Claims Kit

Reporting of Claim by Employer Minn. Stat. 176.231

Fatalities and serious injuries

Workplace fatalities and serious injuries must be reported to the Department of Labor and Industry within 48 hours via telephone at 651-284-5041 or fax at 651-284-5731, to be followed by the FROI form. Minnesota OSHA Compliance also has workplace fatality reporting requirements.

All other injuries

For all other injuries, where claimed disability exceeds 3 calendar-days, the employer must get the FROI form to its insurance company within 10 days of the first day of disability or the date it was aware of disability, whichever is later.

Likewise, the insurance company must file the FROI form with the department within 14 days of the first day of disability or the date the employer was aware of disability, whichever is later.

For self-insured employers, the FROI form must be filed with the department within 14 days of the first day of disability or the date the employer was aware of the disability, whichever is later. The employee must be given a copy of the FROI form, with the employee information sheet.

Employees are not responsible for completing the FROI form. It should be completed accurately, completely, legibly and timely by the employer. Again, it is very important the FROI form be submitted timely to avoid unnecessary penalties.

Posting Requirements 176.139

All employers required or electing to carry workers' compensation coverage in the state of Minnesota must post and display in a conspicuous location a notice, "Minnesota Workers' Compensation Employee Rights and Responsibilities", advising employees of their rights and obligations, assistance available to them, and the operation of the workers' compensation system, the name and address of the workers' compensation carrier insuring them or the fact that the employer is self-insured.

The notice must be displayed at all locations where the employer is engaged in business.

The commissioner may assess a penalty of $500 against the employer if, after notice from the commissioner, the employer violates the posting requirement.

Poster

Poster - Spanish

OSHA Poster

Penalties for Late Reporting  5220.2820    176.231  Subd. 10

A penalty may be assessed against the employer, if a work-related death or serious injury occurs to an employee and:

the commissioner is not notified within 48 hours; or
the commissioner is notified within 48 hours  but the report of the injury is not filed with the commissioner within 7 days 

Against the employer, if any other injury which must be reported to the division occurs and:

the employer is self-insured and the electronic first report of injury is filed with the division,  more than 14 days after the first day of lost time or 14 days after the date when notice of lost time was received by the employer, whichever is later; or
the employer is not self-insured and the first report of injury is received by the insurer more than10 days after the first day of lost time or 10 days after the date when notice of lost time  was received by the employer, whichever is later; or

Against the insurer, if:

an injury which must be reported to the division occurs;
the first report of injury is received by the insurer from the employer within the 10-day period  and
the electronic first report of injury is filed with the division, more than 14 days after the first day of lost time  or 14 days after the date when notice of lost time was received by the employer, whichever is later.

Amount.

If the employer or insurer has violated the above  and has had no similar violations in the 12-month period prior to the assessment, an advisory letter informing the employer or insurer of the violation and the statutory requirement must be sent. If the employer or insurer has had one violation in regards to the above in the past 12 months, a penalty of $125 must be assessed. If the employer or insurer has had two violations in the past 12 months, a penalty of $250 must be assessed. If the employer or insurer has had three violations in the past 12 months, a penalty of $375 must be assessed. If the employer or insurer has had four or more violations in the past 12 months, a penalty of $500 must be assessed.

Assessment.

The penalty must be assessed by written notice of penalty assessment informing the employer or insurer of the number of violations in the past 12 months on record and the amount of the penalty. The notice must contain instructions for payment.

Payable to.

The penalty is payable to the commissioner for deposit in the assigned risk safety account.

Failure to file required report, penalty.

If an employer, qualified rehabilitation consultant or rehabilitation vendor, insurer, physician, chiropractor, or other health provider fails to file with the commissioner any report required in the manner and within the time limitations prescribed, or otherwise fails to provide a report required the commissioner may impose a penalty of up to $500 for each failure.

The imposition of a penalty may be appealed to a compensation judge within 30 days of notice of the penalty.

Physician Selection 

Employees may choose their health care provider for treatment of a work-related injury. An employer may require an employee to see a designated health care provider for treatment only in the following circumstances.

  An employer may require an employee to receive treatment and supplies from a managed care plan certified under  176.1351 except as otherwise provided by        that law and corresponding laws  Rules Chapter 5218.
  An employer that is part of a collective bargaining agreement, recognized and on file with the department, may include a provision specifying a list of health care      providers that may be the exclusive providers of medical and related treatment and independent medical examinations  176.1812
  An employer may require an employee to obtain outpatient prescription and nonprescription medications from a pharmacy or network of pharmacies as long as         it is within 15 miles of the employee's residence 176.135, Subd. 1(g)