Subsequent Injuries Benefit Trust Fund (SIBTF)In this blog article, I am going to talk about SIBTF. That stands for Subsequent Injuries Benefits Trust Fund.
What is SIBTF?
This is a common issue missed in many workers' compensation cases. You'll have somebody that has a workers' compensation claim and they have a certain amount of disability in that claim and they have pre-existing disability usually caused by something that's unrelated to the workers' compensation injury that was present before the injury.
An example would a worker’s compensation injury to the back that it affects your legs; you're not able to do a lot. That injury put you “over the edge” on being able to function when combining that back injury with your pre-existing conditions. SIBTF may be applicable in this situation and could help this injured worker with the pre-existing conditions.
For example, I've had clients with diabetes, heart problems, people with depression and anxiety that have been functioning in the workforce; using the example of the back injury, this person has to deal with the back problem and the pre-existing diabetes, heart problem, and/or depression and anxiety. That person really can't do much of anything or is severely restricted from the job market.
If you look closely at the pre-existing conditions (usually anxiety and depression), I’ve had clients who (because of the anxiety and depression) were precluded from a great deal of the job market and ended up only finding laborious jobs. In many cases, it was the only place they could work based on their emotional issues (they can’t deal with people in an office, service, or retail job). Then the work injury happens such as a bad back injury. You have to ask yourself as an attorney: “What can this person do now?”
If you think you're eligible and you have an attorney, you want to discuss this Fund with your attorney. If you don't have an attorney and you think you may be eligible, you need to contact one; These are very complicated cases and sometimes the way you handle the underlying workers' compensation case (for example, the back injury), needs to be handled maybe a little bit differently if SIBTF is involved.
How does the qualification work?
Your regular workers’ compensation case will get a rating or percentage of disability. If the doctor’s report says anything over 25% medical impairment (this number comes from the report and not from the calculation that you may be performed by a State Rater or your Attorney, because that number isn’t the number we use.)
If you have a prior injury or medical problem that affects a leg such as diabetic neuropathy and then a back injury that affects the other leg (and you are severely disabled overall), then you could be eligible for the fund even if you don’t see a number above 25% in your medical report.
Where does prior health conditions and accidents come from?
Prior auto accidents Prior military service Prior disabilities you were born with Prior workers’ compensation claims Prior health conditions
What is labor disablement?
Many State lawyers that represent the Fund will argue that each prior condition must be labor disabling meaning that it must have affected your ability to perform work in the job market. If I have somebody that has diabetes, we must show that the diabetes affects the person in the labor market. You may say, "Well, I don't know that diabetes affects me in the job market. I've been working in jobs all my life with diabetes. It's never been a problem.” That doesn't mean it's not labor disabling.
You are harder to employ than somebody without diabetes. I have a lot of my clients (using diabetes as an example but it could also be a heart condition, prior physical injury, mental injury, etc.), with diabetes on insulin. Diabetes is a roller coaster for their A1Cs. It can affect the way they think cognitively. They can feel tired. They have to take more breaks. They have to take more bathroom breaks. There's all kinds of things that impact employability.
That's all labor disablement because these are things that a future employer has to deal with and although it may not have been a problem until the injury, it’s a problem now. When you add the new workers’ compensation injury to the pre-existing problem, then you are much less employable than the person who only had the back injury.
Social Security Disability
If you’ve applied (and more importantly) been approved for Social Security Disability (this is the benefit that some are eligible for before retirement age) after a workers’ compensation injury, then the Fund should be investigated.
Credits and Offsets
If you are eligible for the Fund, then the Fund will avoid you getting a “windfall” and being paid by other agencies. They get credits for:
- Social Security Disability
- Industrial Disability Retirement (police, firefighters, CHP, correctional officers, etc.)
- Disability Retirement
- Prior auto accidents used to quality
- Prior workers’ compensation injuries used to qualify
They don’t get credits for:
- Veterans Disability
- Social Security Retirement Benefits
That's it in a nutshell. I wanted to cover the Fund because I get a lot of questions about (from clients and attorneys). It's something that I see a lot of in my daily practice. If you don’t have an attorney and you think you may be eligible for the Fund, please contact our office.