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Second Injury Fund Surcharge

Second Injury Fund Surcharge

Overview

The Second Injury Fund (SIF) compensates injured workers when a current work-related injury combines with a prior disability to create an increased combined disability. The SIF is funded by a surcharge paid by employers. The Missouri State Treasurer is the “custodian” of the SIF. The Missouri Attorney General’s Office defends the claims made against the SIF and obtains the Treasurer’s authority to settle cases for the SIF. The Second Injury Fund Unit is responsible for the billing and collection of the Second Injury Fund Surcharge from insurance carriers writing workers’ compensation premiums in Missouri and from self-insurers or group trusts authorized to self-insure in Missouri.

An injured worker must have a permanent, pre-existing disability to trigger liability of the SIF. The prior disability must be "of such seriousness as to constitute a hindrance or obstacle to employment". In order for an employee to recover from the SIF, certain minimum thresholds must be met.

The SIF also is responsible for paying medical bills of injured workers when the employer fails to insure its workers' compensation liability. In addition, if the employee is killed, burial expenses and death benefits in the form of weekly payments to the surviving spouse or dependents of the employee are paid from the SIF if the employer is uninsured.

The SIF also provides benefits to injured workers who are undergoing physical rehabilitation. To qualify for these benefits, the employee must be seriously injured and be receiving therapy at a facility certified by the Division. If the injured worker qualifies, he/she will receive $40 per week for up to 20 weeks for rehabilitation.

The last benefit from the SIF is second job wage loss benefit. The benefit applies to injuries that occurred after August 28, 1998. The employee must be injured on the job with the first employer. If the employee is unable to work at a second job as a result of the injury these benefits may be claimed from the SIF.

Only the employee, the employee's lawyer or the employee's dependent(s) can make a claim against the SIF. This is done by the filing of a Claim for Compensation with the Division.

Workers’ Compensation Insurance Companies & Self-Insured Employers: Responsible for Paying SIF Surcharge

The Second Injury Fund is funded through a surcharge on employers’ workers’ compensation net deposits, net premiums or net assessments and net premium equivalent for self-insured employers. Each year by October 31, the Director of the Division of Workers’ Compensation estimates the benefits payable from the Second Injury Fund during the following calendar year in order to set the surcharge rate. The rate is based on a statutory formula to generate 110% of the moneys to be paid from the Second Injury Fund in the following calendar year less any moneys contained in the fund at the end of the previous calendar year. Under 2005 Senate Bill 1 and 130, the rate was capped at three percent.

To address the solvency issues of the SIF, Mo. Rev. Stat. §287.715.6 authorizes the Division Director to collect a supplemental SIF surcharge not to exceed 3 percent for calendar years 2014 to 2021, of policyholder’s or self-insured’s workers’ compensation net deposits, net premiums or net assessments of the previous policy year.  The following rates are in effect for Calendar Year 2014:

– Administrative Tax (authorized under Sec. 287.690) - 1 percent

– Administrative Surcharge (authorized under Sec. 287.716) - 1 percent

– Second Injury Fund Surcharge (authorized under Sec. 287.715) - 3 percent

– Second Injury Fund Supplemental Surcharge (authorized under Sec. 287.715.6) – 3 percent

The surcharge and supplemental surcharge are collected quarterly from insurance carriers and self-insurers. In order to satisfy your obligation under Section 287.715 RSMo, insurance carriers writing workers’ compensation premiums or having the authority to write workers’ compensation premiums in Missouri and employers/group trusts that have been authorized to self-insure in Missouri need to register with the SIF Surcharge Unit by sending the Division an e-mail at [email protected] or call 573-526-5756.

Upon contacting us, we will get your company set up to file all quarterly reports online. Our online filing system is a Web-based system. Most correspondence from the Division is now electronic; therefore, each company representative responsible for SIF Surcharge Quarterly reporting will need to complete and fax an Electronic Partnering Confidentiality Agreement to the Division at the fax number on the agreement. The information on this agreement will be entered into our system and a printout will be faxed to the representative (company contact) with the information necessary to login to our on-line reporting system. The link to the login is: https://apps.labor.mo.gov/dwc/surcharge/login.asp. At this link, you will find the Electronic Partnering Confidentiality Agreement, Affidavit of Zero Reporting (insurance carriers only), other information regarding our system and the actual login.

Each quarter, approximately 15 days prior to the quarter end, an e-mail with the login link will be sent from [email protected] to the company contact stating that the quarterly report is available for completion. The contact will need to click on the link and login to the site with the e-mail address, Access Code and ID Number (faxed printout). After accessing the quarterly report, there are instructions for completing the report. Be sure to submit the form prior to printing the form so that you have a confirmation number reflecting that the form was properly filed and a copy to send with the payment. If you have any problems with the quarterly filing or cannot find the items needed to access the log in, please email [email protected] or call 573-526-5756.

The Division will send an e-mail approximately 10 days prior to the due date as a reminder. If your payment and printed report have a postmark date after the 30th (due date), you will receive an e-mail stating that you are delinquent or have underpaid and now are subject to a late fee (.5% of unpaid balances) and interest (1.5% per month or fraction thereof delinquent). Each month that your payment is delinquent or underpaid, the interest will increase. After 90 days of non-compliance, the Division will refer the delinquent or underpaid amount to the Attorney General’s Office.

Insurance carriers who are not writing workers' compensation premiums but have the authority to write in Missouri can file an Affidavit of Zero Reporting each year. You still will receive the e-mails approximately 15 days prior to the end of the quarter stating that the quarterly reports are available for completion; however, if you are not writing and you have filed the affidavit with the Division, you do not need to complete the quarterly reports. You may find the affidavit on our Web site at the link to the login https://apps.labor.mo.gov/dwc/surcharge/login.asp.

If you have any questions regarding this information and your responsibility to be in compliance with Section 287.715 RSMo, please e-mail [email protected] or call 573-526-5756.

If you have any questions regarding the Missouri Workers’ Compensation Administrative Tax or Administrative Surcharge, please contact the Missouri Department of Insurance, Financial Institutions and Professional Registration at [email protected] or by phone at 573-526-1589.

Payment Processing to the Injured Party

The Division of Workers' Compensation is responsible for processing Second Injury Fund benefits. When an employee is eligible for benefits and a compromise settlement has been approved or an award has been issued, the Division processes payments to the injured worker.

Claims for uninsured employer- death, permanent total, permanent partial, uninsured employer – medical, and second job wage loss benefits are made by filing a Claim for Compensation, indicating Second Injury Fund benefits are being sought by the injured worker. Answers to claims are filed by the Office of the Attorney General that represents the Treasurer of the State of Missouri, as custodian of the Second Injury Fund.

In pre-hearing conferences, mediations or hearings before the Division’s administrative law judges, eligibility for Second Injury Fund benefits is determined based upon medical evidence submitted by the employee and the Attorney General's Office. Payments are made consistent with the award issued by an administrative law judge or stipulation agreements, properly executed by all parties, and approved by an administrative law judge.

Checks are prepared at the Office of Administration, Division of Accounting, and distributed by direct deposit or mail. Direct deposit services are only available to claimants receiving lifetime payments.

Outstanding child support liens and or Medicaid liens from the Department of Social Services, are deducted from payments and must be honored before payments are issued to the injured worker.

Claims for physical rehabilitation benefits are generally initiated by the Division from a review of injury and medical reports, or referrals from lawyers, rehabilitation nurses, physicians, injured workers, case managers or claims adjusters.

For more information about Second Injury Fund benefits, call 800-775-2667.

DISCLAIMER - More Information

The Employers, Insurers, TPAs section of the Workers' Compensation portion of this web site is targeted specifically to employers, insurers and third party administrators and is intended to be a resource throughout the workers' compensation claim process. It is NOT intended to be a substitute for legal representation.

Injured workers seeking information about the workers' compensation process should use the Injured Workers section of the Workers' Compensation web site to find information targeted specifically to them.

Additional information about Missouri Workers' Compensation laws, the Division of Workers Compensation, the Second Injury Fund and more may be found via the Workers' Compensation home page.