Social Security and Workers Compensation
We have many clients who receive benefits under both their workers compensation claim and a Social Security Disability claim. This is absolutely allowed, and may well increase your overall monthly income. You can collect both benefits, up to a cap of 80% of your highest average annual earnings. Because everyone’s earning are different, everyone’s 80% cap will be different. The Social Security Administration (SSA) has various formulas for figuring each person’s highest average annual earnings, and they will use the formula which is the most advantageous to you.
Individuals with a high earning history will have a high 80% cap, and may get nearly the full benefit of both the Social Security Disability and Labor & Industries (L&I) benefits. Workers with a lower earnings history will have a lower 80% cap, and payment of either Social Security or L&I benefits alone may put the worker at or near the cap. If combined benefits exceed the 80% cap, either the SSA or L&I will take an offset, reducing your payments to the 80% cap.
If you have applied for Social Security Disability benefits and your application has been denied, it is important to Request Reconsideration. The denial will come with instructions for how to make such a request, and the timeline for doing so. It is important to request reconsideration within the time allowed. You do not need an attorney at this stage.
After you have requested reconsideration, you should work with the SSA to provide all the up to date information about your condition. Keep in mind that for purposes of Social Security Disability it does not matter what caused the particular condition, or whether the condition is related to a work injury. Social Security looks at your complete medical and/or psychiatric picture.
If you application is denied a second time, this is when you should contact an attorney. At this stage your claim is moving toward a Hearing. Hiring an attorney will assure you the best possible chance of obtaining a favorable result.
While you can collect benefits under both a Social Security Disability and a workers compensation claim, they are two completely different systems. Obviously, one is a Federal benefit and one is a State benefit. Beyond that, each system uses its own criteria for determining total disability. Being found totally disabled under one set of guidelines does not necessarily mean you will considered disabled under the other. A decision by one agency is not binding on the other agency. It can be a bit of a maze. But, applying for Social Security Disability benefits when you have a long-term work related disability can be to your advantage. Get the ball rolling, and call for help if your application is denied a second time.
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disaster says : I absolutely agree with this !
I was injured at work and was receiving time loss payments, and it was not enoughf to live on. My L&I appointed vocational counsler said that I should draw early social security ( I was 63 at the time) and that would be a big help with my bills. I did, and no sooner than I got my first retirement check, Labor and Industries attached it!!!!!!!!! I was coersed to take early retirement by L&I so that they would get my check to help to pay me!!!!!!!!!REDICULOUS.
I don’t think L&I ‘attached’ your Social Security. It does sound like there was an offset. Your combined Social Security and L&I benefits were probably over your 80% cap. (That is, 80% of your highest average annual earnings) So, either L&I or the SSA (depending on your age) reduced their payment to keep you at that 80% cap. It may be that L&I is paying less, but your monthly income is likely higher when you receive the combined benefits, then it would be if you received just one or the other. That is why the vocational counselor suggested you draw your Social Security – because your overall monthly income would be higher.
who gets the offset. Can we choose for L&I to get it instead of Social Security? Reason is that when time loss payments stop, it will take Social security a long time to get us back to full payments.
My husband was injured at work on the 21st of May and has been on time lose payments most of the time since then. After his 12 weeks of family leave was used up, the company canceled his medical insurance and other benefits. His time lose payments went up $360.00 every two weeks to compensate for the medical and all. He has other health issues and is 58 years old, so we put in for his social security disability and it was approved. Will social security figure the offsets just on the wage portion of his time lose, or will they also deduct for the medical benefit reimbursement that he is receiving? doesn’t seem fair that they could take away the portion that is to compensation for lost benefits, if there wage calculations to not take benefits into consideration.
The short answer is “yes”. Social Security is going to consider the entire TL payment when any offset is calculated, even the portion for the employer provided health care benefits. The amount is thought of as consideration which is “like wages” – which is why it was included in the first place.
To answer the second question – No, you do not get to pick who takes the offset. L&I will get the benefit of the offset until your husband turns 62 – which means he will be receiving his full Social Security benefit already if the time loss benefits stop. Between ages 62 and 65 there is a glitch in the law, and the Social Security Administration will take the offset.
If your husband is unable to return to reasonable continuous gainful employment, he may be permanently totally disabled, and entitled to an L&I Pension benefit. If there has not already been a vocational referral on the file, there will be soon. He should definitely talk to an attorney to make sure he avoids any missteps, and receives the benefits he is entitled to receive.
I’m still confused.. will his currrent earnings # from SSD be based on just his payroll amount, (about $39,000 annual) or on his payroll plus employer paid benefits (about $53,000). thanks for your help.
Social Security does not include benefits in the calculation of highest average annual earnings.
I was ijured a few years ago and am now on total disability with L&I and as they suggested I applied and was granted SSI disabiliy. Everything was caculated (offset)ect. that was two years ago, now I recieved letter that L&I is going to offset about $650. Well I used my settlement for a down and my SET income with the Bank for morgage payments, now with this Ille be homeless.
Is there any kind of time limit on offsets, especially when its set in stone and verified. Thank you
I was ijured a few years ago and am now on total disability with L&I and as they suggested I applied and was granted SSI disabiliy. Everything was caculated (offset)ect. that was two years ago, now I recieved letter that L&I is going to offset about $650. Well I used my settlement for a down and my SET income with the Bank for morgage payments, now with this Ille be homeless.
Is there any kind of time limit on offsets, especially when its set in stone and verified. Thank you Randy
The easy answer to your question is no – there is not a set time limit. The Department can calculate the offset whenever they get the information. There is a limit to how far back they can go to collect an overpayment which may result form the new calculation – but that does not seem to be your question. It does seem odd that such a large change is taking place. It is possible that you are in that 62 to 65 year old offset loop, and maybe it is not as bad as you think. Washington is a reverse offset State – there are only a handful. Up until age 62 the State takes any necessary offset, and the Federal Government pays the full SS benefit. Because of a weird glitch in the law, between age 62 and 65 the State can not take the offset, but the Federal Government does. So, L&I pays your full benefit, and SS pays less. At age 65, it switches back – L&I reduces payments and takes the offset, and your full Ss benefit is paid. It is possible you are in the last part of this loop. L&I has notified you they are once more taking the offset, so SS should be paying the full benefit. If this sounds like what might be happening, call SSA and let them know Washington is a reverse offset State, and L&I is reducing your benefit. They should be able to tell you if your SS benefit will be increasing.