The Uninsured Employers’ Guaranty Fund (UEGF), and its role in the Pennsylvania workers’ compensation system, has been discussed previously in this Blog. While the UEGF plays under different rules than every insurance carrier that writes PA workers’ compensation insurance coverage, and the UEGF can be incredibly difficult and frustrating to litigate against, there is no argument that the UEGF is an improvement over how things were, before the UEGF was enacted.
The different rules which apply to the UEGF were further set when the legislature passed, and Governor Thomas Wolf signed, Act 132 in October, 2018 (has it been a year already?). This new legislation provided new protections for the UEGF to enjoy, in an effort to protect limited resources in the face of the increasing number of claims (perhaps a more effective method of protecting UEGF assets, rather than leave injured workers without remedy, would be to focus on the employers who violate PA law by failing to carry PA workers’ compensation insurance).
Among the changes to the UEGF rules in Act 132 are:
– An injured worker employed by an employer located in another State must provide proof that the injured worker is not entitled to workers’ compensation benefits in that State.
– An injured worker must notify the UEGF within 45 days of when he or she “has been advised by the employer or another source” that the employer is uninsured; failure to act within those 45 days is a complete bar to recovery.
– Once the injured worker files a Notice of Claim against the UEGF (and waits the requisite 21 days), he or she must file a Claim Petition against the UEGF within 180 days; again, the failure to act within those 45 days is a complete bar to recovery.
– The UEGF can establish a list of designated health care providers in each county, to obtain the ability to be responsible for medical treatment only with a provider on that list for the first 90 days after the work injury.
– Proof of wages must be made by one of seven specified methods listed in Act 132. If the only proof of wages given is the testimony of the injured worker, and this testimony is found credible by the Workers’ Compensation Judge (WCJ), the Average Weekly Wage (AWW) shall be the AWW of the injured worker’s occupation (it cannot be the amount to which the injured worker testified, even if found credible by the WCJ).
As you can see, the new legislation (assuming a year old still counts as “new”) creates many pitfalls for those injured workers without the benefit of legal representation. Without even being aware, an injured worker could easily lose his or her entire ability to obtain any kind of benefits from the UEGF in as little as 46 days. All because his or her employer violated the law by failing to carry PA workers’ comp insurance coverage. How is that even remotely fair?