803 KAR 25:030. Special fund and employer; joint liability

Section 1. Reimbursement of Carriers and Self-insured Employers by Special Fund. (1) Each insurance carrier and self-insured employer applying for reimbursement by the Special Fund under the provisions of KRS 342.120 shall furnish the Division of Workers' Compensation Funds quarterly a statement using the "Request for Reimbursement Form Special Fund" form, showing: (a) The name of the employee; (b) The amount of compensation paid the employee; and (c) The periods for which the compensation has been paid. (2) The statement shall be filed with the Division of Workers' Compensation Funds within thirty (30) days from the end of each quarter for which reimbursement is sought. The Division of Workers' Compensation Funds may grant an extension for good cause. (3) The quarterly statement shall be certified by a designated officer or employee of the employer or insurance carrier. Section 2. Incorporation by Reference. (1) "Request for Reimbursement from Special Fund", August 2005, is incorporated by reference. (2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Department of Workers' Claims, Mayo-Underwood Building, 3rd Floor, 500 Mero Street, Frankfort, Kentucky 40601, Monday through Friday 8 a.m. to 4:30 p.m.