Minn. R. 5221.6700
What PTSD treatment does Minnesota workers' comp cover?
16-week psychotherapy periods, no more than twice a week except emergency care
Indicated modalities include trauma-focused psychotherapies such as prolonged exposure, CPT, CT-PTSD, EMDR, narrative exposure, brief eclectic psychotherapy, and other evidence-based trauma-focused modalities subject to subpart 7. The provider must give prior notice at least seven working days before each additional 16-week period. Benzodiazepines are not indicated for PTSD.
When the limit can be longer
More than one 16-week period
There is no cap on the number of psychotherapy periods. An additional period is indicated only if the worker still meets DSM PTSD criteria and the conditions in 5221.6700, subp. 6, are met. Some additional periods require a complete psychological assessment.
Minn. R. 5221.6700, subp. 6
Emergency frequency
Treatment is not indicated more than two times per week except to provide emergency treatment as defined in 5221.6040, subp. 5.
Minn. R. 5221.6700, subp. 5
The specific counts
Psychotherapy period
16 weeks from the first indicated modality
Adding another modality during those 16 weeks does not extend the period. Additional periods need prior notice at least seven working days before they start.
Minn. R. 5221.6700, subp. 6
Session frequency
Not more than twice per week except emergency treatment
The treating mental health provider must be trained in the modality used and keep documentation of that training.
Minn. R. 5221.6700, subp. 5
PTSD medication prescriptions
Initial prescription up to 3 months; later refills of the same medication up to 6 months
If the worker is not in psychotherapy, the prescriber must evaluate whether psychotherapy would help before prescribing. Benzodiazepines are not indicated.
Minn. R. 5221.6700, subp. 9
If this care was denied or stuck
If the insurer denies authorization or payment in writing, the dispute is a Medical Request to DLI under Minn. Stat. § 176.106, not a Claim Petition, so long as primary liability for the injury is admitted. The denial must state why the proposed care is not supported and that departures may apply. Minn. R. 5221.6050, subps. 7.B and 7.C.
Prior notification, silence, and the 45-day IME window
Seven days to answer
For departures, inpatient surgery, some chronic programs, and certain equipment, the treating provider must notify the insurer at least seven working days before the care starts. The rule then gives the insurer seven working days to approve, deny in writing, ask for more records, require a second surgical opinion, or schedule an employer IME. For non-emergency surgery, the statute is tighter: the insurer must answer in writing within seven calendar days.
Minn. R. 5221.6050, subp. 9.A and 9.C; Minn. Stat. § 176.135, subd. 1a(a)
Complete silence counts as authorization
If the provider hears nothing for seven working days after proper notice, authorization is deemed given. If the insurer affirmatively authorizes care, it generally may not later refuse to pay that authorized treatment.
Minn. R. 5221.6050, subp. 9.C, items (1) and (2)
An IME or second-opinion request is not a denial
A second-opinion request, an employer IME under Minn. Stat. § 176.155, or a demand for more records is not a denial. Non-emergency surgery usually waits while those steps run. Workers' comp is primary for work-injury treatment under Minn. Stat. § 176.135, subd. 1, so group health is not a practical backup. Many providers will not schedule major care until someone with a comp claim number accepts financial responsibility. That is the gap: no surgery, no health-plan bill, and no denial letter to file on.
Minn. R. 5221.6050, subp. 9.C, items (5), (6), and (7); Minn. Stat. § 176.135, subd. 1
Forty-five days after an employer IME on surgery
When prior notification of non-emergency surgery is required and the insurer timely requests an employer examination, the surgery may not be performed pending that exam. After 45 days from the insurer's exam request, the surgeon may elect to proceed, subject to a later compensability decision. That is when the stall is usually ripe to file a Medical Request. DLI can decide the fight at a conference if the amount in dispute is $7,500 or less; a larger surgery dispute can be certified to OAH.
Minn. R. 5221.6050, subp. 9.C, item (6); Minn. Stat. § 176.106, subds. 1 and 3
When there is an actual denial
A written denial triggers the medical dispute path: request the insurer's internal review, or file a Medical Request with DLI attaching the provider's notice and the insurer's response. That route applies when liability for the injury itself is not in dispute. A primary liability fight still belongs in a Claim Petition at OAH.
Minn. R. 5221.6050, subps. 7.C and 9.C, item (3); Minn. Stat. § 176.106
Frequently asked questions
- How long does Minnesota workers' comp cover PTSD therapy?
- A psychotherapy period is 16 weeks from the first indicated modality. Additional 16-week periods are allowed when the worker still meets PTSD criteria and the rule's conditions are met. Listed trauma-focused therapy is not indicated more than twice a week except emergency care.
Related treatments
General information, not legal advice. Read the cited rule before relying on a number. The interactive checker can count weeks from a start date.