Section 408.32. Compensation supplement fund; "maximum benefit" defined.

(1) A carrier, second injury fund, or self-insurers’ security fund shall claim reimbursement from the compensation supplement fund for payments made in accordance with section 352 of the act. A carrier, second injury fund, or self-insurers’ security fund, shall make a claim on bureau form 114, application for reimbursement.

(2)    A carrier, second injury fund, or self-insurers’ security fund shall make an initial application for reimbursement not later than 3 months after the end of the quarter for which the right to reimbursement first accrues.

The right to reimbursement first accrues on the  first   day  of  the   quarter following any quarter for which  supplemental  benefits are first paid or ordered to be paid.

(3)      A carrier, second injury fund, or self-insurers’ security fund may make subsequent application for reimbursement quarterly, but not later than 1 year after the closing date of the quarter for which reimbursement is being requested.

(4)    A carrier, second injury fund, or self-insurers’ security fund shall submit a separate form 114 for each  quarter  for  which   reimbursement  is requested. A quarter, as used in this rule, is based on a calendar year as identified by the bureau on an annual basis.

(5)    Upon a proper showing of a claim for reimbursement, the compensation supplement fund shall make payment within a reasonable time after the receipt of the claim. The compensation supplement fund shall  normally  make reimbursement within 3 months after the receipt of form 114, unless a dispute arises.

(6)     For the purpose of these rules, "maximum benefit" means the statutory maximum for the year of injury upon which benefits are based; 2/3 of the employee’s average weekly wage on the date of  injury;  the  minimum compensation rate in effect on the date of injury; or a maximum compensation rate established by bureau order. If an employee, or his or her dependents, is receiving maximum benefits as defined in this subrule, there will be a presumption that benefits are being paid under section 351 or 321 of the act.

(7)   A compensation supplement shall not be paid for any of the following received by an eligible employee or dependent:

(a)   Benefits received for any period of disability before January 1, 1982.

(b)   Benefits received under an agreement to redeem the  liability  of  the carrier.

(c)   A lump sum payment for remarriage under section 335 of the act.

(d)  Interest paid on benefits awarded by a magistrate.

(e)   Partial compensation paid under section 361(1) of the act.

(8)   In a case involving a lump sum advance payment, supplemental benefits shall not be part of the advance payment,  but shall continue to be paid weekly.

(9)   In a case involving the carrier’s right to subrogation in a third-party recovery, the amount of supplemental benefits shall be based on the weekly compensation rate that the employee would have been receiving on  January  1, 1982.

(10)    If compensation supplement benefits have been paid and if the employee is later found to be entitled to total and permanent disability benefits, then the second injury fund shall reimburse the compensation supplement fund for the  appropriate amount of benefits paid by the compensation supplement fund, and the second injury fund shall reimburse the carrier for the balance of benefits that would have otherwise been  paid  by  the  compensation supplement fund.

(11)   If the second injury fund is paying differential benefits directly to the injured employee and if the amount of differential benefits increases, then the second injury fund either shall  reimburse   the  compensation   supplement  fund   for  any overpayment    of    monies    that    the      compensation  supplement  fund  has  already

reimbursed the carrier     or    shall    reimburse    the carrier directly in cases where the compensation supplement fund has not yet reimbursed the carrier.

(12)   If a case is on appeal over the issue of whether the injured employee is totally and permanently disabled and if the claimant is receiving 70% of the amount of differential benefits that would be owed if total and permanent disability is found to apply, the amount of supplement that is due may be reduced or offset by the 70% amount that is being paid.

(13)     If the compensation supplement fund has reimbursed a carrier for the supplemental benefits paid, and if it is  later  found  that  the  amount reimbursed included an overpayment, then the compensation supplement fund shall be entitled to recoupment of the overpayment from the carrier. The carrier is entitled to recoup the overpayment from the employee.

(14)     Section 357 of the act shall not be applied when the amount of supplemental benefit, as provided for in section 352 of the act, is calculated for eligible employees whose date of personal injury is before July 1, 1968.

(15)   After the supplemental benefit has been computed in accordance with section 352(1) of the act, based on the weekly compensation rate that the employee or dependent of a deceased employee is receiving or is entitled to receive on January 1, 1982, had the employee been receiving benefits at that time, the supplemental benefit shall not be reduced or increased by changes to the weekly compensation rate that occur after January 1, 1982,  except  as provided in section 352 and in this rule.

History: 1979 AC; 1980 AACS; 1984 AACS; 1986 AACS; 1998-2000 AACS.