How does workers’ compensation affect Social Security Disability?

injured worker files insurance claim
injured worker files insurance claim

Depending on your situation, it can have different affects.  Assuming you have a workers compensation wage award in Virginia and you are approved for social security disability payments, there can be an “off-set” (reduction) of your disability benefits based upon the amount of your workers’ comp payments.  Under Social Security Administration rules, you may collect a combination of workers’ comp wage benefits up to 80% of your “average current earnings,”( also called ACE.)  This figure is determined  by looking at your maximum gross wages you earned in any one tax year in the 5 years before you were injured at work.  For instance, if your ACE is $40,000.00, you would not be eligible to receive more that $32,000.00 per year, or $2,666.67 per month in combined workers’ compensation and social security disability benefits.  If your weekly workers’ compensation benefit is $400.00, this equals $20,800.00 per year, and $1733.33 per month.  Your SSDIB benefit would then be $933.34 per month.

If you reach a settlement of your workers’ compensation claim, there may also be an offset/reduction of your SSDIB benefit.  Again, depending on your situation, the way your settlement documents are written can help ensure that your SSDIB reduction is minimized or eliminated entirely.  It is possible to have all or some of the proceeds from your settlement “pro-rated” over your life expectancy which can allow you to collect the maximum amount of money you may be entitled to in SSDIB.  Having a qualified, experienced Virginia workers’ compensation attorney assist you with this can be of great help and is highly recommended.

Another issue to be aware of is how your medical benefits may be affected if you are approved for Social Security Disability.  Depending on your situation, you may be immediately eligible for Medicare or eligible within 30 months after you are found to be disabled.  This can create a situation where you have to use your workers’ comp insurance for the work injury, and Medicare for other non-work injury related care.  It can get complicated.  However, there are situations where you might be able to settle your workers’ compensation claim and resolve the conflict with Medicare.  Again, getting the help of a qualified workers’ compensation attorney is strongly recommended.

These are some of the situations that arise when you have both a workers’ compensation claim as well as a social security disability claim.  This is not a complete summary of all of the possible situations that may arise.

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