In California, workers compensation is a state benefit for workers who suffer work-related injuries. On the job injuries can include a one-time traumatic event (such as suffering a back strain while lifting a heavy object) or a repetitive use injury that has developed over time (such as carpal tunnel syndrome).
Social Security Disability Insurance Benefits
In addition to workers compensation benefits, an individual may also be entitled to social security disability insurance benefits. Social security disability benefits are different in that these benefits are issued under a federal program for disabled people. The Social Security Administration runs the federal program which provides social security disability benefits.
With some exceptions, workers comp benefits are meant to be paid out on a temporary basis, while social security disability benefits are available to injured workers and others, who are permanently disabled. You may qualify for one or the other, or both benefits.
Limitations on Receiving Benefits for Both Workers’ Compensation and Social Security Disability
Although a worker injured on the job may be eligible to collect benefits under both the state workers’ compensation system and the federal social security disability program, there are certain limitations to the total amount of disability money an injured worker may receive. Under federal law, the social security administration is allowed an offset or deduction for what it pays an injured worker, when the injured worker is eligible to receive both workers’ compensation and social security disability benefits. Generally, the Social Security Administration will reduce its monthly payment to the injured worker so that the combined total benefits do not exceed 80% of the injured workers Average Current Earnings (ACE).
Generally, the injured workers ACE is considered to be her highest annual earnings for the five-year period leading up to her disability onset date, which is then divided by 12 months. For instance, if the injured worker’s highest annual earnings during the previous five years was $30,000, that figure would be divided by 12 months (i.e. $30,000 ÷ 12mos = $2500mos), resulting in an ACE of $2500 per month. Thus, if the total combined disability benefits the injured worker receives between workers comp and Social Security disability, is greater than eighty percent of their ACE, the Social Security Administration will reduce its payments in order to bring the injured worker’s total benefits down to eighty percent of their ACE. The workers’ compensation benefits would remain the same.
If you are receiving both workers’ compensation benefits and social security disability benefits and your social security benefits were reduced to keep the combined disability benefits under this eighty percent threshold, you can contact the Social Security Administration when your workers’ compensation benefits end. The Social Security Administration can then adjust your benefits accordingly, by increasing your Social Security disability payment to the correct rate.
Requirements for Qualifying for Workers Compensation and Social Security Disability
Generally, you are considered qualified to receive workers compensation benefits when a doctor determines you are no longer able to perform the job you were doing when you became injured. The requirements for eligibility for social security disability benefits, however, involve more than just not being able to perform your job.
In order to be eligible for social security disability benefits, you must be unable to perform any job you were able to perform in the past 15 years. The Social Security Administration must also make a determination that you are unable to adjust to other types of work that someone with your physical and mental abilities and your level of education could perform.
Additionally, you must have worked and paid into the social security system. That means you must have worked at least five out of the last ten years to qualify for these benefits. There are more precise requirements depending on your age. Very young and very old workers tend to have less strict requirements than workers between the ages of thirty and fifty.
Long-Term Disability Benefits and Workers Compensation
You or your employer may have purchased a long-term disability insurance policy to protect you in the event you suffer a long term disability. Receipt of private disability insurance benefits will not affect your right to receive workers’ compensation benefits. However, just as the Social Security Administration is allowed an offset for payments it makes to you, so too may the private disability insurance company offset the amount they pay you if you are also entitled to workers’ compensation benefits.
Get Legal Help
Since these matters can be complicated, you may want to contact an attorney in order to ensure you maintain eligibility for all benefits you are entitled to. A Santa Rosa workers’ compensation attorney at Kneisler & Schondel can give you the advice you need. Call us at (707) 542-5132 or ask a question by using our online contact form.