The Injury Protection Program pays claims when someone has been injured or killed while doing unpaid work for public programs.

Be sure that the participant knows that there is an injury protection program and explain how it works.

· It covers reasonable medical expenses, compensation for partial disability, and burial costs.

· It covers those costs up to $200,000.

· The Department approves coverage on a case by case basis.

Do not place a participant in an unpaid work experience program unless 1 of the following is true:

Option 1:
The site has liability insurance covering unpaid workers or volunteers for injuries or death while doing work at the site.

Option 2:
The county or tribe has an Unpaid Work Experience Program approved by the Minnesota Department of Human Services and has filed the Injury Protection Program with the Department.

Have the participant and worksite supervisor complete the following forms after an incident in which a participant has been injured while doing unpaid work:

Form	Purpose	Who Should Complete This Form
Notice of Privacy Practices (DHS-3979) (PDF) -- even if the participant received this earlier as part of enrollment.	· Notifies clients about how their private information may be used. · Available in 7 languages. See 4.6 (Data Privacy).	No one.
Injury Protection Program Participant Information and Authorization to Release Medical Information (DHS-3994) (PDF).	Permission to release data and medical information.	The participant.
Injury Protection Program First Report of Injury (DHS-3995) (PDF).	Provides information about the participant, the injury or accident and the worksite.	Worksite supervisor or authorized staff.

Steps others will do:

DHS.	· Will refer the participant to a medical care provider. · Submit the Injury Protection Program claim.
The medical care provider.	· Will provide a report and diagnosis.
Counties or tribal agencies.	· Will investigate the claim. · Will submit claims to an insurance agency or to DHS after the treatment is complete and all treatment bills are available.