2013 CHANGES TO THE MINNESOTA WORKERS’ COMPENSATION LAW INTRODUCTION In 2013, the Minnesota Legislature undertook and passed a Bill which was signed into law by Governor Dayton relating to workers’ compensation that intended to make “various policy and housekeeping changes.” It also adopts certain advisory council recommendations. A copy of the Bill that was signed into law is attached and the underlined sections of that Bill reflect the changes to the statute. This law includes a significant change to compensability for mental-mental claims, a significant change limiting the provision of rehab services in the form of job search assistance and development, some changes to attorney’s fees (including Subd. 7 attorney fee reimbursement), a requirement for the Workers’ Compensation Division to adopt rules relating to the long-term use of opioids or other scheduled medications and to include the use of written contracts between the injured worker and the healthcare provider. It also provides for a maximum rate change and Minn. Stat. §176.645 adjustment change with regard to indemnity benefits along with some other minor changes that will have little impact on claims handling on a daily basis. MENTAL-MENTAL INJURIES The legislature amended Minn. Stat. §176.011, Subd. 15 Occupational disease and Subd. 16 Personal injury in a way to allow compensability of so-called mental-mental claims in a limited fashion. The statute has been amended and redefined Occupational disease and Personal injury to allow for compensability of post-traumatic stress disorder (PTSD) claims. The definitions in Subd. 15 and 16 of Minn. Stat. §176.081 both refer to mental impairment which is now defined in Minn. Stat. 176.011, Subd. 15(d) to be “a diagnosis of post-traumatic stress disorder by a licensed psychiatrist or psychologist. For the purpose of this chapter, “post-traumatic stress disorder” means the condition as described in the most recently published edition of the Diagnostic and Statistical Manual of Mental Disorders by the American Psychiatric Association.” The Diagnostic and Statistical Manual of Mental Disorders is also known as DSM and the most recent and current iteration of that document is DSM 5. The statutory changes do not impact physical stimulus resulting in mental injury and mental stimulus resulting in physical injury. These circumstances remain compensable. That is not a change in the law. The change comes where the statute now reads that mental stimulus resulting in a diagnosis of post-traumatic stress disorder and resulting disability and need for treatment is now compensable. The amendments to the statute go on to further state that there are certain mental impairments from specified causes not considered a disease or injury. Mental Impairment that “results from a disciplinary action, work evaluation, job transfer, layoff, demotion, promotion, termination, retirement, or other similar action taken in good faith by the employer,” is not compensable. The normal stresses and strains of a job and interaction with the employer and co-workers are not to be considered sufficient to lead to a diagnosis of post-traumatic stress disorder resulting in a compensable mental injury. This would be consistent with DSM 5 which seems to suggest in its definition of post-traumatic stress disorder that it must be caused by exposure to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence. This is contained in DSM 5. This portion of DSM 5 is attached. If that is the standard, then, it is axiomatic that disciplinary action, work evaluation, job transfer, layoff, demotion, promotion, termination, retirement, or similar action taken in good faith by the employer would not be sufficient to lead to the diagnosis of PTSD. The statute also states that the diagnosis of PTSD must be made by a licensed psychiatrist or psychologist. Therefore, a family doctor or a general practitioner, for instance, cannot diagnose a compensable case of post-traumatic stress disorder if the actual words of the statute are to be given meaning and force and effect. 2 SUMMARY The only mental injury that is compensable under this law is post-traumatic stress disorder. PTSD must be diagnosed by a licensed psychiatrist or psychologist. The diagnosis must be consistent with DSM 5 which states that the diagnosis comes from exposure to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, and not standard work place stressors. This change in the law only applies to injuries occurring on or after the effective date of October 1, 2013. 3 CHANGES TO REHABILITATION SERVICES One important and significant change and other more minor changes were made to Minn. Stat. §176.102 and Minn. Stat. §176.106 as it impacts Minn. Stat. §176.102. At Subd. 5 of that statutory section, job development is defined and limited. It is defined as “systematic contact with prospective employers resulting in opportunities for interviews and employment that might not otherwise have existed, and includes identification of job leads and arranging for job interviews.” In other words, job search assistance – once an employee is out looking for work. Those services can often times be rendered and billed at excessive rates and expense. They are now subject to limitations. The first limitation is that those services provided by either a qualified rehabilitation consultant firm or a registered rehabilitation vendor must not exceed 20 hours per month. Furthermore, those services cannot be provided for a period of more than 26 weeks – consecutive or intermittent. Additionally, once 13 weeks – consecutive or intermittent – of job development have been provided, the QRC on the case is required to consult with the parties and come up with a plan amendment reflecting agreement of the parties to extend job development services for up to an additional 13 consecutive weeks – or some lesser term of time. If an agreement is not reached, the QRC must file a request for a rehabilitation conference to address the provision of ongoing and continuing job development services. This statutory change does not impact the QRC’s provision of the services during job search beyond that which already exists in the statute. This change in the statute is directed at job placement vendors. Since the statute expressly provides that the services can be provided on an intermittent basis, some thought needs to be given to how to best control the expense by requesting or requiring consecutive weeks to buy down the number of weeks available or to allow intermittent or periodic job development services to be provided and spread out over a longer period of time. Negotiation of the rehab plan when job placement is to begin may help to develop a less costly job search. One potential impact of this change relating to job development services and limitation is that retraining claims and permanent total disability claims may surface a little earlier than they have in the past. There was also a change to Minn. Stat. §176.102, Subd. 10 which impacts the provision of disability case management services and QRCs. The new statutory section reads as follows: “(b) An individual qualified rehabilitation consultant registered by the Commissioner must not provide any medical, rehabilitation, or disability 4 case management services related to an injury that is compensable under this chapter when these services are part of the same claim, unless the case management services are part of an approved rehabilitation plan.” It is the intent of this section to prevent a disability case manager that is placed on the case before statutory rehab services begin, (usually 90 days or 13 weeks after disability began) from staying on the case as the QRC. Effectively, that means there will be a change from the disability case manager to a new person assigned as the QRC. There are not likely to be any QRCs that will then allow disability case management services to continue, thereby rendering useless the final phrase of that change that says “unless the case management services are part of an approved rehabilitation plan.” No QRC is going to write a plan that allows a disability case manager that was already in existence to remain on the file or a new one to be involved. One potential way to walk around or avoid a new QRC becoming involved is to assign a QRC earlier than normal to act as a QRC and not a disability case manager. In other words, start statutory rehab with assignment of a QRC right away, do not use a disability case manager. That call will have to be made on a case by case basis. Another change to the statute affecting rehab services is that rehabilitation conferences pursuant to Minn. Stat. §176.106, Subd. 3 that involves a rehabilitation issue “must be held within 21 days unless it only involves fees for rehab services, or there is good cause for holding a conference later than 21 days. “That timing could become very problematic for schedules of those who are involved in rehab issues. These changes are effective on October 1, 2013 to all dates of injury. 5 HOUSEKEEPING CHANGES COMPENSATION RATE AND ADJUSTMENT TO BENEFITS The maximum compensation rate pursuant to Minn. Stat. §176.101, Subd. 1 is now a floating rate. It is 102% of the statewide average weekly wage beginning October 1, 2013. The maximum rate effective October 1, 2013 is $963.90. Over a 130 week temp total claim at the max compensation rate, the employee would be paid $125,307. At the $850 max rate applicable currently and before October 1, 2013, an employee would have been paid $110,500 over that same 130 week timeframe. A maximum rate employee will be paid almost $15,000 more over the course of the 130 week TTD schedule at the new max rate. This max rate is floating, which means that it will be subject to amendment and change each and every October 1 based upon the statewide average weekly wage being determined each year. Coupled with the change in the maximum rate, Minn. Stat. §176.645 was changed to allow for a maximum adjustment of 3% per year for injuries occurring on or after October 1, 2013. This is up from the 2% for injuries prior to that date. Also, the adjustment will now apply on the 3rd anniversary of the date of injury rather than the 4th year. Furthermore, there is a floor on adjustments. An adjustment can never be less than zero. ATTORNEY’S FEES The 25/20 percent attorney fee formula of Minn. Stat. §176.081 is gone. Minn. Stat. §176.081 has been amended to provide that an employee’s attorney is entitled to a straight 20 percent fee up to a maximum of $26,000. An employee would have to have received $130,000 in compensation to entitle an attorney to the maximum fee of $26,000. The $26,000 fee limit does not affect the right to claim Irwin/excess fees with proper proofs. Another change, which should be well received by employers and insurers, is that the Subd. 7 attorney fee section of Minn. Stat. §176.081 has been modified. There is no longer the windfall of Subd. 7 attorney’s fees reimbursement payable on hourly fee claims under Roraff, Heaton or otherwise. Subd. 7 attorney’s fees reimbursement will, again, be just that – reimbursement. They are once again only payable as reimbursement on contingent fees payable to an employee’s attorney from the employee’s indemnity benefits. These changes to the attorney’s fees are effective for dates of injury on or after October 1, 2013. 6 You are still subject to Subd. 7 attorney fee reimbursement claims on Heaton, Roraff, or other hourly fee claims for dates of injury prior to October 1, 2013. SETTLEMENT STIPULATION APPROVAL The statute no longer provides for approval of a Settlement Stipulation by the Workers’ Compensation Court of Appeals. If a settlement occurs in a matter that is pending before the Workers’ Compensation Court of Appeals, the matter will be sent back to the Office of Administrative Hearings for review and approval of the Stipulation. A letter to the WCCA should be sent advising them that the matter has settled and a Stipulation will be provided to OAH for review. Good practice would suggest that OAH be copied on that letter. SPECIAL COMPENSATION FUND There were changes made to Minn. Stat. §176.183 that affect the Special Compensation Fund’s procedure and methodology to obtain approval of settlement in an uninsured employer claim. The Special Compensation Fund must notify the uninsured employer of a pending settlement and the employer has a period of time, 15 days, within which to object to a proposed settlement in an uninsured case. Also, there was a change in Minn. Stat. §176.129, Subd. 13 regarding insurer bankruptcies and reimbursements to insolvent insurers for second injury or supplementary benefits after a declaration of bankruptcy. DEPARTMENT OF LABOR AND INDUSTRY This bill, signed into law by Governor Dayton also compels the Department of Labor and Industry, Workers’ Compensation Division to study possible reforms to drive down medical costs in the work comp system. One of the statutory mandates is that the Department of Labor and Industry must develop a criteria for long term use of opioids and other scheduled medications to include use of written narcotic contracts between the injured worker and the medical provider. The new law also provides that there is to be an advocate pilot program relating to back fusion candidates. As a general proposition, the Department of Labor and Industry is also to study possible reforms to the Healthcare Provider Reimbursement system that would effectively reduce expense and the department is authorized to conduct a study towards that end. © Arlen R. Logren, Esq. 7 Peterson, Logren, & Kilbury, P.A. Suite 315 2233 University Avenue West St. Paul, MN 55114 Phone: 651-647-0506 Fax: 651-647-0532 Larry J. Peterson LJP@plklaw.net Arlen R. Logren ALogren@plklaw.net T. Michael Kilbury TMK@plklaw.net Brent C. Kleffman BKleffman@plklaw.net Krista Hiner KHiner@plklaw.net Paralegals Sandra L. Roesner sroesner@plklaw.net Kat J. Berube kberube@plklaw.net Cassie J. Gunderson cgunderson@plklaw.net 8