The insurance that your Pennsylvania employer purchases can provide benefits to you if you suffer injury in the workplace. Such benefits might include financial provision to help cover medical expenses or replace lost wages if your injuries necessitate time off work during recovery. In some cases, you might qualify for Social Security Disability (SSD) benefits. There are intersecting issues with these two programs that you’ll want to be aware of before filing a claim.
SSD insurance is a federally governed program that provides financial supplement to workers who have certain medically determined conditions that impede their ability to work. In certain circumstances, it’s possible for you to collect SSD benefits and workers’ compensation at the same time. Such is the case whether you’re receiving workers’ comp installments or a lump settlement.
There is a cap on combined benefits amount
While it is often possible to receive SSD benefits and workers’ comp benefits simultaneously, certain regulations may affect the amount of total financial assistance you receive. In most cases, there is an 80% cap on the amount of benefits combined between the two programs, meaning that your total combined benefits may not exceed 80% of the typical income you earned before your disability arose.
The way it usually works is that your SSD benefits will be lowered, when necessary, to meet the 80% cap in conjunction with your workers’ comp benefits. In other words, if you’re receiving a certain amount of workers’ comp, it may lower the amount of SSD benefits for which you might be eligible.
Full disclosure of workers’ comp benefits is required
Some people mistakenly believe that they can qualify for a greater amount of SSD benefits by not disclosing the fact that they are receiving workers’ comp benefits as well. This is a big mistake. You’re required to fully disclose any amount of workers’ comp that you will be receiving or have received when you apply for SSD benefits.
Certain expenses may be excluded from calculations when determining whether there will be an offset in SSD benefits to meet the 80% cap. However, it is imperative that you report accurate workers’ comp information when filling out an SSD benefits application.
Making sure you receive maximum benefits
Filing a workers’ comp claim through a Pennsylvania employer or filling out an application for SSD benefits can be a complex and stressful experience. When you’re dealing with injuries or a health condition that prevents you from being able to work, trying to navigate the workers’ comp or SSD systems on your own might merely intensify your stress.
It’s helpful to seek additional support before navigating the claims process. Having a personal advocate on your side also comes in handy if one or both of your claims are denied.