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Special Disability Fund Reimbursements Procedure

Special Disability Fund

Special Funds Group (SFG) Reimbursement

Step 1

Before submitting a reimbursement request the insurer or self-insured employer (SIE) must have an Statewide Financial System (SFS) account.

Step 2

Insurer submits reimbursement request

5-10 days

Step 3

SFG sends confirmation


SFG sends an email rejecting the submission

Step 4

SFG sends response to reimbursement

60 days to file C-251.6

Step 5

Insurer submits request for reconsideration

Step 6

SFG sends confirmation

Step 7

SFG sends final determination

  • C-251.6R
  • All SFG responses are subject to audit by Office of State Comptroller (OSC)

30 days

Step 8

Insurer submits request for review of SFG final determination

Form Number and Name
Number Name
C-251 Insurer's Request Reimbursement of Indemnity Payments Under WCL Section 14(6) or Section 15(8)
C-251C* SFG Receipt of Form C-251
C-251N Insurer's Notification of Initial Request for Reimbursement Under Section 14(6) or Section 15(8)
C-251R* SFG Response to Form C-251
C-251.1 Insurer's Request for Reimbursement of Medical Payments Under WCL Section 15(8)
C-251.1C* SFG Receipt of Form C-251.1
C-251.1R* SFG Response to Form C-251.1
C-251.6 Insurer's Request for Reconsideration of Reduction Under WCL Section 14(6) or Section 15(8)
C-251.6C* SFG Receipt of Form C-251.6
C-251.6R* SFG Response to Form C-251.6
RFA-2 Request for Further Action by Carrier/Employer

* These forms are sent by the Special Funds Group.

RFA-2 Evidence

When seeking review of the Special Funds Group Decision Form C-251.6R, the insurer must also submit the following forms and emails with Form RFA-2. New evidence may not be submitted with the Form RFA-2, and will not be considered by the WCLJ: