Tampa, FL (WorkersCompensation.com) – Workers’ compensation and Social Security Disability share a unique relationship. While both benefits serve different purposes and are paid for by different entities, they often interact, which is why it is helpful to understand the intersection between these two benefits.
Workers’ compensation is usually a creature of state law. Federal workers’ compensation benefits do exist but it covers a much smaller amount of people. Social Security Disability comes from federal tax dollars and is funded by the U.S. Congress.
Workers’ compensation proceedings are typically before a Judge of Compensation Claims. This administrative law judge holds hearings in adversarial proceedings where there are lawyers present for both sides. In Social Security Disability proceedings, they are in front of a federal judge. Workers’ compensation judges are appointed by a state government whereas a Social Security Judge is appointed by the federal government.
One main difference is that there is a six month period of waiting time before you can apply for Social Security Disability after a diagnosis or accident. Workers’ compensation, on the other hand, can be sought immediately following an accident.
Oftentimes, the two benefits interact with respect to permanent total disability. Those who qualify for PTD typically also qualify for Social Security Disability. These are people who cannot return to the same or similar employment after an industrial accident.
Some states allow for an offset of PTD benefits if the claimant is also receiving Social Security Disability. This means that the payments from the employer/carrier would be reduced based on a percentage of what the claimant is receiving from Social Security Disability. This offset can also apply to temporary indemnity benefits.
However, many people who are on Social Security Disability can have part-time work schedules and remain employed while still receiving the benefits. But those who are receiving PTD by definition cannot continue to work.
Some states have laws requiring claimants to share information with the workers’ compensation carrier if they have applied for or received Social Security Disability. The two benefits also differ with respect to when they end. Social Security Disability benefits end at the age of 65. As for PTD, the time period for when those benefits end differs from state to state.
The standard to prove entitlement to Social Security Disability is to show the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.
The standard for workers’ compensation differs from state to state but many states have the standard of major contributing cause, which is that the accident is more than 50 percent responsible for the need for medical treatment when compared to all other causes.
When applying for both benefits, claimants should expect to have to submit to one or more medical exams to have their conditions evaluated.