Subsequent Injuries Benefits Trust Fund (SIF)
One often overlooked aspect of workers compensation claims is the Subsequent Injuries Benefits Trust Fund (fka Subsequent Injuries Fund or SIF). The SIF was established to encourage employers to hire employees with prior disabilities by providing coverage for the effects of pervious disabilities or impairments. For example, a job applicant with asthma applies for a job as a truck driver. He subsequently injures his low back loading a truck and files a workers compensation claim. When he is examined by a Qualified Medical Examiner his asthma is noted and rated. However, the asthma pre-existed his employment as a truck driver. If he meets the requirements of the SIF, his asthma is combined with his low back injury to create a higher disability and benefits are paid by the SIF.
The SIF can also come into play when someone has previously filed a workers compensation claim. If the two claims combined to rate 70% or more and the second injury is at least 35% WPI without adjustment for age and occupation, the two separate injuries can be combined. Or if there was a previous disability of 5% or more in the hand, arm, foot, leg, or eye and the new injury is to the opposite body part. For these later opposite body part injuries, adding the first injury can significantly increase disability payments because there is no issue of apportionment etc.
In order to proceed against the SIF, a party must file an application stating the basis of the SIF claim and petition the court to join the SIF as a party. The SIF then monitors the claim until the case is settled, then steps in to pay benefits along with the carrier, who is still responsible for providing medical treatment. The SIF only pays permanent disability.
One of the most exciting cases to issue in the last several years was the Panel decision of Gilbert Lopez vs City and County of San Francisco in February 2015 Cal. Wrk. Comp. PK Lexis 46. In that decision, which was upheld by the WCAB, the court found a Diminished Future Earnings Capacity (DFEC) over 35% qualified the applicant for SIF benefits because the DFEC was a part of the rating string not disqualified by the legislature in calculating impairment for obtaining SIF benefits. In other words, a 50% loss in earnings met the 35% WPI standard for obtaining SIF benefits. The significance is that many workers are injured and have a significant loss of earnings but fail to qualify for the SIF based upon actual physical injuries, but do when earnings loss is considered.
Unfortunately, the SIF does not make lump sum payments, which does not matter in a 100% case. Further, if you want to close your case by Compromise & Release, the SIF pays less than most carriers.
Certified Specialist workers compensation
California Board of Legal Specialization