Suppose you have suffered a serious injury at work and you already had a preexisting condition when the injury happened. In that case, you may be eligible for additional income from Workers’ Compensation benefits through the State of California’s Subsequent Injuries Benefits Trust Fund (“SIBTF” or “SIF”).
In other words, if you were already disabled or impaired and then got hurt at work, you may be entitled to receive extra compensation in addition to your regular WC payout if the subsequent injury results in permanent total disability of 70% or more.
Why Eason & Tambornini
Workers’ Compensation attorneys at Eason & Tambornini, specifically trained in the complexities of these cases, are on hand to help you through the entire process, from filing the initial application to winning an award. And remember: We work on a contingency basis, meaning we win when you win first.
Quick Facts About SIBTF
What is the SIBTF?
The fund was established in 1945 and is administered by the State of California Division of Workers’ Compensation. It exists to provide additional income from workers’ compensation benefits to persons injured in the workplace who already had a preexisting condition. In addition, the fund was designed to promote the employment of disabled and impaired workers.
Who Qualifies for SIBTF?
Applicants must meet two main requirements, or thresholds, for a workers’ compensation case to qualify for additional compensation from the fund.
- You must show proof of having a preexisting disability or impairment at the time of the subsequent injury
- The combined effects of your preexisting disability or impairment, plus your subsequent injury, must result in a minimum permanent disability of 70%
What Types of Previous Injuries or Illnesses Qualify as Preexisting?
Preexisting conditions that you suffered from that come from any source, including acquired illness or disease, congenital or developmental diseases, war or other situational injuries, or prior industrial disabilities, up to the date of the new workplace injury may qualify, including those relating to:
- Arthritis
- Auto-immune diseases
- Balance issues
- Cancer
- Chronic pain disorders
- Circulatory issues
- Dental issues
- Diabetes
- Gastrointestinal diseases or disorders
- Hearing issues
- Heart or cardiovascular illnesses
- High blood pressure (“hypertension”)
- Orthopedic or musculo-skeletal injuries or disorders
- Sleep issues
- Vision issues
How Does the Process of Receiving Compensation Begin?
- Fill out a special application with the help of an experienced workers’ comp attorney
- Attend one or more Qualified Medical Evaluations
- Remain in touch with your case manager or work comp attorney for the next steps
UNDERSTANDING MORE ABOUT THE SIBTF FUND
Purpose of the SIBTF Fund
The fund was established to provide a way for employers to freely hire persons who have a disability or other impairment due to illness or disease without fear of being held liable for workplace injuries that might occur.
As a source of additional compensation to injured workers with a preexisting disability or impairment at the time that the labor-disabling injury occurs (but not necessarily caused by the preexisting condition), specific criteria must be met.
Unknown Preexisting Conditions
You might qualify for SIBTF compensation even if your preexisting condition was not known to you at the time of the on-the-job injury. In some cases, preexisting injuries are discovered by the workers’ comp physician who performs the post-injury examination. Some common examples of conditions that exist yet are unknown include fibromyalgia, degenerative disc disease, and other orthopedic conditions of the spine and joints, etc.
Proving a SIBTF Case
Eason & Tambornini has helped many clients like you through these complicated claims. With the help of experienced workers’ compensation attorneys like ours, an applicant who can demonstrate the following elements* may receive compensation from the fund:
- The occurrence of a compensable workplace injury
- The existence of a permanent partial disability at the time of the workplace injury
- The combined disability resulting from the preexisting condition plus the subsequent injury is greater than the disability from the subsequent injury alone
- The combined disability from the preexisting condition and the subsequent injury equal at least 70% of total permanent disability
- The disability from the subsequent workplace injury equals at least 35% of the total disability (before adjustment for age or occupation).
- *An experienced WC attorney can explain other qualifying factors
How Long Does it Take to Settle a SIBTF Claim?
Once your application is received, the Division of Workers’ Compensation sends all Claims for Compensation to the State of California Attorney General. The AG’s office then has 30 days to respond. After that, they will file an Answer to the Claim for Compensation.
It is important to note that many factors can affect the claim outcome and the time it takes to complete the claim process. For this reason, it is essential to find an experienced attorney who understands the many facets of this specific type of case law.
Where the Money Comes from
All employers in California who carry insurance pay various surcharges, one of which funds the SIBTF. As funds are available, recipients are issued payouts directly by the State of California, not the injured person’s employer.
Fund Payments vs. Medical Expenses
Qualified recipients receive “indemnity payments” in the form of cash disbursements. There is no award for or entitlement to medical treatment through the fund.
Deductions and Credits
Per California Labor Code Section 4753, some deductions and credits are mandatory when calculating fund benefits. These include deductions from Social Security Disability Benefits (SSDI), prior Workers’ Compensation awards, and previous personal injury claims.
If the SIBTF Case is Settled
After all the paperwork has been submitted, applicants may be notified that their case has been settled. Two settlement options are possible:
- Stipulated Award: benefits are paid out over time in separate payments
- Compromise and Release: a one-time, lump-sum payout
If the Case Goes to Trial
If the applicant’s case is not settled, there is a legal process for completing the claim, including a trial before a special judge. The fund administrators may appeal any resulting decision. Eason & Tambornini attorneys have helped many other SIBTF applicants through this specialized process and are ready to help you.
Just to remind you, not all attorneys are experienced in SIBTF cases. Only some are due to the complex nature of these claims. The workers’ compensation professionals at Eason & Tambornini are ready to answer your questions about the specifics of your case at no cost.
