Clarifying “Ascertainable” Medical Benefits for Roraff Fees: WCCA Must Apply a Reasonable-Mind/Record-as-a-Whole Review

Court: Minnesota Supreme Court

Case: Rodney Dean Bjornson, Relator v. McNeilus Companies, Inc. and Travelers Indemnity Company of America and Property & Casualty Insurance Company of Hartford

Docket: A24-0454

Date: April 30, 2025

Opinion by: Justice Hennesy

Introduction

This workers’ compensation appeal centers on how an employee’s attorney proves the “ascertainable” dollar amount of medical benefits for purposes of Roraff attorney fees under Minn. Stat. § 176.081, subd. 1(a). The case arises from two work-related injuries suffered by relator Rodney Dean Bjornson while employed by McNeilus Companies, Inc. Bjornson’s attorney, David C. Wulff, sought Roraff fees based on medical benefits he contended were paid by a self-funded health plan administered by United Healthcare Services to the Mayo Clinic, later recognized as causally related to the work injuries in a settlement.

The compensation judge awarded $49,000 in Roraff fees, finding that the amount of medical benefits was ascertainable. The Workers’ Compensation Court of Appeals (WCCA) reversed, concluding the amount was not ascertainable because the appellate record lacked the itemized Mayo Clinic bills referenced by the compensation judge, and it reduced the fee to $500 under the statutory formula applicable when benefits are not ascertainable.

The Minnesota Supreme Court reversed and remanded. It held that the WCCA failed to apply the proper standard of review—whether, viewing the record as a whole, a reasonable mind might accept the evidence as adequate to support the compensation judge’s findings—and ordered further proceedings. The Court also directed procedural steps to clarify the evidentiary basis referenced by the compensation judge, without reopening the record.

Summary of the Opinion

The Supreme Court’s holding is twofold:

The WCCA must assess whether evidence in the record—such as sworn testimony and a reliable summary of voluminous records—would be accepted by a reasonable mind as adequate to support the compensation judge’s finding that an ascertainable dollar amount of medical benefits was recovered for the employee under Minn. Stat. § 176.081, subd. 1(a).
The matter is remanded with instructions:
- First, the WCCA must remand to the compensation judge to clarify whether the “itemized medical bills from the Mayo Clinic” referenced by the judge were the actual bills or instead the summary exhibit (“Employee’s Itemization of Benefits Claimed,” Exhibit G). The record is not to be reopened for new evidence.
- Second, after that clarification, the WCCA must evaluate the entire existing record and decide whether a reasonable mind could accept the evidence (including sworn testimony and the summary exhibit) as adequate to support the compensation judge’s determination that the benefit amount was ascertainable.

The Supreme Court also granted respondents’ motion to strike 50 pages of Mayo Clinic bills included in an amended addendum because they were not part of the appellate record.

Factual and Procedural Background

Bjornson sustained two work-related injuries while employed by McNeilus and was treated at the Mayo Clinic. A self-funded health plan administered by United Healthcare Services reportedly paid the Mayo Clinic.
In a settlement, McNeilus and its insurers (Travelers for the first injury and Hartford for the second) agreed the Mayo treatment was causally related to the work injuries and agreed to defend and hold Bjornson harmless from reimbursement or subrogation claims by Mayo Clinic or UnitedHealthcare.
Attorney Wulff received a $3,000 contingent fee on a $15,000 lump sum paid for non-medical claims (temporary total disability and permanent partial disability), with the settlement expressly reserving the question of Roraff fees.
Wulff sought Roraff fees, asserting an ascertainable medical-benefit value of $327,257.37 (the amount United allegedly paid to the Mayo Clinic), and requested $49,000 more in fees—20% caps per injury cumulatively less the prior $3,000 fee.
At the attorney-fee hearing, Wulff offered:
- Exhibit G: “Employee’s Itemization of Benefits Claimed,” a summary of the Mayo bills reportedly paid by United.
- Exhibit D: Employee’s Claim Petition (which, as it appears in the appellate record, also included the itemization summary).
- Sworn testimony that United paid $327,257.37 and that Exhibit G itemized those payments.
The compensation judge found the medical benefits ascertainable in the amount of $327,257.37 and awarded $49,000 in Roraff fees.
The WCCA reversed, reasoning that because the itemized Mayo Clinic bills were not in the appellate record, there was a paucity of evidence and the medical-benefit amount was not ascertainable, thereby limiting fees to $500 under the statute.
The Supreme Court reversed and remanded, directing the WCCA to apply the proper evidentiary review and to obtain clarification from the compensation judge about what exhibit the judge meant by “itemized medical bills.”

Detailed Analysis

Precedents and Authorities Cited

Roraff v. State Department of Transportation, 288 N.W.2d 15 (Minn. 1980): The seminal decision that created a method for awarding attorney fees when an employee’s attorney secures payment of medical benefits. The Legislature later codified this mechanism in Minn. Stat. § 176.081.
Minn. Stat. § 176.081, subd. 1(a) (2022/2024): Governs workers’ compensation attorney fees. The case applies the 2022 version because fee caps are determined by the law in effect at the time of injury. The statute permits additional fees when the contingent fee is inadequate, and it ties enhanced fees to the “ascertainable” value of medical benefits recovered; if not ascertainable, the statute limits the fee to the lesser of hourly charges or $500.
Joyce v. Lewis Bolt & Nut Co., 412 N.W.2d 304 (Minn. 1987): Confirms that the law in effect at the time of injury controls the fee cap. Here, the 2022 fee cap applies even though the cap was raised to $55,000 per claim effective October 1, 2024.
Lagasse v. Horton, 982 N.W.2d 189 (Minn. 2022): Reiterates the standard of review the WCCA must apply to compensation judge findings—whether, in the context of the record as a whole, the findings are supported by evidence that a reasonable mind might accept as adequate (i.e., substantial evidence).
Hudson v. Trillium Staffing, 896 N.W.2d 536 (Minn. 2017): Appellate courts will strike materials not contained in the record below. The Court relied on this principle in striking the Mayo Clinic bills newly appended to the amended addendum.
Minn. Stat. § 176.481 (2024): Confers authority on the Supreme Court to remand to the WCCA for further proceedings with appropriate directions.

Legal Reasoning

The Supreme Court’s analytical focus was procedural and evidentiary, not on a merits determination of the fee amount. Its reasoning proceeded in three steps:

Clarification of the WCCA’s Review Duty: The WCCA must evaluate whether the compensation judge’s finding that medical benefits are “ascertainable” is supported by evidence that a reasonable mind might accept as adequate when considering the record as a whole. Merely noting the absence of specific documents (the “itemized Mayo Clinic bills”) without evaluating other record evidence (sworn testimony, summary exhibit, stipulation terms, claim petition attachments) is error under Lagasse’s substantial-evidence framework.
Scope of the Record and Proper Appellate Materials: The Court reaffirmed that the appellate record cannot be supplemented with new evidence on appeal. It granted respondents’ motion to strike 50 pages of Mayo bills that were not part of the original record before the compensation judge or the WCCA, underscoring the importance of record integrity (Hudson).
Targeted Remand Instructions without Reopening the Record:
- The compensation judge’s order referenced “itemized medical bills from the Mayo Clinic,” but the appellate record does not contain the actual itemized bills. The Court directed the WCCA to remand to the compensation judge for a limited clarification: whether the judge’s reference was to the actual bills or to Exhibit G (the itemization summary prepared by counsel) that had been received into evidence.
- The record is not to be reopened. After receiving that clarification, the WCCA must conduct the substantial-evidence assessment on the record as it stands, including sworn testimony and the summary exhibit.

Importantly, the Supreme Court did not decide whether Exhibit G and the sworn testimony are, in fact, sufficient to establish an ascertainable amount. It held that the WCCA must address that question using the correct evidentiary standard.

Impact

The decision provides important guidance on evidentiary sufficiency and appellate review in Roraff fee disputes:

Substantial Evidence Standard Reaffirmed and Applied to “Ascertainability”: The WCCA cannot short-circuit the inquiry by focusing on missing documents alone; it must ask if the evidence that is in the record, taken as a whole, could be accepted by a reasonable mind as adequate to support the compensation judge’s determination of an ascertainable benefits amount.
Testimony and Summaries May Suffice—If Reliable and Adequate: While the Court did not conclusively bless attorney-prepared summaries as sufficient in all cases, its remand directions explicitly instruct the WCCA to consider whether sworn testimony and a credible summary of voluminous medical billing can prove an ascertainable amount. This invites careful, fact-specific evaluations going forward.
Record Management Matters: Parties must ensure that the evidentiary record at the hearing level contains the materials they will rely on. Appellate courts will strike efforts to add new documents post hoc. Compensation judges should clearly identify which exhibits they rely on, particularly where “itemized bills” may refer to either actual invoices or a summary exhibit.
Practical Effects on Fee Litigation: Attorneys seeking Roraff fees should expect closer scrutiny of how they prove “ascertainable” amounts, especially when relying on third-party payments (e.g., a self-funded health plan) and hold-harmless stipulations. This decision strengthens the pathway for using reliable summary evidence, while emphasizing the WCCA’s duty to apply the correct standard of review.

Complex Concepts Simplified

Roraff Fees: Originating from Roraff v. MnDOT and codified in Minn. Stat. § 176.081, these fees compensate an employee’s attorney for securing payment of medical benefits. They supplement or replace the standard contingent fee when that contingent fee is inadequate to fully compensate counsel.
Ascertainable Dollar Value: To award Roraff fees based on a percentage, the dollar value of medical benefits recovered must be calculable and supported by the record (e.g., itemized bills, reliable summaries, or credible testimony). If the value is not ascertainable, fees are limited to the lesser of hourly fees or $500.
Substantial Evidence / Reasonable-Mind Standard: On appeal, the WCCA must uphold the compensation judge’s findings if, when viewing the record as a whole, there is evidence that a reasonable person could accept as adequate.
Record on Appeal and Motions to Strike: Appellate courts review only what was admitted below. Attempting to introduce new materials on appeal can result in those materials being stricken.
Hold-Harmless and Subrogation Context: In settlements, employers/insurers may agree to defend and indemnify the employee against reimbursement or subrogation claims by healthcare providers or health plans. Where insurers accept liability for medical treatment previously paid by a health plan, the value of those medical benefits can be central to calculating Roraff fees—provided the amount is proven and tied to the litigation outcome.
Fee Caps and Timing: The statutory cap applies based on the law at the time of injury. Although the Legislature increased the cap to $55,000 per claim effective October 1, 2024, this case applies the earlier $26,000-per-injury cap.

Practical Guidance for Future Cases

Build a Clear Record: Ensure that all exhibits relied upon are offered, received, and properly identified in the hearing record. If relying on a summary of voluminous records, make the summary as detailed and verifiable as possible.
Use Reliable Summaries with Foundation: While the Court did not formally adopt evidentiary rules for summaries, it signaled that attorney-prepared summaries, corroborated by sworn testimony and grounded in underlying records, can be considered in assessing “ascertainable” amounts.
Testimony Matters: Sworn testimony from counsel or witnesses about amounts paid and what the summary reflects can be part of the substantial-evidence mix. Establish the source of the numbers, how they were derived, and their linkage to the claims resolved.
Stipulations Should Be Specific: When a settlement recognizes medical treatment as work-related and includes hold-harmless obligations, consider stating with specificity the medical amounts and the evidentiary basis, or explicitly incorporating precise itemizations by reference in a way that ensures they are part of the record.
Appellate Strategy: Do not attempt to add documents to the appellate record. If a necessary document is missing, the appropriate remedy is a targeted remand for clarification—not supplementation at the appellate stage.
Judicial Clarity: Compensation judges should precisely identify which exhibit supports their findings, especially where identical or similar documents (e.g., itemized bills versus a summary itemization) could be confused.

What the Decision Does Not Decide

Whether Exhibit G and Wulff’s testimony, in this case, are sufficient to establish an ascertainable amount of $327,257.37. The Supreme Court left that determination to the WCCA applying the proper standard after receiving the compensation judge’s clarification.
Whether attorney-prepared summaries will always suffice. The Court merely held that such evidence must be evaluated under the reasonable-mind standard; sufficiency remains fact-specific.

Conclusion

The Minnesota Supreme Court’s opinion establishes a clear procedural and evidentiary directive for Roraff fee disputes: the WCCA must conduct a substantial-evidence review that considers the entire record and asks whether a reasonable mind could accept the evidence as adequate to support the compensation judge’s finding that medical benefits are “ascertainable.” The Court’s remand ensures careful, fact-driven evaluation of sworn testimony and reliable summary exhibits in the absence of voluminous underlying bills—without reopening the record or tolerating appellate supplementation.

In practical terms, the decision elevates the importance of meticulous record-building and precise judicial references to exhibits, while reaffirming the WCCA’s obligation to apply the correct standard of review. For practitioners, it clarifies that ascertainability may be established through well-founded summaries and testimony, but the adequacy of such proof will be judged case by case under the reasonable-mind standard.

Key Takeaways

WCCA must decide if, on the record as a whole, a reasonable mind could accept the evidence as adequate to support a finding that medical benefits are ascertainable for Roraff fee purposes.
Sworn testimony and reliable, detailed summaries of voluminous medical billing can be part of the evidentiary foundation; their sufficiency is a fact question.
Appellate records cannot be supplemented with new documents; attempts to do so will be stricken.
On remand, the compensation judge must clarify whether “itemized medical bills” meant actual bills or the summary exhibit, without reopening the evidentiary record.
The 2022 statutory cap applies because fee caps are governed by the law in effect at the time of injury, notwithstanding the 2024 increase.