COA: Man has exhausted compensation benefits

An Indiana statute is ambiguous as to whether a person who has exhausted his actual worker’s compensation benefits prior to 500 weeks is eligible to receive benefits from the Second Injury Fund starting on the date of the exhaustion of the actual benefits, the Indiana Court of Appeals concluded today.

The appellate judges ruled that a man who was entitled to receive 500 weeks of benefits, but only received benefits for 264 weeks, should be allowed to collect from the Second Injury Fund once he exhausted his benefits after the 264th week.

R.M. was injured at his workplace when his arms were pulled into a conveyor belt he was cleaning. He is now permanently disabled and entitled to receive worker’s compensation benefits pursuant to Indiana Code Section 22-3-3-10 for 500 weeks from the date of his injuries. He’s also allowed to recover from the Second Injury Fund after he has received the maximum compensation to which he is entitled under the Workers’ Compensation Act. The Full Worker’s Compensation Board originally ruled R.M. wasn’t eligible to receive benefits from the Second Injury Fund, but the Indiana Supreme Court reversed in 2008.

But R.M. only collected for 264 weeks because his employer and employer’s worker’s compensation insurance provider went out of business. Because of this, he argued he should be eligible for money from the Second Injury Fund beginning with the 265th week after the date of his workplace injury. The Full Worker’s Compensation Board determined he would be eligible beginning with the 501st week after the date of his injury.

Judge Cale Bradford wrote in R.M. v. Second Injury Fund, No. 93A02-1007-EX-792, that the judges believe the statute is ambiguous as to this issue. I.C. Section 22-3-3-13(h) provides that a person is eligible for benefits from the Second Injury Fund after exhausting benefits available to him or her under I.C. Section 22-3-3-10. Under -10, R.M. was entitled to receive worker’s compensation benefits for 500 weeks, but because his employer and employer’s worker’s compensation insurance provider went out of business before he met the 500-week threshold, the judges concluded he effectively received the maximum benefits possible and exhausted his right to receive worker’s comp.

“Having concluded that R.M. has effectively exhausted his right to receive worker’s compensation benefits, we believe that the legislature intended that an individual under these specific circumstances shall be considered to have exhausted their right to worker’s compensation benefits, thus making them eligible to recover additional benefits from the Second Injury Fund,” wrote Judge Bradford in reversing the full board. “Any other interpretation would result in the unjust and absurd result of R.M. being left without the assistance of the additional benefits to which he is entitled for a period of 236 weeks.”