does the job actually fit the medical restrictions?
• Is the work physically realistic?
• Are the hours and wages appropriate?
• Is the job temporary or permanent?
• What does the treating physician say?
• What does the QRC say?
• Is the position actually available?
• Can the employee physically perform the essential duties?

An employee should be cautious about rejecting an offer of work without understanding the potential workers’ compensation consequences.

What Role Does My QRC Play?

If you are receiving vocational rehabilitation services, your Qualified Rehabilitation Consultant, or QRC, may have important information concerning your ability to return to work.

The QRC may have evidence regarding:

• your restrictions;
• communication with the employer;
• modified-duty offers;
• job-search efforts;
• vocational barriers;
• earning capacity; and
• whether the pre-injury job remains realistic.

QRC records can sometimes become important evidence in a discontinuance dispute.

What If My Treating Doctor Changes My Restrictions?

Updated restrictions can materially affect whether the insurer has a basis to discontinue benefits.

For example, your doctor may:

• continue existing restrictions;
• increase restrictions;
• release you to modified work;
• release you to full duty; or
• take you completely off work.

A current, clearly written work-ability report can be very important.

If there is a dispute, make sure the restrictions accurately reflect your actual condition and that the insurer and employer have the current information.

Should I Speak With a Workers’ Compensation Attorney After Receiving an NOID?

Receiving an NOID is one of the situations where speaking with an experienced Minnesota workers’ compensation attorney promptly can be especially important.

The deadlines can be short, and the legal issue may be more complicated than the NOID itself suggests.

An attorney can evaluate:

• whether the insurer followed the proper procedure;
• whether the stated reason for discontinuance is legally sufficient;
• whether the medical evidence supports the insurer’s position;
• whether additional medical evidence should be obtained;
• whether an administrative conference should be requested;
• whether your treating physician should clarify your restrictions;
• whether your QRC or rehabilitation records support continued benefits; and
• what options may remain if the insurer is permitted to discontinue benefits.

Minnesota Workers’ Compensation Attorneys for Injured Workers

Lemmon & Tanasychuk, LLC represents injured workers throughout Minnesota.

We represent employees—not employers and insurance companies—in Minnesota workers’ compensation matters involving:

• stopped wage-loss benefits;
• NOIDs;
• temporary total disability;
• temporary partial disability;
• independent medical examinations;
• maximum medical improvement;
• denied medical treatment;
• QRC and rehabilitation disputes;
• permanent disability; and
• workers’ compensation settlements.

If your workers’ compensation benefits have been stopped or you recently received an NOID, we can review the notice and help you understand what options may be available.

Contact Lemmon & Tanasychuk, LLC for a free consultation.

This article provides general information about Minnesota workers’ compensation law and is not legal advice. Workers’ compensation rights depend on the facts of each case, and applicable statutes and deadlines can change.