When you sustain a work-related injury, but already have a previous injury or disability, you may have a claim against the Subsequent Injuries Benefits Trust Fund (SIBTF), so long as the combined total of your disability is above 70%.
In order to qualify for California’s SIBTF, the current industrial injury has to amount to at least 35% disability or at least 5% if there’s a corresponding opposite body part. The idea behind this fund is for the State of California to pay handicapped employees or workers who suffer any subsequent industrial injury.
While records have shown a rising number in workers’ compensation claims seeking benefits from the SIBTF, under California’s Labor Code § 4751, the process of claiming from this SIB fund is often complex. Unfortunately, not all attorneys who deal with work-related injury cases handle SIBTF claims.
So, what is a subsequent injury trust fund in California? We’re going to look at some of the most critical things you should know.
Understanding the Legislative Intent of Labor Code § 4751
The legislative intent of California’s Labor Code § 4751 was to allow workers with any pre-existing disabilities to have the right to obtain any gainful employment without an employer having any concerns regarding economic responsibility for a worker’s pre-existing condition, should they incur a work-related injury that may cause the pre-existing disability to worsen. Despite this, there was a need to have a legal mechanism in place to assist workers should their disability increase. This is where the SIBTF comes in.
With the complexity of understanding Labor Code § 4751, litigators often find it hard when it comes to deciding how to prepare a SIBTF case for trial. Understanding the code is critical to providing litigators the necessary guidance when dealing with issues presented by the statute, as well as guiding workers who are eligible as to the right steps to take.
The SIBTF Threshold
The SIBTF has two main elements. The first one is that the worker’s permanent disability must be determined at a specific disability level from the present worker’s industrial injury. Second, the injured worker or employee must have a verifiable and credible pre-existing disability, medical condition or surgery, which in one way or another, limited them in seeking employment in the labor market. If all of these conditions exist, an injured worker may be entitled to lifetime benefits through the SIBTF.
However, to qualify for the SIBTF funds, the worker has to meet some of these conditions:
- They must have a pre-existing permanent disability which can either be industrial or non-industrial in origin
- They must have a verifiable subsequent industrial disability
- The disabilities combined must be greater than what the worker’s disability would have been if only the subsequent injury had been suffered and not the pre-existing one
- The two disabilities when combined must be equal to at least 70% or more
It’s important to note that even if you qualify, the fund can claim credit for social security disability insurance payments as well as disability pensions. Being familiar with the SIBTF threshold is a critical part of understanding a subsequent injury trust fund in California.
Why an Applicant Attorney Should do SIBTF
In workers’ compensation cases where an injured worker qualifies for the SIBTF, it’s the norm to find only a few lawyers who are willing to take the path of doing SIBTF. For lawyers who want to get the best for their clients, the fund can get an injured worked the much needed additional benefits for the duration of the lives. By doing so, clients can live a much better quality of life and have less stress.
Beyond this, attorneys usually receive a portion of the SIBTF payout of the claim which is also subject to “Cost of Living Adjust” increases as deemed appropriate. Any injured worker who meets the SIBTF threshold is entitled to receive the fund benefits. If an attorney is not willing to help them get the benefits, they are free to seek the services of an experienced and knowledgeable applicant attorney who is ready and willing to help them with SIBTF.
Pre-Existing Disability Must be “Labor Disabling”
In order for a worker to qualify for the SIBTF benefits, they must be able to prove that prior to the subsequent industrial injury, they had attained the factual status of the permanently partially disabled as per California’s laws, and that such previously known disability was labor disabling. However, the previous knowledge by the employer is not required as a legal condition to award the employee benefits from the SIBTF.
Statute of Limitations for SIBTF Cases
There is no specified statute of limitations that directly applies to SIBTF cases, but the applications must be filed within a reasonable time frame. Otherwise, understanding what is a subsequent injury trust fund in California for the average worker can be complex, unless they work closely with an informed applicant attorney.
If you’re an injured worker with a previous disability and have an applicant attorney representing you, it’s important to inquire about SIBTF. In the process of getting the benefits, an independent evaluation is usually done to prove the pre-existing or subsequent injury. In regards to this, working with the right independent medical evaluators is critical. At Arrowhead Evaluation Services, we provide the most comprehensive independent medical evaluation services to attorneys and their clients to help them answer complex questions related to SIBTF cases.