Meadow

Claims

5 year accident frequency reduction from 3.9 claims per $1 million of payroll to 2.4 claims per $1 million of payroll producing total cost savings (at $2,640 per claim severity) of $185,000 per year.

We ask for and value your input during the claims process. We work with you to get an employee back to work. Claims are handled with full knowledge that it is the member’s contribution funding the payments. All GMSIF members agree to have a plan in place to return workers as soon as possible. Members also have monthly claims conference calls with their adjuster. These calls give both parties an opportunity to discuss issues with specific claims.





Minnesota Workers’ Compensation Claims Basics

First Report of Injury

First Report of Injury (FROI)

Download the First Report of Injury Form here

The First Report of Injury form (FROI) is the employer’s reporting document for work-related injury claims.  A completed FROI provides the basic information necessary to start a workers’ compensation claim:

  • The FROI should be legibly completed with accurate, detailed, complete and timely information by the employer’s representative.  Injured employees should not complete the FROI.
  • Deaths and serious injuries must be reported to Meadowbrook and ultimately to the Department of Labor and Industry within 48 hours.
  • For all other injuries where claimed disability exceeds three calendar days, the employer must get the FROI to Meadowbrook within 10 days of the first day of disability, or the date they are aware of disability, whichever is later.
  • Meadowbrook then files the FROI with the Department of Labor and Industry within 14 days of the first day of disability, or the date the employer was aware of disability, whichever is later.

Early reporting of all work-related injuries is essential in managing your claims. All incidents should be reported, no matter how minor, to your Meadowbrook team. 

DOLI Workability Form

Waiting Period

Waiting Period:

Minnesota has a three calendar day waiting period before temporary total disability or temporary partial disability is paid.  The first day of disability is the first day of the waiting period.  The first day of disability can be either a full day or partial day lost from work.  If there is disability on the 10th calendar day or beyond, compensation is owed from the first day of disability.  If the only disability beyond the waiting period is for non-scheduled work days, no temporary benefits are paid. 

Restricted work/reduced hours

Restricted work/reduced hours:

A Minnesota employee is paid 2/3 of the difference between the average weekly wage on the date of injury and the average weekly wage of his/her restricted work assignment.  If the restricted job assignment changes the employee’s earning capacity, Meadowbrook must be notified so the appropriate statutory paperwork is processed and the employee is paid for loss of earnings.

Time Requirements

Time Requirements:

  • For injuries with claimed disability extending more than three calendar days, a compensability determination must be made within 14 calendar days.  Failure to pay or deny within 14 days, may result in penalties. 
  • Once payment of wage loss benefits has begun, they cannot be stopped without giving notice to the injured employee.  This is done by filing a Notice of Intention to Discontinue Benefits Form (NOID) or a Petition to Discontinue.
  • Exception:  If benefits are initially paid, but then a determination is made soon afterward that the injury is not compensable, primary liability may be denied and benefits discontinued by filing a Notice of Insurer’ Primary Liability Determination form within 60 days from the first day of disability, or the date the employer was aware of disability, whichever is later.  If more than 60 days have elapsed, an NOID must be filed to discontinue the benefits when denying primary liability.

Return to Work

Return to Work

  • Light Duty Return to Work Programs are one of the most effective ways of controlling claim costs.
  • The longer an employee is off work the more difficult it is to bring them back to work.
  • Returning your employees to work significantly reduces claim costs including indemnity payments and rehabilitation costs.
  • Your Meadowbrook team will assist with your Return to Work options.  Employers are encouraged to be creative in light duty positions. Light duty does not need to be in the same department or same shift.  Keep in mind, if the light duty work is on a different shift; the employee may have grounds to decline if there are transportation or day care issues.
  • Employers should work to avoid terminations of an employee while on light duty restrictions, if at all possible. A termination increases the cost of the claim for the possibility of additional disability benefits, as well as rehabilitation services and re-training.

Meadowbrook Claim Handling Standards

Meadowbrook Claim Handling Standards:

Meadowbrook Claim Handling Standards:

The first step is for the employer to send in a completed First Report of Injury (FROI) to Meadowbrook:

  • FROI is reviewed by Claims Supervisor and is assigned to the appropriate Claims Representative within 24 hours of receipt of claim.
  • Claims Representative will make initial contacts with the employer, employee and medical provider within 2 working days of receipt of the claim.
  • Compensability on Lost Time claims must be completed within 14 days of the knowledge of the lost time.  Compensability for Medical Only claims needs to be completed within 30 days of the receipt of the claim.

Meadowbrook will return all phone calls within 24 hours of receipt.

Medical bills should be paid or denied within 30 days of receipt.

Meadowbrook will respond to any request for authorization of procedures within 5 business days.

Managing The Claim

Managing The Claim:

  • Medical Appointments: Employees should schedule doctor’s appointments on off hours whenever possible.  If an employee must seek medical treatment during work hours, the employee will be reimbursed for lost time.  Payment will be made at a percentage of earnings lost.
  • Physical therapyPhysical therapy referrals by a physician should be sent to Meadowbrook for approval.
  • Medical bills: Medical bills should be sent directly to Meadowbrook for consideration and payment.
  • Change of physician: Employees can change physicians once during the first 60 days from date of injury.  After 60 days, the employee must have permission from Meadowbrook for any change in order to insure payment of medical charges.
  • Mileage reimbursement for doctor’s appointmentsEmployees should submit mileage request directly to Meadowbrook. The request must indicate starting address, ending address, and miles round trip for each doctor’s appointment.
  • Prescription reimbursementEmployees should submit medication charges to Meadowbrook.  Payments will require medical documentation indicating the necessity for the medication.
  • Legal correspondencePlease forward legal correspondence received at your location to Meadowbrook to insure we are receiving all notifications.

Minnesota Workers’ Compensation Penalty Overview

In Minnesota Penalties May be Assess for:

1. Late file of First Report of Injury:

  • Meadowbrook does not receive notice within 10 days of the first day of disability
  • The FROI is not received by the Department by the 14th day after the first day of disability
  • If Meadowbrook does not file the report with the department by the 14th day after the first day of disability or the date the employer received notice, whichever is later.
  • Penalty amounts range from $125 to $500 depending on the number of violations.

2. Late First Payment of Benefits:

  • The first payment of temporary total disability is due by the 14th day after the first day of disability or the date the employer received notice, whichever is later.  If payment is late and the claim has not been denied, a penalty may be assessed.  A penalty is not assessed if there is a proper wage continuation plan by the employer.
  • Calculations are based on the number of violations recorded for the employer,

self-insured employer or Meadowbrook over the previous 12 months period.

  • Penalty amounts range from $500 to $5,000 depending on the number of days late.

3. Late Denial of Liability

  • A denial of liability must be filed within 14 days of the first day of disability or the day the employer received notice, whichever is later.  If the denial is filed beyond the 14 day time limit and no other liability determination has been previously filed, the denial of liability is late and is subject to penalty.
  • The penalty amount is based on the number of days the denial is filed late. 
  • Penalty amounts range from $250 to $2000 depending on the number of days late.

4. Frivolous Denial of Liability

  • A frivolous denial under MN Rules of Practice include one which

does not state facts indicating that an investigation has been completed or that a good faith effort to investigate has been attempted.

  • A denial is also potentially frivolous if it states a basis which is a clearly inaccurate statement of fact or applicable law.
  • In addition, a penalty may be assessed under Minnesota Statutes payable to the employee, in the amount of up to 30% of the benefits found to be delayed.
  • The penalty may be assessed in addition to penalties for late denials of liability and penalty amounts range from $1000 to $2000 depending on the number of violations. 

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Avoiding Penalties

Avoiding Penalties:

  • Promptly investigate claims and be familiar with the statutes and rules.
  • Do not deny a claim without conducting an investigation.
  • Inform all involved in the reporting process that prompt reporting allows more time to conduct an investigation to make proper determinations.
  • Remind health care providers that authorizations to release medical information are not necessary for work related injuries.

Benefit Terms

Minnesota Workers’ Compensation Benefits Definitions Meadowbrook Insurance:

A Minnesota injured employee can potentially receive four kinds of benefits:

1. Indemnity (Wage Loss) Benefits:

  • Temporary Total Disability (TTD)
    Partial wage replacement during the employee’s recovery
  • Temporary Partial Disability (TPD)
    Benefits paid to employee who is working in some capacity, but wages are lower due to injury.
  • Permanent Total Disability (PTD)
    Benefits paid to employees who are permanently unable to work after injury.
  • Permanent Partial Disability (PPD)
    This benefit is not a wage replacement. Instead, it is compensation for permanent damage to a body part.

2. Medical Benefits:

  • All reasonable and necessary medical expenses associated with a covered work-related injury are paid.

3. Rehabilitation Benefits:

  • Rehabilitation benefits provide the employee with vocational treatment and training in order to assist the return to work.
  • Employee entitled to request a rehabilitation consultation to determine eligibility for rehabilitation services.

4. Death Benefits:

  • In the event an employee dies as a result of a work-related injury; there is an obligation to make several types of payments.
  • If there are dependents or a surviving spouse, there may be entitlement to payments to replace the employee’s lost wages.
  • If there were no dependents and no surviving spouse, a lump sum payment of 60,000.00 is paid to the employee’s estate.
  • Burial expenses up to $15,000.00 are also paid.

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