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What Does a Workers’ Compensation Investigation Look Like?

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Posted By 1p21.admin | February 11 2025 | Workers' Comp

In Minnesota, if you are hurt at work, you have the right to file a workers’ compensation claim. This no-fault insurance policy provides benefits for medical care, wage loss, and even permanent disability, as long as the injury occurred within the scope of your employment.

The insurer will undertake an extensive investigation process to verify that your injury is indeed work-related and that you are truly entitled to the benefits that you are claiming. During this complex process, it is essential to have a Minneapolis workers’ comp attorney on your side who can help prove your right to a fair settlement. 

Initial Reporting

Minnesota law requires you to report your work-related injury to your employer within 14 days, although reports made within 30 days may still qualify for benefits.

Your employer must then file a First Report of Injury form with their insurance provider and the Minnesota Department of Labor and Industry within 10 days. The insurance company has 14 days to investigate and decide on your claim. 

The Insurance Investigation Process

Once your claim is filed, the insurance company begins a thorough investigation. Their primary goal is to determine if your injury is genuinely work-related and to assess its severity. During the investigation process, they will review your medical records, employment history, and the circumstances of your accident.

Insurance companies often require injured workers to undergo an independent medical examination (IME) with a doctor of their choosing. This doctor must be located within 150 miles of your home, and the examination must be scheduled at a reasonable time. The company should reimburse you for any expenses you incur for attending this examination.

Additional Requests for Information

During the investigation, the insurer may request additional information to verify your claim. This can include interviews with you, your coworkers, and your supervisor about the incident. They may also request access to your prior medical records to check for pre-existing conditions or previous injuries.

These additional requests for information can start a slippery slope. They may try to find unrelated issues in your medical history that could be used to minimize or deny your legitimate claim or ask questions that are designed to contradict your initial statement. An attorney can protect your rights during this process and make sure only relevant information is shared.

Negotiations, Decisions, and Appeal Hearings

After completing their investigation, the insurance company will either approve or deny your claim. If approved, they will begin paying benefits. If denied, you have several options to challenge this decision.

Your most effective option is to file an Employee’s Claim Petition with help from a Minnesota workers’ compensation attorney. This formally requests a hearing to appeal your denial.

At this hearing, a judge from the Office of Administrative Hearings will evaluate evidence presented by both sides, similar to a trial. Your employer and their insurer will likely have legal representation, so it is important to have your own attorney there as well.

Navigate the Workers’ Comp Process with an Attorney

The workers’ compensation process is complex and designed to protect employers and insurance companies as much as injured workers.

Having a Minnesota workers’ compensation attorney by your side levels the playing field. If you are hurt at work, don’t wait to seek help—contact a workplace injury lawyer at Kemmit, Sanford & Kramer as soon as possible and begin building your case for benefits.

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