Most people are forced to learn about workers’ compensation when they are injured on the job. So what if your injury leaves you injured severely enough that you qualify for workers’ comp benefits, but your injury lasts longer than your benefits?
In this scenario, you should consider applying for Social Security disability benefits.
Types of Social Security disability insurance
There are 2 types of Social Security disability benefits available to those who are injured.
1. Social Security Disability Insurance (SSDI)
Social Security Disability Insurance (SSDI) is a federally funded program that provides those who haven’t reached the age of full retirement with a monthly stipend in the event that they can’t work or have a substantial gainful activity (SGA).
In other words, SSDI is a form of long-term disability that requires the worker applying for the coverage to have a condition that prevents them from either earning more than a specific sum of money OR from working entirely. Not only is there a maximum for the amount of money a worker can earn each month, but the figure is quite low and changes regularly.
Furthermore, SSDI was developed to allow those who have become disabled severely enough that they can’ work but they have earned sufficient work credits to qualify for Social Security payments before the age of 65. There’s no set formula for the number of work credits needed to qualify for SSDI as the number depends on the age at which the worker became disabled, the amount of money they’ve earned and the year that they’re applying for SSDI.
2. Supplemental Security Income (SSI)
Supplemental Security Income is also part of the Social Security program; however, this payment is income-based. SSI payments are only available to adults and children who are disabled and have limited means.
Workers’ compensation and SSDI
When an employee is injured on the job, their first thought is typically on applying for workers’ compensation. What if their injury is severe enough that it will limit their future earning potential and they could qualify for SSDI? Can they receive both benefits at the same time? The short answer is yes.
Qualified workers can draw payments from both workers’ compensation and SSDI; however, they should be aware that their SSDI payments will be reduced due to their workers’ comp benefits.
Additionally, there is a chance that a worker receiving both benefits may be required to pay taxes on the entire amount of SSDI payments they receive, meaning the original amount before it’s reduced for receiving workers’ comp benefits.
Another factor to consider is that the combined income an employee receives from workers’ comp and SSDI cannot exceed 80 percent of the income they were receiving when they became injured/disabled.
If the income totals more than 80 percent of their previous income, the Social Security Administration (SSA) will reduce the amount of SSDI they receive by enough money to keep them under the 80 percent threshold.
Additionally, if their workers’ compensation benefits run out while they’re still able to collect SSDI, a call to the SSA will allow them to reevaluate the person’s SSDI and raise their benefits accordingly.
Qualifying for workers’ compensation is much different from qualifying for SSDI. Workers’ compensation is granted when an employee is unable to perform the duties of their employment because they were injured on the job.
By comparison, the SSA requires that a worker be completely disabled to qualify for SSDI. This means that they are incapable of performing any work in any field that you could train for—not that they can’t work to the standards they did before becoming injured.
Furthermore, the injury must be severe enough that it should last over 1 year or result in death.
Montana SSDI benefits process
As with most things that are managed by the federal government, the process can be lengthy due to the volume of applications. There are typically 4 steps to the qualification process:
- Contact the Social Security office for a disability benefits application.
- Once filled out, you’ll send the application to Montana’s Disability Determination Services (DDS).
- The DDS will review your medical records to determine benefits.
- The claim is either approved or denied.
If the claim is approved, the process stops here and the worker will begin receiving their benefits. If the claim is denied, there are further steps:
- Ask the DDS for a reconsideration.
- If the reconsideration is also denied, a hearing with the Office of Adjudication and Review (ODAR) can be requested.
- In order to negotiate during the hearing, you should hire a personal injury attorney.
From start to finish, the process can take between 3 and 4 months to receive a decision. On average, a third of those who apply for SSDI in Montana are denied on their first submission. Most claims are denied due to insufficient evidence (for example, incomplete medical records).
If a person’s reconsideration is also denied, the wait for an appeal through the Office of Adjudication and Review can take even longer. Some cases have a wait time of over 1 year before a hearing date is set. This hearing is an injured worker’s final chance at receiving benefits through SSDI; this is why it’s vital to hire an experienced disability attorney to help.
If you’ve been hurt on the job and feel you’re entitled to workers’ compensation, disability or both, it’s essential that you hire an attorney who is experienced in these types of lawsuits. Getting in front of a judge for a hearing can be confusing and downright intimidating, but hiring an experienced attorney can help make you feel more at ease.