Stephen Hasner | Workers' Compensation | February 21, 2023
Most employees injured on the job are covered by the Georgia workers’ compensation system. Employers are required to have workers’ compensation insurance. You are not required to prove negligence to receive benefits since workers’ compensation is a no-fault system.
Workers’ comp benefits cover medical treatment and a portion of your lost wages for a work-related injury. Generally, an injured worker can receive roughly 2/3 of their average weekly wages for lost wages, up to a maximum weekly amount. You can also receive benefits if you are placed on light duty and cannot receive your full wages because of a work injury.
However, what happens if you sustain a permanent disability? Can you receive Social Security disability benefits and workers’ comp benefits? Could you receive private disability benefits and workers’ comp at the same time?
Yes, it is possible to receive workers’ comp and disability benefits. However, your disability benefits could reduce your workers’ comp benefits and vice versa.
The amount of the reduction depends on several factors. Sorting out the details could be complicated. An Atlanta workers’ compensation lawyer can review insurance policies and benefits to ensure you receive the maximum amount available for a work-related injury.
How Does Workers’ Comp Affect Social Security Disability Payments?
The Social Security Administration (SSA) administers long-term disability benefits. SSDI (Social Security Disability Insurance) pays monthly benefits to workers who become disabled. The disability can be from a work injury, illness, or other injury the employee sustains off the job.
If the disability occurs because of a workplace accident or injury, the worker could be entitled to workers’ comp benefits. Additionally, if they can prove the requirements for SSDI, they could receive benefits from the SSA.
SSDI requires a worker to prove they are disabled. The definition of disabled for SSDI is as follows:
- The person cannot engage in a substantial gainful activity (work);
- Because of a condition that has lasted or is expected to last at least one year; or,
- The condition is expected to result in death.
If you receive SSDI payments, the SSA considers workers’ comp benefits when determining how much you receive each month for disability. Your workers’ comp and SSDI benefits cannot exceed 80% of your average earnings before your disability.
When the total of your workers’ comp benefits and SSDI benefits exceeds 80% of your average earnings, your SSDI benefits are reduced by the amount over 80%. The reduction continues until you reach full retirement age or your workers’ comp benefits end.
Private Disability Payments and Workers’ Compensation Benefits in Atlanta, GA
Some individuals purchase short-term (STD) or long-term (LTD) disability insurance policies from private insurers. Other individuals might have disability benefits through their employers.
Private disability insurance pays a worker when they sustain an injury or condition that prevents them from working. The terms of the policy determine how much you can receive for STD or LTD benefits and when you are eligible to receive private disability benefits.
In most cases, the disability insurance policy contains an offset clause. The clause defines “deductible sources of income” or “other benefits” that impact the amount of weekly benefits.
The amount of your private disability benefits is offset or reduced by the amount of your workers’ comp benefits. Some policies have a minimum benefit amount you receive, regardless of how much your workers’ comp benefits pay.
Reducing Workers’ Compensation Benefits Because of Disability Payments
Section 34-9-243 of the Official Code of Georgia Annotated permits an employer or workers’ compensation insurance provider to credit payments made under an employer-funded disability plan. Therefore, if your employer provides an STD or LTD plan and you receive benefits under the employer disability plan, your workers’ comp benefits may be reduced by the disability payment.
What Happens When Both Sources Try To Reduce Benefit Payments?
Unfortunately, you could be in a situation where the workers’ comp insurance company and the disability insurance company try to reduce your payments. Likewise, the SSA and the workers’ comp carrier could try to reduce payments. You are caught in the middle of the argument.
At least one of the companies should pay full benefits until a court determines which source of benefits should take precedent. Contact an Atlanta workers’ compensation lawyer immediately if you are in this situation. An attorney works to get you the maximum compensation while protecting your legal rights and best interests.
Contact the Atlanta Workers’ Compensation Lawyers at Hasner Law, P.C. For Help
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