Medical cost -- The cost of medical services and supplies provided to the injured or ill worker, including payments to providers and certain reimbursements to the worker. All reasonable and necessary medical costs related to the injury or illness are covered, subject to a maximum-fee schedule.
Medical-only claim -- A claim with paid medical costs and no indemnity benefits.
Medical Request form -- A form by which a party to a medical dispute requests assistance from the Department of Labor and Industry (DLI) for resolving the dispute. The request may lead to mediation or other efforts toward informal resolution by DLI Alternative Dispute Resolution or to an administrative conference.
Mediation -- A voluntary, informal proceeding conducted by Department of Labor and Industry Alternative Dispute Resolution to facilitate agreement among the parties in a dispute. If an agreement is reached, the terms are formally recorded. A mediation occurs when one party requests it and the others agree to participate. This often takes place after attempts at resolution by phone and correspondence have failed.
Minnesota Workers' Compensation Insurers Association (MWCIA) -- Minnesota's workers' compensation data service organization (DSO). State law specifies the duties of the DSO and the Department of Commerce designates the entity to be the DSO. Among other activities, the MWCIA collects data about claims, premium and losses from insurers, and annually produces pure premium rates.
Nonconference decision and order -- A decision issued by the Department of Labor and Industry Alternative Dispute Resolution unit without an administrative conference, about a dispute for which it has administrative conference authority (see administrative conference), when it has sufficient information without conducting a conference. The decision is binding unless appealed or overturned by review at the Office of Administrative Hearings (OAH).
Objection to Discontinuance form -- A form by which an injured worker requests a formal hearing to contest a proposed discontinuance of wage-loss benefits (temporary total disability (TTD), temporary partial disability (TPD) or permanent total disability (PTD)). The hearing is at the Office of Administrative Hearings (OAH).
Office of Administrative Hearings (OAH) -- An executive branch body that conducts hearings about administrative law cases. One section is responsible for workers' compensation cases; it conducts administrative conferences and settlement conferences, as well as hearings.
Permanent partial disability (PPD) -- A benefit that compensates for permanent functional impairment resulting from a work-related injury or illness. The benefit is based on the worker's impairment rating, which is a percentage of whole-body impairment determined on the basis of health care providers' assessments according to a rating schedule in rules. Currently, the PPD benefit is calculated under a schedule specified in law, which assigns a benefit amount per rating point with higher ratings receiving proportionately higher benefits. The scheduled amounts per rating point were fixed for injuries from 1984 through September 2000. The PPD benefit is paid after temporary total disability (TTD) has ended. For injuries from October 1995 through September 2000, it is paid at the same rate and intervals as TTD until the overall amount is exhausted. See Appendix B for related law changes.
Permanent total disability (PTD) -- A wage-replacement benefit paid if the worker sustains a severe work-related injury specified in law. Also paid if the worker, because of a work-related injury or illness in combination with other factors, is permanently unable to secure gainful employment, provided that, for injuries on or after Oct. 1, 1995, the worker has a permanent partial disability (PPD) rating of 13 to 17 percent, depending on age and education. The benefit is equal to two-thirds of the worker's gross pre-injury wage, subject to minimum and maximum weekly amounts, and is paid at the same intervals as wages were paid before the injury. For injuries on or after Oct. 1, 1995, benefits end at age 67 under a rebuttable presumption of retirement. Minimum and maximum weekly benefit provisions are described in Appendix B. Cost-of-living adjustments are described in this Appendix and Appendix B.
Petition to Discontinue Benefits form -- A document by which the insurer requests a formal hearing to allow a discontinuance of wage-loss benefits (temporary total disability (TTD), temporary partial disability (TPD) or permanent total disability (PTD)). The hearing is at the Office of Administrative Hearings (OAH).
Policy year -- The year of initiation of the insurance policy covering the accident or condition that caused the injury or illness. In policy-year data, all claims and costs are tied to the year in which the applicable policy took effect. Because policy periods often include portions of two calendar-years, the data for a policy year includes claims and costs for injuries occurring in two calendar-years.
Primary liability -- The overall liability of the insurer for any costs associated with a claim when the injury is determined to be compensable. An insurer may deny primary liability (deny the injury is compensable) if it has reason to believe the injury was not work-related, was intentionally self-inflicted, resulted from intoxication or happened during participation in a nonrequired recreational program.
Pure premium -- A measure of expected losses, equal to the sum, of all insurance classes, of payroll times the applicable pure premium rate(s) -- the rate(s) for the insurance class(es) concerned -- adjusted for individual employers' prior loss experience. It is different from (and somewhat lower than) the actual premium charged to employers, because actual premium includes other insurance company costs plus taxes and assessments.
Pure premium rates -- Rates of expected indemnity and medical losses per year per $100 of covered payroll, also referred to as "loss costs." Pure premium rates are determined annually by the Minnesota Workers' Compensation Insurers Association (MWCIA) for approximately 560 insurance classes in the voluntary market. They are based on insurer "experience" and statutory benefit changes. "Experience" refers to actual losses relative to pure premium for the most recent report periods. The pure premium rates are published with documentation in the annual Minnesota Ratemaking Report subject to approval by the Department of Commerce.
Qualified rehabilitation consultant (QRC) -- A professionally trained individual registered with the Department of Labor and Industry to provide statutory vocational rehabilitation services to injured workers. The QRC determines whether the injured worker is eligible for vocational rehabilitation services by means of a rehabilitation consultation, develops a rehabilitation plan with assistance from the injured worker and employer, and facilitates implementation of the plan.
Rehabilitation Request form -- A form by which a party to a vocational rehabilitation dispute requests assistance from the Department of Labor and Industry (DLI) to resolve the dispute. The request may lead to mediation or other efforts toward informal resolution by DLI Alternative Dispute Resolution or to an administrative conference.
Request for Administrative Conference form -- A form by which the injured worker requests an administrative conference to contest a proposed discontinuance of wage-loss benefits (temporary total disability (TTD), temporary partial disability (TPD) or permanent total disability (PTD)).
Restricted-work-activity-only (RWAO) cases -- Used in the Survey of Occupational Injuries and Illnesses results prior to 2002, RWAO cases are a subset of lost-workday (LWD) cases. RWAO cases are cases that have days of restricted work activity, but no days away from work.