Background of Second Injury Fund (SIF):
The Second Injury Fund (SIF) was created to protect Employers from permanent and total disability (PTD) when an injured worker’s work injury combines with his pre-existing medical conditions and injuries to make him unable to return to any type of work for gainful employment. When the SIF is responsible for PTD then it is referred to PTD due to a “combination” of the work-related injury and the prior medical conditions and injuries. The employer is then responsible to pay for the permanent partial disability (PPD) only related to the work-related injury. The Employer is only responsible for PTD when the work-related injury alone renders the injured worker unable to return to work.
Timeline of Developments in the Law regarding the Second Injury Fund:
“In 2013, the legislature amended section 287.220, which governs[Second Injury] Fund liability,” to limit the number of workers eligible for fund benefits because the Fund was insolvent.” Treasurer of Mo. v. Parker, 622 S.W.3d 178, 181 (Mo. banc 2021). Section 287.220.2 retained the pre-amendment framework for Fund liability for compensable work-related injuries that occurred before January 1, 2014. Id. Section 287.220.3, which governs compensable work-related injuries that occurred after January 1, 2014, eliminated Fund liability for permanent partial disability (“PPD”) claims and limited Fund liability for permanent total disability (“PTD”) claims by requiring that the claimant’s preexisting disabilities be medically documented, equal at least 50 weeks of PPD, and meet one of the criteria listed in section 287.220.3(2)(a)a(i)-(iv). Id. See RSMo 287.220 These Changes took effect on January 1, 2014 Weibrecht v. Treasurer of Mo., No. SC 99493 659 S.W.3d 588, 590-91 (Mo. banc 2023). This new section eliminated Fund liability for permanent partial disability (PPD) cases. Id.
Since January 1, 2014, there have been interpretations by the courts of section 287.220. The courts address this law in the following cases.
In 2019, the Missouri Supreme Court upheld the revisions in the law removing SIF liability for permanent partial disability (PPD) Cosby v. Treasurer of Missouri, 579 S.W.3d 202 (Mo. banc 2019)
Non-Qualifying Disabilities cannot be considered in determining SIF liability: 2022
Any pre-existing disabilities and injuries that do not qualify under RSMo 287.220.3(2)(a)a(ii) can not be considered in determining SIF liability. See Klecka v. Treasurer of Mo., 644 S.W.3d 562, 567 (Mo. banc 2022)
Medically documented qualifying pre-existing disability & Directly and Significantly Aggravated or Accelerated
Dubuc v. Treasurer of Missouri, 659 S.W.3d 596 (Mo. banc 2023)
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Issue: What is a medically documented qualifying preexisting disability that directly and significantly aggravates or accelerates the primary work injury? AND What does “Directly and Significantly Aggravated or Accelerated” mean?
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Holding: Claimant failed to establish any “medically documented” preexisting disabilities that “directly and significantly aggravated or accelerated” his primary injury pursuant to Section 287.220.3(2)(a)a(iii), and Claimant failed to prove that his pre-existing disability “directly and significantly aggravated or accelerated” his primary injury. Id. at 605.
- The Court reasoned that Claimant’s self-reported pre-existing hernias was insufficient where there existed no pre-existing medical records for same. Though claimant self-reported his pre-existing by communicating them to the doctors, the claimant’s own statements did not conclusively support that any doctor medically documented claimant having hernias. Id. at 605. The court also reasoned that claimant’s doctor’s statement alone that claimant was permanently and totally disabled (PTD) due to the combination of his work injury and his pre-existing injuries was insufficient to support SIF PTD liability. Under the statute, claimant must show that the impact of his pre-existing injuries and medical conditions more than incidentally effects the work injury. The claimant must show that the prior injuries exacerbate the primary work injury in a meaningful way. Id. at 605.
Therefore, to help prove a PTD case against the SIF, an employee must have actual treatment records showing evidence of a pre-existing injury/medical condition. It is not enough to have reference of a pre-existing injury mentioned in the history of other doctors’ medical records. Additionally, It is necessary for a doctor to explain in detail the bio-mechanical, physiologically effects of a prior injury in how it combines with the work injury to make the employee PTD.
Compensable Prior Injury:
A Commission determined what is means for a pre-existing injury to be defined as “compensable” under Missouri law to qualify for SIF liability. An injury is defined as “compensable” under RSMo 287.020.3(1) which states that an injury is compensable if the accident was the prevailing factor in causing both the resulting medical condition and disability. In this matter, the claimant testified that he had an out-of-state work injury for which he received benefits. However, claimant failed to produce evidence that his prior work injury in another state was “compensable” as defined under Missouri law. No evidence was presented from a doctor stating the the prior out-of-state work injury was the prevailing factor in causing the injury and resultant disability See Commission Decision, Thomas v. Collins & Hermann, Inc., 052924 MOWC 15-092163
Occupational Diseases do not qualify as Pre-existing injuries: 2025
- The Missouri Supreme Court held that occupational diseases, such as carpal tunnel syndrome do not qualify as pre-existing disabilities under Missouri law RSMo 287.220.3(2)(a)a(iii), See Treasurer of the Missouri v. Penney, SC 100693 (Mo. banc 2025)

If you’ve been injured at work, then please immediately contact our law firm, and one of our skilled attorneys will be happy to discuss your rights and benefits under workers’ compensation law. Call us for a free consultation: 314-631-6777
Steven Edelman, Attorney