Minnesota Department of Labor and Industry

Attorney Request for Certificate of Dispute

Notice: This application will not be available after Jan. 5, 2016. It is being replaced by a new application. The new application requires each user to enter a one-time access code that enables the user to then set up their own I.D. and password for future use. Attorneys will use their license number issued by the Minnesota Supreme Court as their access number. Those who are not attorneys may obtain an access number by calling (651) 284-5030 at the Department of Labor and Industry.

Form must be completed in ONE session. Answers cannot be saved and then restored. Please allow for at least 20 minutes to complete. It may be helpful to have all of the required information and attachments available prior to completing a form.