While the law does allow you to receive Social Security Disability benefits after being awarded workers’ compensation benefits in Colorado, your Social Security Disability payments will be reduced, such that the total of your workers’ compensation benefits and Social Security Disability benefits does not exceed 80 percent of your average weekly wage when you were working.
Trying to collect both workers’ compensation and Social Security Disability benefits can be a complicated process. Let an experienced workers’ compensation attorney from The Sawaya Law Firm help you pursue the full benefits you are eligible to receive from workers’ compensation and Social Security. Contact our firm today for a free consultation.
How Do You Qualify for Workers’ Compensation Benefits in Colorado?
An employee can qualify for workers’ compensation benefits in Colorado if he or she is injured in the course and scope of employment, or if the employee develops an occupational illness or medical condition, and that injury or illness requires medical treatment and/or keeps the employee out of work.
A worker does not need to prove that his or her employer bears some fault for the injury or illness. The worker only needs to establish the work-related nature of the injury or illness. A worker can qualify for workers’ compensation benefits even if the person bears responsibility for the work injury or occupational illness (although in certain circumstances, a worker’s own fault might render him or her ineligible for benefits).
How Do You Qualify for Social Security Disability Benefits in Colorado?
A person qualifies for Social Security Disability benefits if he or she has a medical condition and specific criteria that are listed in the Social Security Administration’s medical guide, called the Blue Book. Your disability must also be expected to last for at least 12 months or result in death. For example, if you claim you are disabled due to cancer, you must meet the specific medical criteria for your type of cancer in order for your condition to be deemed disabling.
You will generally need to present medical documentation to substantiate your claim, including showing that you do not have any residual functional capacity, or RFC. If the Social Security Administration concludes that you have RFC, or an ability to work in a particular job that exists in substantial numbers in the national economy, you will not be found to be totally disabled, and thus, your claim for benefits will be denied.
In addition to establishing total disability, a person must have accumulated sufficient work credits to qualify for Social Security Disability benefits. You must have worked long enough and been employed recently enough to accumulate a certain number of credits, depending on your age. By default, a worker must have earned at least 40 work credits (with a maximum of four credits earnable per year), with 20 of those credits earned in the last 10 years. Younger workers have lower requirements.
Is There A Limit on the Amount of Compensation Available From Worker’s Comp?
Although workers’ compensation does not place a limit on the amount of medical benefits you receive, there are limits on the amount of compensation you can receive for wage replacement or disability payments.
Wage replacement or total disability benefits under workers’ compensation are limited to two-thirds of your average weekly wage at the time of your injury, up to a maximum amount set by the state. Temporary partial disability benefits, which are paid if you return to work but end up earning a lower amount of income, are equal to two-thirds of the difference in your earnings, up to a maximum amount set by the state.
Can I Work While Receiving Workers’ Comp or SSD Benefits?
You may be eligible to receive workers’ compensation benefits even if you can still work. For example, if you can work but still require medical treatment for a work-related injury or illness, workers’ compensation will continue to pay for those treatments. Or, if you return to work with restricted duties and end up earning a lower amount of income compared to your pre-injury/illness income, you may receive temporary partial disability benefits from workers’ compensation to help offset the difference in your income.
However, if you are able to work, the Social Security Administration will deny your claim for disability benefits because Social Security does not provide partial disability benefits.
How Long Can I Get These Benefits?
Wage replacement or temporary disability benefits are paid until you reach maximum medical improvement (meaning your condition will not improve with any further medical treatment), and you return to work. However, if you reach maximum medical improvement and cannot return to work, you will be evaluated for a permanent disability.
If you are found to be permanently disabled, you will receive compensation at a set rate distributed over a set period of time, as set forth in the Colorado workers’ compensation schedule of payments, based on the extent of your disability.
My Claims Were Denied, Now What?
If your workers’ comp or Social Security Disability claim was denied, the first thing you should do is to confirm with your employer’s workers’ compensation insurer or with the Social Security Administration the reason or reasons your claim was denied. In many cases, claims are denied due to a lack of information needed to establish your eligibility, so clearing up the dispute can sometimes require submitting additional information or correcting clerical errors.
If the dispute is more complex than that, you also have the option to appeal the denial of your claim. Appealing the denial of a workers’ compensation claim or Social Security Disability claim involves a hearing before an administrative judge or hearing officer of the Colorado Division of Workers’ Compensation or the Social Security Administration.
If your claims for workers’ comp or Social Security Disability benefits have been denied, you should speak to an attorney who has extensive experience handling these specific types of claims. A knowledgeable attorney from The Sawaya Law Firm can help you understand your legal rights and fight for the full amount of benefits you deserve. Contact us to schedule a free consultation today.