What Is the Subsequent Injuries Benefits Trust Fund?
Many injured workers have never heard of the Subsequent Injuries Benefits Trust Fund (SIBTF), and this lack of knowledge costs them a lot of money that they are legally entitled to. The state runs the SIBTF fund, which gives extra money to workers who had a permanent disability before getting hurt on the job.
The fund exists for a specific policy reason: to get employers to hire people with disabilities. The “grand bargain” of workers’ compensation says that an employer is only responsible for the injury that happens at work if the worker has a disability from before. The state pays the difference when the combined disability is bad enough to meet the eligibility threshold. Employer assessments for SIBTF have gone up from about $14 million in 2015 to more than $850 million in 2025. This is a 6,000% increase that has raised serious questions about the fund’s long-term viability.
AB 1329 and other budget bills that are currently being considered will make changes that will help deal with a projected debt of between $7.9 billion and $10.5 billion. It’s important for any worker with a pre-existing condition who has been seriously hurt at work to know what is changing and what is still available.
The 70% Combined Disability Threshold Is the Main Requirement
The 70% Rule Explained
According to California Labor Code §4751, a worker can get SIBTF benefits if the total permanent disability (PD) from their pre-existing condition and their new job injury is at least 70%. It’s important that the level of disability from the combination is higher than the level of disability that would have come from the new injury alone. Adding two ratings together isn’t enough; the result must be significantly worse than what would have happened if the injury had happened on its own.
How to Figure Out Combined Ratings
The “Combined Values Chart” (CVC) is a formula used by California’s Permanent Disability Rating Schedule that doesn’t allow for simple addition and instead shows how stacked disabilities lose value over time. In Todd v. SIBTF, a decision from 2020, doctors were allowed to use a different “additive method” to reach the 70% mark. This made it easier to prove eligibility in borderline cases. One of the main goals of the 2026 reform law is to get rid of the Todd additive method. Workers who have claims pending should know that this way of calculating may not be available in the future.
The 35% Requirement for the New Work-Related Injury
The new industrial injury must have a permanent disability rating of at least 35% on its own, without taking into account age or occupation or dividing the rating between industrial and non-industrial factors. This requirement for a separate rating makes sure that SIBTF is not used to cover up minor injuries. The new workplace injury must be a serious and significant impairment on its own.
One important exception is when the new injury and the pre-existing disability affect opposite and corresponding body parts. For instance, if someone has a pre-existing left knee condition and then hurts their right knee, this would be an example. In that case, the new injury only needs to be rated at 5% to meet the threshold. This exception acknowledges that bilateral impairments exacerbate functional limitations in ways that the standard rating may not completely encompass.
What Does It Mean for a Disability to Be “Labor-Disabling”?
The Standard Right Now
According to the Ferguson decision from 1958, a pre-existing condition didn’t have to cause actual wage loss to be considered a prior disability. It only had to be “ratable,” which meant that it could be looked at like an industrial injury. This standard made it possible for many different conditions to qualify for SIBTF. Almost 70% of current SIBTF claims list chronic conditions like acid reflux, high blood pressure, arthritis, sleep apnea, and diabetes as the qualifying pre-existing disability.
What the Changes in 2026 Would Mean
The proposed changes for 2026 would make the definition of “labor-disabling” much more specific. The new standard says that a pre-existing impairment must show proof of lost earnings, interference with work activities, or a clear effect on the ability to work. If a worker could work without being disabled, conditions that are controlled by medication, like managed hypertension or treated sleep apnea, would no longer count. The reforms also say that vocational reports or retroactive work restrictions can’t be used to prove that someone was disabled before the injury happened; instead, the condition must be documented in medical records that were already in place.
The “Second-Chance” Fund Reform of 2026
Pending legislation, mostly AB 1329 and related budget trailer bills, would change the name of SIBTF to the “Second-Chance Employer’s Risk Reduction Trust Fund” and make the biggest structural changes to the fund in decades. The changes would also make the definition of pre-existing conditions that make it impossible to work more strict and focus on the Todd additive method. They would also set a new deadline for filing SIBTF claims: they must be filed within five years of the injury or six months after the permanent disability issue is resolved, whichever comes later.
The changes would also end the current practice of letting both sides in SIBTF cases submit reports from their own medical experts. Instead, the law suggests that neutral QME evaluations be required. This would make SIBTF more like the standard medical-legal process for workers’ compensation. One of the most important proposed changes for workers with high-value claims is getting rid of the 1.4 modifier that was used to figure out eligibility after 2013. This could make it much harder to reach the 70% and 100% disability tiers.
What This Means for Pensions for People With Permanent Disabilities
A worker is eligible for a life pension, which is a benefit that lasts for the rest of their life, when their combined PD rating is between 70% and 99.75%. If a worker has a 100% total disability rating, they will get payments for the rest of their life at the total disability rate. For 2026, this rate is $1,764.11 per week. Every year, these lifetime benefits get cost-of-living adjustments (COLA) based on the State Average Weekly Wage (SAWW).
SIBTF benefits add to, but do not replace, standard permanent disability payments from workers’ compensation. The employer is still responsible for the PD that comes from the new industrial injury. The fund pays for the extra compensation that comes from the combined, more serious impairment. When looking at the overall value of a high-disability claim, it’s important to know the difference between benefits paid by the employer and benefits paid by the fund.
Steps in the Process and Technical Problems
When and How to File
When you file a SIBTF claim, you are suing the state, not your employer. Most of the time, the case is heard by the Workers’ Compensation Appeals Board (WCAB) after the main workers’ compensation case has been settled or the permanent disability rating has been set. One of the most common mistakes is filing too soon, before the PD rating is set in stone. If you file too late and miss the five-year window set by the 2026 reforms, your claim could be permanently denied.
Why These Claims Are Very Technical
SIBTF claims are hard to deal with because they involve complicated math for rating, arguments over whether previous conditions meet the labor-disabling standard, issues with dividing up the claim, and, since the 2026 reforms, stricter rules for proving that someone was already disabled. SIBTF proceedings currently allow each party to submit expert medical reports instead of going through the QME panel process, which is not the case with standard workers’ compensation claims. However, this practice is set to be phased out. Early legal analysis is important to find out if you qualify, keep the right evidence, and avoid mistakes in the process that could make a claim that would otherwise qualify invalid.
Conclusion: How to Get Through SIBTF in 2026
The 70% combined disability threshold is still the biggest problem with any SIBTF claim. To meet it, there must be a new industrial injury that rates at least 35% on its own, a qualifying pre-existing disability that made it hard to work, and combined rating calculations that can stand up to the stricter rules that will be in place in 2026. The proposed changes don’t get rid of the fund, but they make it harder to get to, raise the bar for evidence, and set new deadlines that make it more important than ever to get legal help early.
People who have had disabilities in the past and get hurt badly at work should not assume they are either qualified or disqualified without a full technical evaluation. The quality of the paperwork and when you file your SIBTF claim can make the difference between getting what you want and missing out.
Call ODG Law Group for a Private Case Review
If you were already disabled and then got hurt badly at work, you might be able to get more money from the Subsequent Injuries Benefits Trust Fund. The 2026 reforms make these claims more complicated and put them under more scrutiny. Early legal analysis can figure out if someone is eligible before important deadlines pass.
ODG Law Group has been helping injured workers in Glendale and Fresno with complicated permanent disability and SIBTF cases for more than ten years. They are experts in high-value, technically difficult workers’ compensation litigation. Please call our office for a private review of your case.
