Understanding the California Subsequent Injury Benefit Trust Fund (SIBTF)
Many individuals manage chronic health conditions with medications, lifestyle changes, or other treatments, allowing them to continue working without significant challenges. However, when a new work-related injury or illness is added to a pre-existing condition, the combined impact may significantly hinder a person’s ability to work.
Workers’ Compensation benefits typically cover only those injuries or illnesses directly caused by job duties. However, if a work-related injury worsens a pre-existing condition, leading to a more severe overall disability, you may be eligible for additional support through California’s Subsequent Injury Benefit Trust Fund (SIBTF). This program can provide supplemental disability benefits to help you manage the financial impact. For assistance in navigating this process, consult with a knowledgeable Workers’ Compensation attorney.
Eligibility Criteria for SIBTF Benefits
Under California Labor Code §4751, you may qualify for SIBTF benefits if you have a pre-existing permanent partial disability and then experience a work-related injury or illness that results in additional permanent disability. Your total disability must be at least 70 percent, with the new work injury contributing at least 35 percent to your overall disability in most situations.
There are specific exceptions to this rule. If your pre-existing condition affects a limb or an eye, and your new injury impacts the corresponding opposite body part, you may be eligible if the work-related injury results in at least a 5 percent disability. For example, a person with 40 percent vision loss in one eye due to a pre-existing condition might qualify if a work-related injury results in at least 5 percent impairment in the other eye.
A California Workers’ Compensation attorney can review your medical history and current situation to determine if you meet the qualifications for SIBTF benefits.
How SIBTF Benefits Work Alongside Standard Workers’ Compensation
When a work injury leads to a permanent disability, Workers’ Compensation provides benefits based on the affected body part and the degree of disability. If a pre-existing condition increases your overall level of disability, the SIBTF may offer additional benefits.
Your employer is responsible for compensating you based solely on the impact of the recent work injury or illness. The SIBTF then supplements these benefits, accounting for the difference between your total disability and the disability caused solely by the work-related condition.
SIBTF benefits are typically available for the remainder of your life. However, the amount may vary depending on whether you receive additional benefits, such as Social Security, due to your pre-existing condition. An experienced attorney can provide an estimate of the SIBTF benefits you might receive based on your specific circumstances.
Applying for SIBTF Benefits
To apply for SIBTF benefits, you must submit a claim to the local Workers’ Compensation Appeals Board. Your application should include detailed information about your work-related injury and the pre-existing condition that resulted in permanent partial disability. The Board may schedule a hearing to evaluate your claim.
Obtaining medical reports from doctors familiar with the SIBTF can strengthen your application. A knowledgeable attorney can recommend qualified physicians to provide the necessary evaluations and reports. Even if the Board denies your claim, the SIBTF covers the cost of these evaluations.
Contact Us for Help with SIBTF Claims
Navigating the SIBTF process can be complex, especially when dealing with pre-existing disabilities. If you believe you might be eligible for benefits, consulting with an attorney experienced in SIBTF claims can help ensure your application is properly prepared.
Reach out to us today to discuss your case and learn how we can assist you in securing the benefits you are entitled to.
