Second Injury Fund - Frequently Asked Questions

How do I know if I am eligible for this benefit?

The eligibility guidelines for the rehabilitation benefit can be found on our Physical Rehabilitation Page.

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How are the rehabilitation benefit amounts calculated?

We begin treatment dates with the first date of therapy and we end treatment dates with the last date that therapy was received; therefore, the last week of treatment will be prorated based on the last treatment date versus the start date. If you originally started on a Friday and the last week ended on a Tuesday, we would calculate your benefit at $40 multiplied by the number of full weeks and 5/7 of a week.

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What is the maximum number of weeks allowed for this benefit?

We can pay up to 20 weeks. There could be an additional 20 weeks. This would need to be approved by the Director of the Division of Workers’ Compensation.

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How much money will I receive if I qualify for this benefit?

The Second Injury Fund pays $40.00 for each full week that you qualify.

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How often do checks for the rehabilitation benefit get mailed?

We mail checks one time per month for the physical rehabilitation benefit (usually the third Tuesday of each month).

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What happens if I go to a facility that is not certified by the Division?

You still can receive physical therapy at this facility, as long as the insurance company/employer has approved the treatment; however, you will not be eligible for the physical rehab benefit from the Second Injury Fund.

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How do I qualify for Second Injury Fund?

To qualify for the Second Injury Fund, you must have a current work-related injury. You must have a rating on that injury from the doctor(s) of at least 15 percent of a major extremity or 12 ½ percent of the body as a whole. In addition to this, you must have a previous work-related injury or a previous disability which also has a rating from the doctor of at least 15 percent of a major extremity or 12 ½ percent of the body as a whole. If you were injured on your job and have a second job, and because of your work-related injury are unable to work your second job, you might qualify for Second Injury Fund Second Job Lost Wages.

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How do I claim benefits from the Second Injury Fund?

Except for physical rehabilitation benefits, no payments can be made from the Second Injury Fund unless a “Claim for Compensation” is filed against the Second Injury Fund. Only the employee, or (in a death benefits case) the employee’s dependents can file a claim against the Second Injury Fund. Employees or dependents may hire their own lawyer to represent their interests when filing for benefits. Read Obtaining a Lawyer

A claim against the Second Injury Fund is made by filing an approved Division form Claim for Compensation, indicating which of the Second Injury Fund benefits is being sought. If form WC-21 is filed against the Second Injury Fund based upon a pre-existing disability, the employee needs to complete the date(s) of previous injury or disease, the part(s) of the body affected by the previous injury or disease, as well as state whether permanent partial or permanent total benefits are being sought.

There are time limits to filing a claim against the Second Injury Fund. A claim against the Second Injury Fund must be filed within two years after the date of the work-related injury or within one year after a claim is filed against an employer or insurer, whichever is later. This is a somewhat technical requirement; therefore, in most cases, you will want to file a claim against the employer and the Second Injury Fund before entering into a settlement with your employer. As with any legal question, you may want to consult with a lawyer before filing a claim or entering into a settlement.

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Do I need an attorney to file a claim against the Second Injury Fund?

No.

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What happens after a claim is filed, and how long does it take for my Second Injury Fund case to settle?

The Division of Workers’ Compensation will send the Claim for Compensation to the Attorney General’s Office for their response. (Remember that the Attorney General is responsible for defending claims against the Fund.) The Attorney General has 30days to file its Answer to the Claim for Compensation. You will receive a copy of the Answer. The Answer will either admit or deny the allegations or statements made in the claim. The Second Injury Fund also may state that it lacks information to admit or deny the statements made in the claim and in this instance will re-evaluate the case when additional information is made available.

The claim will be scheduled for a “pre-hearing” conference before an administrative law judge. You (or your lawyer, if you are represented) must appear at the pre-hearing to discuss your claim with the assistant lawyer general and the judge. This is an informal meeting which may result in a settlement of your claim.  After a pre-hearing, a mediation may be requested. A mediation is a confidential settlement conference with an administrative law judge.

As in other workers’ compensation cases, the Fund or the employee may request to have an evidentiary hearing (trial) held before an administrative law judge to determine if the employee is eligible for the benefits being sought. Evidence, including medical evidence, is required. The employee has the burden of proof on all contested issues. For more information about evidentiary hearings, awards and appeals, read What to Expect If Your Case Goes To Trial and Appealing The Judge’s Decision. As for an actual time period, time depends on the judge’s caseload and the severity of your case.

The claim will be scheduled for a “pre-hearing” conference before an administrative law judge. You (or your lawyer, if you are represented) must appear at the pre-hearing to discuss your claim with the assistant lawyer general and the judge. This is an informal meeting which may result in a settlement of your claim. After a pre-hearing, a mediation may be requested. A mediation is a confidential settlement conference with an administrative law judge.

As in other workers’ compensation cases, the Fund or the employee may request to have an evidentiary hearing (trial) held before an administrative law judge to determine if the employee is eligible for the benefits being sought. Evidence, including medical evidence, is required. The employee has the burden of proof on all contested issues. For more information about evidentiary hearings, awards and appeals, read What to Expect If Your Case Goes To Trial and Appealing The Judge’s Decision. As for an actual time period, time depends on the judge’s caseload and the severity of your case.

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What is the status of my claim?

Call the Division at 800-775-2667.

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How long do I have to file a claim against the Second Injury Fund?

A Second Injury Fund claim must be filed within two years of the date of your most recent work-related injury or within one year of the date a claim is filed against the employer, whichever is later.

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How are payments made?

After the claim against the Second Injury Fund is resolved, either by an approved settlement, or based upon a Final Award entered by an administrative law judge, the Division will requisition the payments. Payments for medical bills may go directly to the medical providers or to the employee and his/ her attorney in uninsured employer cases. All attorney’s fees and applicable liens are deducted prior to the final payment being made in the case. Direct deposit is an option available to persons receiving ongoing weekly benefits.

If you have a question as to the status of your payment from the Second Injury Fund, call 800-775-2667 and ask for a Second Injury Fund Technician.

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How much money will I get/how is the settlement figured?

Each case is figured based on the severity of your case, your degree of disability, the ratings you received from your doctors, and your average weekly rate of compensation.

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My attorney won’t return my calls. What can I do?

For complaints regarding your attorney, you may call the Office of Chief Disciplinary Counsel at 573-635-7400.

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May I come and pick up my check?

Yes, as long as you and your attorney, if represented, have a written agreement, a copy of which must be supplied to the Second Injury Fund payment section in advance. You also will need two forms of identification when picking up your check.

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I received an e-mail about a quarterly report that was due to the Division. What is this quarterly report for? We don’t write Workers’ Compensation policies. Why do I have to report?

If your company is licensed with B2 authority through the Department of Insurance, Financial Institutions and Professional Registration, your company must report to the Division of Workers’ Compensation. B2 authority means that your company has the authority to write Workers’ Compensation policies in the state of Missouri, if your company chooses to do so. B2 authority allows your company to write lines of business other than Workers’ Compensation. Therefore, as long as your company retains the B2 authority in Missouri, you are required by law to submit quarterly reports to the Division for your company.

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Do we have to report quarterly? Can we be exempt from reporting, since we don’t write workers’ compensation insurance?

Your company may now report once a year if you are not planning to write workers’ compensation premiums in the current calendar year. You will need to follow the link to the log in screen which is now e-mailed to your company contact. The Affidavit of Zero Reporting is on the left corner of the login screen. After you complete and notarize the affidavit, you will need to mail it to the Division at 3315 West Truman Blvd., Jefferson City, MO 65109. The affidavit must be submitted by the 1st quarterly billing due date of April 30th. Your company contact will continue to receive an e-mail notice from Sifsurcharge@labor.mo.gov for each quarter saying that the quarterly surcharge report form is available for completion; however, if you have filed the Affidavit of Zero Reporting for the current calendar year, you may disregard the quarterly e-mails. Your company must complete and mail a new affidavit to the Division annually.

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Where can I find the Affidavit of Zero Reporting? (Commercial Insurers Only)

You will need to follow the link to the login screen which is now emailed to your company contact. The Affidavit of Zero Reporting is on the left corner of the log in screen. If you have any questions regarding the affidavit of zero reporting please e-mail Sifsurcharge@labor.mo.gov.

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Can the Affidavit of Zero Reporting be faxed to the Division?

No, the affidavit needs to be printed. It must be completed with the appropriate signatures, notarized and then mailed to the Division at 3315 West Truman Blvd., Jefferson City, MO 65109.

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If I am reporting $0s or have a credit balance for a quarter, do I still need to mail a hard copy to the Division?

No, if you are submitting a ‘NONE’, $0s or have a credit balance for a quarter, you will only need to submit it electronically. Nothing needs to be mailed to the Division.

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Where do I find my access code and ID number?

Originally, all companies were notified by letter November 19, 2008. Your Second Injury Fund Surcharge company contact should have received a four-page letter containing your company’s access code & ID number (see the bottom of the 1st page). The last two pages of this letter were in regard to the Electronic Partnering/Confidentiality Agreement. A company may request their Access Code & ID Number after they have an Electronic Partnering/Confidentiality Agreement on file. If you have any questions concerning your access code and ID number, please e-mail Sifsurcharge@labor.mo.gov.

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Do I have to fill out the Electronic Partnering/Confidentiality Agreement?

Yes, ALL companies with the authority to write workers’ compensation policies must complete this agreement to include the company’s NAIC number, contact name, phone number and email address. This agreement must be completed and faxed to our office at (573) 522-1623. Upon receiving this completed agreement, the Division then can supply your company contact with the unique Access Code & ID Number that is assigned to your company.

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Does a new Electronic Partnering/Confidentiality Agreement need to be completed if the contact person changes?

Yes, anytime the person responsible for submitting the quarterly reports changes, a new agreement must be completed and faxed to the Division.

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Can more than one person receive the e-mails from the Division?

Yes, anyone that your company would like to have set up as a contact may receive all e-mails from the Division regarding the Second Injury Fund Surcharge. An Electronic Partnering Agreement must be completed and faxed to the Division for each person to receive the e-mails.

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Does each contact on file with the Division have his/her own access code & ID number?

Yes, each contact will have his/her own Access Code & ID number.

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How are the late penalty and interest calculated?

If a company is reporting $0, then there are NO late penalties or interest due. However, any late payments postmarked after the due date will have a late penalty of 0.5% applied to the late surcharge amount. Interest is applied to the late surcharge amount at 1.5% multiplied by the number of months late.

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What is considered late?

Anything that is postmarked after the quarter’s respective due date is considered late. Even if it is received one day past the due date, it is considered late and the interest is calculated as one whole month late. The interest is not prorated based on the number of days late.

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Does the Division accept postmark dates?

All quarterly reports and payments are due on their respective due dates; however, the Division is now accepting the postmark date when calculating late penalties and interest.

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I report for more than one company. Can I send in one check for all the companies for which I am reporting?

Yes, one check may be sent when reporting for several companies; however, please keep in mind that if one of the companies has a credit for a particular quarter, you CANNOT offset the overall total due for the remaining companies. The credit must stay with that company and be applied to future quarterly assessments until the credit is exhausted.

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What are the historical Second Injury Fund Surcharge (SIF), Workers’ Compensation Administrative Tax and Workers′ Compensation Administrative Surcharge rates?

The rates have been:

Year SIF Admin Tax Admin Surcharge
1993  3%  2%  
1994 0% 0%  

1995

0% 0%  
1996 0% 1%  
1997 1.5% 1%  
1998 3% 2%  
1999 3% 2%  
2000 3% 0%  
2001 2.5% 0%  
2002 2.5% 1%  
2003 4% 2%  
2004 4% 1% 1%
2005 3.5% 0% 0%
2006 3% 0% 0%
2007 3% 1% 1%
2008 3% 1% 1%
2009 3% .5% .5%

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How do I report retrospective policies?

If your company has retrospective policies, you will need to include the total dollar amount for these policies on the appropriate line of the online Second Injury Fund Surcharge report form. In addition, separate documentation MUST be sent to the Division (either by e-mail or mail) to support the dollar amount entered on the quarterly surcharge report form for the retrospective policies.

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How do I correct a quarterly report form after I have submitted it electronically to the Division?

If you need to make a correction to a quarterly report form that has been electronically submitted to the Division, you can write in the corrections on the original copy and mail it to the Division. Please mark the form ‘AMENDED’.

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Do we have to report quarterly? Can we be exempt from reporting since we don’t write workers’ compensation insurance?

You must report quarterly if you are authorized to self-insure or are a member of a group trust that is authorized to self-insure in Missouri. The Division has implemented a new online filing system. Please contact Sifsurcharge@labor.mo.gov if you have any questions regarding the filing of your quarterly surcharge report forms.

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If I am reporting $0s or have a credit balance for a quarter, do I still need to mail a hard copy to the Division?

No, if you are submitting a ‘NONE’, $0s or have a credit balance for a quarter, you will only need to submit it electronically. Nothing needs to be mailed to the Division.

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Where do I find my access code and ID number?

Originally all self insured entities or group trusts were notified by letter dated November 19, 2008. Your Second Injury Fund Surcharge company contact should have received a four-page letter containing your company’s access code & ID number (see the bottom of the 1st page). The last two pages of this letter were in regards to the Electronic Partnering/Confidentiality Agreement. A company may request their Access Code & ID Number after they have an Electronic Partnering/Confidentiality Agreement on file. If you have any questions concerning your access code and ID number, please e-mail Sifsurcharge@labor.mo.gov.

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Do I have to fill out the Electronic Partnering/Confidentiality Agreement?

Yes, ALL self-insurers and group trusts with the authority to self-insure in Missouri must complete this agreement to include the company’s WI number (self-insurers) or WG number (group trust), contact name, phone number and email address. This agreement must be completed and faxed to our office at 573-522-1623. Upon receiving this completed agreement, the Division can then supply your company contact with the unique Access Code & ID number that is assigned to your entity.

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Does a new Electronic Partnering/Confidentiality Agreement need to be completed if the contact person changes?

Yes, anytime that the person responsible for submitting the quarterly reports changes, a new agreement must be completed and faxed to the Division.

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Can more than one person receive the e-mails from the Division?

Yes, anyone that your company would like to have set up as a contact may receive all e-mails from the Division regarding the Second Injury Fund Surcharge. An Electronic Partnering Agreement must be completed and faxed to the Division for each person to receive the e-mails.

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Does each contact on file with the Division have his/her own access code & ID number?

Yes, each contact will have his/her own Access Code & ID Number.

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How are the late penalty and interest calculated?

If a company is reporting $0, there are NO late penalties fees or interest due. However, any late payments postmarked after the due date will have a late penalty of 0.5 percent applied to the late surcharge amount. Interest is applied to the late surcharge amount at 1.5 percent multiplied by the number of months late.

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What is considered late?

Anything that is postmarked after the quarter’s respective due date is considered late. Even if it is received one day past the due date, it is considered late and the interest is calculated as one whole month late. The interest is not prorated based on the number of days late.

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Does the Division accept postmark dates?

All quarterly reports and payments are due on their respective due dates; however, the Division is now accepting the postmark date when calculating late penalties and interest.

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I report for more than one company. Can I send in one check for all the companies for which I am reporting?

Yes, one check may be sent when reporting for several entities; however, please keep in mind that if one of the entities has a credit for a particular quarter, you CANNOT offset the overall total due for the remaining entities. The credit must stay with that entity and be applied to future quarterly assessments until the credit is exhausted.

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What are the historical Second Injury Fund Surcharge (SIF), Workers’ Compensation Administrative Tax and Workers’ Compensation Administrative Surcharge rates?

The rates have been:

Year SIF Admin Tax Admin Surcharge
1993  3%  2%  
1994 0% 0%  

1995

0% 0%  
1996 0% 1%  
1997 1.5% 1%  
1998 3% 2%  
1999 3% 2%  
2000 3% 0%  
2001 2.5% 0%  
2002 2.5% 1%  
2003 4% 2%  
2004 4% 1% 1%
2005 3.5% 0% 0%
2006 3% 0% 0%
2007 3% 1% 1%
2008 3% 1% 1%
2009 3% .5% .5%

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How do I correct a quarterly report form after I have submitted it electronically to the Division?

If you need to make a correction to a quarterly report form that has been electronically submitted to the Division, you can write in the corrections on the original copy and mail it to the Division. Please mark the form ‘AMENDED’.

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