An employee’s work capacity may be impacted by much more than a serious injury at work. If an employee is unable to come back to work following an injury or illness, financial stressors like lost wages, medical costs and future financial issues can be significant. In certain cases, an injured employee might have the ability to get workers’ compensation benefits in addition to Social Security Disability Insurance (SSDI). These programs are not all the same, have different eligibility criteria and are for different reasons, so it is crucial to understand how they relate to each other when considering the benefits that are available.
A person who has a disabling condition in the workplace might want to consult a Williamsburg Social Security Disability & Workers’ Compensation Lawyer for insight on how these two systems would benefit him or her. The workers’ compensation typically covers qualifications injuries or illnesses related to work, while SSDI is based on a qualifying disability and work history. A person may be able to receive benefits from either program or both programs, but benefits from one program may impact benefits from the other.
The Difference of the Two Programs
Workers’ compensation and SSDI are two different benefits. Workers’ compensation is typically intended to pay benefits to workers suffering from certain kinds of work-related injuries or illnesses. Depending on the circumstances and subject to state law, benefits can include medical care, a wage replacement benefit, disability benefit payments and other types of benefits.
However, SSDI is a federal (government) program, run by the Social Security Administration. General eligibility criteria include having a disability that hinders from performing a substantial amount of work and the work credits. Generally, eligibility is determined by whether a person has a qualifying disability that affects his or her ability to perform a substantial amount of work and whether he or she has a sufficient number of work credits.
The difference can be explained as below:
| Workers’ Compensation | SSDI |
| Typically associated with a work injury or illness. | Based upon an eligible disability. |
| Managed in state workers’ compensation programs. | A federal program which is managed by the Social Security Administration. |
| May include medical costs relating to work-related illness. | Protects against loss of income due to disability. |
| May be able to offer some form of disability benefits (temporary and/or permanent). | Most often used for long-term disabilities. |
| There are state laws and conditions of employment that determine eligibility. | Requirements for eligibility do include disability and work-credit. |
These differences can be helpful to an injured worker who might assume a decision to grant one program automatically grants him or her eligibility to the other program.
When Workers’ Compensation and SSDI Benefits Intersect
If a worker gets hurt in the workplace or develops an occupational illness and it creates a disability, the worker can receive benefits from both programs. Federal rules, however, may restrict the total amount of disability benefits, which could make the interaction of benefits complicated.
Let’s say that a person is receiving workers’ compensation and then learns that because of the injury, they will not be able to go back to doing a substantial job, so they apply for SSDI afterwards. The worker might have to submit to a medical exam to let the doctor know how serious and long-lasting the disabling condition is.
Being injured at work doesn’t guarantee that you’ll qualify for SSDI. For most people, SSDI will require proof of a disabling condition that will last for a certain amount of time or until death, as well as having a sufficient work history.
Likewise, approval of SSDI does not answer the questions of whether or not one is eligible for workers comp benefits. The two programs assess various factors about an individual’s situation.
Addressing Changes to Employment and Benefits
A person’s situation could evolve during the course of a disability claim. An injured employee might work, be given modified duties, have an aggravation of their condition, or settle their workers’ compensation case. The impact of these changes may be on the assessment of benefits. For example, the person’s return to work might lead to queries whether the person still meets disability criteria.
Similarly, a workers’ compensation settlement may need careful consideration, as how it is structured may have an impact on the calculation of benefits. It may be helpful to keep records up-to-date and to get guidance before making major changes to minimise unnecessary complications.
Frequently Asked Questions
Is it possible to collect workers’ comp and SSDI?
In some circumstances, yes. If the eligibility criteria for both programs are met, a person can be eligible for both programs. An offset can, however, decrease the amount of SSD that’s received.
Does a workers’ compensation claim automatically qualify someone for SSDI?
No, just because a worker’s compensation claim is made, does not automatically mean that an individual is entitled to SSDI.
Does SSDI impact Workers’ Compensation benefits?
Depending on which laws and circumstances apply it will depend on the interaction. When determining eligibility for workers’ compensation, SSDI may have to be disclosed.
Will the workers’ compensation settlement impact on SSDI?
It can. Some workers’ compensation payouts can have an impact on your SSDI benefits. The particular conditions and distribution of a settlement may be significant.
Why is it significant to have medical records for both claims?
Medical records provide documentation for the nature and severity of the disabling condition, treatment(s) provided, functional limitations and the anticipated duration of the disability.
Conclusion
For those who are unable to keep their job due to injuries or illnesses, these two types of benefits may offer valuable financial support: worker’s compensation and SSDI. The two programs, however, have different rules and qualifying for one does not mean that a child is qualified for the other. Where there is a combination of benefits, offsets, medical evidence, and settlement terms can make for more considerations.
Early recognition of these interactions can assist injured workers to make informed decisions regarding applications, settlements and continuing benefits. Land Parker Welch LLC can offer facts and legal information to individuals that are dealing with workers’ compensation and Social Security Disability issues. Eligibility for benefit systems might overlap, and there may be aspects of an individual’s situation to take into account if they seek to better understand how their eligibility might intersect with other benefit systems.
