My name is Antonio Bruni. I’m with the firm of Michles and Booth, and I’m here to talk to you today about disability benefit programs, and specifically workers’ compensation programs and Social Security Disability (SSD).
These are two separate and distinct programs that have a lot of overlap between them, so it’s something that comes up quite a bit and something that we’re going to want to address and discuss today.
We’ll get started and we’ll start with what is the difference between workers’ compensation and Social Security Disability?
Workers’ compensation is a federal or state program that pays medical benefits and lost wage benefits if you’re injured in the course and scope of employment. If you fall and injure your back at work, they will send you to the doctor and pay your lost wages while you’re work until your back is healed up.
That’s a simplification, but that’s basically how it works. If you fall and hurt your back at home, workers’ compensation will not help you. You have to be on the clock at work.
Social Security Disability
SSD is a federal program that covers medical and lost wages but does not care how you hurt yourself. If you are unable to perform what’s called substantial gainful activity, which means you can’t perform full-time work for at least a 12 month period or you have a condition that’s expected to end in death, then Social Security will accept you, pay you lost wages every month up to about $2,600, and they will grant you Medicare after a waiting period. Unfortunately, the waiting period is about 24 months.
With workers’ compensation, there is no medical waiting period. With Social Security, there is a 24 month waiting period.
The Differences & Similarities
What they both have in common are some lost wage provisions and some medical benefit provisions. Workers’ compensation obviously is for injuries, accidents that occur at work. Social Security Disability is can be for any medical condition, regardless of whether or not it happened at work.
Qualifying As Disabled – Full-time vs Part-time
Since we’re in Florida, I’ll explain the Florida workers’ compensation criteria. We’re talking about disability, so I’ll do what’s called permanent and total disability. In order to qualify as permanently and total disability in Florida, you have to be incapable of performing at least sedentary work within a 50-mile radius of your residence.
In Florida, they’ll go and look to see if any job exists that’s hiring within 50 miles of your residence that you could so perform based on your work restrictions. It can be a part-time job or a full-time job, and it can be any job that you basically have the resume to perform.
The difference between that and Social Security is that Social Security requires that that job is full time. Whereas workers’ comp could say, “look there’s a job that’s available working 12 hours a week, you’re not disabled”. Social Security would say 12 hours a week isn’t a full-time job, you can still be disabled. That’s a fairly significant difference between disability on workers’ comp and disability with Social Security is the difference of requiring full-time versus non-full-time work.
Workers’ compensation, you’re not disabled if you can still do part time work. Social Security, if you can only do part time work, you could still be disabled.
Qualifying As Disabled – Hiring vs Not-Hiring
Social Security also looks nationwide and they don’t have to be hiring. With Social Security, the job just has to exist anywhere in the country. If we’re in Pensacola, Florida and the job exists in Washington State and if they’re not hiring, it doesn’t matter. The job exists. It exists in the United States. You could still do it. You’re not disabled. In Florida work comp, it has to exist, they have to be hiring, and it has to be within 50 miles of your house. There are some differences, but the criteria for acceptance are not the same between work comp and SSD.
The Amount Paid Is Different
There’s also a difference in how the amount that you’re paid is determined. In workers’ compensation, the amount that they’re going to pay you comes usually every week or two and it’s based on how much you earned in the 13 weeks before you hurt yourself. Social Security Disability bases it on your earnings over your lifetime and at least over the last five years. It’s over a much longer period in average earnings that you’ve had with SSD; with workers’ compensation, they’re really just looking at the three months before your hurt yourself.
Workers’ compensation benefit tends to be a higher benefit. SSD benefit averages about $1,100 a month, which is about $250 a week, while the workers’ comp benefits usually average around $400 a week.
Can You Qualify for Both?
The next topic that usually comes up is can I do both? The answer to that is yes, you can have both. You can be on Social Security Disability and permanent and total disability through workers compensation. You can file your claim for SSD while your workers’ compensation claim is still open; or you can file your SSD claim after you’ve settled your workers compensation claim, but this is one that gets extremely complicated and this is one that you really, really need to hire an attorney for because there are offsets.
Be wary Of Offsets!
In the state of Florida, the state of Florida is known as a reverse offset state, which means the workers’ compensation carrier can take the offset over the Social Security Administration.
What that means is if you have an attorney when you settle your workers’ compensation claim, they can make sure that the language is included in your workers’ compensation settlement documents that says that the offset has already been taken and that way Social Security will not be able to reduce your monthly check because you got a workers’ compensation settlement.
If that language is not in there, if your lawyer does not protect you, Social Security will reduce your Social Security check if you had a workers’ compensation claim during the period you’re claiming disability. They will do it. They will do it every time. If you do not tell them about it and they figure it out on their own later, they will reduce your checks later and ask for money back. They’re going to find out, you need to tell them about it, and you need to hire an attorney and make sure that you are protected.
Just know there’s an offset that you don’t get your full social security benefit and your full workers’ compensation benefit, either the work comp carrier or the Social Security Administration is going to try to take that offset and you need to hire an attorney to make sure that they don’t both take it. Be wary of that.
If you have any other questions, you can call Michles and Booth. We have a free, no obligation consultation. My name is Antonio Bruni, and I represent injured workers and Social Security Disability claimants. I’m happy to talk to you about this anytime you want. You have a great day. I’ll talk to you all soon.
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