If you have been injured or become disabled as a result of the work you do, you’re likely dealing with physical, emotional, and financial hardship as a result. If this is your situation, you may be wondering: Can you receive workers’ comp and Social Security Disability benefits at the same time?
The short answer is yes. If you have suffered a work-related injury and/or developed a chronic condition, you may qualify for 1) Workers’ Compensation, 2) Social Security Disability, or 3) both. Unfortunately, navigating the claims process and ensuring you get (and keep) both your Social Security and worker’s comp can be complicated and challenging.
In this article, we’ll look at both types of financial assistance separately and together. We’ll also take you through a representative case study to examine how Social Security can impact workers’ comp and how you can ensure you get the assistance you need and deserve.
Workers’ Compensation & Social Security
It’s possible to receive both Workers’ Compensation and Social Security Disability Insurance (SSDI) if you’ve been injured or disabled due to your work. However, receiving one can impact your eligibility to receive the other in full. An attorney can help you navigate the claims process to make sure you receive all the financial assistance you’re entitled to.
Before we discuss how applying for Social Security can impact your workers’ comp, let’s look at each type of financial assistance individually:
If you’ve suffered a work-related injury or illness, you may be entitled to worker’s compensation. Workers’ comp laws are in place to help individuals and their families as they recover physically and financially. They generally protect workers who experience 1) accidents or traumatic injuries and/or 2) overuse injuries and occupational diseases. Depending on your situation, you may be entitled to a variety of types of workers’ comp, including:
- Medical expenses
- Lost wages
- Vocational rehabilitation
- Permanent disability
Social Security Disability
Long-term Social Security Disability benefits are there to protect people who have been diagnosed with long-term or permanent medical conditions that prevent them from working and earning a living. Unfortunately, many people qualify to receive these benefits without even realizing it.
How Social Security Can Impact Workers’ Compensation: A Case Study
While you may qualify for and receive both Social Security and workers’ comp, one can impact the other. To illustrate, let’s consider the story of a local Oregon man whose case we fought:
Our client was an older worker from Pendleton who injured his back several years ago while lifting a heavy box of freight. Sadly, this resulted in a herniated disc that required surgery. This surgery had been denied by Oregon’s State Accident Insurance Fund (SAIF). The worker contacted Ransom, Gilbertson, Martin, & Ratliff, LLP and we won his case. But SAIF appealed.
Whenever an appeal is in progress, a workers’ compensation insurer must pay temporary disability; however, they’re not required to pay for medical treatment until their appeal is denied. We fought his case and won on appeal, and the worker’s claim was finally accepted, allowing him to have the required surgery. Unfortunately, the disc was pinching the nerve as it exited his spine for too long, leaving him with permanent nerve damage and disability. SAIF was required to pay a significant amount for this permanent disability.
In the meantime, the injured worker had applied for SSDI and requested our help with his claim. He asked what would happen to his workers’ comp pay when he got his Social Security benefits. Our answer? Worker’s compensation may reduce the amount of Social Security benefits you can receive.
In simple terms, if you receive both workers’ compensation and SSDI, the total amount of your benefits cannot exceed 80% of your average earnings prior to the start of your disability. If it does, the amount you are eligible to receive through Social Security will be reduced. For example, if you were earning $4,000 per month at the time of your injury, and workers’ comp covers 66% of that amount, or $2,640, for temporary disability, the maximum that Social Security could pay you each month would be $560. That’s because 80% of your $4,000-per-month pre-injury wages would be $3,200).
Our client asked us: Well, is there anything else that can be done? We explained that if we were to get SAIF to pay him in a lump-sum settlement, he could receive his full Social Security benefits. This type of settlement is referred to as a Claims Disposition Agreement (CDA), and since 1990, half of all Oregon workers’ comp cases have been settled as CDAs.
With a CDA, you receive an immediate payment as a lump sum, but give up rights to all other benefits, with the exception of medical expenses that are directly related to the injury. Most importantly, with a CDA, a worker’s attorney can specify a monthly amount, based on the individual’s life expectancy, that the lump sum must compensate. For example, if your settlement is $75,000 and you’re expected to live for 26.3 more years (or 315.6 months), you’re entitled to $237.60 per month for the rest of your life. Therefore, Social Security must pay you this amount each month, rather than $75,000 all at once.
By negotiating a CDA, you can receive all of the workers’ comp money you’re entitled to upfront, as a lump sum, and your full Social Security benefits in the form of monthly payments.
Our client from Pendleton received all the benefits he was entitled to, and was very happy with the outcome.
Make Sure You Get All The Benefits You Deserve
If you’ve suffered a workplace injury or illness and are trying to figure out whether you qualify for either type of financial assistance, you’re not alone. The claims process can be complicated and frustrating, and appeals can be even more challenging. The workers’ comp and disability attorneys at Ransom, Gilbertson, Martin, & Ratliff, LLP are here to fight for your rights to receive every kind of assistance you’re entitled to.
We’re honored to help workers fight for what they deserve, just like we did for our client in Pendleton. We never charge fees for consultations and we don’t take anything from you unless we win your case. Reach out to us to tell us about your situation and we’ll help you figure out the next steps.