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Workers’ Compensation and Disability After an Accident

Workers’ Compensation and Disability After an Accident

If you suffer a workplace injury, you want reimbursement for your losses. Your employer should pay you for medical expenses and lost income benefits. Permanent injuries make the employee eligible for disability. This situation often leaves injury victims wondering if they can apply for and collect disability insurance and workers’ compensation simultaneously.

Working with the right workers’ compensation lawyer can result in getting both benefit options. There are some caveats to consider as they affect how much you can collect.

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How workers’ compensation works

Your employer provides workers’ compensation to cover workplace injuries. The guidelines for who should purchase these policies will vary. You qualify for workers’ comp from the first day of employment. You do not have to work a certain amount of time to gain access to these benefits. When you suffer an injury, you can file a claim to cover medical costs and supplemental income during your recovery.

An injury does not have to happen in the workplace, but you must perform work duties. Suffering an injury while on a business trip is sufficient for you to pursue workers’ compensation benefits. This is an employer-sponsored program.

Benefits for injured workers

Experience Lawyers for Workers’ Compensation in Orange County CA areaWorkers’ compensation provides a slew of benefits. The program intends for workers to heal and return to work. However, people with disabilities can benefit. Below are the benefits you may receive for your workplace injury:

Medical benefits

Employers are responsible for keeping you safe. When an injury occurs, they must pay for your medical treatments.

Some medical expenses they are responsible for paying include:

  • Primary care physician or specialist
  • Mileage reimbursement or transportation costs to travel to your appointments
  • Authorized medical procedures and treatments for your injury, such as:
    • Hospitalizations
    • Doctor’s visits
    • Physical therapy
    • Medical tests
    • Prostheses
    • Prescription medications
    • Attendant care  

Temporary total disability 

You can receive these benefits if you cannot work. You can recover a total of 104 weeks of these benefits. The duration of your temporary total disability benefits depends on your injury or illness.

You can receive the following depending on what medical professionals say:

  • 66⅔ of your regular income
  • Some severe injuries may result in the recovery of 80 percent of your income. This is up to six months after your injury.
  • You will not get benefits during the first seven days of your disability
  • State maximum reimbursement amounts might impact your recovery benefits

Temporary Partial Disability 

You may receive these benefits when your doctor deems you can return to work with restrictions. This benefit applies when you cannot earn 80 percent of your previous income. Like TTD, you can receive up to 104 weeks of these benefits.

Permanent Total Disability

Some injuries are so severe that the person can never work again. Once you reach maximum medical improvement, your doctor can determine if your condition hurts your ability to earn a living. They will likely evaluate you to get an impairment rating and permanent work restrictions. If they find it does, you might receive permanent total disability benefits. These benefits are long-term.

Vocational Rehabilitation Benefits

When employees can no longer work in the same role as before, they must change careers. Since the injury was not the employee’s fault, the employer may need to pay for vocational training. They may also have to help the employee find a job accommodating their limitations.

You can register for up to two years of vocational benefits with a maximum expenditure. The employee will also have various roles when applying for this program.

Death Benefits

Some workplace injuries and illnesses can lead to a loved one’s death. If the death occurs within a year of the accident, the family may recover death benefits. Additionally, if the death occurs within five years of continuous disability, that is another way to qualify.

Some of the benefits include:

  • Funeral expenses coverage up to $7,500
  • Educational benefits for the surviving spouse
  • Compensation for dependents

Benefits are typically payable up to $150,000 but will vary. The state has various guidelines to determine the acceptable amounts for these cases. Let a local workers’ compensation lawyer handle this process so you can focus on other things.

Helpful hints for workers’ comp claims

You enjoy your job and believe your employer will take care of you when you suffer an injury, but their insurance company may have other plans.

Here are some helpful tips for handling your claim:

  • Report your injury immediately and get medical attention. The employer can approve the initial treatment, but all follow-up care goes through the insurance company.
  • If you go to an emergency room, inform staff your injury was from a workplace accident. You must also give them the contact information for your employer.
  • Refrain from going to your primary care doctor until the insurer approves or you speak to a workers’ comp lawyer.
  • Attend all your appointments. Skipping even one can cause your benefits to cease.
  • If you receive any medical bills, forward them to the insurance company or your workers’ comp lawyer.

How Social Security disability works

While workers’ compensation is employer-sponsored, SSDI is federally sponsored by the Social Security Administration. However, there are some ties to your employment history. When you work, you pay into SSDI with every paycheck.

The program provides income to individuals with disabling conditions. Your condition does not need to result from a work-related accident to qualify for these benefits.

Eligibility for disability benefits

The eligibility requirements for Social Security disability vary from workers’ compensation.

To qualify for SSDI, you must meet the following criteria: 

  • Paid into SSD through prior employment
  • Earned sufficient work credits over a decade
  • Have a recognized disabling condition
  • Your condition prevents you from working for at least a year
  • Or have a situation expected to result in death

SSD is similar to workers’ comp in continuing until the person can return to work. However, you need to know all the stipulations of either program. Speak to a disability lawyer familiar with both programs.

Collecting workers’ comp and disability

Both programs are separate and different entities oversee them. If you receive benefits from one program, you might also benefit from the other. One program doesn’t disqualify you from another, but it will work in tandem in some areas.

One caveat is you cannot collect more than 80 percent of your previous income when you apply for either program.

Sometimes, employees receive workers’ compensation while waiting for their SSDI benefits approval. Other times, people will get benefits from both programs. When that happens, your SSD may decrease by a certain amount depending on your workers’ compensation award. The Social Security Administration will handle these calculations and inform you of the max you can get from either program.

Workers’ compensation is often temporary and can end while you are in both programs. If that happens, you should inform the SSA that workers’ compensation benefits are no longer coming in. They will review your case again, and you might see increased SSD benefits.

Defining disability

The definition of disability varies for workers’ comp and Social Security agencies. For workers’ compensation, you suffer a disability if a workplace injury prevents you from performing your duties. You can obtain temporary total disability benefits in these instances, assuming you can return to work after completing your treatment.

Social security has a different definition. You must be unable to work in any capacity to get these benefits. You cannot perform tasks at your previous job or any other occupation. If the disability stems from a workplace accident, you may qualify for permanent total disability benefits in workers’ comp and SSDI benefits.

Sometimes, you can recover permanent partial or temporary partial disability benefits. You can do this through your workers’ comp claim if you are left taking a lower-paying job once you can return to work.

Approval for workers’ comp and disability

The first thing you must do is get medical attention. Then, you can start on your claim.

Some steps you should take include:

  • Report your injury to your employer
  • Complete paperwork for your workers’ comp claim
  • Submit the paperwork to your employer and their insurance company
  • Continue and complete your medical treatments
  • Speak to a local workers’ compensation lawyer
  • Begin an SSD application if you qualify

Move quickly and start either application immediately. Workers’ comp can take several days or weeks to go into effect. A disability case can sometimes take months. Time is of the essence. Before submitting any paperwork, ask a workers’ comp lawyer for help. A minor error can result in a benefits denial.  

How denials can happen

It is sad to say, but denials for SSDI and workers’ comp benefits are common. Many people get a rejection on their first attempt. This often leads to them losing faith that they will overcome this situation.

Do not fret. A lawyer can get you the financial benefit you deserve for your disability. Often, people believe these programs are a charity, but they are not. You are putting money into these programs with every paycheck. If you need these benefits, you should have access to them.

After a rejection, you have the opportunity to appeal the decision. However, you should enlist the help of a disability lawyer to do so. They can review your initial application and denial letter to determine the best approach. They will craft the best strategy to get your approval. However, these actions take time. The longer you wait, the more challenging you will make it.

Differences between SSDI and short-term state disability insurance

Social Security disability insurance and short-term disability are different programs. You must know the differences to seek compensation from the right one. The first difference is one is a federal program, and the other is state-specific. The state program can take up to 14 days to process, while the SSDI can take three to five months. SSDI has strict eligibility requirements.

Short-term disability only lasts for a year. SSDI can last as long as the disability does or until the person turns 65 and reaches retirement eligibility. The amount you can obtain from each program also varies.

Short-term disability depends on your income, while SSDI has monthly caps. Depending on your circumstances, you can qualify for one or both programs. You must consider these programs and how they affect your workers’ comp claim. It can get confusing with so many disability benefits and programs. Speak to a disability lawyer to find the best option for your injury.

Why you need legal assistance

Before you hire a lawyer, you must ensure they have experience handling SSD and workers’ compensation claims. An attorney with experience in only one of these might need help to give you advice or assistance on getting a benefit in the other program. However, some attorneys work in tandem with lawyers who have experience with the other program. Our workers’ comp lawyers will advise you on the best course of action for your situation

Your legal team will do many things to get the benefits you need for your injury or disability.

When handling SSD and workers’ comp cases, they will:

  • Complete and file all legal applications, documents, and paperwork to avoid mishaps
  • Gather evidence to support both claims
  • Speak to experts in the field and obtain supporting testimony
  • Represent your best interests from the Social Security Administration and workers’ compensation insurance company

Get an initial consultation with an experienced lawyer today. They will make an assessment and craft a strategy that benefits you. Our goal is to get you a successful outcome.

Greg Bentley & Keith More - Experienced Workers’ Compensation Cases Lawyer in Orange County CA area

Greg Bentley & Keith More Workers’ Comp Attorney in Orange Count

Speak to a disability lawyer today

You will have many decisions to make when you suffer a workplace injury. The first is, of course, to get medical treatment. Then, you must decide what legal steps to take.

The best action step is to speak to an experienced personal injury lawyer in Orange County immediately.

Schedule a Free Initial Consultation Today!