Auto Insurance

Property Insurance

General Liability

Professional Liability

Non Profit Liability

Certificate of Insurance

Miscellaneous Insurance

Frequently Asked Questions for Employees

What is workers' compensation and who is entitled to it?

Who pays for workers' compensation?

Why am I requested to go to the clinic the University recommends?

Do I have to go to the "designated" clinic?

What if I want to treat with my own physician?

What do I do if my claim is denied or I have other problems with my claim?

What benefits am I entitled to?

Where do I go to get my questions answered?

Why does the University try to get me back to work before I am completely healed?

Do I have to go back to work when I am released with restrictions?

Do I need an attorney?

Return to the Employees page

Return to top

What is workers' compensation and who is entitled to it?

Workers' compensation is a mandatory insurance program that provides for the payment of medical expenses and wage loss replacement for people who are injured while on the job. It is a no-fault system and all employers must participate in the workers' compensation system. Any employee who is injured in the "course and scope" of their employment is entitled to file a claim.

Return to top

Who pays for workers' compensation?

The University of MN is self-insured. Sedgwick was hired by the University to administer the claims. The University of Minnesota funds all claim payments.

Return to top

Why am I requested to go to the clinic the University recommends?

"Designated" medical providers are clinics that are chosen by the University of MN because they are staffed by physicians who are trained in occupational medicine (the treatment of injured employees; generally are in close proximity to the University of MN; and are committed to seeing injured employees within 24 hours. These clinics often tour the employer's premises to see the types of work that can cause injuries as well as the types of work that can be utilized for temporary alternate duty. They will directly send the bills to Sedgwick so you do not have to submit any additional paperwork.

Return to top

Do I have to go to the "designated" clinic?

You have the right to choose your own doctor. However, Sedgwick Claims Management Services or the University of MN can request that you be examined by the designated clinic in addition to being seen by your own physician.

Return to top

What if I want to treat with my own physician?

You may choose to treat with your own physician. However, Sedgwick or the University of MN may also ask you to be seen by their doctor at the same time.

Return to top

What do I do if my claim is denied or I have other problems with my claim?

If your claim is denied, you will receive a Notice of Denial of Liability. The Notice will give the reason and facts explaining why your claim was denied. If you disagree with the denial, you should first talk with the claim adjuster. (See suggestions below) Most workers' compensation claims are paid without any problems. If you think the insurance company is not paying you correctly or your bills are not being paid, you should:

1. Call the claim adjuster to discuss the issues at 612-826-3800 or 1-800-231-0165.

2. Call the Workers' Compensation Department at 612-624-6019 or 612-624-6054

3. Discuss your problem with a specialist at the Department of Labor and Industry. The Specialist will help you resolve the dispute or help arrange an informal conference.

4. If the problem can not be resolved with the above steps, the Department of Labor and Industry specialist can explain the dispute resolution options and help you decide what option is best for your situation.

Return to top

What benefits am I entitled to?

Under the Minnesota's Workers' Compensation system, an injured worker is entitled to:

• Reasonably necessary medical services related to the injury. The Medical Fee Schedule limits the amount insurers pay for treatment. The Department of Labor and Industry has developed treatment standards to help determine if treatment is reasonable. A medical provider is not allowed to ask you to pay additional fees or to pay for unnecessary treatments. The insurer will not pay for treatments unrelated to the workers' compensation injury. The insurer may refuse to pay bills if the doctor has not sent all information that explains the services provided. You can assist the process by making sure that your doctor is regularly sending all bills and other medical information to your insurer.

• Part of your wage loss or inability to earn a full income You are entitled to receive wage-loss benefits (Temporary Total Disability -TTD) if you are unable to work more than three days because of a work related injury or illness. The first three days are considered a waiting period and are not paid unless you are off ten (10) or more days due to the injury. If this is the case, the first three days will be reimbursed. TTD is paid until:

• You return back to work or 104 weeks;

• You have been released back to work which may be with or without any physical restrictions from the work related injury;

• You retire for reasons other than your injury;

• 90 days have passed since you reached Maximum Medical Improvement (MMI) or the end of an approved retraining program;

• Other events occur that can be legal reasons for stopping benefits. A Notice of Intent to Discontinue Benefits will be sent to you before benefits are discontinued. If you work but because of your injury, you are earning less than before your injury, you may qualify for Temporary Partial Disability benefits (TPD). TPD pays two-thirds of the difference between your date of injury wage and your new wage. There are time limits on how long TPD benefits are paid.

• Benefits to dependents for work related death

• Compensation for permanent loss of use of or loss of body function Some injuries are permanent. If you have a permanent injury, you might receive Permanent Partial Disability (PPD) benefits. The physician sets the level or percentage of a disability, pursuant to Minnesota rules governing permanency ratings. This benefit is paid in weekly amounts after your temporary total disability benefits end.

• Vocational rehabilitation services if you cannot return to the job or to the employer you had before the injury. If you cannot return to your pre-injury job, you may ask for vocational rehabilitation. To do so, you should notify SCMS in writing of your request.

• How are my wage loss benefits calculated? You are entitled to receive wage-loss benefits (Temporary Total Disability -TTD) if you are unable to work more than three days because of a work related injury or illness. The first three days are considered a waiting period and are not paid unless you are off ten or more days due to the injury. If this is the case, the first three days will be reimbursed. The wage loss benefit is designated to replace two-thirds of the before tax average weekly wage you received at the time of your injury. The benefit is generally not taxable. There is a minimum and maximum rate set by the state.

Return to top

Where do I go to get my questions answered?

• The University of Minnesota's Workers' Compensation Department at 612-624-6019 or 612-624-6054

• Sedgwick Claims Management Services at 612-826-3800 or 1-800-231-0165.

• The Department of Labor and Industry at 651-296-2432 or 1-800-342-5354

Return to top

Why does the University try to get me back to work before I am completely healed?

Studies show that employees heal more quickly and often more completely if they remain active and at work with co-workers. Working, even if only in a limited capacity, gets you up and moving and keeps you in a routine.

Return to top

Do I have to go back to work when I am released with restrictions?

Your temporary total disability benefits may be permanently discontinued if you refuse a job consistent with your doctor's restrictions. (If you are concerned that the job provided is not consistent with the restrictions, discuss the issue with your supervisor, your adjuster, the Director of Workers Compensation for the University and/or your doctor).

Return to top

Do I need an attorney?

You always have the option to hire an attorney at any time during the process. However, in general, you do not need an attorney to file a claim or to collect benefits. Minnesota's Workers' Compensation statute describes and defines the benefits to which you are entitled. The claim adjuster and/or the University's Workers' Compensation department are also available to answer your questions. If you retain an attorney, the state statute provides for the attorney's fees to be paid from the workers' compensation benefits you receive or based on the benefits awarded. Many times there are simple miscommunications or misunderstandings, which could easily be corrected by open communication with the claims adjuster or the Department of Labor and Industry; therefore you may want to try to resolve the issues yourself prior to obtaining representation.