Annual Deadline for SIF Recovery in Multiple Employment Cases is Quickly Approaching

Did you know that you can pursue benefits paid due to multiple employment from the Subsequent Injury Fund? This has been permitted ever since the legislature passed the provision regarding multiple employment. With the passage of that legislation the legislature included a provision for SIF reimbursement. Reimbursement is automatic when the required documentation is timely submitted to the SIF. The right to reimbursement is waived if not timely presented. And the deadline to apply for payments made in fiscal year 2018 is fast approaching.

Carriers have one year from the end of the fiscal year payments to seek SIF reimbursement on multiple employment reimbursement or they will waive their right to that year’s reimbursement. Therefore, carriers have until August 31, 2019 to request reimbursement for payments made to the claimant between September 1, 2017 and August 31, 2018. The Division will not review any claims for insurance carrier payments related to multiple employment that are not submitted within the required timeframe.

Rule 116.11(e) provides the steps to take and the information required to support such a request. The rule provides as follows:

These requests shall be filed with the SIF administrator in writing and include:

(1) a claim-specific summary of the reason the insurance carrier is seeking reimbursement and the total amount of reimbursement requested;
(2) a detailed payment record showing the dates of payments, the amounts of the payments, purpose of payments, the payees, and the periods of benefits paid, all PLNs regarding the payment of benefits, as well as documentation that shows that the overpayment was unrecoupable as described in subsection (b) of this section, if applicable;
(3) the name, address, and federal employer identification number of the payee for any reimbursement that may be due;
(4) information documenting the injured employee’s average weekly wage amounts paid from all non claim employment held at the time of the work related injury pursuant to §122.5 of this title (relating to Employee’s Multiple Employment Wage Statement); and
(5) information documenting the injured employee’s average weekly wage amounts paid based on employment with the claim employer.

DWC has created a form for SIF reimbursement requests involving multiple employment cases. The DWC-97 should be used in seeking reimbursement of this type.

Note that any benefits paid to the claimant as a result of including wages from other employment are reimbursable from the Subsequent Injury Fund on an annual basis. Thus, any documentation submitted should be sufficient to support your request for reimbursement.

If you’d like assistance in requesting SIF reimbursement, we are happy to help. Please contact Brandi Blassingille at bnb@fol.com for assistance.