CHAPTER 1
Compensable Claims/Covered Employees
Compensable Injuries; Noncompensable Injuries; Jurisdiction; Special Employment Situations; Excluded Employments; Applicable Law; Equitable Estoppel
– Hon. David M. Bateson & Joshua M. Steinbrecher

CHAPTER  2
Arising Out Of and In the Course Of Employment
Historical Overview and The Concept Of Primary Liability; The “Arising Out Of” Requirement – Causation By Employment Increasing the Risk of Injury; The “In the Course Of” Requirement – The Time, Place, and Circumstances of an Injury; Subsequent Non-Employment Injuries
– Hon. N. Amee Pham & Erin E. Gross

CHAPTER 3
Time-Barred Claims
Introduction; Notice Requirement; Statute of Limitations; Occupational Disease Cases; Equitable Doctrine of Laches; Retraining Time Limitations
– Eric Beyer

CHAPTER 4
Wage-Loss Benefits
Temporary Total Disability; Permanent Total Disability; Temporary Partial Disability
– Jeffrey W. Jacobs & Samuel A. Heacox

CHAPTER 5
Permanent Partial Disability
Basic Concepts; Injuries Occurring Prior To January 1, 1984; Injuries Occurring January 1, 1984 Through June 30, 1993; Injuries Occurring July 1, 1993 Through September 30, 1995; Injuries Occurring October 1, 1995 Through September 30, 2000; Injuries Occurring October 1, 2000 Through September 30, 2018; Injuries Occurring October 1, 2018 Through September 30, 2023; Injuries Occurring October 1, 2023 Through Present; Rating Disability When a Single Body Part is Injured in a Single Occurrence; Rating Disability When Multiple Body Parts Are Injured in a Single Occurrence; Weber Ratings of Unscheduled Injuries; Apportionment of Permanent Partial Disability Resulting From Multiple Occurrences; How To Rate Specific Types Of Injuries
– Carrie I. Jacobson & Thomas Atkinson

CHAPTER 6
Death/Dependency Benefits
Introduction; The Controlling Law; Statute of Limitations; Dependents – Definitions; Burial Expense; No Surviving Dependents; Minimum Payment; Appointment of Guardian or Conservator For Dependents or Incapacitated Dependents; Dependent Spouse with No Dependent Child – MINN. STAT. § 176.111, SUBD. 6; Dependent Spouse with One Dependent Child – MINN. STAT. § 176.111, SUBD. 7; Dependent Spouse with Two or More Dependent Children – MINN. STAT. § 176.111, SUBD. 8; Last Weekly Benefit Payment – Definition; Remarriage of Spouse; Orphans/Parents/Remote Dependents; Computation of Benefits, Allocation, and Offsets; Survivability of Temporary Total, Temporary Partial, Permanent Total, Permanent Partial, and Medical Benefits; Cessation of Dependency Benefits
– David B. Kempston & Maxwell F. Riebel

CHAPTER 7
Medical Benefits
Introduction; General Principles; Who May Provide Treatment Under the Workers’ Compensation Act; Employee’s Right to Choose Treating Health Care Providers; Managed Care Plans; The Medical Treatment Parameters; Specific Treatment Considerations; Medical Billing, Fees, and Review; Independent Medical Examinations; Second Opinions, Impact of Decisions Regarding Proceeding with Surgery, and Neutral Examinations; Medical Dispute Resolution
– Charlene K. Feenstra & David B. Kempston

CHAPTER 8
Rehabilitation and Retraining
Introduction; Initiation of Rehabilitation Services; Initiation and Change of Rehabilitation Personnel; Rehabilitation Plan; Retraining; Termination of Rehabilitation Plan; Rehabilitation Providers
– Whitney Teel & Brian Mak

CHAPTER 9
Rates/Wages
Introduction; General Principles; Methods of Calculation; Specially Treated Occupations, Employers, and Employees; Other Considerations Affecting Wage; Effect of Computing Wage on Specific Benefits; Appendix A – Workers’ Compensation Benefit Adjustments
– Stephanie K. Thiemann & Kelly B. Lambert

CHAPTER 10
Attorney Fees
Introduction; Contingent Fees; Fees on Intervenor Recoveries; Fees Paid By the Employer or Insurer; Fees in Multiple Issue Cases; Procedures For Approval of Attorney Fees; Fees Payable To Defense Counsel
– Hon. Grant R. Hartman & Amanda M. Furth

CHAPTER 11
Penalties, Interest, and Costs
Introduction; Penalties Assessed Against Employer/Insurer and Payable To the Employee; Penalties Assessed Against Employer/Insurer and Payable To the State; Penalties Payable To Employee’s Attorney; Appeal of Penalties; Civil Actions Under Minnesota Statutes Section 176.82; Interest; Costs and Disbursements
– Karen M. Charlson

CHAPTER 12
Apportionment, Contribution, and Reimbursement
Introduction; History and Development of Apportionment; 1995 Amendments – Legislative Restrictions on Equitable Apportionment; Apportionment By Injury Type; Controlling Law; Statutory Apportionment; Contribution and Reimbursement; Computation of Benefits
– Jay T. Hartman, Kelly P. Falsani & David O. Nirenstein

CHAPTER 13
Special Compensation Fund
Introduction; Uninsured Employers; Supplementary Benefits; Subsequent Disability (a.k.a. “Second Injury Fund”) Reimbursement; Subrogation Rights of the Special Compensation Fund; Assessments
– Laura B. Zajac, Patricia Munkel-Olson & Fred A. Simon

CHAPTER 14
Workers’ Compensation Reinsurance Association
Introduction; Organization of the WCRA; Regulation; Coverage; Financial Structure; Claims; Dispute Resolution; Other Duties of Members; WCRA Services
– James A. Heer

CHAPTER 15
Coordination of Benefits
Variety of Benefits Payable to Injured Workers; No-Fault Basic Economic Loss Benefits; Veterans’ Administration Benefits; Longshore and Harbor Workers’ Compensation Act; Mutually Exclusive Benefits; Rights of Third-Party Payors; Overpayment Recovery Pursuant to Minnesota Statutes Section 176.179; Appendix A – Scenarios
– Jennifer Yackley & Edward C. Olson

CHAPTER 16
Medicare
Basics of Medicare Coverage; The Medicare Secondary Payer Act; Medicare, Medicaid, and SCHIP Enforcement Act, Section 111: Reporting Requirements For Employers And Insurers; Reimbursing Medicare’s Past Conditional Payments; Workers’ Compensation Medicare Set-Aside Arrangements; Setting Up a Medicare Set-Aside Account; Timing of Approval of a Medicare Set-Aside Account; What Happens After a WCMSA Has Been Submitted; Avoiding a Medicare Set-Aside Account; Effect of a Workers’ Compensation Judge Approving a Workers’ Compensation Settlement; Penalties; False Claims Act and Private Cause of Action; Selected Cases; Useful Resources; Appendix A – Glossary of Common Acronyms
– Jerry W. Sisk & Joseph P. Mitchell

CHAPTER 17
Settlement Agreement/Vacation of Awards
Introduction; Applicable Statutory Provisions and Rules; Contents of Stipulation For Settlement; Types of Settlements; Approval of Stipulation For Settlement; Preserving Claim For Contribution in Settlement Agreement; Award On Stipulation; Persons Excluded From Settlement; Payment Per Award; Miscellaneous; Vacation of Settlement Agreements
– Hon. Deborah K. Sundquist, Gregg A. Johnson & Hon. Nicholas W. Chang

CHAPTER 18
Third-Party Practice
Introduction; The Employer’s Right of Subrogation; Third Party Contribution Liability; Workers’ Compensation Payments as an Offset Against Civil Damages
– Scott A. Wilson

CHAPTER 19
Employment Law Issues for Workers’ Compensation Practitioners
Introduction; Americans With Disabilities Act, Minnesota Human Rights Act, and the Family and Medical Leave Act; Minnesota Sick and Safe Time; Minn. Stat. § 176.82 – Workers’ Compensation Retaliation; Settlement Agreements; Conclusion
– Leonard B. Segal

CHAPTER 20
Intervention
Introduction; Notice of Right to Intervene Under Minnesota Administrative Rules Part 1415.1100; Right to Intervene – Minn. Stat. § 176.361; Amount Payable; Reimbursement From Benefit Award; Edquist Fees
– Jane C. Poole

CHAPTER 21
Practice and Procedure
Introduction; Actions Commenced With the Filing of a Claim Petition; Other Actions Commenced With the Filing of a Petition; Procedures For Continuation or Discontinuance of Weekly Benefits; Procedure For Resolving Medical Issues; Procedure For Resolving Rehabilitation Issues; Collectively Bargained Alternative Dispute Resolution System
– Kathryn Hipp Carlson, Michael F. Scully & Hon. Kirsten M. Marshall

CHAPTER 22
Practice Forms
Introduction; Court and Filing Information
– Hon. Kirsten M. Marshall & Michael F. Scully

Table of Authorities
Subject Index

Forms Included: 

• WC01 – Affidavit of Counsel in Support of Motion to Compel [Additional Discovery] [Attendance at IME/IVE/Deposition]
• WC02 – Affidavit in Support of Motion for Continuance
• WC03 – Affidavit in Support of Motion for Medical Testimony
• WC04 – Affidavit in Support of Petition to Vacate [Award on Stipulation] [Findings and Order]
• WC05 – Affidavit in Support of Motion to Dismiss
• WC06 – Affidavit in Support of Motion for Joinder
• WC07 – Affidavit in Support of Motion to Reinstate on Hearing Calendar
• WC08 – Affidavit in Support of Motion to Strike the Employee’s Claim Petition
• WC09 – Affidavit of Significant Financial Hardship
• WC10 – Affidavit of Service
• WC11 – Annual Claim for Reimbursement from the Second Injury Fund
• WC12 – Annual Claim for Reimbursement of Supplementary Benefits
• WC12.1 – Addendum to Annual Claim for Reimbursement of Supplementary Benefits
• WC13 – Answer to Claim Petition
• Application to Intervene (see Form WC41 – Motion to Intervene)
• WC14 – Authorization to Release Medical Information
• WC15 – Authorization To Use And/Or Disclose Medical Records
• WC16 – Authorization to Review File
• WC17 – Authorization For Release of Employment Information
• Award on Stipulation:
• WC18 – Award on Stipulation (with legal representation and conclusively presumed)
• WC19 – Award on Stipulation (with legal representation and with judicial review)
• WC20 – Award on Stipulation: all parties not represented and with judicial review
• WC21 – Employee’s Claim Petition (OAH)
• NOTE: Filers wishing to initiate proceedings at the DLI in conformity with Minnesota Statutes section 176.2611should use the DLI’s form. Filers wishing to initiate proceedings at the OAH in conformity with Minnesota Statutes section 176.2611 should use the OAH’s form.
• WC22 – Employee’s Claim Petition (DLI)
• NOTE: Filers wishing to initiate proceedings at the DLI in conformity with Minnesota Statutes section 176.2611should use the DLI’s form. Filers wishing to initiate proceedings at the OAH in conformity with Minnesota Statutes section 176.2611 should use the OAH’s form.
• WC23 – Claim Petition for Dependency Benefits or Payment to Estate (OAH)
• WC24 – Demand for Discovery Pursuant to Minnesota Rule 1420.2200
• WC25 – Disability Status Report
• WC26 – Employee or Insurer’s Objection to Requested Attorney Fees and/or Costs
• WC27 – Excess Fee Exhibit
• WC28 – First Report of Injury
• WC29 – Health Care Provider Report
• WC30 – Interim Status Report
• WC31 – Medical Request (Parties filing this form at DLI should do so online through the Campus system.)
• WC32 – Medical Response (Parties filing this form at DLI should do so online through the Campus system.)
• WC33 – Mediation Request Form (OAH)
• Motions:
• WC34 – Motion to Compel [Additional Discovery] [Attendance at IME/IVE/Deposition]
• WC35 – Motion for Continuance
• WC36 – Motion for Consolidation
• WC37 – Motion for Medical Testimony
• WC38 – Motion to Dismiss
• WC39 – Motion for Extension of Time Within Which To Complete an Independent Medical Examination Pursuant to Minn. Stat. § 176.155
• WC40 – Motion for Joinder
• WC41 – Motion to Intervene (OAH)
• WC42 – Motion to Intervene (DLI)
• WC43 – Motion to Reinstate on Hearing Calendar
• WC44 – Motion to Strike From Active Trial Calendar
• WC45 – Notice of Appeal to Workers’ Compensation Court of Appeals (OAH)
• WC46 – Notice of Appearance of Attorney for Employee
• WC47 – Notice of Appearance
• WC48 – Notice of Benefit Payment
• WC49 – Notice of Benefit Reinstatement
• WC50 – Notice of Case Settlement
• WC51 – Notice of Discontinuance of Workers’ Compensation Benefits Upon Death of Employee
• WC52 – Notice of Discontinuance of Workers’ Compensation Dependency Benefits
• WC53 – Notice of Insurer’s Primary Liability Determination
• WC54 – Notice of Intention to Discontinue Benefits (This form is usually created online through DLI's Campus system.)
• WC55 – Notice of Taking Deposition
• WC56 – Notice to Potential Intervenors (DLI)
• NOTE: If matter is pending at the DLI, this notice should be used. The OAH’s form (Form WC59, Notice of Right to Intervene), should be used when matter is pending at the OAH.
• WC57 – Notice of Right to Intervene (OAH)
• NOTE: If matter is pending at the OAH, this notice should be used. The DLI’s form (Form WC58, Notice to Potential Intervenors), should be used when matter is pending at the DLI.
• WC58 – Employee’s Objection to Discontinuance
• WC59 – Objection to Request for Expedited Hearing Based Upon Financial Hardship
• WC60 – Objection to Petition for Contribution and/or Reimbursement
• WC61 – Objection to Petition for Joinder
• WC62 – Objection to Request for Formal Hearing
• WC63 – Order Allowing Medical Testimony
• WC64 – Order Compelling Discovery
• WC65 – Order for Consolidation
• WC66 – Order for Continuance
• WC67 – Order Denying Motion for Dismissal
• WC68 – Order Awarding Attorney Fees (Lump Sum)
• WC69 – Order Determining Attorney Fees (Ongoing)
• Order Determining Attorney Fees (Medical)  (see Form WC71 – Order Determining Attorney Fees (Rehabilitation))
• WC71 – Order Determining Attorney Fees (Rehabilitation)
• Order Dismissing Claim Petition:
• WC72 After Stricken
• WC73 Claim/Pleading Withdrawn
• WC74 – Order Dismissing Parties
• WC75 – Order Dismissing Pleadings
• WC76 – Order Extending Time to File Independent Medical Examination
• WC77 – Order Granting Joinder
• WC78 – Order Reinstating Employee’s Claim Petition
• WC79 – Order Striking Employee’s Claim Petition from Active Trial Calendar
• WC80 – Permanent Total Disability Agreement (Effective Only for Dates of Injuries Prior to 10/01/1995)
• WC81 – [Petition for Contribution and/or Reimbursement] [Request for Hearing on Liability on Temporary Order]
• WC82 – Petition to Discontinue Workers’ Compensation Benefits
• WC83 – Petition for Joinder
• WC84 – Petition for Permanent Total Disability
• WC85 – Petition for Reassignment (OAH)
• WC86 – Petition for Reimbursement from the Special Compensation Fund
• WC87 – Petition for Temporary Order
• WC88 – Petition for Taxation of Actual and Necessary Disbursements
• WC89 – Petition for Writ of Certiorari
• WC90 – Petition to Vacate [Award] [Order]
• WC91 – Pretrial Statement
• WC92 – Rehabilitation Request (Parties filing this form at DLI should do so online through the Campus system.)
• WC93 – Rehabilitation Response (Parties filing this form at DLI should do so online through the Campus system.)
• WC94 – Report of Work Ability
• WC95 – Request for Administrative Conference on Discontinuance of Workers’ Compensation Benefits
• WC96 – Attorney Request for Certification of Dispute
• WC97 – Request for Formal Hearing
• WC98 – Request to Cancel Settlement Conference
• WC99 – Request to Cancel Minn. Stat. § 176.239 Administrative Conference
• WC101 – Objection to Motion to Intervene
• WC102 – Sample Retainer Agreements
• WC103 – Statement of Attorney Fees and Costs
• WC104 – Stipulation for Dismissal
• WC105 – Stipulation of Intervention (OAH)
• WC106 – Stipulation of Intervention (DLI)
• WC107 – Stipulation for Settlement
• WC108 – Stipulation for Settlement (Multiple Parties)
• WC109 – Stipulation For Settlement Provisions Relating to Social Security Offsets
• WC110 – Stipulation of Permanent Total Disability
• WC111 – Stipulation Waiving Bond
• WC112 – Subpoena
• WC113 – Substitution of Attorneys
• WC114 – Temporary Order
• WC115 – Writ of Certiorari
• WC116 – Request for Interpreter
• WC117 – Request for Administrative Conference 
• WC118 – Petition for Contribution/Reimbursement

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