Services That Maximize Recovery Opportunities
Second Injury Fund Reimbursement
In an effort to encourage employers to hire previously injured or partially disabled workers, many states established Second Injury Funds (SIF) to offset financial disincentives associated with the employment of impaired workers. When compensation is being paid as the result of a combination of a worker’s prior impairment and the “second” work related injury, the insurer or self-insured employer may be entitled to reimbursement of benefits from the state Trust Fund. The insured employers may be entitled to an adjustment to their insurance premiums because of experience modification factors as a result of these reimbursements. We work hard on our clients’ behalf to obtain the maximum possible reimbursements in a timely manner.
To learn more about our procedure for SIF recovery, click here.
Cost of Living Adjustment (COLA) Reimbursement
In Massachusetts workers’ compensation, COLA benefits are eligible for reimbursement for claims with dates of loss prior to October 1, 1986, at 100% recovery, and for dates of loss between October 1, 1986 and December 23, 1991. Our service includes identifying claims with reimbursement potential, completing reimbursement requests and working with the Trust Fund to obtain timely reimbursement. We review claims to ensure that COLA benefits are calculated correctly – a critical task, given that multiple versions of the COLA table has been published in past years.
Concurrent Employment Reimbursement
We offer concurrent employment reimbursement services for New Hampshire and New York claims. Indemnity benefits attributable to employment concurrent to the position involved in the workplace injury are eligible for reimbursement from the Trust Funds in these jurisdictions. We review claims to identify potential, perfect the claims, draft reimbursement requests and monitor submissions to ensure timely payment.
Reverse Offset Services
Section 224 of the Social Security Act requires the federal government to apply an offset or reduction in the amount of federal benefits, Social Security Disability Insurance (SSDI) or Social Security Retirement (SSI) if the individual also receives workers’ compensation benefits. However, some states have approved laws that do the opposite and reduce workers’ compensation benefits when the disabled worker is also receiving public benefits to avoid duplicate payments to the claimants. This is known as Reverse Offset; where the Social Security Administration (SSA) recognizes a reverse offset statute, the claimant’s federal benefits will not be offset and the workers’ compensation carrier has an opportunity to reduce the claimant’s benefits without impacting the claimant’s gross income by applying the reverse offset. Our expertise in working with the Social Security Administration gives us the ability to accurately identify and calculate the appropriate offsets available to insurers in the jurisdictions with approved Reverse Offset statutes.