When a worker is injured on the job in California, the employer’s insurance policy will pay that worker compensation for their injuries. If the worker is partially disabled, then the worker can get benefits (compensation) for that disability.
But what happens when an already disabled worker (or a worker with pre-existing injuries) gets injured and is now totally disabled? Does the most recent employer pay for the permanent disability for the rest of the worker’s lifetime? If so, why would an employer hire someone who has a previous disability coming into the job?
To help those who are already disabled, or have pre-existing conditions that add to their disability, the State of California set up the Subsequent Injuries Benefits Trust Fund (SIBTF), also called Second Injuries Fund, to help pay for the disability payments so a new employer doesn’t have to pay for the whole disability.
A typical example is a worker who is partially disabled with a 25 percent permanent partial disability rating to the body due to a back injury. This employee started a job with that condition and is injured on the new job, but without the previous injury, the worker would not be completely disabled, but now is.
The new employer would only be responsible for the percentage of disability caused by the new injury (even though the totality of the injuries suffered by the worker over his/her lifetime has caused permanent total disability). Without the fund, the employee, who is unable to work in any capacity, would only receive the limited compensation reflected by the latest injury with the new employer.
So, any employee with a pre-existing disabling condition who suffers a subsequent work injury that results in greater (see below) or total permanent disability may qualify for SIBTF.
To be eligible, the worker must have had a previous disability and then become injured on the new job. If both disabilities add up to over 70 percent of total disability, then the SIBTF will pay for the percentage of disability payments that are equal to the previous injury.
After the second injury, the worker has a deadline to make a claim for SIBTF payments. Usually, the SIBTF claim is made after the conclusion of the workers’ compensation claim, although this is not a requirement. A medical evaluation will then be arranged by our office. Based on the medical evaluation (report) and other pertinent medical records, a committee will decide if the worker qualifies for additional benefits through SIBTF and will issue an award.