- (a) A claim against the State Treasurer as custodian of the Multiple Injury Trust Fund shall be commenced by filing an executed CC-Form-3F or electronic equivalent. The CC-Form-3F shall list each of the claimant's prior adjudicated claims, the date of each injury, the file number and the percentage of permanent partial disability awarded for each injury. If the claimant claims a pre-existing obvious and apparent disability, the disability shall be fully described on the CC-Form-3F, but no percentage of impairment need be included. A CC-Form- 9 or electronic equivalent shall be filed to request a hearing. Upon filing the CC-Form-9, the claimant or the claimant's attorney, if any, shall mail a copy thereof to the Multiple Injury Trust Fund.
- (b) The CC-Form-3F filed with the Commission shall be served on the State Treasurer and the Multiple Injury Trust Fund and shall have a certificate of service setting forth the manner of such service as required by 810:10-1-7.
- (c) A notation on the CC-Form-3 or CC-Form-3B that the claimant is a previously impaired person shall not be deemed to commence a claim against the Multiple Injury Trust Fund. The CC-Form-3F must be filed in the claim in which benefits are sought and shall use that same Commission file number.
- (d) All requests by the Multiple Injury Trust Fund for the appointment of an independent medical examiner shall be governed by 85A O.S. § 112 and 810:10-5-45.
Added at 31 Ok Reg 468, eff 2-4-14 (emergency)
Added at 32 Ok Reg 1461, eff 8-27-15
Amended at 37 Ok Reg 2335, eff 9-11-20