A recent court decision has significant implications for workers seeking subsequent injury benefits in California. On July 15, 2024, the Subsequent Injuries Benefits Trust Fund (Fund) filed a complaint with the Court of Appeal of the State of California, Second Appellate District, Division Six, challenging a ruling by the Workers’ Compensation Appeals Board (Board) regarding Nancy Vargas's entitlement to Social Security Disability Insurance (SSDI) payments.
Nancy Vargas, a bus driver for the Santa Barbara Metropolitan Transit District for 25 years, injured her foot at work in March 2018. She subsequently applied for subsequent injury benefits from the Fund while her workers' compensation case was pending. Vargas had pre-existing disabilities affecting her back, upper extremities, left knee, and right ankle and had been receiving SSDI payments since October 2018. The Fund acknowledged that Vargas qualified for benefits but sought to reduce these benefits by claiming credit for her SSDI payments under Section 4753 of the Labor Code. The Board ruled against this claim, stating that the Fund had not proven that Vargas’s SSDI payments were awarded "for or on account of" her pre-existing disabilities.
The Fund contended that the Board erred by placing the burden of proof on them to show that Vargas received SSDI benefits due to her pre-existing disabilities. They argued that public policy justified placing this burden on applicants like Vargas because they have greater access to information about their disability payments. However, the court affirmed the Board's decision, emphasizing that both sides must meet their burden by a preponderance of evidence and that section 4753 does not relieve the Fund of its burden.
During trial proceedings in May 2023, no live testimony was heard; instead, stipulated facts and exhibits were admitted as evidence. Medical reports evaluated Vargas’s injuries and disabilities but did not conclusively attribute her SSDI payments to pre-existing conditions. The award letter from SSA stated she became disabled as of April 18, 2018—shortly after her foot injury—without detailing whether this was due to pre-existing conditions or the new injury.
The court agreed with the Board's interpretation that it is up to the Fund to prove entitlement to credit for SSDI payments received by applicants like Vargas. This decision underscores that workers' compensation laws should be liberally construed to protect employees injured during employment and ensure they receive appropriate benefits without undue reduction.
Representing Nancy Vargas were attorneys Russell R. Ghitterman and Benjamin P. Feld from Ghitterman & Ghitterman & Feld law firm.
The Workers’ Compensation Appeals Board was represented by Allison J. Fairchild and Eric D. Ledger. Judges Cody J., Gilbert P.J., and Baltodano J., concurred in affirming the Board’s order denying reconsideration of the Fund’s petition under Case ID No. B3833633.