Dec

15

2018

The Second Injury Fund and Your Workers Compensation Case

If you already have a disability, and you are injured on the job in the State of Missouri, how does that affect your workers compensation rights?

This is where the Second Injury Fund comes into play. It may allow you to recover additional workers comp benefits, especially if your first disability stems from service in the armed forces or law enforcement, or a prior workplace injury.

Workers Comp Benefits Available from the Second Injury Fund

Missouri’s Second Injury Fund is paid for by a surcharge on employers. The State Treasurer is the legal custodian and the Attorney General is legally bound to defend claims made against the SIF.

In the event that a worker with a pre-existing disability gets injured on the job, the employer is only liable for compensation stemming from the new injury, while additional benefits are paid from the SIF.

As a result of changes to Missouri workers comp law, the SIF pays the following types of benefits for injuries occurring on or after January 1, 2014.

  • Rehabilitation benefits. The rehabilitation benefit is intended to restore the injured person to a condition of self-support and self-maintenance. Individuals receiving this benefit must attend therapy as ordered by a physician and must use a facility certified by the Missouri Division of Workers Compensation. Injuries that may qualify for rehab benefits include:
    • Quadriplegia
    • Paraplegia
    • Amputation of a hand, arm, foot or leg
    • Atrophy due to nerve injury or non-use
    • Back injuries not amenable alone to regular treatment or surgery
  • Permanent total disability. A permanent total disability means you are unable to work at any job. In order to receive SIF benefits for permanent total disability, you must have a medically documented pre-existing disability and subsequent work related injury resulting in permanent total disability. The pre-existing disability must be equal to a minimum of 50 weeks of permanent partial disability compensation and must meet one of the following criteria:
    • Result of active military duty, OR
    • Result of a compensable injury under Missouri Workers Compensation Law, OR
    • Directly and significantly aggravates or accelerates the subsequent injury, OR
    • For cases in which the worker had pre-existing impairment in one eye, the subsequent injury causes blindness in the other eye, OR
    • For cases in which the worker had pre-existing impairment in one ear, the subsequent injury causes deafness or hardness or hearing in the other ear
  • Permanent partial disability. You may be eligible for this benefit if you (1) have a pre-existing disability of any nature that occurred prior to January 1, 2014, and (2) suffer an enhancement of disabilities due to workplace injuries that occur on or after that date. Permanent partial disability means your doctor has determined that you have permanent impairments caused by an injury. You are still able to perform some jobs, but unable to perform others.

How to Apply for Benefits from the Second Injury Fund

Workers compensation is a complex system, and filing for benefits from the Second Injury Fund only adds to that complexity.

It is essential that you hire a qualified workers comp attorney to help you process your claim.

Here’s what you need to do to claim SIF benefits:

  • File a Claim for Compensation
  • Indicate which SIF benefits you are seeking — rehabilitation, permanent total disability or permanent partial disability
  • Provide information such as the date(s) of your pre-existing disabilities and part(s) of your body affected
  • You must file your claim within two years of your injury, or within one year of filing a claim against your employer or their insurer, whichever is later

Here’s how the process will unfold after you file your claim:

  • The Division of Workers Compensation sends your claim to the Attorney General’s Office
  • The AG has 30 days to file an Answer either admitting or denying the statements in your claim, or state a lack of information to admit or deny
  • As the Claimant, you receive a copy of the AG’s Answer
  • Your claim is scheduled for a prehearing with an Administrative Law Judge (ALJ). Both you and your attorney must appear
  • Mediation may be requested by one or both parties
  • Either you or the SIF may request an evidentiary hearing or trial before ALJ
  • As the person claiming SIF benefits, you have the burden of proof

If you qualify for SIF benefits, your payments may go directly to your medical providers. You may also recover lawyer’s fees and liens, and direct deposit is an option for receiving weekly benefits.

Do you believe you are entitled to SIF benefits after a workplace injury?

Contact The Alberhasky Law Firm right away. Attorney Randy Alberhasky will answer all of your questions and work to ensure that your receive the benefits you deserve.