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  • Application For Second Injury Fund Benefits Sf 51247 Form 2015

Get Application For Second Injury Fund Benefits Sf 51247 Form 2015-2025

Accident Number Indiana Worker's Compensation Board Application for Second Injury Fund Benefits State Form 51247 (2-03) Instructions: This form must be submitted in duplicate to: Indiana Workers Compensation.

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The Second Injury Fund was created by the Indiana General Assembly primarily to encourage the employment of partially disabled workers. The intent is to relieve employers who hire disabled persons from some liability for workplace injuries that cause such persons to become permanently totally disabled.

$1,750 per degree for the first 10 degrees of impairment. $1,952 per degree for impairment degrees between 11 and 35.

Permanent Total Disability (PTD) Benefits: Compensation is 66 2/3 percent of the injured workers average weekly wage. Minimum weekly payment is $50 or average wage if less. Maximum weekly payment is $636. Maximum number of payments is 500 weeks.

What Does the Second Injury Fund Do? The workers' comp Second Injury Fund assumes liability for compensation benefits attributable to prior injuries or illnesses. This happens when a worker subsequently becomes totally disabled because of a workplace injury.

The Second Injury Fund (SIF) compensates injured workers when a current work-related injury combines with a prior disability to create an increased combined disability. The SIF is funded by a surcharge paid by employers.

The Second Injury Fund was created in 1923 to make benefit payments to to- tally and permanently disabled workers in cases where the cause of disability was subsequent to a prior disability render- ing the worker permanently and partially disabled.

How Do you Qualify for the SIBTF? Qualifying for the SIBTF can be complicated, which is why usually only injured workers represented by an attorney apply. To qualify for SIBTF benefits, the work injury and pre-existing disability must, when combined, equal at least 70 percent permanent disability.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232