If you are disabled because of an injury suffered in the course of your employment, you may qualify for both workers’ compensation and Social Security Disability Insurance (SSDI) benefits. However, it’s important to understand the relationship between these programs since there is a limit to how much you can receive in total benefits.
How Workers’ Compensation Affects SSDI
Workers’ compensation benefits are available for most Virginia part-time and full-time employees who were injured on the job, even if their own inexperience or inattentiveness caused their injury. Most workers receive benefits temporarily, but lifetime medical care and permanent partial disability benefits are available when a worker has suffered the loss of use of a body part, amputation, disfigurement, bodily scarring, loss of hearing, loss of vision, or lung disease.
SSDI benefits provide compensation when a person has a physical or mental impairment that has lasted 12 months or more, is expected to last 12 months or more, or is considered terminal. The impairment must be severe enough that it prevents the applicant from returning to their previous employment or finding other types of employment suitable for their age, education, and experience. Only workers with the most serious injuries will be eligible for both workers’ compensation and SSDI.
Understanding the Reverse Offset
Although it’s possible to receive benefits from both programs, people are not allowed to receive more than 80% of their previous earnings from workers’ compensation and SSDI. To calculate your previous earnings, the SSA will use one of the following:
- Your average monthly wage
- The average of the top five profitable months of the year (the “high five” method)
- Your most profitable year (the “high one” method)
The Virginia Workers' Compensation Board (WCB) will decrease your benefits to reach the 80% limit, if applicable. This is referred to as a reverse offset. States that are considered offset states will have Social Security reduce SSDI payments to meet the 80% threshold.
Medicare and Workers’ Compensation Benefits
People who receive SSDI become eligible for Medicare after 24 months, but Medicare provides secondary coverage for healthcare costs when other insurance is available. If your workers’ compensation settlement includes medical benefits, the workers’ compensation insurer is responsible for covering as much of the cost as possible.
Have You Or A Loved One Been Denied Social Security Disability Benefits?
If you or a loved on has been denied Social Security Disability Benefits you need to speak with an experienced SSD attorney as soon as possible. Please contact us online or call our Virginia Beach office directly at 757.490.3500 to schedule your free consultation. We have offices throughout Virginia including Chesapeake, Newport News, Norfolk and Suffolk.