Law Enforcement Officers and Fire Fighters Disability Benefits Trust Fund Policies

Title 3. Office of the Attorney General Part 2. Law Enforcement Officers and Fire Fighters Disability Benefits Trust Fund Policies and Procedures 100 PURPOSE The Law Enforcement Officers and Fire Fighters Disability Benefits Trust Fund (herein referred to as “the Fund”) was created by the Mississippi Legislature to provide disability benefits to law enforcement officers and fire fighters injured in the line of duty. These benefits shall be payable for the period of time the covered individual is physically unable to perform the duties of his or her employment, [not to exceed one (1) year of payments for any one (1) injury]. The Fund originated at the Mississippi Department of Public Safety and came under the purview of the Mississippi Attorney General’s Office on July 1, 2006, pursuant to Section 45-2-21, Mississippi Code Annotated (1972). 101 DEFINITIONS 1. “Law enforcement officer” means any lawfully sworn officer or employee of the state or any political subdivision of the state whose duties require the officer or employee to investigate, pursue, apprehend, arrest, transport or maintain custody of persons who are charged with, suspected of committing, or convicted of a crime. 2. “Fire fighter” means an individual who is trained for the prevention and control of loss of life and property from fire or other emergencies, who is assigned to fire-fighting activity, and is required to respond to alarms and perform emergency actions at the location of a fire, hazardous materials or other emergency incident. 3. “Covered individual” means a part-time or full time law enforcement officer or fire fighter (as defined above) while actively engaged in protecting the lives and property of the citizens of this state when employed by an employer as defined below. Reserve/auxiliary law enforcement officers and volunteer fire fighters are also covered individuals. Employees of independent contractors are not included in this definition. 4. “Employer” means a state board, commission, department, division, bureau, or agency, or a county, municipality or other political subdivision of the state, which employs, appoints or otherwise engages the services of covered individuals. 5. “Regular base salary” means regular earnings, but excludes payments for overtime, shift premiums, incentive compensation, bonuses and other special payments. 102 ELIGIBILITY Any actively employed part-time or full time law enforcement officer or fire fighter, or reserve/auxiliary law enforcement officer or volunteer fire fighter, who is accidentally or intentionally injured in the line of duty as the direct result of a single incident, is eligible to receive benefits. The individual must be employed by a state board, commission, department, division, bureau, or agency, or a county, municipality, or other political subdivision of the state. Employees of independent contractors are not eligible. Effective January 1, 2011, reserve/auxiliary law enforcement officers and volunteer fire fighters are now eligible to receive benefits under the fund. 103 EXCLUSIONS Chronic or repetitive injury is not covered. Section 45-2-21, Mississippi Code Annotated (1972) states, Compensation under this section shall not be awarded where a penal violation committed by the covered individual contributed to the disability or the injury was intentionally self-inflicted. 104 EXEMPTION FROM CREDITORS Payments made from the Law Enforcement Officers and Fire Fighters Disability Benefits Trust Fund are exempt from the claims and demands of creditors of the covered individual per Section 45-2-21, Mississippi Code Annotated (1972). 105 OBTAINING PROGRAM INFORMATION Applications are included in these policies and procedures as EXHIBIT A. Also, applications and instructions can be obtained from the following sources: Website: AttorneyGeneralLynnFitch.com Mail: Mississippi Attorney General’s Office Law Enforcement Officers and Fire Fighters Disability Benefits Trust Fund P. O. Box 220 Jackson, MS 39205 LEOFFFund@ago.ms.gov Phone: (601) 359-6766 Applications for benefits must be submitted to the Mississippi Attorney General’s Office through our website or at the mailing or email address listed above. 106 APPLICATION/APPROVAL PROCESS Upon receipt of the application, information on the application is reviewed/investigated to ensure validity of the claim for benefits. If the application for benefits is approved [based on the criteria stipulated in these policies and procedures and Section 45-2-21 of the Mississippi Code Annotated (1972)], the Applicant shall be notified via certified mail or electronic mail, read receipt requested, indicating the approval of benefits, the amount of benefits to be awarded, the number of payments to be awarded, and the method of payment. If the application for benefits is denied, the Applicant shall be notified via certified mail or electronic mail, read receipt requested, stating the grounds for denial of the application. Applicants who disagree with any decision made have the right to appeal within thirty (30) days of receipt of the letter approving or denying benefits. For further information on the appeals process, see Section 114. Applications should be submitted to the Mississippi Attorney General’s Office within one (1) year of the date of injury. The Mississippi Attorney General’s Office may extend the deadline for submitting an application beyond one (1) year at its discretion. 107 BENEFIT PAYMENTS Once the application is approved for actively employed part-time or full time law enforcement officers and fire fighters, the Mississippi Attorney General’s Office will make a monthly disability benefit payment equal to thirty-four percent (34%) of the covered individual’s regular base salary at the time of injury, in addition to any Workers’ Compensation benefits, not to exceed the amount of the covered individual’s regular base salary. The benefit is payable for the period of time the covered individual is physically unable to perform the duties of his or her employment [not to exceed one (1) year of payments for any one (1) injury]. The physician’s report (which is included in the application for benefits) will document the dates the applicant is unable to work and the anticipated return to work date. Once the application is approved for reserve/auxiliary law enforcement officers and volunteer fire fighters, the Mississippi Attorney General’s Office will make a monthly disability benefit payment equal to thirty-four percent (34%) of the covered individual’s regular base salary, at the time of injury, from their primary employment, in addition to any Mississippi Workers’ Compensation benefits, not to exceed the amount of the covered individual’s regular base salary. The benefit is payable for the period of time the covered individual is physically unable to perform the duties of his or her employment [not to exceed one (1) year of payments for any one (1) injury]. The physician’s report (which is included in the application for benefits) will document the dates the applicant is unable to work and the anticipated return to work date. The Mississippi Attorney General’s Office has discretion to determine the primary employment of applicants and the amount of the regular base salary to be used in computing benefits. Benefit payments will be mailed to the covered individual on the first working day of each calendar month. Benefit payments from the Law Enforcement Officers and Fire Fighters Disability Benefits Trust Fund are excluded from gross income and thus are not taxable. 108 WORKERS’ COMPENSATION If the covered individual receives workers’ compensation benefits in addition to benefits from the Law Enforcement Officers and Fire Fighters Disability Benefits Trust Fund, then payments from the Fund will be limited to the difference between workers compensation benefits and the amount of the covered individual’s regular base salary. 109 CONFIDENTIALITY OF RECORDS Records held and acquired in the administration of the Fund may be confidential information and privileged and are subject to the Mississippi Public Records Act of 1983. 110 OVERPAYMENT OF BENEFITS If a payment or overpayment of benefits is made due to clerical error, mistaken identity, or innocent misrepresentation by or on behalf of the covered individual, the covered individual is responsible for repayment of the benefits received. 111 FALSE INFORMATION The filing of a false application for benefits (i.e., fraudulent, or false information is knowingly submitted and/or failure to disclose pertinent information) is unlawful. In addition to any criminal penalties, the Mississippi Attorney General’s Office shall have a right to commence civil action for the recovery of benefits obtained by the covered individual upon filing a false application. In such cases, the defendant shall be responsible for the fees, court costs, and other expenses of litigation. 112 REDUCTION OF BENEFIT PAYMENTS Notwithstanding any other provisions herein, no benefit payments shall be made unless adequate funds are available in the Law Enforcement Officers and Fire Fighters Disability Benefits Trust Fund. The State shall not be liable for a written order to pay compensation, except to the extent that monies are available in the fund on the date the claim is approved. The Mississippi Attorney General’s Office has the right to adjust benefit payments so that the total amount awarded does not exceed the amount of money on deposit in the fund. During the approved benefit period when such reduction is due to the unavailability of funds, covered individuals may not seek future reimbursements due to any reductions in benefit payments. The Mississippi Attorney General’s Office may opt to suspend payments until sufficient funding is on deposit in the fund. 113 EMPLOYER RESPONSIBILITIES The covered individual’s employer is responsible for completing the “Employment Information” section of the application for benefits. The employer is required to provide all necessary certification, wage information, doctor excuses and time missed as needed and requested by the Fund in determine eligibility and calculate benefits due to the covered individual. In addition, the employer is required to send written notice in the format prescribed by the Mississippi Attorney General’s Office notifying the Attorney General’s Office the exact date the employee returned to work. This written notice must be submitted no later than ten (10) working days after the employee returns to work. See format for “Employee Return to Work Letter,” EXHIBIT B. 114 APPEALS If the claim is denied for any reason, the applicant has the right to appeal within thirty (30) days of receipt of the letter denying benefits. The appeal process consists of two steps: reconsideration and a contested hearing. Reconsideration is intended to be an informal resolution of a claim. If the applicant disagrees with the original determination, he or she may request reconsideration through the Mississippi Attorney General’s Office. If the applicant disagrees with the decision of reconsideration, he or she may request a contested hearing within fifteen (15) days of the decision of reconsideration before a committee. The committee consists of three (3) members appointed by the Attorney General. This hearing is informal; however, the applicant shall be notified by certified mail or electronic mail, read receipt requested, that he or she must appear in person at the Hearing, and a record of the hearing is made. The decision made by the committee is the final decision of the Mississippi Attorney General’s Office. 115 RE-CERTIFICATION OF BENEFITS If a covered individual returns to work based on his or her physician’s recommendation in the application for benefits and it is later determined the employee is still unable to perform his or her duties, the covered individual may apply for a re-certification of benefits. The covered individual must have his or her employer and physician complete the Application for Re- Certification of Benefits to extend the period the covered individual is unable to work. This period should begin on the last date worked (note: this date will be different from the date on the initial application for benefits). See EXHIBIT A. This application must be submitted as described in Section 105.