Minnesota Continuation of Health Insurance Claims: The “Nothing to Continue” Defense
What benefits does Minnesota Statutes § 299A.465 provide for duty disabled officers?
Minnesota Statutes § 299A.465 provides duty disabled police officers, firefighters and their dependents with health insurance coverage through their former employer through the age of 65. The employer must continue to pay its share of the duty disabled officer or firefighter’s health insurance premiums, as if he or she continued to work as an employee. To qualify for continued health insurance benefits under § 299A.465 the injured police officer or firefighter must have been approved for Duty Disability benefits under Minnesota Statutes § 353.01, subd. 41. This statute provides that a police officer or firefighter is eligible for benefits if he or she has a condition that is expected to prevent him or her, for a period of not less than 12 months, from performing the normal duties of the position and the condition is the direct result of an injury incurred during the performance of inherently dangerous duties that are specific to the positions covered (i.e., the positions of police officer or firefighter).
When an injured police officer or firefighter is approved for Duty Disability benefits, the employer is notified of its obligation to continue the officer or firefighter’s health insurance benefits until they reach the age of 65. If the employer wishes to appeal PERA’s Duty Disability determination the employer has the burden of showing that the police officer or firefighter does not have a disabling condition that is expected to prevent him or her, or has actually prevented him or her, for a period of not less than twelve months, from performing the normal duties of a police officer, and the disabling condition is the direct result of an injury incurred during, or disease arising out of, the performance of inherently dangerous duties specific to the position of a police officer or firefighter.
Failure to continue health insurance coverage
Courts have consistently held that an officer or firefighter’s failure to continue employer-based health insurance coverage is not a valid reason for employers to deny a duty disabled police officer or firefighter’s access to or eligibility for 299A.465 health insurance coverage. Unfortunately, this has not prevented employers from appealing a Duty Disability determination and asserting this “defense” time and time again.
Last fall, I appeared in Anoka County District Court on behalf of three duty disabled police officers and firefighters. Each had been approved for PERA Duty Disability benefits and each were denied 299A.465 health insurance coverage by their former employer. The reason? The officer or firefighter had elected coverage through their spouses, or through another outside source, when they sustained their disabling injuries on the job. The former employer did not follow the appeals process set forth by statute so Meuser Law Office, P.A. filed the case in Minnesota District Court.
On cross motions for summary judgment, the former employer argued that the use of the word “continued” in the title of Minnesota Statutes § 299A.465 and the use of the word “continue” in the body of the statute eliminated an employer’s obligation to a duty disabled police officer or firefighter who was not enrolled in the employer’s group health insurance plan at the time of the injury.Essentially, the employer argued that if a police officer or firefighter was not enrolled in employer-based health insurance at the time they sustained their injury, there was nothing for the employer to continue. At the summary judgment hearing, I argued the Defendant’s interpretation of the law would result in police officers and firefighters who were not enrolled in their employer-based health insurance plan being excluded from receiving 299A health insurance benefits, which are provided for similarly situated police officers and firefighters who are eligible to receive this coverage through age 65. The distinction was nonsensical and not supported by the statute’s construction or the intent behind the statute. The judge agreed and granted summary judgement for my clients, ruling that the legislature intended that officers and firefighters injured while carrying out duties that are inherently dangerous and specific to their position receive medical insurance until they reach the age of 65, whether or not they were actively enrolled in health insurance coverage at the time they sustained their injuries.
I have also represented injured police officers and firefighters in administrative law court against employers making the same “failure to continue” arguments with the same results. Even though the courts agree that the intention, construction and policy behind Minnesota Statutes § 299A.465 do not support this often-made argument by employers, they continue to try to make it.
Contact Meuser Law Office, P.A. for a free, no-obligation case evaluation and consultation. We’ve successfully represented hundreds of State Patrol, police officers and firefighters throughout the state for both workers’ compensation and PERA/MSRS disability claims. The knowledgeable attorneys at Meuser Law Office, P.A. take the time with each client to help determine which benefits under the Minnesota Workers’ Compensation Act you are entitled as well as discuss PERA Duty Disability benefits, motor vehicle claims, and Healthcare Continuation Benefits under Minnesota Statute §299A.465. Call us today at 1-877-746-5680.