If you have incurred a workplace injury, or have been diagnosed with an occupational disease or have a medical diagnosis that impedes your ability to continue working, it can be difficult to know what your next steps should be. There will be conflicting information and advice coming from several different sources about what you need to do to get help to make ends meet. A friend will tell you one thing, your boss may tell you another, while an internet search of your situation will give you all different kinds of conflicting advice. This can understandably lead to being overwhelmed and lost on about what you should actually do.
One Question Many People Have is if They Should Apply for Workers’ Compensation or Social Security Disability.
How are the Two Different?
Workers’ Comp vs. Disability
The workers’ compensation program provides coverage from a State agency funded by employment taxes, or in the case of some large companies, by the employer directly, for any injury or illness that was incurred while on the job. In Washington State, the agency responsible for administering the Workers Compensation program is the Department of Labor and Industries, or “L&I.”
If you are unable to work as a result of something that happened outside of the workplace, you will need to look into receiving disability benefits. There is a State-funded disability program in Washington State for individuals who are both disabled and impoverished, Aid to the Blind or Disabled (“ABD”). Most people do not meet the very stringent income/resources restrictions, however, so if you do not have private disability insurance, the only other option may be Federal Disability Benefits (SSI or Social Security Disability benefits).
Which One Should You Apply For?
To determine which type of benefits you qualify for, you can start by asking yourself some simple questions:
- Was the injury or illness work-related? If you answer yes to this then you would apply for workers’ comp.
- Will you be able to return to work? If you are only temporarily out of work, and are certain that you will return to work within 12 months, you probably will not qualify for Social Security Disability benefits. If your medical prognosis is uncertain, however, you should apply – especially if the injury or illness is not work-related.
- Are you now permanently disabled? If the injury was work-related, workers can qualify for “pension” benefits through workers’ comp for the rest of their lives. If your injury was not work-related you will need to apply for Social Security Disability Income. “Permanent” in SSA terms means for 12 months or longer. If you have already been out of work for 12 months, or if your doctor expects that your impairments will keep you from working for 12 months or more, you may qualify.
The main indicator of what type of benefit you should pursue mainly depends upon if you are injured as a result of performing your job duties or as a result of your work environment, or if your injury or illness is not work-related. Workers’ compensation insurance paid by your employer will cover medical care for your work-related illness or injury only. If you are found eligible for federal disability, you may be entitled to medical coverage through Medicare or Medicaid.
Some employers will try to encourage employees to file a disability claim in hopes of bypassing having to pay workers’ compensation. This is a fraudulent practice.
Can a Person Collect Workers’ Comp and Disability at the Same Time?
An individual is eligible to collect benefits from both a workers’ comp program and Social Security Disability at the same time if the person is permanently disabled from an injury or illness incurred on the job. The person will not, however, receive both benefits in whole. Washington is a “reverse-offset State,” meaning that L&I payments will be offset by ongoing disability benefits, but for retroactive benefits, the offset is applied against the Social Security Disability benefits. There is a complicated cap on the amount you can receive in benefits, termed your “Average Current Earnings,” or “ACE” Basically, you are allowed to collect 80% of your pre-injury earnings between the two programs.
If you have questions about what type of benefits you should apply for and qualify for it is a good idea to talk with an experienced Social Security Disability lawyer. If you need to apply for Social Security Disability benefits they are usually able to help you with the application process.
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