Articles Posted in Workers Compensation

Many people ask about the difference between Workers Compensation benefits and Social Security Disability Benefits (“SSDI”). While there are certainly differences between them, what many people don’t think to ask is whether you can collect from both programs at the same time. The answer might surprise you.

If you have been injured at work and have or are receiving Workers’ Compensation, you may also be eligible for disability payments under Social Security’s SSDI program. Because there are no asset limitations for SSDI, getting Workers Compensation payments does not automatically preclude you from qualifying for SSDI. However, that does not mean that there will be no impact on any potential SSDI benefits. 

In most situations, Social Security requires that SSDI benefits be reduced or “offset” so that the total monthly amount that a disabled worker receives is no more than 80% of the amount she/he earned when she/he was fully employed (“average current earnings”). In order to calculate the offset amount, Social Security will first determine the maximum total monthly amount of combined benefits that the recipient is allowed to get under federal law. This is known as the “applicable limit.” If, in any given month, a claimant receives money exceeding the applicable limit, then Social Security will offset SSDI payments in the amount required to bring the total back down to the applicable limit. An offset is most common among individuals who earned lower incomes when they were working. This is due to the fact that their applicable limits are lower and more easily exceeded once the worker starts to receive both SSDI and workers compensation.

Most people know that if you were injured at work, you may be eligible for what is known as “Workers’ Compensation.” But, oftentimes, injured workers don’t know what kind of benefits are available, and they don’t always know how to qualify.

What is Workers’ Compensation?

Workers’ Compensation is a form of insurance that every employer is supposed to have to cover injured employees. While there are many types of benefits available, the two main types of benefits provide wage replacement and medical benefits to employees injured during the course of employment. One of the good things about Workers Comp is that it is supposed to provide you benefits right away. The system was set up this way because when a worker is injured, he/she might not be able to pay rent or put food on the table if they go too long without a paycheck. However, there is a tradeoff for these “quick” benefit. Under the Workers’ Compensation system, the employee forfeits the right to sue his or her employer for negligence. 

When you’re hurt on the job and you can’t work, the insurance company should be paying your wages. However, what many people don’t know is that an insurance company can decide to stop paying you without much notice.

This is called the “Pay Without Prejudice” period. For the first 180 days you receive Workers Compensation, the insurance company can decide to stop paying you with only about a week’s notice.

If you’ve been on Workers Comp for more than 180 days, the insurance company can’t stop your benefits without getting approval from the Department of Industrial Accidents. Since this process can take a few months, it gives workers time to plan their finances.

The workers compensation system was created to make sure that injured workers can get quick and fair compensation when a work injury keeps them away from the job. But whenever you throw insurance companies into the mix, it’s not always that easy.

At Marcotte Law Firm, we always tell our clients that there are two ways to get workers compensation benefits. First, the insurance company can pay you voluntarily. Second, you can file a claim and get a judge to force them to file benefits. Obviously, the first option gets a check in your hand much faster than the second.

If the insurance company agrees to pay you voluntarily, you can get your first check in a week or two, and then either weekly or bi-weekly after that. If you have to file a claim and force the insurance company to pay, it can take up to 5 months to get in front of a judge.

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