Minn. R. agency 151, ch. 5220, WORKERS' COMPENSATION RULES OF PRACTICE, pt. 5220.2680
Notice of intention to claim reimbursement under Minnesota Statutes, section 176.131, subdivision 6, must be on forms prescribed by the division. In a claim under Minnesota Statutes, section 176.131, subdivision 1, forms must be filed within one year after the payment of sufficient weekly benefits or medical expenses to make claim against the special compensation fund. In a claim under Minnesota Statutes, section 176.131, subdivision 2, forms must be filed within one year from the first payment of weekly benefits or medical expense. The insurer must file with the division one clean copy suitable for imaging and one copy of the notice of intention to claim reimbursement.
Reimbursement will be made by an order of the division or Workers' Compensation Court of Appeals from the special compensation fund on a yearly basis upon application for reimbursement on forms prescribed by the division. The insurer must file one clean copy suitable for imaging and one copy of the claim for reimbursement with the division. The application must be verified, set out in detail expenditures made and expenditures for which reimbursement is claimed, and must be supported by medical reports, showing the nature and extent of disability and relationship to the injury and physical impairment for which reimbursement is claimed.
Minn. R. agency 151, ch. 5220, WORKERS' COMPENSATION RULES OF PRACTICE, pt. 5220.2680
Statutory Authority: MS s 175.17; 175.171; 176.83