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AG Chris Koster | FAQs
Missouri Attorney General

Frequently asked questions of the Labor Division

Table of Contents

What is the Second Injury Fund?

Established by the Missouri General Assembly, the Second Injury Fund is a fund contributed to by all employers obtaining workers' compensation insurance in the state of Missouri. The Second Injury Fund provides benefits to employees who have sustained workers' compensation injuries in certain instances. The Second Injury Fund is managed by the State Treasurer; claims made against it are defended by the Attorney General's Office.

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When can an employee file a claim for benefits?

Anyone may file a claim against the Second Injury Fund if they believe they are entitled to benefits.

Examples of when claims might be made for workplace injuries occurring on or before January 1, 2014, include:

  • If an employee is working for an employer which should have obtained workers' compensation insurance, but did not.
  • If an injured employee works for more than one employer, and sustains an injury at one of those jobs causing the injured employee to miss time from work at his other job as well.
  • If an injured employee is receiving certain physical rehabilitation services following a serious injury following the time in which he or she receives medical aid.
  • If an injured employee has previously sustained a disability, which might be combined with the work-related disability to create a greater disability than the simple sums.

Examples of when claims might be made for workplace injuries occurring after January 1, 2014, include:

  • If an injured employee is receiving certain physical rehabilitation services following a serious injury following the time in which he or she receives medical aid.
  • If an injured employee has previously sustained a qualifying disability, which might be combined with the work-related disability to result in the employee being permanently totally disabled.
  • If an employee is injured while working for a sheltered workshop and the disability from that injury might be combined with the employee’s preexisting disability to result in the employee being permanently totally disabled.

In this context, being permanently totally disabled means that an employer on the open labor market would not reasonably be expected to hire the employee in his or her current physical condition.

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How do I file a claim against the Second Injury Fund?

A Claim for Compensation is filed with the Division of Workers' Compensation. The Claim for Compensation has a specific place to indicate that you are alleging a claim against the Second Injury Fund and to list what particular circumstances you believe qualify you for benefits from the Second Injury Fund.

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What happens after I file a claim for compensation against the Second Injury Fund?

After a Claim for Compensation is filed with the Division of Workers' Compensation, the Division forwards the claim to the Attorney General. The Attorney General's Office has 30 days to file an answer to the claim with the Division; a copy is also sent to the employee who filed the claim. The Attorney General's Office will send a letter to the employee stating the specific information the Office needs in order to evaluate the employee's claim against the Fund. This information could include records of medical treatment for prior disabilities or for the work-related injury; independent medical evaluations done on behalf of either the employee or the employer; copies of medical bills; and information about the circumstances of the injury. Affidavits (signed statements) from the employee may also be required.

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How does an injured employee obtain the documents to provide to the Second Injury Fund?

The Attorney General's Office does not, and cannot represent injured employees. If an employee has an attorney representing him or her, the attorney will know how to obtain the necessary information. If an employee needs to obtain the needed documents on his or her own, medical information can normally be obtained by contacting the medical provider, either the doctor's office or the hospital. This may require submitting forms and may involve a charge for the records. Copies of Stipulations settling Claims for Compensation with employers can be obtained by contacting the Division of Workers' Compensation at 573-751-4231 or at their web site.

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Why does the Second Injury Fund need this information?

In order to determine if the alleged disabilities fulfill the requirements of the law for Second Injury Fund liability, the Fund must have the records regarding the treatment received for each injury as well as knowledge regarding the amount of disability determined to have existed when the claim settled with the employer.

In permanent total disability claims, the law says that a person may be entitled to permanent total disability benefits from the Second Injury Fund if they are unable to compete in the open labor market due to a combination between prior disabilities and a work related disability. In order to determine a person's ability to compete in the open labor market, many times it is necessary for the Second Injury Fund to take a deposition (or sworn statement) of the employee to fully understand the extent of disabilities as well as to determine the potential ability of the employee to return back to the open labor market in some capacity.

In uninsured claims, the Second Injury Fund may be liable for payment of medical bills incurred as the result of an injury sustained by an employee of an employer who should have had workers' compensation insurance but failed to properly insure. In order to ascertain the necessity of the medical bills claimed, the Second Injury Fund must have both medical records and the medical bills to review. It is also necessary that the Second Injury Fund have information regarding the employer so that it can ascertain whether or not the employer was subject to the Workers' Compensation Act and indeed failed to properly insure.

In a wage loss claim, the Second Injury Fund must determine whether or not both employments were with "employers" as defined by the Workers' Compensation Act, thus the necessity for information regarding the employments. We also need information regarding wages to ascertain what wage rate, any benefits might be due. We need medical information to determine if a medical provider has kept the employee off work from that second job due to the injury at the first.

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How do I close my claim against the Second Injury Fund?

Claims can be closed in one of four ways: A voluntary dismissal at the request of the employee; an involuntary dismissal entered by the Division of Workers' Compensation if an employee fails to appear at a pre-hearing; a voluntary settlement between the employee and the Second Injury Fund; or an award entered by an Administrative Law Judge after a hearing is held in the case.

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What if I don't agree with an offer from the Second Injury Fund?

If the parties are unable to reach a voluntary agreement, any party may request a final hearing with the Division of Workers' Compensation. At a final hearing, evidence is offered and accepted pursuant to formal rules of evidence. An award is then entered by an Administrative Law Judge based upon the evidence presented. Such an award is binding on all parties unless an appeal is made.

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How do I appeal an Award?

Appeals from Awards of Administrative Law Judge are made to the Labor and Industrial Relations Commission. Forms are available for such appeals through the Division of Workers' Compensation. Appeals from a decision of the Labor and Industrial Relations Commission are made to the Missouri Court of Appeals.

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Do I need an attorney?

There is no requirement in a workers' compensation proceeding to have an attorney representing an employee. However, understand that if you hire an attorney, the Assistant Attorney Generals representing the Second Injury Fund can only communicate to you through your attorney.

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