How to Report a Loss
Claim reports must be submitted electronically via the Association's secure eMember service. To be able to report using the eMember tool, a personal account with a username and password needs to be set up for you. If you are not already an eMember, please apply here.
For the first report, use the Initial Claim Report and include basic claim caption information, a complete description of the occurrence and injury, payment information, and the current status of the claim including recovery potential. For subsequent reports, prior to submitting a reimbursement, use the Interim Claim Report to provide a status update. If a Reimbursement Request is submitted, you do not need to submit a separate Interim Claim Report.
Which Claims Should be Reported to the WCRA?
All serious claims of WCRA members involving a loss which occurred on or after October 1, 1979, or subsequent to membership in the Association, may be appropriate for reporting to the WCRA. Members should report claims involving serious injury or significant anticipated costs as described below.
Claims involving the following injuries should be promptly reported to the WCRA within 15 business days of notification of the injury to the member:
- Central nervous system injury:
- Spinal cord injury resulting in paraplegia or quadriplegia.
- Brain damage affecting cognition and/or resulting in conditions such as permanent disorientation, behavior disorder, personality change, seizure disorder, motor-sensory deficits, aphasia, or coma.
- Fatality, except for a no-dependent exposure.
- Third-degree burns covering 10 percent of the body, or second-degree burns covering 30 percent of the body, or if significant medical costs can be anticipated.
- Amputation of a significant portion of one extremity or multiple amputations.
Claims involving the following injuries should be promptly reported to the WCRA after taking into consideration the member’s selected retention limit:
- Impairment of total vision by 50 percent or more.
- Peripheral nerve damage causing major muscle dysfunction or paralysis in an extremity.
- Serious internal injuries resulting from blunt, penetrating, or crushing injuries to the chest or abdomen.
- Multiple fractures or significant degloving injuries involving more than one arm, hand, or leg; malunion; or significant shortening of the limbs.
- Fracture of both heel bones (bilateral os calcis).
- Occupational disease allegedly caused by working conditions or other job-related factors, including asbestosis, chronic pulmonary disease, or other occupational disease which results in a disability expected to last two years or more. In cases of occupational disease, each person who has been exposed is considered a separate claim.
Significant Anticipated Costs
A claim should be reported promptly to the Association if the total incurred cost of a claim exceeds 50 percent of the retention limit that was in effect when the loss was incurred. The total incurred cost of a claim equals payments made to the claimant(s) involved in the loss, plus the undiscounted reserves (including the aggregate reserve in a multi-claimant loss) established by the member for future claim costs. For example, in an industrial explosion where three people suffer burns, the total incurred cost of the claim will be the payments made to date plus the estimated outstanding claim reserves for each of the three people involved.
Please note that there are some exceptions to these criteria. A claim need not be reported to the WCRA if it has been settled on a full, final, and complete basis with limited medical exposure, and the total payments will not exceed the retention limit. Nor is it necessary to report a perfected Second Injury Fund claim, a claim not under Minnesota jurisdiction, or a claim where a recovery is being made and total payments will not exceed the applicable retention limit.
When to Report a Loss
Catastrophic claims* are required to be reported to the WCRA within 15 business days of the member's notification of the injury. Members are encouraged to report claims as soon as possible, even if all the information requested on the Loss Reporting Form is not yet available.
*Including paraplegia, quadriplegia, serious brain injury, severe burn, and amputation.