Uninsured Employers’ Fund
June 21, 2011
Victoria Plotsky, Associate Attorney
Where is UEF?
Legal Hearings Unit’s Many Hats
 Represent
UEF in uninsured claims
 Represent the World Trade Center
Volunteer Fund
 Represent the Board for defaulting selfinsured employers
 Represent the Board in Stop Work Order,
131.3 & Misclassification Penalty Appeals
Purpose of the UEF
 Created
in 1962 to guarantee workers’
compensation benefits to all employees in
New York State even if employer did not
have compensation coverage.
 Before
1962, if no coverage, no benefits!
The U in UEF
UNINSURED Employers’ Fund
not
UNIDENTIFIED Employers’ Fund
and not
MISCLASSIFIED Employers’ Fund
The E in UEF
Uninsured EMPLOYERS’ Fund
There must be an Employer
A LEGAL ENTITY
The F in UEF
We are a STATE
FUND
Not a
CARRIER
CARRIER








Client
Application
Premium
Policy
C-7s
25(2)(b) applies
Files PHC statements
25(1)(f) applies
UEF









Restricted by Statute
Pay only as WCLJ directs
No privity with Employer
No knowledge of employer,
accident or employee
No C-7s
25(2)(b) does not apply
PHC not required
Adversarial position with
Employer
25(1)(f) does not apply
20 UEF Hearing Locations
UEF Attorney Territories
George Trimper
Dave Filion
Tanya Lambert-Watkins
Ernestine Jenkins
Laura Yellon
Miggie Warms
Arif Khan
Typical Carrier Claim


Worker falls & breaks arm at construction site.
Worker was hired by “Insured Construction, Inc.”
 Worker is paid by “Insured Construction, Inc.”
 Worker files an accident report with employer.
 Employer tells its carrier about the accident.
 Carrier accepts the claim & pays wages and medical.
 Claim may come before the Board if carrier disputes the
claim or as future issues arise.
In a Carrier case, the EMPLOYER is known. The CARRIER
is known. Not a lot of issues.
Typical UEF Claim







Worker falls & breaks arm moving bricks at construction site.
Worker was hired off the street by “Joe”. He knew Joe because he
hired workers from the same street corner whenever he needed
help. Joe had his own business, “Bricks R Us.”
Worker was paid by “Nancy” every Friday in cash from a truck at the
construction site.
The truck said “Fly-by-Night Construction”
Joe told him when to be there and what to do, but also that “Bob”
was the big boss.
“Bob” supervised all the workers, including Joe and Worker.
Bob wore a shirt that said “Insured General Contractor, Inc.”
WHO DOES WORKER WORK FOR? Joe, Nancy or Bob?
 Worker files a claim against Joe/Bricks R Us.
 A coverage check shows no coverage.
UEF Claim Diagram
Comp Carrier
Insured General Contractor, Inc.
Fly by Night – Nancy
Bricks R Us - Joe
Worker
Law Judge Finds:






Employer-Employee Relationship
Accident, Notice & Causal Relationship
No Coverage = Violation of WCL § 50, WCL §
26-a penalties & assessments
Lost Time & Medical Expenses awarded
General Contractor’s carrier pays or if no GC
Employer is directed to pay. If Employer does
not pay or appeal within 30 days, UEF pays.
UEF Appeals
 UEF
appeals about 2 decisions a
month out of 420 hearings, .4%
 UEF files about 15 rebuttals per month
 UEF occasionally appeals to the
Appellate Division
 Dedicated Senior Attorney to Appeals,
Kim Swidler
Third Party Actions
Money recovered in
2007
$827,916
2008
Recovered to date 2011
$889,036
$553,170
2009
$1,165,361
2010
$1,392,349
UEF Hearings per Year
UEF Hearings 2008-2010
7500
7095
7000
6500
6284
6000
5500
5303
5000
4500
4000
2008
2009
25% drop from 2008 - 1010
2010
Section 50 Findings
Newly established UEF cases
600
563
503
505
547
480
500
496
469
434
408
409
369
400
327
300
248
200
110
100
0
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
32 % drop in established UEF cases 2008-2010
2011
2010 Uninsured Claims by type
Construction 42.5%
Information 0.3%
Accommodations
0.3%
Domestic 1.9%
Manufacturing 0.3%
Arts/Entertainment
0.5%
Taxi & Limo 24.4%
Passenger Trans.
1.6%
Admin & Support Sv.
1.9%
Landscaping 1.6%
Healthcare 2.2%
Trucking 3.0%
Food Sv. 8.7%
Retail/Wholesale
4.3%
Services 6.5%
Uninsured Claims 2009-2010 by Type
Classification
2009
2010
change
% change
Construction
176
157
-19
-11%
Taxi & Limo
116
90
-26
-22%
Food Sv.
52
32
-20
-38%
Services
32
24
-8
-25%
Retail/Wholesale
16
16
0
0%
Trucking
25
11
-14
-56%
Healthcare
18
8
-10
-56%
Landscaping
18
6
-12
-67%
Admin & Support Sv.
12
7
-5
-42%
Passenger Trans.
10
6
-4
-40%
Arts/Entertainment
5
2
-3
-60%
Manufacturing
5
1
-4
-80%
Domestic
4
7
3
75%
Accommodations
2
1
-1
-50%
Information
0
1
1
NA
Farming/Agriculture
2
0
-2
-100%
Banking/Real Estate
3
0
-3
-100%
496
369
-127
-26%
total
WHY ARE UEF HEARINGS &
CASES DOWN?
Lower Premiums – 20% drop in 2007
The Economy – Construction
Greater Compliance & Stop Work Orders
ILDBF – Few taxi hearings
UEF : LHU - Summary

Ensuring prompt benefits to injured workers


Protecting the assets of the Fund
Helping assess penalties and increase
compliance among employers

Protecting the Board against Fraud
Download

Uninsured Employers` Fund: Legal Hearings Unit