Uninsured Employers Fund(amentals)

By Judge Dale Tipps, Murfreesboro

Dale Tipps

Attorneys, did you know the Workers’ Compensation Statute contains a Part 8?

If you represent injured workers, Part 8 might occasionally cross your path. It established the Uninsured Employers Fund (UEF), which provides for the enforcement of insurance coverage requirements.

The part that might intersect with your practice is Tennessee Code Annotated section 50-6-802(a), which allows eligible employees who are injured while working for an uninsured employer to request temporary disability or medical benefits from the Bureau.

You might be interested to know that the Bureau has received nineteen requests to date and has paid benefits from the fund in thirteen of those cases.

The fine print on eligibity for an employee and the procedures he or she must follow to request benefits from the UEF is beyond the scope of this post. (Take a look at this previous post and the Bureau’s general description of the program here.)

Instead, let’s examine how these provisions might affect the way you pursue your injured client’s claim in the Court of Workers’ Compensation Claims. The good news is, not much. Contrary to some popular misconceptions, you don’t need to name the UEF as a party, and the UEF won’t send an attorney to participate in the litigation.

Perhaps the most important concept is that the court cannot order benefits to be paid by the UEF.

Instead, the judge will simply make the usual determination as to whether an employee is entitled to benefits. If the court orders medical or temporary disability benefits, the employee may file a request with the Bureau for payment of those benefits (up to the limits authorized by section 802).

Note that if you’re seeking benefits under a compensation hearing order, you must file the request within sixty days after the conclusion of the claim, including all appeals.

In most cases, you won’t need additional proof to establish eligibility to request benefits from the UEF. This is because a petition for benefit determination naming an employer with no workers’ compensation insurance is automatically referred to a UEF investigator when it’s filed. That investigator’s report becomes part of the court file and is normally sufficient for the court to make the necessary findings of fact. Obviously, it’s a wise idea to keep an eye on this part of the process to make sure the report is included in the record.

It’s not always necessary to wait until a final compensation hearing to obtain medical or temporary disability benefits for your client. The statute also allows requests for these benefits from the UEF after an expedited hearing. However, if the Bureau grants your request for payment of interlocutory benefits by the UEF, don’t stop litigating. Section 802(e)(2) provides that if an employee who receives benefits “fails to prosecute the claim” to its conclusion, the Bureau may seek recovery of those benefits from the employee.

Finally, the UEF has drafted benefit request rules, which await approval by Joint Governmental Operations Committee. If you have questions about those draft rules, contact Troy Haley at troy.haley@tn.gov.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s