Uninsured Employers' Fund: Appeal of UEF Benefits Determination

Car Werks, LLC v. Uninsured Employers' Fund v. Gawronski [06/12/15] 2015 MTWCC 13 Despite the uninsured employer’s claim that the specific issue of medical causation was not mediated, when a party contests the decision on initial compensability, the mediation of that issue encompasses all subjacent compensation issues whether or not they are specifically mentioned in the request for mediation.  The uninsured employer’s dispute with the UEF over acceptance of a claim on its theory that a previous motorcycle accident caused claimant’s injuries is subjacent to the issue of whether the UEF correctly accepted liability.

Car Werks, LLC v. Uninsured Employers' Fund v. Gawronski [06/12/15] 2015 MTWCC 13 Although couched as an appeal of the mediator’s non-binding decision, it is clear from the initial pleading that the uninsured employer is really contesting the UEF’s decision to accept liability for the claimant’s claim.

Horizon Custom Homes v. UEF [02/14/07] 2007 MTWCC 8 Where an uninsured employer failed to request mediation within 90 days of the UEF’s unconditional acceptance of an injured employee’s claim, as required by § 39-71-520, MCA, the uninsured employer is without recourse.
Howe v. UEF [12/23/05] 2005 MTWCC 59 Section 39-71-520(1), MCA (2003), requires that following a benefits determination by the Uninsured Employers’ Fund, an aggrieved party must appeal to mediation within ninety days, otherwise the determination is final. A petitioner may effectively meet the requirements of § 39-71-520(1), MCA (2003), if a petitioner notifies the Uninsured Employers’ Fund in writing of his or her disagreement with its decision.
James v. UEF [10/22/02] 2002 MTWCC 51 Section 39-71-520, MCA, requires that following a benefits determination by the Uninsured Employers' Fund an aggrieved party must request mediation within 90 days, otherwise the determination is final. Since mediation is a prerequisite to filing a petition in the Workers' Compensation Court, 39-71-2401(1), -2408(1), and -2905, MCA, a failure to request mediation within 90 days bars the Court from reviewing the UEF determination.
Hoff v. Uninsured Employers’ Fund [7/19/00] 2000 MTWCC 44 The triggering event for running of the 90 days to appeal to mediation from a determination of the uninsured employers’ fund under section 39–71-520, MCA (1999) is not receipt of the determination, but the determination itself.
Hoff v. Uninsured Employers’ Fund [7/19/00] 2000 MTWCC 44 Although section 39-71-520, MCA (1999) requires a dispute concerning uninsured employers’ fund benefits to be appealed to mediation within 90 days from the date of the determination or the date the determination became final, a letter from the UEF to claimant discussing permanent partial disability benefits was not a determination regarding temporary total disability benefits and thus did not commence the running of the appeal period regarding TTD entitlement.