The South Carolina Second Injury Fund By Latonya Dilligard Edwards, Esq.

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Presentation transcript:

The South Carolina Second Injury Fund By Latonya Dilligard Edwards, Esq.

July 1, 2008 The Second Injury Fund shall not consider a claim for reimbursement for an injury that occurs on or after July 1, S.C. Code Ann. § (B).

December 31, 2010 T MINUS 73 DAYS AND COUNTING The Fund must receive notice of a potential claim by December 31, S.C. Code Ann. § (B)(1). Notice must include the following:

December 31, 2010 T MINUS 73 DAYS AND COUNTING --date of accident --employee’s name --employer’s name and address --insurance carrier’s name, address, NCCI code, claim number, policy number and effective date. S.C. Code Ann. § (f)

Notice to the Fund is effective upon receipt. See Cincinnati Ins. Co. V. South Carolina Second Injury Fund, 297 S.C. 372, 377, S.E.2d 130 (S.C. App. 1989), review dismissed 301 S.C. 180, 391 S.E.2d 235.

Question: I submitted notice to the Fund by December 31, 2010 but it does not include all of the information outlined in § (f). Am I barred from reimbursement recovery?

Answer: As long as the defect is cured by June 30, 2011, your notice will not bar you from reimbursement recovery. However, all of the other reimbursement criteria have to be established in order to qualify for reimbursement.

June 30, 2011 All information required for the Fund to accept, deny or compromise a claim must be submitted by June 30, Some of the required documents for submission include medical records, Form 18, 19, or 16, and knowledge information.

June 30, 2011 For a complete list of required documents, please go to select “Forms”, then “Information Needed for Second Injury Fund Investigation.” Failure to submit all required information by June 30, 2011 shall bar recovery. S.C. Code Ann. § (B)(2).

December 31, 2011 The Fund must make a decision on all claims by December 31, The Fund shall not accept a claim for reimbursement after December 31, S.C. Code Ann. § (B)(1).

July 1, 2013 The Second Injury Fund is terminated on and after July 1, All remaining liabilities, assessments, and administration of obligations will be determined by the State Budget & Control Board. S.C. Code Ann. § (A)

July 1, 2013 All Uninsured Employers’ Fund employees, equipment, etc. are transferred to the State Accident Fund. S.C. Code Ann. § (A)(1)

Recent Second Injury Fund Cases State Accident Fund v. SC Second Injury Fund, Opinion No April 15, 2010 (Argued); May 5, 2010 (Filed) The South Carolina Court of Appeals held that the Fund’s Agreement to Reimburse was not ambiguous And the Fund is not required to pay beyond the express terms of the Agreement.

Cases Continue Transportation Ins. Co. v. SC Second Injury Fund Opinion No Petition in the Original Jurisdiction May 12, 2010 (Argued); September 13, 2010 (Filed) In reversing the South Carolina Workers’ Compensation Commission, the South Carolina Supreme Court held that the ten-year statute of limitations period outlined in S.C. Code Ann. § applied to reimbursement cases and that the limitations period accrues on the date the Fund receives notice of a potential Second Injury Fund claim rather then the date of the claimant’s injury, as the Fund proposed.

Second Injury Fund Adjusters We have two adjusters evaluating Second Injury Fund claims. Each adjuster has 600 cases a month in their diary, which does not include s, telephone calls, and mail that they may receive regarding a claim. Please keep in mind that your claim is not the only one being evaluated.

Contacts If you have questions about the status of your claim, please contact the following individuals: Pete Calamas Director of Claims 100 Executive Center Drive, Suite 101 Santee Building Columbia, SC (803) ext. 115

Contacts Phillip Johnson Senior Claims Analyst (803) ext. 118

Phillip Johnson Assigned Counties Abbeville Kershaw Aiken Lancaster Anderson Laurens Beaufort Lexington Cherokee McCormick Chester Newberry Chesterfield Oconee Edgefield Orangeburg Greenville Pickens Greenwood Saluda Horry Spartanburg

Contacts Marla Rehborn Claims Analyst (803) ext. 131

Marla Rehborn Assigned Counties Allendale Florence Bamberg Georgetown Barnwell Hampton Berkeley Jasper Calhoun Lee Charleston Marion Clarendon Marlboro Colleton Richland Darlington Sumter Dillon Union Dorchester Williamsburg Fairfield York

The End