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How to Claim SIBTF Benefits?

On behalf of Mitchell Law Corporation
November 10, 2023

California’s Subsequent Injuries Benefits Trust Fund (SIBTF) is a special fund managed by the California Division of Workers’ Compensation (DWC) that exists to provide specific relief to workers who suffer exacerbated preexisting conditions. The California SIBTF ensures that if a worker already had an injury or disability and is further harmed at work, they can receive additional benefits beyond their initial workers’ compensation settlement.

Filing a Claim for SIBTF Benefits

Workers’ compensation benefits can be an invaluable lifeline for anyone who sustains an injury on the job in the state. However, there are limits to what you can reasonably expect from a successful workers’ compensation claim. Additionally, the benefits you receive will only apply to the specific injury. The SIBTF is separate from workers’ compensation but can work in tandem with a workers’ compensation benefits determination to enhance your recovery.

While any work-related injury has the potential to be severely damaging in many ways, it is also possible for an industrial injury to exacerbate a preexisting disability or medical condition. In some cases, these preexisting conditions aren’t discovered until a new injury has made them worse. It is also possible for a new injury to result in a disability that makes a preexisting disability even more challenging despite it affecting a separate part of the body.

How to Claim SIBTF Benefits?

The SIBTF exists to address these situations, offering affected workers an avenue of compensation if their most recent injuries have made preexisting conditions worse. The amount you can receive in SIBTF benefits depends on the values of your most recent disabling injury and the combined disability resulting from the most recent injury and your preexisting condition.

An experienced attorney can be an invaluable asset for your SIBTF claim filing process. While this benefits option can be invaluable for anyone who has developed a combined disability from a recent work injury and a preexisting condition, the reality is that the calculations and procedural steps involved in the claim can be very challenging. When you have experienced legal counsel on your side, you can approach your claim with confidence.

Qualifying for SIBTF Benefits

If you are unsure whether you qualify for SIBTF benefits, it’s vital to contact an attorney you can trust to help determine your eligibility. The SIBTF pertains to combined disability from work-related injuries and preexisting conditions. Commonly cited preexisting conditions in these claims include fibromyalgia, herniated vertebral discs, cancer, diminished sensation, and partial blindness.

There are two main formulas used to determine eligibility, and your total combined disability rating must be 70% or more. The first is the 35% rule, meaning that you can qualify for SIBTF benefits if your total permanent disability from your most recent injury is 35% or more and you have a preexisting condition. The second pertains to injuries to the extremities or the eyes. This is the opposite and corresponding requirement.

An individual qualifies if their preexisting permanent disability affects a hand, foot, limb, or eye, and their new injury affects the opposite and corresponding member with a 5% or greater increased disability. For example, if you are 35% disabled on your left side from a preexisting condition and suffer a 40% disability on your right side from a new injury, it would satisfy the opposite and corresponding requirement.

It is difficult to provide an estimate or average of how much you can likely expect in SIBTF benefits due to the fact that these cases fluctuate on a case-by-case basis. Benefits determinations also consider the time that has passed since the claimant began experiencing their combined permanent disability. An SIBTF benefit award may be paid over time in a stipulation award or in a one-time lump sum payout through compromise and release.

FAQs

Q: What Do SIBTF Benefits Include?

A: SIBTF functions differently than standard workers’ compensation benefits and aims to augment these benefits. The SIBTF provides compensation for the combined permanent disability resulting from the claimant’s most recent injury. This can be a complex calculation, and the amount you have already received in workers’ compensation benefits will influence how much you can receive in SIBTF benefits.

Q: How Do You Qualify for SIBTF Benefits?

A: An individual qualifies for SIBTF benefits if they have a preexisting disability that predates their most recent industrial injury, and it does not matter whether they only recently discovered their preexisting condition. If their combined disability rating from their preexisting condition and their new injury is 35% or greater, or if they have suffered injuries to both sides of their body (such as both eyes or both hands) and one side is 5% or more disabled than the other, they qualify.

Q: What Is the Statute of Limitations for an SIBTF Claim?

A: There is no statutory time limit for filing a claim for SIBTF benefits. However, the claimant should file their claim for SIBTF benefits within a reasonable time after discovering the full extent of their disability. It is generally advisable to file your claim for SIBTF benefits as soon as you determine that you qualify.

Q: Are SIBTF Benefits Taxable?

A:
No, SIBTFs are similar to workers’ compensation benefits in that they intend to compensate for a loss and do not qualify as earned income. Therefore, the SIBTF benefits you receive are not taxable at the state or federal levels.

Q: Should I Hire an Attorney to File a Claim for SIBTF Benefits?

A: The SIBTF has more stringent eligibility requirements than a standard workers’ compensation claim, and gathering the documentation you will need to file your claim successfully can be more challenging than you might expect. Having a seasoned Subsequent Injuries Benefits Trust Fund lawyer assist you will make the claim filing process much easier, and you will have a legal advocate readily available to help should you encounter any unexpected problems with your claim.

The attorneys at Mitchell Law Corporation strive to help every client we represent maximize the benefits they obtain from their workers’ compensation claims and related legal efforts. If you have recently discovered that your latest industrial injury has exacerbated any preexisting medical condition, you may be eligible to claim SIBTF benefits. Contact Mitchell Law Corporation today to learn more about the legal services we offer.

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