21
The South Carolina Second Injury Fund By Latonya Dilligard Edwards, Esq.

The South Carolina Second Injury Fund

Embed Size (px)

DESCRIPTION

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, 2008. S.C. Code Ann. §42-7-320(B). December 31, 2010 T MINUS 73 DAYS AND COUNTING. - PowerPoint PPT Presentation

Citation preview

Page 1: The South Carolina Second Injury Fund

The South Carolina Second Injury Fund

By Latonya Dilligard Edwards, Esq.

Page 2: The South Carolina Second Injury Fund

July 1, 2008

The Second Injury Fund shall not consider a

claim for reimbursement for an injury that

occurs on or after July 1, 2008.

S.C. Code Ann. §42-7-320(B).

Page 3: The South Carolina Second Injury Fund

December 31, 2010T MINUS 73 DAYS AND COUNTING

The Fund must receive notice of a potential

claim by December 31, 2010.

S.C. Code Ann. §42-7-320(B)(1).

Notice must include the following:

Page 4: The South Carolina Second Injury Fund

December 31, 2010T 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. §42-9-400(f)

Page 5: The South Carolina Second Injury Fund

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.

Page 6: The South Carolina Second Injury Fund

Question: I submitted notice to the Fund by

December 31, 2010 but it does not include all

of the information outlined in §42-9-400(f).

Am I barred from reimbursement recovery?

Page 7: The South Carolina Second Injury Fund

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.

Page 8: The South Carolina Second Injury Fund

June 30, 2011

All information required for the Fund to

accept, deny or compromise a claim must be

submitted by June 30, 2011. Some of the

required documents for submission include

medical records, Form 18, 19, or

16, and knowledge information.

Page 9: The South Carolina Second Injury Fund

June 30, 2011

For a complete list of required documents,

please go to www.scsif.sc.gov,

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. §42-7-320(B)(2).

Page 10: The South Carolina Second Injury Fund

December 31, 2011

The Fund must make a decision on all claims

by December 31, 2011. The Fund shall not

accept a claim for reimbursement after

December 31, 2011.

S.C. Code Ann. §42-7-320(B)(1).

Page 11: The South Carolina Second Injury Fund

July 1, 2013

The Second Injury Fund is terminated on and

after July 1, 2013. All remaining liabilities,

assessments, and administration of obligations

will be determined by the State Budget &

Control Board.

S.C. Code Ann. §42-7-320(A)

Page 12: The South Carolina Second Injury Fund

July 1, 2013

All Uninsured Employers’ Fund employees,

equipment, etc. are transferred to the State

Accident Fund.

S.C. Code Ann. §42-7-200(A)(1)

Page 13: The South Carolina Second Injury Fund

Recent Second Injury Fund Cases

State Accident Fund v. SC Second Injury Fund,

Opinion No. 4684

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.

Page 14: The South Carolina Second Injury Fund

Cases Continue

Transportation Ins. Co. v. SC Second Injury FundOpinion No. 26880Petition in the Original JurisdictionMay 12, 2010 (Argued); September 13, 2010 (Filed)In reversing the South Carolina Workers’ CompensationCommission, the South Carolina Supreme Court held that theten-year statute of limitations period outlined in S.C. CodeAnn. §15-3-600 applied to reimbursement cases and that thelimitations period accrues on the date the Fund receivesnotice of a potential Second Injury Fund claim rather then thedate of the claimant’s injury, as the Fund proposed.

Page 15: The South Carolina Second Injury Fund

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 e-mails, 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.

Page 16: The South Carolina Second Injury Fund

Contacts

If you have questions about the status of your claim, please contact the

following individuals:

Pete CalamasDirector of Claims

100 Executive Center Drive, Suite 101Santee Building

Columbia, SC [email protected]

(803) 798-2722 ext. 115

Page 17: The South Carolina Second Injury Fund

Contacts

Phillip Johnson

Senior Claims Analyst

[email protected]

(803) 798-2722 ext. 118

Page 18: The South Carolina Second Injury Fund

Phillip JohnsonAssigned Counties

Abbeville Kershaw

Aiken Lancaster

Anderson Laurens

Beaufort Lexington

Cherokee McCormick

Chester Newberry

Chesterfield Oconee

Edgefield Orangeburg

Greenville Pickens

Greenwood Saluda

Horry Spartanburg

Page 19: The South Carolina Second Injury Fund

Contacts

Marla Rehborn

Claims Analyst

[email protected]

(803) 798-2722 ext. 131

Page 20: The South Carolina Second Injury Fund

Marla Rehborn Assigned Counties

Allendale FlorenceBamberg Georgetown

Barnwell HamptonBerkeley Jasper

Calhoun Lee Charleston Marion

Clarendon MarlboroColleton Richland

Darlington SumterDillon Union

Dorchester WilliamsburgFairfield York

Page 21: The South Carolina Second Injury Fund

The End