Highlights of Noteworthy Decisions

Decision 2041 19
E. Kosmidis
  • Experience rating (NEER) (retroactive adjustment)
  • Second Injury and Enhancement Fund {SIEF} (preexisting condition)
  • Board Directives and Guidelines (SIEF) (matrix or fifty per cent relief provision)

The Board applied the automatic 50% SIEF relief provision found in OPM Document No. 14-05-03.

This provision provides that, if there has been an aggravation of a pre-existing condition or if there is evidence that the disability following the accident has been enhanced because of a pre-existing condition, 50% of the cost of the claim (compensation and health care) is charged to the SIEF.
The Vice-Chair, following Decision No. 1034/14, found that in this appeal the provision was superseded by the matrix found in the SIEF policy, as there was a compensable permanent impairment in this case and the 50% relief only applies to compensation and health care costs.
The Vice-Chair went on to find that the employer was entitled to 75% SIEF relief based on a moderate accident and a major pre-existing condition.
The employer was further granted a retroactive adjustment to its NEER account.