Many people have health conditions that they manage with medication, lifestyle adaptations, or other methods. When treated properly, these conditions may not greatly affect their ability to work or do their jobs, while in some cases they do.
Sometimes, though, a subsequent work-related illness or injury when combined with a pre-existing condition may make working much more difficult. The combined effect of the work-related condition and a pre-existing health problem could leave you unable to work.
Usually, Workers’ Compensation only pays for occupational illness or injury—conditions arising from your work. However, when the occupational condition affects a pre-existing health problem and results in a significant disability, Workers’ Compensation may offer relief. A successful claim against the Subsequent Injury Benefit Trust Fund (SIBTF) in California could provide you with the disability payments you need to get back on your feet. Contact a Workers’ Compensation attorney for help presenting your case.
According to the California Labor Code §4751, an individual is eligible for SIBTF benefits if they have a pre-existing, permanent partial disability and then suffer an occupational illness or injury that causes partial permanent disability. The individual’s total disability must be at least 70 percent. They qualify for SIBTF benefits if the most recent occupational injury causes at least 35 percent in most cases.
However, the work injury does not need to meet that threshold if (1) the pre-existing condition affects a limb or an eye, and (2) the recent occupational injury or illness involves the opposite corresponding body part and causes at least 5 percent disability. For example, a person with a pre-existing eye disease that left them 40 percent blind in their left eye could be eligible for SIBTF if they suffer a work-related injury to their right eye that leaves them with five percent or more impairment to that eye.
A California attorney could evaluate a specific worker’s history to determine whether they meet the requirements for SIBTF benefits.
When a work-related injury leaves an employee with a permanent disability, Worker’s Compensation pays them benefits based on the body part affected and the degree of disability. When a pre-existing condition increases the total degree of disability, an eligible worker could receive some additional benefits from the SIBTF.
The employer would be responsible for paying disability benefits based on the impact of the work injury or illness alone. The SIBTF would pay supplemental benefits based on the difference between the disability caused by the most recent occupational impairment and the worker’s total disability.
SIBTF pays lifetime benefits in most cases. However, the amount the SIBTF offers varies depending on whether an individual also receives Social Security or other benefits for their pre-existing condition. A California attorney could evaluate a specific worker’s case and estimate the amount the SIBTF might pay.
A worker makes an initial claim for SIBTF by filling out an application and submitting it to the local Workers’ Compensation Appeals Board. The application requires a description of the current work-related injury and the pre-existing condition that caused permanent partial disability. The Board might hold a hearing to consider the worker’s application.
It is often advantageous to obtain medical reports from doctors familiar with the SIBTF and the issues the Board needs to consider when deciding whether to approve benefits. A California attorney with experience working with SIBTF applicants could recommend one or more physicians to provide medical reports supporting the application. The SIBTF pays for the exams, even if the Board ultimately decides the worker does not qualify for compensation.
The SIBTF could be a valuable source of additional support for workers with pre-existing partial, permanent disabilities. However, eligibility requirements are complex, and the application process is difficult for a worker to navigate without professional assistance.
If you believe you might be eligible for the Subsequent Injury Benefits Trust Fund, call a local attorney today. They could help you prepare your application to receive the benefits you have earned.