Application For Subsequent Injuries Fund Benefits

APPLICATION FOR SUBSEQUENT INJURIES FUND BENEFITS. This form is used in the state of California by employees who have a pre-existing disability or medical condition that is worsened or aggravated by a work-related injury. The form is used to apply for benefits from the Subsequent Injuries Benefits Trust Fund (SIBTF). The SIBTF is a program administered by the California Division of Workers' Compensation that provides benefits to employees who have a pre-existing permanent disability or medical condition that is aggravated by a subsequent work-related injury. The program is designed to encourage employers to hire individuals with pre-existing disabilities by limiting the liability of the employer for the pre-existing disability. The Application for Subsequent Injuries Fund Benefits requires the employee to provide information about their pre-existing disability or medical condition, as well as information about the subsequent work-related injury. The form also requires medical documentation supporting the employee's claim that their pre-existing disability or medical condition was worsened or aggravated by the work-related injury. www.FormsWorkflow.com