Workers' compensation -- compliance penalty reference table

Workers' compensation penalties accessed by compliance
Violations	Statutes violated	Applicable rules	Assessment statutes	Paid to	Formula and dollar amount
Late First Report of Injury Against ER or IR	176.231 s1 & 2	5220.2820	176.231 s10	ARSA	based on number of violations in past 12 months prior to assessment 1st = warning 2nd = $125 3rd = $250 4th = $375 5th+ = $500
Late first-payment of benefits Against IR or self- insured ER	176.221 s1	5220.2770 & 5220.2790	176.221 s3 & 176.225 s5	ARSA & EE	based on number of days late, percent of amount due, subject to maximums Days late % of $ due Maximum 1-15 30% $500 16-30 55% $1,500 31-60 80% $3,500 61+ 150% $5,000 & 25% of amount found to be delayed
Late denial of liability Against IR or self- insured ER	176.221 s1	5220.2770	176.221 s3a	ARSA	based on number of days late Days late/$ penalty 1-15 = $250 16-30 = $500 31-60 = $1,000 61+ = $2,000
Frivolous denial of liability Against IR or self- insured ER	176.221 s1	5220.2570 5220.2770 5220.2540 & 5220.2760	176.221 s3a & 176.225 s1	ARSA & EE	based on number of violations in past two-year period prior to the assessment Violations/$ penalty 1-5 = $1,000 6+ = $2,000 & up to 30 percent of amount found to be delayed This penalty may be assessed in addition to penalties for late or nonspecific denial.
Nonspecific NOID or denial of liability Against IR or self- insured ER	176.84 s1	5220.2570	176.84 s2	ARSA	based on set dollar amount $500 This penalty may be issues in addition to penalties for late or frivolous denial.
Prohibited practices Agains IR, self- insured ER, TPA or adjuster	176.194 s3	None	176.194 s4	ARSA	based on number of violationsin past 12 months Violations of: Violation sub.3 (1-6 & 9) sub.3 (7-8) 1-5 warning $3,000 each 6-10 $3,000 each $6,000 each 11-30 $6,000 each $6,000 each 31+ $6,000 each for sub.3 (1-9); in addition, may refer to Department of Commerce for license review
Late or improper payment of permanent partial disability Against IR or self- insured ER	176.021 s3/3a &/or 176.221 s6a &/or 176.221 s7	5220.2750 & 5220.2790 or 5220.2760	176.221 s3 & 176.225 s5 = fail to pay or 176.221 s1 = late pay	ARSA & EE or EE	based on number of days late, percent of amount due, subject to maximums Days late % of $ due Maximum 1-15 30% $500 16-30 55% $1,500 31-60 80% $3,500 61+ 105% $5,000 & 25 percent of amount found to be delayed or Days late/percent of $ due 1-5 = 6% 6-15 = 12% 16-30 = 18% 31-60 = 24% 61+ = 30%
Late payment of order or award Against IR or self- insured ER	176.221 s8	5220.2780 & 5220.2760	176.221 s3 or 176.221 s3a (used when $ amount owed isn't clear) & 176.225 s1	ARSA & EE	based on number of days late, percent of amount due, subject to maximums or based on set amount Days late % of $ due Maximum 1-15 30% $500 16-30 55% $1,500 31-60 80% $3,500 61+ 105% $5,000 or Days late/$ penalty 1-15 = $500 16-30 = $1,000 31-60 = $1,500 61+ = $2, 000 & Days late/percent of $ due 1-5 = 6% 6-15 = 12% 16-30 = 18% 31-60 = 24% 61+ = 30%
Improper discontinuance of benefits Against IR or self- insured ER	176.238 or 176.239	5220.2720 & 5220.2760	176.238 s10 = if $ amount owed is unclear or 176.221 s3 = if $ amount owed is clear & 176.225 s1 = only if additional benefits clearly due	ARSA or ARSA & EE	based on number of violations in past year and days late 176.238 s10 = first violation in one year = warning If not corrected in 10 days from warning, apply following: 11-20 days late = $200 21-30 days late = $600 31-60 days late = $800 61+ days late = $1,000 Second+ violation in a year, then the following applies: 1-10 days late = $400 11-20 days late = $600 21-30 days late = $800 31+ days late = $1,000 or Days late % or $ due Maximum 1-15 30% $500 16-30 55% $1,500 31-60 80% $3,500 61+ 105% $5,000 & Days late/percent of $ due 1-5 = 6% 6-15 = 12% 16-30 = 18% 31-60 = 24% 61+ = 30%
Late pament of ongoing benefits Against IR or self- insured ER	176.221 s1	None set & 5220.2760 or 5220.2790	176.221 s3a & 176.225 s1 = based on length of delay or 176.225 s5	ARSA & EE or EE	based on number of days late, percent of amount due, subject to maximum up to $2,000 (no set rules) & Days late/percent of $ due 1-5 = 6% 6-15 = 12% 16-30 = 18% 31-60 = 24% 61+ = 30% or 25% of amount found to be delayed
Failure to notify EE of time limit to request retraining Against IR or self- insured ER	176.102 11	None	176.102 s11	ARSA	based on number of days late $25 a day, up to $2,000 max. Note:  Applies only to dates of injury Oct. 1, 1995 or later.
Late payment or denial of medical bills Against IR or self- insured ER	176.135 & 176.221 s6a	5220.2740	176.221 s3a	ARSA	based on number of days late, set amount Days late/$ penalty 1-15 = $500 16-30 = $1,000 31-60 = $1,500 61+ = $2,000
Failure to release existing medical data Any party to a claim that is holding existing medical data relating to the claim	176.138	5220.2810	176.138	ARSA	based on number of days late > 7 days without response = $300 > 30 days without response = $450 > 60 days without response = $600
Refusal to file or failure to file required reports other than FROI in a timely manner Against IR, self- insured ER, TPA or HCP	176.231 s3, 4, 6, 7, 10	5220.2830	176.231 s10	ARSA	based on number of days late Not filed within 21 days of written request = $125 Not filed after 2nd request = $375 Subsequent failure to file = $500 or Not filed within 30 days of date due = $125 Not filed within 90 days of date due = $375 Not filed within 180 days of date due = $500
Late payment of rehabilitation Against IR or self- insured ER	176.102 s9, 11 & 176.221 s6a	5220.1900 s19? None?	176.221 s3 or 3a?	ARSA	No clear rules regarding penalties Note:  Rules pending

Abbreviations
ARSA:  Assigned Risk Safety Account	IR:  insurance company
DOI:  date of injury	MCO:  managed care organization
EE:  employee	NOID:  Notice of Intention to Discontinue Benefits form
ER:  employer	QRC:  qualified rehabilitation consultant
FROI:  First Report of Injury form	TPA:  third-party administrator
HCP:  health care provider

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