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Am I Entitled to Any Benefits After My Workers’ Compensation Case Closes?

My workers’ compensation case is closed. Does that mean everything is over? Are there any other benefits in the workers’ compensation system that I am entitled to?

You should ask yourself these questions because you may be able to access additional benefits after your workers’ compensation case closes. These benefits are known as Subsequent Injury Benefits Trust Fund (SIBTF) benefits. They are provided by the State of California to injured workers to compensate them from the combined effects of their pre-existing disabilities and work related injuries where the work injury was only a part of a more serious overall disability.

To be clear, your employer and the insurance company that you dealt with during your workers’ compensation claim are not involved in SIBTF claims. SIBTF benefits are paid out from a state-supervised trust that is funded by surcharges imposed upon employers in proportion to their payrolls.

The next question is, how do you know if you are entitled to these benefits? There are three requirements you must meet to qualify for SIBTF benefits.

(1) The first requirement is that you need to have a pre-existing disability. Here are some examples of situations that meet this requirement:

  • A disability resulting from a prior workers’ compensation injury with your same employer
  • A disability resulting from a prior workers’ compensation injury with a different employer
  • A disability resulting from a prior injury unrelated to work (e.g. a car accident)
  • A disability related to an internal medicine condition arising before your workers’ compensation injury (e.g. a heart condition you were born with)
  • A disability related to mental capacity (a neurological, cognitive, or psychological condition) you developed before your workers’ compensation injury 

(2) The second requirement is that your disability rating from your most recent workers’ compensation case must be substantial. To be substantial, the disability must meet a certain ratable level. If you received a disability rating in your workers’ compensation case, this can help in the assessment. This can be tricky to identify, but at GG&F, we are here to help you determine which benefits you are eligible for, so feel free to reach out to us with any questions. Some exceptions may apply, which is why you may want to consult an attorney to determine if you are eligible for the benefit.

(3) The third requirement is that your overall disability rating (including your pre-existing disability and the disability resulting from your workers’ compensation injury) must be severe. To be severe, the disability must be rated at or above a certain level, often preventing any future employment. Again, we can help you determine whether you meet this requirement.

Even after your workers’ compensation case is closed, you still may be entitled to additional benefits, such as SIBTF benefits. If you have any questions, give us a call at 805-214-8888 or fill out our Contact Us form.