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Late filing of First Report of Injury form

  • Statutes violated -- Minnesota Statutes 176.231, subd. 1 and 2

  • Applicable rules -- Minnesota Rules Part 5220.2820

  • Assessment statutes -- Minnesota Statutes 176.231, subd. 10

  • Penalty payable to -- Assigned Risk Safety Account (ARSA)

  • Assessed against -- employer or insurance company

Determination

The information used to determine if a penalty will be assessed includes:

  • the first day of disability;

  • the date the employer received notice of the injury or disability, whichever is later;

  • the date the insurer received notice of the alleged injury from the employer; and

  • the date the First Report of Injury (FROI) form is received by the department.

The penalty may be assessed against the employer if the insurance company does not receive the FROI form within 10 days of the first day of disability or the date the employer received notice, whichever is later.

The penalty may be assessed against the employer if the employer is self-insured and if the FROI form is not received by the department by the 14th day after the first day of disability or the date the employer received notice, whichever is later.

The penalty may be assessed against the insurance company if the insurance company received the FROI form from the employer in a timely manner, but did 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.

If the date the FROI form is due falls on a weekend or legal holiday, the due date is the next regular business day.

This penalty can be assessed on claims that are required to be filed by Minnesota Statutes 176.231. If there is no claimed disability beyond the waiting period, the claim is not required to be reported and is not subject to this penalty.

Calculation

The penalty amount is based on the number of penalties assessed against the employer or insurance company for violations during the previous 12-month period prior to the current violation. The chart below shows the current penalty amounts for each violation.

Number of violations Penalty amount
One Warning
Two $125
Three $250
Four $375
Five or more $500

How to avoid a penalty 

Documentation is the key to avoiding this penalty. The insurance company should document the date it received the FROI form from the employer in box 50 of the form. Make sure the date is marked clearly. If it is not clear, the date will not be readable when it is placed in the department's imaging system.

The Minnesota workers' compensation statutes do not require the filing of a FROI form with the department if the claimed disability does not exceed the waiting period. Quite often, an insurer does not send the department a FROI form for this reason, but later learns there is claimed disability beyond the waiting period. The insurer then sends DLI benefit payment information for a claim for which there is no FROI form. By the time the insurer files the FROI form in response to the department's written request, the filing is late and subject to penalty. Therefore, if the injury results in compensable disability beyond the waiting period later in the claim, the insurer should ensure the FROI form is filed with the department as soon as notice of the disability is received. Also, the insurer needs to document the status of the original period of disability when filing the completed Notice of Insurer's Primary Liability Determination (NOPLD) form.

Continually educate employers about the timely filing of claims. Remind them of the consequences if they fail to file the FROI form in a timely manner. Supply as much of the information requested on the FROI form as possible, especially the data used to determine timeliness of the FROI form. If there are unusual circumstances the department should know about, attach a note to the FROI form.