Uninsured Employers’ Fund

1. Uninsured Employers’ Fund June 21, 2011 Victoria Plotsky, Associate Attorney

2. Where is UEF?

3. Legal Hearings Unit’s Many Hats • Represent UEF in uninsured claims • Represent the World Trade Center Volunteer Fund • Represent the Board for defaulting self-insured employers • Represent the Board in Stop Work Order, 131.3 & Misclassification Penalty Appeals

4. 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!

5. The U in UEF UNINSURED Employers’ Fund not UNIDENTIFIED Employers’ Fund and not MISCLASSIFIED Employers’ Fund

6. The E in UEF Uninsured EMPLOYERS’ Fund There must be an Employer A LEGAL ENTITY

7. The F in UEF We are a STATE FUND Not a CARRIER

8. 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 CARRIER • Client • Application • Premium • Policy • C-7s • 25(2)(b) applies • Files PHC statements • 25(1)(f) applies

9. 20 UEF Hearing Locations

10. UEF Attorney Territories George Trimper Dave Filion Tanya Lambert-Watkins Ernestine Jenkins Laura Yellon Arif Khan Miggie Warms

11. 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.

12. 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.

13. UEF Claim Diagram Comp Carrier Insured General Contractor, Inc. Bricks R Us - Joe Fly by Night – Nancy Worker

14. 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.

15. 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

16. Third Party Actions Money recovered in 2007 $827,916 2008 $889,036 Recovered to date 2011 $553,170 2009 $1,165,361 2010 $1,392,349

17. UEF Hearings per Year 2008 2009 2010 25% drop from 2008 - 1010

18. Section 50 Findings Newly established UEF cases 32 % drop in established UEF cases 2008-2010

19. 2010 Uninsured Claims by type

20. Uninsured Claims 2009-2010 by Type

21. WHY ARE UEF HEARINGS & CASES DOWN? Lower Premiums – 20% drop in 2007 The Economy – Construction Greater Compliance & Stop Work Orders ILDBF – Few taxi hearings

22. 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