Primary Liability Determination In Minnesota Work Comp Cases

After you’ve visited your doctor, collected all the evidence you need and laid everything out in a workers’ compensation claim, you will wait to hear back from the insurance company to see if they approve or deny your claim. This decision will be made when you receive the Notice of Insurer’s Primary Liability Determination (NOPLD) from the insurance company. This form will have a lot of important information on it, and in today’s blog, we want to explain how this form will determine the next steps you’ll take with your injury case.

Liability Determination – Acceptance

Let’s start by looking at what type of information you can expect to find on this form assuming you get good news. If the form shows that your employer’s workers’ compensation provider has accepted primary liability for coverage, you will be in line to collect compensation for your work injuries. The form may:

Accept liability for coverage of medical expenses and wage loss, including for temporary total disability, temporary partial disability, permanent total disability or dependency benefits.

Accept liability for coverage of medical expenses and wage loss benefits that will begin on a specific date once additional wage loss information has been provided.

Accept liability for medical expenses but deny liability for wage loss benefits. If you have reason to believe wage loss were wrongfully denied, consult a lawyer, but in many instances this is standard if the employee does not miss enough time following a work injury to collect wage loss benefits.

Liability Determination – Denial

Unfortunately, not all claims are accepted, and in these instances you may receive your NOPLD that confirms that the insurance company is denying primary liability. The insurance company has 14 days to issue this denial, and this determination needs to be sent to a few different parties. The determination of a denial of primary liability for your workers’ compensation case will be sent to:

The injured employee
Any heirs or dependents following a fatal work accident
The attorney representing the injured worker
The Department of Labor and Industry’s Workers’ Compensation Division
The injured employee’s employer

Receiving a denial is more common than many people expect, and it should not be the end of your injury claim. Review the notice carefully and determine exactly why primary liability was denied. From there, sit down with your attorney and go over your next steps. For many, submitting additional evidence or clarifying certain aspects of your claim can be enough to flip a denial to an accepted claim.

If it’s unlikely that a revised claim will earn a primary liability determination, your attorney may decide to appeal the decision to a higher power. Your attorney can take the lead here, and they may appeal the decision to the Minnesota Department of Labor and Industry, or the case may end up before an administrative judge or the Workers’ Compensation Court of Appeals. You can oftentimes win a determination at these levels, but it’s highly unlikely you’ll achieve this without a professional by your side, simply because the right processes need to be followed and a compelling argument needs to be pitched. We’ve done that for countless clients battling an initial denial, and we can do the same for you.

For help understanding your NOPLD decision, or for assistance filing a claim or contesting a denial, reach out to Dean and the team at Margolis Law Firm today at (952) 230-2700.