Workers' Compensation and Disability Benefits Information

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Are you unable to work because of an injury or illness? If so, you may be eligible to receive workers' compensation or disability benefits.

Workers' Compensation

Employees who are injured or become ill on the job are covered by state workers' compensation laws. In every state, employers are required to have workers' compensation insurance though there are a few exemptions. Benefits include payment for lost wages and payment of medical bills.

 However, you will only be paid a portion (usually two-thirds) of your salary. The first step in filing a claim is to notify your employer. Your employer should be able to supply you with the forms needed to file a claim. If they can't, contact your state Workers' Compensation Office immediately.

Disability Insurance

California, Hawaii, New Jersey, New York, and Rhode Island have state-sponsored disability programs. These programs are typically short-term, and the benefit amounts are low. In New York, for example, the weekly benefit amount is 50% of the employee's average weekly wage, up to $170 for a maximum of 26 weeks.

Your employer may also provide additional disability coverage in these states as well as in the rest of the country. So, if you are unable to work, your first step should be to inquire as to what insurance your employer provides. If you have your own disability coverage, file a claim with that insurance company as well.

If you don't have state or employer-based coverage, consider purchasing disability insurance while you're healthy. First, check with your employer to see what coverage they provide, then ask if you can purchase supplemental coverage. Calculate if the benefits you'll get will be enough to maintain your lifestyle.

If they're not, consider purchasing personal disability insurance.

Social Security Disability

To qualify for benefits, you must first have worked in jobs covered by Social Security. Then you must have a medical condition that meets Social Security's definition of disability. In general, monthly cash benefits are paid to people who are unable to work for a year or more because of a disability.

According to the Social Security Administration, the following types of impairments may qualify an individual for social security disability:

  • Disorders of the musculoskeletal system.
  • Special senses and speech including loss vision, hearing, and speech.
  • Respiratory disorders like asthma, cystic fibrosis, and chronic pulmonary hypertension.
  • Cardiovascular impairments impacting the proper functioning of the heart or circulatory system.
  • Digestive system disorders including gastrointestinal hemorrhage, liver dysfunction, inflammatory bowel disease, and short bowel syndrome.
  • Genitourinary disorders that compromise kidney function and result in chronic kidney disease.
  • Hematological disorders including cancerous diseases like lymphoma, leukemia, multiple myeloma, and non-cancerous disorders like thrombosis and hemostasis.
  • Skin disorders like ichthyosis, bullous diseases, chronic infections of the skin or mucous membranes, dermatitis, hidradenitis suppurativa, genetic photosensitivity disorders, and burns.
  • Endocrine disorders including diseases attacking pituitary, thyroid, parathyroid, adrenal, and pancreas glands.
  • Congenital disorders that affect multiple body systems
  • Neurological disorders like parkinsonian syndrome, benign brain tumors, cerebral palsy, spinal cord disorders, and multiple sclerosis.
  • Mental disorders including schizophrenia spectrum, bipolar disorders, anxiety and obsessive-compulsive disorders, and autism spectrum disorders.
  • Cancers - malignant neoplastic diseases.
  • Immune system disorders including autoimmune diseases and immune deficiency disorders.

The application process takes 60 - 90 days. Then there is a sixth-month waiting period before you can collect a check.

When and How to File a Claim

  • If you are injured or temporarily or permanently disabled file a claim immediatelyIn many cases, there are dates that claims should be filed by to be valid, typically no later than 30 days after the injury or the illness began.
  • Contact your state Workers' Compensation Board, your state Department of Labor or the Social Security Administration if you have any questions or need help filing a claim.

Getting Legal Help

Many individuals engage a social security disability lawyer to help them navigate the complexities of the system and enhance their chances of being approved for benefits. According to NOLO, attorneys may offer a free consultation and collect fees only after you have successfully secured your disability coverage.

Legal fees are federally regulated, and you will generally be charged the lesser of 25% of your social security back pay (money owed to enrollees covering the time from the application date to the date of approval) or $6000.

Please note: This is general information on workers' compensation and disability insurance. Contact your employer, state Worker's Compensation Office for a determination on your specific circumstances.