Can You Collect Social Security and Workers’ Comp at the Same Time in Illinois?

When accidents happen at work, there are two financial sources most people utilize. Those are Social Security Disability Insurance (SSDI) and workers’ compensation. Many people believe they can only get one or the other, but you can receive both at the same time as long as you understand how they work together.

What is Social Security Disability Insurance (SSDI)?

SSDI is a federal program from the Social Security Administration (SSA) that provides financial assistance to people with a qualifying disability. The disability must prevent them from participating in substantial and gainful activities. To be eligible for SSDI, you need to meet these requirements:

• Be unable to work for a minimum of 12 months because of the disability;
• Have worked long enough and recently enough to earn enough Social Security work credits;
• Have a medical condition that falls under the SSA’s definition of a disability.

The benefits from SSA are based on your average lifetime earnings before you had your disability. This program provides monthly payments to help cover the cost of living and sometimes includes Medicare coverage only after a two-year waiting period.

What is Workers’ Compensation?

Workers’ compensation is a state-mandated insurance program that helps employees financially when they suffer work-related illnesses and injuries. A key difference between workers’ compensation and SSDI is that SSDI is a federal program while workers’ compensation is a state program, which can vary from state to state. Requirements for workers’ compensation are:

• Have an injury or illness that is related to your job;
• Be an employee of a company with workers’ compensation insurance;
• Report the injury or illness to the employer within the specified timeframe;
• File the workers’ compensation claim within the state’s deadline.

Even though workers’ compensation laws can vary from state to state, workers’ comp benefits typically include:

• Medical care for the injury or illness;
• Death benefits for surviving dependents if the work-related injury or illness caused a death;
• Temporary disability benefits to help partially replace lost wages;
• Permanent disability benefits if you can’t fully recover;
• Supplemental job displacement benefits to help enhance or retain your skills.

Can You Receive Workers’ Compensation Benefits and Social Security Disability Benefits Simultaneously?

Yes, you can get workers’ compensation and SSDI benefits at the same time. That being said, there are certain limitations and considerations you should be aware of when receiving both simultaneously.

How One Affects Another

Even though you can receive SSDI and workers’ compensation simultaneously, the amount you’ll receive can be affected by what they call the “offset” rule. The offset rule prevents people from receiving more combined benefits than they would’ve before becoming disabled.

The Social Security Offset

The Social Security Administration applies an offset when the combined total of your workers’ compensation and SSDI benefits is more than 80% of your average current earnings (ACE) before the disability. You’ll hear this 80% threshold as the applicable limit.

If your combined earnings are more than 80%, the SSA will reduce your SSDI benefit to bring the total below 80%. This offset applies only to the SSDI benefit; the workers’ compensation benefits will stay the same.

How the Offset is Calculated

There might be other factors that go into how they calculate the offset, but here’s an example of how a simple offset would work if your average current earnings before disability were $3,000 per month:

• 80% of your ACE of $3,000 would be $2,400
• Your monthly worker’s compensation benefits are $1,500
• Your monthly SSDI benefit is $1,400

Your combined monthly benefit would be $2,900, which is more than your limit of $2,400. The SSA would then reduce your SSDI benefit by $500 to make your total $2,400. Here’s your benefit breakdown based on this example:

• Worker’s compensation benefit is $1,500
• SSDI benefit is $1,400 minus $500 ($900)
• Your total would be $2,400 to meet the 80% applicable limit

Exceptions to the Offset

In some cases, there are exceptions where the SSA offset rule doesn’t apply. Some exceptions are:

• Public Disability Benefits: Some disability benefits, like those from the Veterans Administration or under the Black Lung Act, don’t require an offset.
• Reaching Full Retirement Age: Once you reach the full retirement age of 67, the SSDI benefits convert to retirement benefits, and the offset no longer applies.
• Lump-Sum Settlements: If you receive a lump-sum worker’s compensation benefit, the SSA can prorate the amount over time, which affects how they apply the offset.
• State Variations: Some states have laws that shift the burden of the offset to worker’s compensation instead of the SSDI benefit. This is sometimes called reverse offset.

Navigating the Claims Process

Maximizing your benefits by applying for both these benefits can be very helpful, but the process can be complex. Understanding how these claims processes work will help you feel more prepared as you move through the process.

Applying for Both Benefits

When you’re applying for both benefits, it’s important that you:

• File each claim as soon as possible after you become disabled;
• Provide accurate and thorough information on all the application forms;
• Gather and submit any relevant medical evidence to support your disability claims;
• Prepare yourself for potential delays or appeals, particularly with the SSDI claim;
• Maintain detailed records of all your medical treatments, communications, and benefit payments.

Remember, the SSDI and worker’s compensation benefits are separate claims. Just because you’re approved for one doesn’t mean you’re automatically approved for the other.

Coordination Between the Social Security Administration and Workers’ Comp Insurer

Ensuring effective communication between SSA and your worker’s compensation insurance company is vital to make sure that they perform accurate benefit calculations. You should:

• Report any changes in your worker’s compensation benefit as soon as possible to SSA;
• Keep both benefits insurer informed of your present medical status;
• Provide documentation from one agency to the other when they need it.

Any miscommunication can lead to overpayment of benefits, resulting in you having to make payments later.

The Role of a Lawyer

Since applying for both these disability benefits can be a complicated and tedious process, working with an attorney and legal team with experience with these claims individually and simultaneously can be helpful. A knowledgeable Chicago workers’ compensation lawyer, like those at Rosenfeld Injury Lawyers, can:

• Guide you through the application process for both benefit programs;
• Make sure all documentation is submitted correctly;
• Represent you in appeals if your claim is initially denied;
• Help you understand the offset rule if it applies in your case;
• Negotiate a lump-sum settlement to minimize the impact on your SSDI benefit;
• Help ensure you receive the maximum benefits that you’re entitled to with both programs.

Hiring a lawyer will help you avoid any mistakes that could delay or result in a claim denial. This means you’ll get access to your benefits sooner after a workplace accident than if you were to do it alone and potentially make a mistake.

Secure Expert Legal Representation

There’s a level of complexity when navigating Social Security disability insurance and workers’ compensation, so having an experienced legal team on your side is critical. Our attorneys at Rosenfeld Injury Lawyers have experience handling situations like these and will help guide you through the process.

We understand the intricacies of workers’ compensation and social security claims and will work to ensure you’re paid the full benefits you’re owed while avoiding any delays or pitfalls. Contact Rosenfeld Injury Lawyers by calling (888)-424-5757 or filling out our contact form to schedule your free consultation.

All content undergoes thorough legal review by experienced attorneys, including Jonathan Rosenfeld. With 25 years of experience in personal injury law and over 100 years of combined legal expertise within our team, we ensure that every article is legally accurate, compliant, and reflects current legal standards.