Subsequent Injuries Benefits Trust Fund Lawyer in Los Angeles

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Navigating the complexities of the Subsequent Injuries Benefits Trust Fund (SIBTF) can be overwhelming, especially for workers dealing with the compounded effects of a new injury and a pre-existing disability. Every worker deserves fair compensation for the full extent of their disabilities. The process of proving that the combined effect of these injuries has resulted in a permanent disability of at least 70% can be daunting. It’s crucial to ensure that all necessary steps are taken, from reporting the injury to properly filing claims, to secure the lifetime benefits that can provide financial stability for injured workers who may no longer be able to work.

What is SIBTF?

The State of California Subsequent Injuries Benefits Trust Fund (SIBTF), also known as SIF, is a state-administered fund that compensates workers whose combined disability from a work injury and a pre-existing condition reaches a certain threshold. Funded by workers’ compensation insurance premiums paid by employers, SIBTF is not taxpayer-funded. Despite its importance, SIBTF is relatively unknown, even among some attorneys representing injured workers. A very small percentage of these attorneys have experience handling SIBTF cases or understand how to qualify for these benefits.

It’s important to note that the SIBTF does not compensate for the subsequent injury itself—your workers’ compensation case covers that. Instead, the SIBTF provides benefits for the compounded effect of the subsequent injury when combined with a pre-existing disability. Given the complexity of SIBTF, it might be more appropriately named the “Pre-existing Injuries Combined with Work Injuries Fund.”

How to Qualify for SIBTF Benefits

To qualify for SIBTF benefits, you must meet two key thresholds:

1. First Threshold: Disability from the Work Injury
   • Option 1: You can qualify if your work injury results in a disability rating of at least 35% when your Whole Person Impairment (WPI) is multiplied by 1.4. For example, a minimum WPI of 25% would satisfy this requirement (25% x 1.4 = 35%).
   • Option 2: If your WPI is less than 25%, you may still qualify if your injury affects an eye, arm, hand, leg, or foot and results in a disability of at least 4% WPI (4% x 1.4 = 5.6%). This injury must affect an extremity or eye and combine with a pre-existing disability in the “opposite and corresponding” body part (e.g., a left leg injury combined with a pre-existing right leg disability).
2. Second Threshold: Combined Disability
   • Once you meet the first threshold, the combined disability from your work injury and pre-existing conditions must total at least 70% to qualify for SIBTF benefits. The combined disability is calculated using the same methods as the disability from the work injury, according to the AMA Guides to Impairment, 5th Edition.

How to Request SIBTF Benefits

To apply for SIBTF benefits, you must file an application with the Workers’ Compensation Appeals Board (WCAB), the same court that handles your workers’ compensation case. The WCAB has jurisdiction over SIBTF cases and will review your application to determine if you meet the threshold requirements. You can obtain the SIBTF Application for benefits online through the Department of Industrial Relations (DIR) website.

Do I Have to Use My Workers’ Compensation Doctor’s Reports for My SIBTF Case?

No, you are not required to use the same doctors who evaluated you for your workers’ compensation case. You can seek new medical evaluations from a doctor who understands SIBTF issues. In many cases, additional medical reporting is necessary to support your SIBTF claim. The SIBTF typically covers the cost of these evaluations, whether or not you ultimately qualify for benefits

What is the Value of My SIBTF Case?

he value of your SIBTF case depends on your overall disability rating. If you are 100% disabled, SIBTF will pay 66% of your earnings—the same rate as temporary disability (TD) benefits in workers’ compensation. For disabilities between 70% and 99%, payments are made on a sliding scale, increasing with the level of disability. An experienced workers’ compensation attorney can provide an estimate based on your specific disability rating and earnings history.

Service Offering: Comprehensive legal services are available to assist injured workers in securing benefits from the Subsequent Injuries Benefits Trust Fund (SIBTF). These services include:

1. Initial Consultation and Case Assessment: A detailed evaluation of your case to determine eligibility for SIBTF benefits, assessing the impact of your recent injury in conjunction with any pre-existing disabilities.
2. Claims Management: Assistance with reporting your injury to your employer, demanding necessary medical attention, and ensuring your employer initiates the workers’ compensation claim. This includes meticulous handling of all documentation and filing requirements to avoid delays or denials.
3. Coordination with Other Benefits: Assessment of the impact of any other payments you may be receiving, such as SSDI or other compensation claims, with strategies to maximize your SIBTF benefits.
4. Appeals and Litigation Support: Robust representation through the appeals process if your SIBTF claim is denied or disputed, including taking your case to trial if necessary. The goal is to secure the benefits you deserve and ensure you receive them for as long as needed.

These services are designed to help you navigate the complexities of the workers’ compensation system, ensuring that you receive the full scope of benefits available under the law. Advocates are ready to assist in achieving financial stability and peace of mind after a life-altering injury.