How Do You Request a Workers’ Compensation Penalty in Minnesota?

Form Focus

Eagan, MN (WorkersCompensation.com) -- When there's a potential compliance lapse in the North Star state, what can an aggrieved party due to ensure that the possibility of punishment is set in play?

Minnesota has a form for that, and it's one that Simply Research subscribers have access to.

Here's a sneak preview of what the form requires plus some information on what the rules regarding penalties cover.

Late Ongoing Payments

In Minnesota, a late ongoing payment is: 1) payment not made within three business days of the date due; or 2) more than three occasions of late payment in a 12-month period.

Documentation Required

[ ] Indication of pay-period and normal payday from pre-injury employment (such as weekly or twice a month)

[ ] Copies of checks or pay stubs showing dates checks were issued

[ ] Copies of envelopes if postmarked two or more days later than date on check

[ ] For temporary partial disability payments, copies of documents showing dates pay stubs were sent to the insurer

Late Commencement of Permanent Partial Disability

Documentation Required

[ ] Date of medical report citing PPD rating was sent to the insurer; if a copy is available, it should be attached to the form

[ ] Copy of check or pay stub showing date payment was issued

[ ] Copy of envelope if postmarked two or more days later than date on check

Late Payment of Order or Award

Documentation Required

[ ] Copy of award or order

[ ] Copy of check or pay stub showing date payment was issued

[ ] Copy of envelope if postmarked two or more days later than date on check

Late Payment of Medical Bills

Documentation Required

[ ] Date medical bill sent to insurer with a copy of a billing statement and medical information

[ ] Copy of check or pay stub showing date payment was issued

[ ] Copy of envelope if postmarked two or more days later than date on check

Late Commencement or Recommencement of TTD, TPD Benefits

Documentation Required

[ ] Copy of envelope if postmarked two or more days later than date on form

[ ] Copy of Notice of Insurer's Primary Liability Determination

Excessive Billing for Medical Records by Health Care Provider

[ ] Copy of bills received for medical records request

Improper Collection or Attempt to Collect Payment by Health Care Provider

Documentation Required

[ ] Copy of initial bill injured worker received

[ ] Copy of letter from insurer stating treatment is related to the workers' compensation injury

[ ] Supplemental bill injured worker received after health care provider was notified of work-related injury

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