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Can I Get Disability After a Workers Comp Settlement? (2024 Update)

Whether you can receive disability benefits after a workers’ compensation settlement depends on various factors, including the terms of your settlement and the specific disability benefits you are seeking. It’s crucial to consult with a disability attorney who can review your specific situation and help you understand how a workers’ compensation settlement may impact your eligibility for disability benefits.
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C.L. Mike Schmidt Published by C.L. Mike Schmidt
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What is Workers Compensation?

According to the WCB, workers’ compensation is an insurance program that provides financial and medical benefits to employees who are injured or become ill as a direct result of their job [1].

Employers pay for this insurance, and shall not require the employee to contribute to the cost of compensation. Weekly cash benefits and medical care are paid by the employer’s insurance carrier, as directed by the Workers’ Compensation Board. The Workers’ Compensation Board is a state agency that processes the claims. If Board intervention is necessary, it will determine whether that insurer will reimburse for cash benefits and/or medical care, and the amounts payable – was stated at the Board.

In workers’ compensation cases, no party is found to be at fault. The amount a claimant receives is not reduced by their own carelessness or increased by the employer’s fault. However, a worker loses the right to workers’ compensation if the injury results solely from their intoxication from drugs or alcohol, or from their intent to injure themselves or someone else.

A claim is paid if the employer or insurance carrier agrees that the injury or illness is work-related. If there is a dispute, no cash benefits are paid until a workers’ compensation law judge decides. If a worker is not receiving benefits because the employer or insurance carrier disputes the job-related nature of the injury, the worker may be eligible for disability benefits in the interim. Any payments from the Disability Program will be deducted from future workers’ compensation awards.

If a worker can return to work but their injury prevents them from earning the same wages as before, they may be entitled to a benefit that covers two-thirds of the difference. They may also return to work in light or alternate duty before being fully healed.

What are Disability Benefits?

According to the Social Security Administration, Social Security Disability Insurance (SSDI) is a government program that provides benefits to disabled workers and their dependents [2]. To qualify for SSDI, workers must have earned coverage by paying Social Security taxes on their earnings. The program aims to replace some of the lost income for individuals who can no longer work due to a disability.

Because the Act defines disability so strictly, Social Security disability beneficiaries are among the most severely impaired in the country. In fact, Social Security disability beneficiaries are more than three times as likely to die in a year as other people the same age. Among those who start receiving disability benefits at the age of 55, 1-in-6 men and 1-in-8 women die within five years of the onset of their disabilities – Stated Administration.

The eligibility criteria for SSDI are defined very strictly under the Social Security Act. Unlike some other disability programs, SSDI does not provide temporary or partial disability benefits. To qualify for SSDI benefits, an individual must have a severe medical condition that has lasted or is expected to last at least one year or result in death. The condition must also prevent the individual from performing their past work or adjusting to other work.

Also Read: How Often Do Workers Comp Cases Go to Trial?

Which Kind of Social Security Disability and Workers’ Comp Benefits is a Victim Eligible to Claim in California After a Workers’ Comp Settlement?

According to Gaylord & Nantais, if a victim meets certain criteria, they may be eligible to apply for Social Security disability benefits following a workers’ compensation settlement in California [3].

Here are three important factors to consider:

  • Social Security Disability Insurance (SSDI): If an occupational injury leaves you permanently disabled and unable to perform substantial gainful activity for at least a year, you may qualify for SSDI. You must have accumulated enough work credits from previous jobs to be eligible.
  • Supplemental Security Income (SSI): Administered by the Social Security Administration (SSA), SSI provides financial assistance to disabled individuals with limited resources. If your workers’ compensation settlement is insufficient to meet all your financial needs, you can apply for SSI to supplement your income.
  • Medicare: Some individuals receiving Social Security disability benefits may also qualify for Medicare, which can help cover their disability-related medical expenses.
  • Offset of Benefits: California has a workers’ compensation offset policy, which means that if you receive both workers’ compensation benefits and SSDI payments, there may be an offset applied to your SSDI benefits. The combined amount of workers’ comp and SSDI cannot exceed a certain limit.
  • Vocational Rehabilitation and SSA Evaluations: Following a workers’ compensation settlement, the SSA may assess your eligibility for disability benefits differently. They consider not just the tasks you were performing before the injury but also your ability to perform any type of work. If it’s determined that your illness or injury prevents you from engaging in any work activity, you may still be eligible for SSDI payments. It’s important to note that the maximum monthly SSI payment for 2023 is $914 for an individual and $1,371 for a couple. Understanding this can help you calculate the lump sum settlement payment you may receive.

Workers Comp Insurance Statistics, 2013-2022

Combined ratio (1)
Year Net premiums
written (2)
Annual percent
change
Calendar
year (3)
Annual point
change (4)
Accident
year (5)
Annual point
change
2013 $41,147,216 5.6% 103.0 -7.4 pts. 94 -7 pts.
2014 43,753,885 6.3 101.9 -1.2 88 -5
2015 45,355,102 3.7 95.5 -6.4 86 -2
2016 45,619,831 0.6 95.6 0.1 85 -1
2017 45,047,380 -1.3 92.2 -3.4 87 2
2018 48,614,131 7.9 86.3 -5.8 90 3
2019 47,146,756 -3.0 88.3 2.0 94 5
2020 42,529,620 -9.8 90.2 1.9 97 3
2021 43,051,105 1.2 91.4 1.2 100 3
2022 47,569,194 10.5 87.40 -4.0 97 (6) -3

Source: Insurance Information Institute [4]

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If you or a loved one was involved with these matters, you should contact our law firm immediately for a free case evaluation. You may be entitled to a settlement by filing a suit and we can help.

References:

1. https://www.wcb.ny.gov/content/main/Workers/what-is-workers-compensation.jsp
2. https://www.ssa.gov/disabilityfacts/facts.html
3. https://gaylordnantais.com/2023/10/07/ca-social-security-disability-workers-comp-settlement-2023
4. https://www.iii.org/fact-statistic/facts-statistics-workplace-safety-workers-comp

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