Second-injury claim -- A claim for which the insurer (or self-insured employer) is entitled to reimbursement from the Special Compensation Fund because the injury was a subsequent (or "second") injury for the worker concerned. The 1992 law eliminated reimbursement (to insurers) of "second-injury" claims for subsequent injuries occurring on or after July 1, 1992.
Self-insurance -- A mode of workers' compensation insurance in which an employer or employer group insures itself or its members. To do so, the employer or employer group must meet financial requirements and be approved by the Minnesota Department of Commerce.
Settlement conference -- A proceeding at the Office of Administrative Hearings (OAH) to resolve issues presented about a claim petition when it appears possible to settle the issues without a formal hearing. If a settlement is reached, it typically includes an agreement by the claimant to release the employer and insurer from future liability for the claim other than for medical treatment.
Special Compensation Fund (SCF) -- A fund within the Department of Labor and Industry (DLI) that, among other things, pays uninsured claims and reimburses insurers (including self-insured employers) for supplementary and second-injury benefit payments. (The supplementary benefit and second-injury provisions only apply to older claims, because they were eliminated by the law changes of 1995 and 1992, respectively.) Revenues come primarily from an assessment on paid indemnity benefits. The SCF also funds the operations of DLI, the workers' compensation portion of the Office of Administrative Hearings (OAH), the Workers' Compensation Court of Appeals and workers' compensation functions in the Minnesota Department of Commerce.
Statewide average weekly wage (SAWW) -- The average wage used by the Department of Labor and Industry to adjust certain workers' compensation benefits (see cost-of-living adjustment) and provider fee limits. The SAWW is also used in reports to adjust average benefit amounts for different years, so they are all expressed in constant (1998) wage-dollars. The SAWW, from the Department of Employment and Economic Development, is the average weekly wage of nonfederal workers covered under unemployment insurance.
Stipulated benefits -- Indemnity and/or medical benefits specified in a "stipulation for agreement," which states the terms of settlement of a claim among the affected parties. A stipulation usually occurs in a dispute, but not always. The stipulation may be incorporated into a mediation agreement, or may be reached in a settlement conference or associated preparatory activities, in which case it must be approved by a workers' compensation judge. Stipulated benefits are usually paid in a lump sum.
Supplementary benefits -- Additional benefits paid to certain workers receiving temporary total disability (TTD) benefits or permanent total disability (PTD) benefits for injuries prior to October 1992, or receiving PTD benefits for injuries from October 1992 through September 1995. For injuries from Oct. 1, 1983 forward, eligibility begins after 208 weeks of TTD or PTD benefits have been paid, or four years from the first date of total disability for TTD beneficiaries injured during October 1983 through September 1992, or PTD beneficiaries injured during October 1992 through September 1995. These benefits are equal to the difference between 65 percent of the statewide average weekly wage (SAWW) and the TTD or PTD benefit. The Special Compensation Fund reimburses insurers (and self-insured employers) for supplementary-benefit payments. For injuries on or after Oct. 1, 1995, supplementary benefits were repealed (see Appendix B).
Survey of Occupational Injuries and Illnesses -- The survey, conducted jointly by the U.S. Bureau of Labor Statistics and state agencies, is the primary source of workplace injury and illness data nationwide. Approximately 5,000 Minnesota employers participate annually in the survey. The survey includes all cases on the U.S. Occupational Safety and Health Administration (OSHA) 200 log, their OSHA 300 logs (the form used to record injuries and illnesses in 2002). Injuries and illnesses logged by employers conform with definitions and recordkeeping guidelines set by OSHA. Data comes both from the log and from an additional set of questions regarding relatively serious cases -- those with at least one day off the job. The survey provides a large volume of information for the United States and individual states. This information includes the number and incidence of injuries and illnesses by industry and establishment size and, for cases resulting in time off the job, characteristics of injuries and illnesses, how they occur, severity (number of days away from work), length of time on the job when injured, occupation and worker characteristics. The national data, because of larger sample sizes, includes more detailed categories than the state data and contains smaller sampling errors. The survey defines different types of cases according to whether they have days off the job and/or work restrictions. For survey results prior to 2002, these include "lost-workday" (LWD) cases and "cases without lost workdays." LWD cases are divided into "days-away-from-work" (DAFW) cases and "restricted-work-activity-only" (RWAO) cases. For survey results in 2002 and later, the case types include "cases with days away from work, job transfer or restriction" (DART) cases and "other recordable cases." DART cases are divided into DAFW cases and "cases with job transfer or restriction." An important issue with the BLS survey data is sampling error -- the random error in survey statistics that occurs because they are estimated from a sample. This sampling error is greater for smaller categories, such as particular industries, because of smaller sample size.
Temporary partial disability (TPD) -- A wage-replacement benefit paid if the worker is employed with earnings that are reduced because of a work-related injury or illness, provided three calendar-days have passed, starting with the first day of disability. (A day of disability is a day with any loss of work time or wages due to the injury or illness.) The benefit is equal to two-thirds of the difference between the worker's gross pre-injury wage and his or her gross current wage, subject to a maximum weekly amount, and is paid at the same intervals as wages were paid before the injury. For injuries on or after Oct. 1, 1992, TPD benefits are limited to a total of 225 weeks and to the first 450 weeks after the injury (with an exception for approved retraining).
Temporary total disability (TTD) -- A wage-replacement benefit paid if the worker is unable to work because of a work-related injury or illness, provided three calendar-days have passed, starting with the first day of disability. (A day of disability is a day with any loss of work time or wages due to the injury or illness.) 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. Currently, TTD stops if: (1) the employee returns to work; (2) the employee withdraws from the labor market; (3) the employee fails to diligently search for work within his or her physical restrictions; (4) the employee is released to work without physical restrictions from the injury; (5) the employee refuses an appropriate offer of employment; (6) 90 days have passed after the employee has reached maximum medical improvement or completed an approved retraining plan; (7) the employee fails to cooperate with an approved vocational rehabilitation plan or with certain procedures in the development of such a plan; or (8) 104 weeks of TTD have been paid (with an exception for approved retraining).
Vocational rehabilitation consultation -- The first in-person meeting between the injured worker and a qualified rehabilitation consultant (QRC), to determine whether the injured worker is a "qualified employee" -- eligible for rehabilitation services. The QRC reports to the Department of Labor and Industry about the consultation by filing a Rehabilitation Consultation Report form.
Vocational rehabilitation plan -- A plan for vocational rehabilitation services developed by the qualified rehabilitation consultant (QRC) in consultation with the employee and the employer and/or insurer. The plan is developed after the QRC determines the injured worker is eligible for rehabilitation services, and is filed with DLI and provided to the affected parties. The plan indicates the vocational goal, the services necessary to achieve the goal and their expected duration and cost.
Vocational rehabilitation waiver -- A delay in an injured worker's vocational rehabilitation eligibility consultation, requested by the insurer on the Disability Status Report (DSR) form and granted by the Department of Labor and Industry (DLI). DLI grants the waiver if the insurer and employer document that the employee will return to "suitable gainful employment" with the employer within 180 days of injury. If the employee is not working after 180 days, a rehabilitation consultation must be conducted.
Voluntary market -- The workers' compensation insurance market associated with policies issued voluntarily by insurers. Insurers may choose whether to insure a particular employer. See Assigned Risk Plan.
Workers' Compensation Reinsurance Association (WCRA) -- A nonprofit entity created by law to provide reinsurance to workers' compensation insurers (including self-insureds) in Minnesota. Every workers' compensation insurer must purchase "excess of loss" reinsurance (reinsurance for losses above a specified limit per event) from the WCRA. Insurers may obtain other forms of reinsurance (such as aggregate coverage for total losses above a specified amount) through other means.
Workers' Compensation Court of Appeals (WCCA) -- An executive-branch body that hears appeals of workers' compensation decisions from the Office of Administrative Hearings (OAH). The next and final level of appeal is the Minnesota Supreme Court.
Written premium -- The entire "bottom-line" premium for insurance policies initiated in a given year, regardless of when the premium comes due and is paid. Written premium is "bottom line" in that it reflects all premium modifications in the pricing of the policies.