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Total temporary disability, Social Security disability benefits allowed for same injury
Injured workers in West Virginia can receive temporary total disability benefits and Social Security disability benefits for the same injury. The Social Security benefits are reduced to prevent a double recovery.
Case name: Bevins v. West Virginia Office of the Insurance Commissioner, No. 35548 (W.Va. 10/14/10). Ruling: The West Virginia Supreme Court of Appeals held that injured workers may be entitled to temporary total disability benefits while they also receive Social Security disability benefits in connection with the same injury if they prove an aggravation or progression of the injury.
Summary: In two consolidated cases, workers sustained compensable injuries that prevented them from returning to work. As a result, the workers received Social Security disability benefits. Subsequently, both of the workers suffered an aggravation or progression of their compensable injuries and filed applications for reopening to request temporary total disability benefits. Their requests for benefits were denied. The West Virginia Supreme Court of Appeals held that the injured workers could receive temporary total disability benefits while receiving Social Security disability benefits in connection with the same injury. One worker's case was sent back to the lower court for an award of benefits, and the other worker's case was sent back for further findings to determine whether he sustained a progression or aggravation of his compensable injury. The court explained that TTD benefits are awarded for the inability to return to substantial gainful employment and should be terminated when the worker reaches his maximum medical improvement or has been medically certified to return to work. A claim can be reopened for additional TTD benefits if the worker incurred a progression or aggravation of his compensable injury. The court stated that the law was silent on the effect of Social Security disability benefits on a worker's entitlement to TTD benefits. Based on the law's express inclusion of conditions that bar compensation, the court presumed that the legislature did not intend to impose a bar on recipients of Social Security disability benefits. In discussing a concern that workers may receive a double recovery, the court explained that federal law provides for an offset in Social Security benefits where an individual receives both Social Security and workers' compensation benefits. The court stated the existence of the provision supported its conclusion that a worker can simultaneously receive both benefits. Read more at the WorkersComp Forum homepage. January 3, 2011 Copyright 2011© LRP Publications |
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