"Thanks for your excellent work to bring this Second Injury Fund recovery to a close. We will be working with the Workers’ Compensation Bureau to revise the experience ratings that this claim has impacted."
- Mark Kingston, Senior Vice President, Eastern Insurance Group
WE RECENTLY ASKED Attorney Lou Greenberg to discuss the Second Injury Fund in Massachusetts and how it can impact some workers’ compensation claims, often significantly. Lou specializes in SIF recoveries and has worked extensively with A.I.M. Mutual over the course of two decades, a partnership that has led to more than $55 million in recoveries. Today he is Second Injury Fund Counsel for A.I.M. Mutual.
WHAT IS SECOND INJURY FUND (SIF) RECOVERY?
If you have ever been frustrated by an expensive claim and wondered whether there was any consolation, the answer is: Maybe. Section 37 of the Massachusetts workers’ compensation statute allows insurers to recover when there was a prior injury or medical condition that was known to the employer. The recovery comes from the Massachusetts Workers' Compensation Trust Fund, funded directly by insurers, but effectively by employers through assessments, and administered by the Commonwealth of Massachusetts.
WHAT IS THE ORIGIN OF SIF RECOVERY?
SIF Recovery dates back to World War I, and the goal was to encourage employers to hire disabled veterans even if they were at higher risk for re-injury and extended disability. The recovery was ultimately applied to all workers with previous disabilities.
WHY IS SIF RECOVERY SO IMPORTANT FOR BROKERS AND THEI CLIENTS?
If a previously impaired worker aggravates a pre-existing condition, the SIF steps in to offset the cost to the employer and insurer. The recovery therefore alleviates the unfairness of the current employer bearing the entire cost even when a pre-existing condition is worsening the disability. Although SIF recovery provides reimbursement directly to insurers, employers also benefit frequently through an improvement in their experience modification.
HOW MANY OTHER STATES HAVE SECOND INJURY FUNDS?
Approximately 35 states have had similar reimbursement procedures at one time. Many have eliminated their Funds, and the Massachusetts Workers’ Compensation Advisory Council explored it about 10 years ago. However, thanks in part to A.I.M. Mutual’s presence with the Advisory Committee and the satisfaction of insurers with the reimbursement system, the Advisory Council recommended maintaining the Fund. The legislature accepted this recommendation. New Hampshire is the only other New England state that still has a Second Injury Fund, and A.I.M. Mutual successfully uses local counsel to secure those recoveries.
WHAT HAS GIVEN A.I.M. MUTUAL AN ADVANTAGE IN THIS AREA?
Some insurers have been more effective than others at taking advantage of SIF recovery opportunities. I was originally hired in 1995 by a traditional workers’ compensation defense firm run by Attorney Fred Uehlein, considered ‘The Godfather” of the legal practice behind SIF recovery. At that time, insurers were failing to fully take advantage of recovery opportunities. Defense firms would assign both the defense and the recovery to the same attorney, and the claim for recovery would often take a backseat. Attorney Uehlein tasked me with leading the effort to develop strategies and procedures that would maximize recoveries.
As A.I.M. Mutual continued on its path to becoming one of the largest workers’ compensation carriers in Massachusetts, its superior training methodology and knack for hiring the right personnel resulted in an extremely effective partnership with my firm. In fact, that 20-year partnership led to recoveries of over $55 million, and research showed A.I.M. Mutual was obtaining significantly more recoveries than insurers of similar size.
Although all our firm’s clients benefited from our services, A.I.M. Mutual was uniquely suited to reap these benefits thanks to its claim staff’s acumen. Kathy Kelley has managed A.I.M. Mutual’s SIF recovery process for over 15 years, and she has been an invaluable partner and asset in that process.
WHAT ARE SOME EXAMPLES OF CASES THAT LED TO RECOVERIES?
In recent months, we were able to recover over $300,000 on a claim involving a fall from a building and $220,000 on a claim involving a warehouse accident. Given what the employers knew prior to the injuries, these are examples of claims that might not be explored by a defense firm that lacks a significant focus on recoveries.
WHY DID YOU BRING YOUR EXPERTISE EXCLUSIVELY TO A.I.M. MUTUAL?
Once Attorney Uehlein, who had been a tremendous mentor as well as friend, retired from day-to-day involvement, the opportunity to join the A.I.M. Mutual team was too enticing to pass up. I’m now able to devote my full attention on recoveries to A.I.M. Mutual and its policyholders. The result has been significant increases in A.I.M. Mutual’s average recoveries for 2020 and 2021 compared to the preceding few years, and I look forward to continuing that trend in 2022 and beyond.
Share This Article