The Intersection of Workers’ Compensation and Disability Benefits in Pennsylvania
In Pennsylvania, two key programs provide financial support to workers who are injured or disabled and unable to work: workers’ compensation benefits and Social Security Disability Insurance (SSDI). While applying for workers’ compensation does not affect your ability to apply for SSDI, it’s important to understand that if both claims are accepted, your workers’ compensation payments may reduce the amount you receive in disability benefits. Many workers eligible for both SSDI and workers’ compensation have long-term, serious work-related injuries or disabilities.
Understanding the Benefits
- Workers’ Compensation Benefits
Workers’ compensation is a state-mandated insurance program that provides financial assistance to employees who suffer work-related injuries or illnesses. In Pennsylvania, workers’ compensation covers medical expenses, a portion of lost wages, and rehabilitation costs for workers injured or made ill due to their job. These benefits are available regardless of who was at fault for the injury. - Social Security Disability Insurance (SSDI)
SSDI is a federal program designed to offer financial assistance to individuals with disabilities that prevent them from engaging in substantial work activity. Unlike workers’ compensation, SSDI benefits are not limited to work-related disabilities. To qualify for SSDI, applicants must have earned sufficient work credits and meet the Social Security Administration’s (SSA) strict definition of disability.
The Workers’ Compensation Offset of Benefits
When receiving both workers’ compensation and SSDI benefits, the Social Security Administration (SSA) applies what is known as the “workers’ compensation offset.” The purpose of this offset is to ensure that the combined total of both benefits does not exceed 80% of the worker’s average earnings prior to becoming disabled.
If the combined amount of workers’ compensation and SSDI benefits exceeds this 80% threshold, the SSA will reduce the SSDI payments to bring the total benefits below or at that limit. The workers’ compensation offset only applies to SSDI benefits and does not affect Social Security retirement benefits or Supplemental Security Income (SSI). Furthermore, once an individual reaches full retirement age, the offset no longer applies.
Before calculating the offset, the SSA will exclude certain expenses from the equation, such as legal fees, past and future medical expenses, rehabilitation costs, and other qualifying costs.
Eligibility for Both Benefit Programs
Although workers’ compensation and SSDI both provide crucial financial assistance, they have different eligibility criteria.
- SSDI Eligibility: To qualify for SSDI, the individual must be disabled for at least 12 months or have a condition expected to result in death. The disability does not need to be work-related.
- Workers’ Compensation Eligibility: Workers’ compensation, on the other hand, only applies to work-related injuries or illnesses. It does not have the 12-month disability requirement that SSDI has, meaning you may qualify for workers’ compensation without meeting the criteria for SSDI.
Seek Help from a Trusted Pennsylvania Workers’ Compensation Attorney
Navigating the complexities of workers’ compensation and SSDI benefits can be overwhelming. If you’re dealing with a work-related injury or illness and need guidance, Stern & Cohen can help. Our experienced attorneys specialize in workers’ compensation and can advise you on how receiving both SSDI and workers’ comp might affect your benefits. The consultation is always free and confidential—reach out to us today to ensure you’re in the best hands.