Claims Kit

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

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)

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 5220.2820 Subp. 1 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 of subpart 1 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.

If an employer, qualified rehabilitation consultant or rehabilitation vendor, insurer, physician, chiropractor, or other health provider fails to file with the commissioner any report or other document required by this chapter in the manner and within the time limitations prescribed, or otherwise fails to provide a report or other document 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.

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

Filing first reports of injury for COVID-19 claims

The Minnesota Department of Labor and Industry (DLI) reminds employers they are required to report any injury that wholly or partly incapacitates an employee from performing labor or service for more than three calendar days. This includes an employee's contraction of COVID-19 that may have occurred at work and that could be considered an occupational disease or injury, including for those employees previously covered under the COVID-19 presumption in Minnesota Statutes § 176.011, subdivision 15 (f), that expired at 11:59 p.m., Dec. 31, 2021.

Per Minn. Stat.176.231, subd. 10, failure to file the report in the required time limits may result in penalties against the employer of up to $500 for each occurrence.

When completing the FROI, employer's should use "Nature of Injury Code 83" for COVID-19 claims. Filing a FROI is not an admission of liability -- the insurer makes that determination -- but failure to report the claim to the insurer or TPA may result in time consuming and costly litigation and increased benefits to injured employees.

An insurer or TPA has 14 days to either accept or deny liability. This 14-day period starts on the first day of lost time from work or the date the employer had notice or knowledge of the lost time, whichever is later. A delay in reporting a claim may result in additional penalties for failure to either accept or deny liability in a timely manner.

August 2020

Waiver of workers’ compensation rights prohibited

The Minnesota Department of Labor and Industry (DLI) has received information that some employers are requiring employees to sign a waiver form agreeing the employer is not liable if the employee contracts COVID-19 on work premises. Some waivers state that employees who refuse to sign the waiver will be fired or unable to return to work; others state the employee agrees that by returning to work they have assumed the risk of contracting COVID-19; and some require the employee to agree to mandatory arbitration.

These waivers and agreements are prohibited and are not enforceable under Minnesota law. Employees cannot sign away the right to file a workers’ compensation claim and an employer may not discriminate against a worker for reporting an injury. It is also prohibited for employers to advise employees to not report an injury, agree to hold an employer harmless for an injury or relinquish rights an employee may have to workers’ compensation benefits.

August 2020

Filing a first report of injury for COVID-19 claims

The Department of Labor and Industry (DLI) has become aware of a discrepancy between the number of COVID-19 first reports of injury received to date by DLI and the number of employees reported by the Minnesota Department of Health who have tested positive for COVID-19 who may have contracted COVID-19 at work.

DLI enforces timely compliance with Minnesota’s workers’ compensation statutes and rules. One of these provisions is to ensure the prompt reporting of worker injuries. Employers are required to report an injury, including an employee’s contraction of COVID-19 that may have occurred at work, which wholly or partly incapacitates the employee from performing labor or service for more than three calendar days. The employer is required to report the injury to its insurer on a First Report of Injury (FROI) form prescribed by the commissioner and must provide a copy of the form to the employee, with the Workers’ Compensation System Employee Information Sheet (see Minnesota Statutes § 176.231, subdivision 1). Remember when reporting COVID-19 claims to use the Workers Compensation Insurance Organizations updated cause-of-injury and nature codes. The new codes include a cause code of 83 for pandemic and a nature code of 83 for COVID-19. The codes can be used for any dates of injury beginning in December 2019

An employer must report each COVID-19 injury to its insurer within 10 days after it has received notice of the injury or has knowledge of the injury. Notice may include notification by the Minnesota Department of Health that a worker or workers have tested positive for COVID-19 and knowledge may include an awareness that an employee has, or claims to have, COVID-19 that they may have contracted at work.

An employee must provide notice of an injury to the employer within specified time frames, unlessthe employer had actual knowledge

Payment of full wages and medical bills for employees ill with COVID-19 is not a defense to filing a FROI form. The claim must still be reported. If the claim is compensable, the insurer is required to report the portion of full wages that constitute wage-loss benefits and pay Special Compensation Fund assessments on the wage-loss benefit.

NOID#3 form specificity, supporting documents

DLI has noticed some of the reasons for discontinuing benefits on recently filed NOID#3 forms for COVID-19 claims lack the required specificity to determine whether the reason for discontinuance is valid in accordance with the Minnesota workers' compensation law. In addition, some of the NOID#3 forms being filed lack the required attached documentation that supports the reason for discontinuing the benefits. DLI reminds claims staff members of the following.

• When filing a NOID#3 form, you must "state the date of intended discontinuance and set forth a statement of facts clearly indicating the reason for the action. Copies of whatever medical reports or other written reports in the employer's possession which are relied on for the discontinuance shall be attached to the notice." If the employee has been or is presently represented by an attorney for the same injury, the NOID#3 must also be served on the last attorney of record. (See Minnesota Statutes § 176.238, subdivisions 1 and 9.)
• The legal reason or reasons for the proposed discontinuance or reduction must be stated in language that is easily read and understood by a person of average intelligence and education, and in sufficient detail to inform the employee of the factual basis for the discontinuance or reduction. (See Minnesota Rules 5220.2630, subpart 4(B)(5).)
• A penalty of up to $1,000 for each violation may be assessed for failure to comply with these requirements. (See Minn. Stat. § 176.238, subd. 10.)

Implementation of Work Comp Campus continues

DLI and the Workers' Compensation Modernization Program (WCMP) continue to work diligently in preparation for the launch of Work Comp Campus. DLI's leadership and staff are adapting to the challenges due to the COVID-19 pandemic, while still delivering services to parties across the state.

Campus user training will happen in June, July and August 2020. WCMP is scheduled to go live for all users in August 2020.

Minnesota workers' compensation email filing

The Minnesota Department of Labor and Industry has created a new email address for submission of certain workers' compensation forms, documents, medical records and other correspondence to facilitate compliance with Gov. Tim Walz’s Stay at Home executive orders.

Submission via this email address is meant to help stakeholders continue to submit necessary filings and documents related to reportable workers' compensation claims while working from home offices and without ready access to their usual mail or fax submission methods. If you are able to mail or fax documents, continue to do so, to ensure this email inbox will be available for remote workers who do not currently have access to those methods.

Do not email the forms listed belowthat can already be submitted online.

• First Report of Injury (FROI) – These must continue to be submitted via electronic data interchange (EDI) or eFROI.
• Request for dispute certification
• Medical Request, Medical Response, Rehabilitation Request, Rehabilitation Response
• Mediation request
• Vocation rehabilitation related
  • Rehabilitation Consultation Report
  • R-2 Rehabilitation Plan
  • Plan Progress Report
  • R-3 Rehabilitation Plan Amendment
  • R-8 Notice of Rehabilitation Plan Closure
• Annual request for reimbursement
• Workers' Compensation Report of Benefits Paid

Submission by email is only authorized if the following requirements are met:

1. All documents must be emailed to wcincomingmail.dli@state.mn.us.
2. Your email message should be encrypted or otherwise secure to protect sensitive or private data.
3. Your subject line should be the worker identification (WID) number*, the date of injury (DOI) and a short description of your filing (use the description column in the table below). Never use an employee's Social Security number, name or other identifying information in the subject line.
   • Example: 123456_01/01/2020_NOB
   • The WID number is always returned in the EDI acknowledgement when FROIs are accepted, it is also called the Employee Security ID and is DN0206. Ask your EDI person or team for the WID number on a claim if you do not know where to find it in your system.
4. Documents for only one employee and date of injury can be attached for each email message. If you need to submit documents for more than one employee or more than one date of injury, you will need to send a separate email message for each claim.
5. Email messages received after 4:30 p.m. Central time will be marked as received the next business day.

Questions?

If you have any questions, email Karen Ryba at karen.ryba@state.mn.us or Karen Carlson at karen.carlson@state.mn.us.

HF 4537 bill was passed which ammends 176.011 subdivision 15

The Commissioner is authorized to extend the implementation date of the CAMPUS system beyond August 31, 2020 if the commissioner determines it should be delayed due to the COVID-19.

Effective 4/8/2020

Updated Minnesota workers' compensation injury codes

The Workers Compensation Insurance Organizations (WCIO) updated its cause-of-injury and nature codes. The new codes include a cause code of 83 for pandemic and a nature code of 83 for COVID-19 for dates of injury beginning in December 2019. Minnesota is accepting the new codes immediately.

Reporting of Claim by Employer 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.