Part of our job in handling your workers’ compensation and/or Social Security disability claim is to make sure you pursue as many different types of benefits as possible to maximize your overall recovery.
For example, individuals who are severely injured on the job might be eligible to receive workers’ compensation benefits, as well as Social Security disability benefits. While there is often an offset between the two programs, it is still advisable for some of our clients to pursue both types of benefits. More specifically, if the medical records generated in connection with the workers’ compensation claim also support the fact that the injured worker is not capable of earning wages in any competitive employment for a period of 12 months or longer, the individual should apply for Social Security disability benefits while also receiving wage loss benefits from the workers’ compensation carrier. While the law will not normally allow full recovery from both benefit programs, some additional monetary benefits are usually available, as well as access to either Medicaid or Medicare. If an injured worker’s medical condition is so severe that they are unable to return to their employment, they may well have lost their access to health insurance. Having access to Medicare for such an individual, and for his or her children, is obviously critically important to cover non-work injury medical treatment.
Other disability benefit programs may include short and/or long term disability plans through the employer. Although most of these plans do not cover cover work-related injuries, these programs can be important if the work-related injury is denied by the worker’s compensation carrier. To the extent workers’ compensation payments are ever made, and if the employer paid the premiums for the short-term or long-term disability benefits, the employer may well receive a credit against the amount of back due worker’s compensation benefits owed the injured worker. To the extent this individual’s also approved for Social Security disability, the short and long-term disability benefit carrier will likely be seeking a repayment of benefits paid prior to the Social Security disability award.
Some local government employees are entitled to disability retirement benefits. City and county workers should stay in close contact with their Human Resources department to see whether or not they may be eligible these benefits, in addition to workers compensation benefits and others.
To the extent an injured worker was injured due to the fault of a third party while working, they are allowed to pursue a “third party” claim against the tortfeasor causing the injury. While the law does try to prevent double recoveries in these instances, these kinds of cases should be evaluated on a case-by-case basis for any applicable exceptions. Needless to say, if such an individual is injured severely enough, they would also be eligible to file for Social Security disability.
***This post is not intended to be an exhaustive review of all benefits available or of the way they all interact with each other, but rather to give the reader enough information such that they can can be aware and ask the experts they choose to consult whether there are other ways to maximize the total recovery following a workplace accident or diagnosis of a severe illness.