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    Subdivision 1. Form. A claim for compensation from the fund must be filed with the agency
in the form required by the agency. When a claim does not include all the information required
by subdivision 2 and applicable agency rules, the agency staff shall notify the claimant of
the absence of the required information within 14 days of the filing of the claim. All required
information must be received by the agency not later than 60 days after the claimant received
notice of its absence or the claim will be inactivated and may not be resubmitted for at least one
year following the date of inactivation. The agency may decide not to inactivate a claim under
this subdivision if it finds serious extenuating circumstances.
    Subd. 2. Required information. A claimant must provide the following information as part
of the claim, provided that nothing in this chapter shall be construed to require the claimant to
initiate a court action before filing a claim:
(1) a sworn verification by the claimant of the facts set forth in the claim to the best of
the claimant's knowledge;
(2) evidence that the claimant is an eligible person;
(3) evidence of the claimant's exposure to a named harmful substance;
(4) evidence that the claimant's exposure to the substance in the amount and duration
experienced by the claimant could reasonably have been caused or significantly contributed to by
the release of a harmful substance from a facility where the substance was placed or came to be
located, to the extent the information is available to the claimant;
(5) evidence that the exposure experienced by the claimant can cause or can significantly
contribute to the injury suffered by the claimant;
(6) evidence of the injury eligible for compensation suffered by the claimant and the
compensable losses resulting from the injury;
(7) evidence of any property damage eligible for compensation and the amount of
compensable losses resulting from the damage;
(8) information regarding any collateral sources of compensation; and
(9) other information required by the rules of the agency.
    Subd. 3. Death claims. In any case in which death is claimed as a compensable injury,
the claim may be brought on behalf of the claimant by the claimant's estate for compensable
medical expenses and by the claimant's trustee for death benefits for the claimant's dependents as
defined in section 176.111.
History: 1Sp1985 c 8 s 11; 1989 c 325 s 78; 1991 c 199 art 1 s 24; 2002 c 379 art 2 s
11; 2003 c 128 art 2 s 21

Official Publication of the State of Minnesota
Revisor of Statutes