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Getting hurt on the job can be a daunting experience. Two programs that come to mind when it happens are workers' compensation and Social Security Disability Insurance (SSDI).
People who receive workers' compensation benefits qualify because of the supplementary need in lieu of a standard income. On the other hand, the disability benefits put simply, are meant for those who have become disabled and are no longer able to work.
Considering one unfortunate event could technically lead to the collection of either benefit, people often confuse the two programs. Those who are aware of the differences wonder if it's possible to access both.
The idea behind all the information below is to answer this one question definitively. Can you collect workers' compensation and Social Security Disability Benefits simultaneously?
Beyond answering the base question, you get a deeper understanding of what each of these programs is, claiming them, and even how long they last.
Finally, it's essential to relay the importance of retaining a lawyer who can assist you in accessing workers' comp and Social Security benefits. Simple actions, such as filing one before the other can be very beneficial in your unique situation.
To get a free case evaluation for your case surrounding worker's compensation and social security disability benefits in Columbus, OH, call Larrimer & Larrimer today at (614) 820-1855.
Workers' Compensation Benefits
Those who have work-related illnesses or may have been injured on the job can access workers' compensation' benefits. If applicable, there may be temporary total disability benefits paid during the recuperation period.
However, you may find that permanent total disability benefits may come into play if the employee's condition has lasting effects that go beyond the healing process.
Note that workers' compensation programs are state-designed and administered. Being at the state level and depending on state laws implies that there are generally differences across the country where compensable injuries, benefit levels, etc. are concerned.
Workers Compensation Types
Workers' compensation benefits can be broken down into several types that focus on specific areas of need. When a claim is evaluated, a determination is made on what kind of benefits are to be provided and at what level.
This is per the applicable workers' compensation laws of the jurisdiction in question.
Medical Expenses
When an incident happens in the workplace leading to an injury, medical attention is often needed to offer immediate treatment. Additionally, there are likely going to be continuous medical bills whenever a running course of treatment is required.
The medical benefits offered here aim to lower the amount of medical debt workers face, which implies that the person's finances need not be disturbed.
Rehabilitation Services
Unfortunately, injured workers often find themselves in situations that require special rehabilitation services that aim to get them back to full functionality. Physiotherapy is an excellent example of this. Rehab services are not always covered by worker's comp.
Wage Replacement
Before an injury occurs, the employee would've been gainfully employed making a designated wage at an agreed interval. Unfortunately, the work-related illness or accident may have created a situation where the person cannot work, which means missing out on wages.
The wage replacement element of workers' compensation benefits aims to ensure that the average current earnings before the incident is replaced.
Other Benefits
This is not an exhaustive list of what worker's compensation covers. There are other expenses injured workers incur that may be eligible for worker's comp. A part of the value that an attorney presents is assisting you in identifying these.
Social Security Disability Benefits
The Social Security Administration (SSA) allows workers to access disability benefits when they are totally disabled. Put simply, the state that you're in would not allow you to perform any kind of work. This classification spans whatever previous job you would've had as well as any other job you may be considering.
This is not the same as permanent total disability benefits, which are covered under the workers' compensation umbrella.
There s a medical guide, known as the Blue Book, that the Social Security Administration uses to determine if applicants qualify for SSDI benefits. It boils down to a collection of medical conditions and criteria that are used to make the final decision.
The body is broken down into its different systems in the book and each bears corresponding listings that can then be used to indicate which medical challenges are counted as disabling.
Of course, the required medical evidence must be provided by the claimant, but the Blue Book presents the guidelines for SSDI benefits.
Differences Between Social Security Disability Benefits and Workers Compensation Benefits
First, workers' compensation and social security disability benefits are meant to cover different scenarios.
A simple way of looking at it is that workers' comp is geared towards injured workers who need financial aid until they can recover and return to work, while the Social Security benefits are geared towards those who have been disabled by the said injuries and are not going to be returning to work.
Here's a quick look at some of the key differences to keep in mind:
Service period - SSDI benefits are only afforded to those who have earned "work credits" through Social Security tax payments, meaning you must have been working for some time. However, worker's comp can theoretically be paid out on day one of employment if a work injury happens.
Disability type - You must be totally disabled to qualify for SSDI benefits, which means not being able to work anywhere. A partial or total disability could qualify you for workers' compensation benefits.
Regulatory bodies - In Ohio, the Social Security Administration manages SSDI benefits along with the Opportunities for Ohioans with Disabilities (OOD). The Ohio Bureau of Workers' Compensation (BWC) is responsible for workers' comp.
Benefit start date - Once the injury prevents you from working for over a week, your workers' compensation benefits can begin immediately. However, you must wait several months for your first check from SSDI benefits.
Filing Your Claim for Either Type of Benefits
Before starting either of these processes, it's a good idea to get medical care for the injury you've sustained as your documentation is going to form a big part of the process.
Applying for your Social Security disability benefits is a more straightforward process as you're only required to use the online application process provided on the SSA website. If there is anything you happen not to be too clear on where the process is concerned, there is a FAQ section present to address any of your queries.
Though the workers' compensation application is not a simple online application process, it's still a very straightforward one to get through. Begin by reporting the injury to your HR department or whichever body/person handles employee matters at your place of employment.
You're likely going to need to fill out forms, which are then provided to the relevant agency. The said agency reaches out to you about the workers' compensation claim and its approval or denial status.
A report is also made to the relevant insurance company if your place of employment has a workers' compensation plan set up.
Can Both Benefits Be Collected Concurrently?
The question of combined benefits is the primary one being answered here. The short answer to it is yes. There are cases in which people have collected both Social Security disability insurance and workers' compensation at the same time. Obviously, it translates to being unable to work again because of a disability, but there are a couple more pieces of information below that you're advised to pay attention to.
How Disability is Defined
One thing that you want to bear in mind is the fact that the SSA and BWC don't define "disability" in the same way. This matters because you would need to meet requirements on both sides simultaneously to access the combined benefits.
On the Social Security side, being disabled indicates that there's no capacity to work. If you are out for a few months but manage to heal and return to work, then this doesn't count as being disabled.
On the workers' compensation side, you're disabled when your condition prevents you from carrying out whatever your current duties are. The expectation is that you're going to return to work once your recovery is complete.
In fact, you can get temporary partial or permanent partial disability benefits under workers' comp if your injury causes you to have to take a lower-paying job when you return to work.
The Offset Provision
This clause specifically speaks to the concurrence receipt of workers' compensation benefits and Social Security benefits. It's based on the 1965 Social Security Amendments and mandates a reduction in disability insurance benefits whenever the total of the two benefits would exceed 80% of the worker's average current earnings.
For reference, average current earnings can be one of three things. It is typically the highest of:
The average monthly wage that forms the bases of the unindexed primary disability insurance
The highest five-year consecutive earnings after 1950 from self-employment and covered employment
During the five years ending when the disability began, the average monthly wage from the calendar year of the highest earnings
Note that this applies whether you collect workers' compensation through lump-sum or periodic payments. The idea behind implementing this clause is to prevent the earnings from the combined benefits from being excessive.
Minimizing Your Offset Amount
Even with the calculations covered above on how offset works when both workers' compensation and social security benefits are at play, an injured worker can take action to minimize the offset reduction. These are listed below, as well as a brief outline of how you can go about implementing them.
Retain the Services of an Attorney
The hiring of a law firm was alluded to above, and doing so sees a professional looking out for your best interests. A workers' comp attorney in Columbus Ohio aims to minimize the offset for you by:
Cataloging your expenses
Drafting a favorable workers' compensation settlement agreement
Using intimate knowledge of workers' compensation law to your benefit
Your attorney may use clauses such as a specific start date of payment collection to move the needle in your favor.
Moving to Retirement Benefits
Having Social Security retirement benefits in play can also help you. If you happen to be receiving these before the injury occurs, the offset rule doesn't apply, even when workers' comp begins to kick in.
One strategy that you may consider is early retirement if you were already approaching retirement age anyways. There is one drawback to consider, however. The early collection of retirement benefits means that the monthly payments are going to be lower than they would have been if you would've waited until reaching thing traditional age.
Lower Monthly Benefits
As a part of your lump-sum settlement, you can agree to a lower monthly payment when you start receiving workers' compensation benefits until you reach the designated retirement age. By doing this, when it's time to determine average current earnings, you may find that yours are lowered, meaning that an offset may not even be triggered at all.
Payment Spread
You can also agree to a lump-sum settlement that sees you spread it across the rest of your life. Of course, life expectancy is a factor in this calculation.
It helps to run the numbers with your attorney to determine at what level workers' compensation payments collected this way can result in offset avoidance.
Again, workers' compensation programs vary, but you can leverage the attorney-client relationship to ensure you're maximizing your workers' compensation payments and your monthly SSDI payments.
Expense Exclusion
Immediately, the SSA deducts expenses such as your legal fees, payments for dependents, and rehab costs before it calculates your gross workers' comp settlement.
Other non-automatic expenses may also be excluded, which would lead to a lower gross. Typically, exclusions require both identification and proof on your part. The attorney who takes on your workers' compensation case can direct you here.
Offset Notification
If a workers' compensation offset applies to you, you're going to be notified with a LIBC-761 (Notice of Workers' Compensation) form which is filed by either your employer's insurance company or the employer directly. Apart from notifying you that an offset applies, you also get the following details from the form:
The benefit that led to the workers' compensation rate reduction
The start date of the offset credit
How the offset credit calculation works
The pre-reduction workers' compensation benefit
Other details are present too, but these are among the most important. It would be in your best interest to review the LIBC-761 form with your workers' compensation lawyer. There are often inconsistencies and issues that can affect you negatively.
Not only is the attorney's assistance helpful in identifying these, but you can get useful insights on how to address each. Typically reaching out to the employer or the relevant insurance carrier can provide some level of verification.
How Long Do the Benefits Last?
It's common to hear people wonder about how long they can continue to receive workers' compensation benefits. Numerous factors lead to a final answer here, but it boils down to when you return to proper function.
Alternatively, if your employer can prove that you have regained your ability to enter the labor market or if you have recovered, collecting workers' compensation may be out of the cards. On the side of Social Security disability claims, your benefits associated with these carry on either until you reach full retirement age or for as long as your permanent injury does.
There are too many unique elements to say what the duration of workers' compensation and social security disability benefits is going to look like for you. You may want to discuss the matter with your attorney for an accurate estimation.
Why You Want to Get a Lawyer Involved in Your Workers' Compensation Claim in Short Order
As you've likely gathered via all the insights above, a lawyer can provide a lot of informational and functional benefits to those who may be trying to seek workers' compensation and Social Security disability insurance, especially when the two are to be collected simultaneously. You have medical treatment, lost wages, etc, to contend with and factor in, all while needing to enter into the most favorable settlement agreement possible.
Your lawyer is a key part of ensuring that the combined amount when you start to collect workers' compensation and SSDI benefits isn't subject to a huge offset if there's any at all. A big part of helping you reach this desirable settlement is the extent to which the attorney understands relevant litigation surrounding these benefits.
Conclusion
Being able to collect both worker's compensation and Social Security disability benefits is incredibly helpful for someone who is no longer able to get paid from typical work efforts. This is especially true when a permanent disability is at play and there are medical expenses to contend with.
A passionate lawyer can help you strategically claim lump-sum payments following a work-related injury, allowing you to minimize your offset as much as possible. They can also help provide legal assistance with various concerns such as if one can change jobs while on workers' compensation or if one can use PTO while on workers' compensation.
If you're in Columbus, OH, and need assistance from such a professional, call Larrimer & Larrimer today at (614) 820-1855 for a free case evaluation.