Minnesota Department of Labor and Industry Forms

This Form is used for certified payroll reporting in the state of Minnesota. It helps ensure that contractors and subcontractors on public works projects comply with prevailing wage laws.

This Form is used for submitting a Rehabilitation Plan in Minnesota.

This Form is used for the Annual Claim for Reimbursement From the Second Injury Fund in the state of Minnesota.

This form is used for reporting the first injury that occurs in the workplace in the state of Minnesota. It is important to fill out this form to ensure that the appropriate actions are taken to support the employee and prevent future injuries.

This form is used for claiming reimbursement from the Second Injury Fund in Minnesota.

This form is used for the Permanent Total Disability Agreement in the state of Minnesota. It is used to formalize the agreement between an individual and their employer for long-term disability benefits.

This Form is used for filing a Stipulation of Intervention in the state of Minnesota.

This form is used for filing a Motion to Intervene in the state of Minnesota. It allows a third party to join an ongoing legal case.

This Form is used for submitting a Notice of Appeal to the Workers' Compensation Court of Appeals in Minnesota. It is the first step in the process of challenging a decision related to workers' compensation benefits.

This Form is used for applying to become a qualified rehabilitation consultant intern in Minnesota.

This form is used for applying to become a rehabilitation vendor in Minnesota.

This form is used for individuals or companies wanting to apply as a Qualified Rehabilitation Consultant Firm in Minnesota. It is the required application for those who want to provide rehabilitation services in the state.

This Form is used for applying to become a Qualified Rehabilitation Consultant in Minnesota.

This form is used for submitting an interim status report in Minnesota. It provides updates on the progress of a project or program.

This form is used for the notice of appearance of an attorney representing an employee in legal matters in the state of Minnesota.

This form is used for submitting a Rehabilitation Consultation Report in the state of Minnesota.

This form is used for submitting an amendment to a rehabilitation plan in Minnesota.

This form is used for requesting the reinstatement of benefits in the state of Minnesota.

This form is used for reporting disability status in the state of Minnesota. It helps individuals provide information about their disability to the appropriate authorities.

This Form is used for obtaining a Certificate of Compliance for the Minnesota Workers' Compensation Law in Minnesota.

This form is used for notifying recipients in Minnesota about their benefit payments.

This form is used for declaring and providing evidence of significant financial hardship in the state of Minnesota. It can be used in various legal proceedings and may help individuals qualify for certain financial assistance programs or exemptions.

This form is used for filing a claim petition for dependency benefits or payment to an estate in the state of Minnesota. It allows individuals to request financial support in cases where they are dependent on someone who has passed away.

This Form is used for employees or insurers in Minnesota to object to requested attorney fees and/or costs

This form is used for electing to exclude certain relatives of executive officers of a closely held corporation in Minnesota.

This form is used for electing to exclude certain relatives of managers in a limited liability company in Minnesota.

This form is used for employees in Minnesota to object to the discontinuance of their employment.

This Form is used for employees in Minnesota to file a claim petition.

This Form is used for reporting excess fees in Minnesota.

This form is used for health care providers in Minnesota to report information about patients.

This form is used for medical response in the state of Minnesota. It may be used to report medical emergencies or request medical assistance.

This form is used for submitting a medical request in the state of Minnesota.

This form is used for notifying the discontinuance of workers' compensation dependency benefits in Minnesota. It helps in informing the relevant authorities about the cessation of these benefits.

This document is used to notify the discontinuation of workers' compensation benefits when an employee passes away in Minnesota.

This form is used for creating an on the job training plan for employees in Minnesota.

This Form is used for notifying the intention to discontinue workers' compensation benefits in the state of Minnesota.

This Form is used for reporting the progress of a plan in the state of Minnesota. It is used to track the milestones and accomplishments of the plan.

This Form is used for filing a petition to request taxation of actual and necessary disbursements in the state of Minnesota.

This type of document is used for reporting progress on a plan in the state of Minnesota.