Claims Department Operations

The Claims Department is responsible for the preparation of all new claims in advance of the Workers' Compensation Commission hearing.

The Claims Department files issues and requests information regarding potential third party actions and prior workers' compensation claims from the claimant's attorney.  Written requests for all of the medical records which both pre and post date the accidental injury are mailed to the claimant's attorney and the employer/insurer.

A decision regarding whether or not the Subsequent Injury fund obtains an independent medical evaluation follows review of the medical records and rating evaluations supplied from the claimant and the employer.  Medical examinations are not scheduled in every case, but rather are only scheduled for cases having suspected Fund liability.

A written summary of the claim history and potential Fund liability is provided to the assigned attorney from the SIF Legal Department in advance of the Workers' Compensation Commission hearing.

The Claims Department is also responsible for supervising all permanent total disability claims.  All permanent total disability claimants are contacted annually and asked to provide information regarding their current medical and employment status.  The  Inquiry Report form is initially mailed to the attorney of record, and then directly to the claimant if no response is obtained from the attorney.  The purpose of the annual  inquiry is to verify that claimant is still alive, eligible, and residing at the address where the benefit checks are being mailed.