Workers Compensation Newsletters

Correlation Between Workers' Compensation and Social Security Disability Benefits

Workers' compensation and social security disability insurance (SSDI) benefits both aim to help disabled individuals by providing funds for income replacement. Though similar in purpose, the programs diverge in their criteria for the receipt of benefits. Eligibility for workers' compensation benefits requires that the individual be an employee who was injured on the job. In contrast, SSDI benefits are only issued to those individuals who are so severely disabled by a medically determinable impairment that they cannot engage in any substantial gainful activity. Additionally, to be declared eligible for SSDI benefits, an individual must have worked long enough to be "insured" and must not have reached a certain age.

"Substantial Gainful Activity" for Social Security Disability Determination

To be declared "disabled" for social security disability purposes, the individual must not be able to engage in any substantial gainful activity. "Substantial gainful activity" is a term of art used by the Social Security Administration (SSA) to mean doing significant physical or mental activity for pay or profit. An individual's work can still be substantial even though it is engaged in less than full-time. The SSA does not normally consider activities such as household chores, hobbies, school attendance, or participation in social programs or clubs to be substantial gainful activity.

Jones Act of 1920

The purpose of the Jones Act of 1920, also known as the Merchant Marine Act, is to provide compensation for seamen who have been injured in the course of their employment. Like the Federal Employers' Liability Act for railroad workers, the Jones Act is an alternative to traditional workers' compensation statutes. The Jones Act allows an injured seaman to pursue a negligence action against his employer for money damages that represent, among other things, lost wages, pain and suffering, and emotional distress. Should the injury result in the seaman's death, the Jones Act also authorizes an action by the seaman's personal representative, with any damages recovered going to the seaman's spouse, children, or parents as the case may be.

Arbitration and Mediation

Alternative dispute resolution (ADR) has come to play an increasing role in the resolution of workers' compensation disputes. Almost half the states now offer arbitration and/or mediation as viable ADR methods.

"Benefits" Under the Black Lung Benefits Act

Once eligibility under the Black Lung Benefits Act has been established, a totally disabled miner will receive benefit payments equal to a portion of the monthly pay rate for federal employees. Should the miner succumb to the pneumoconiosis disease, his surviving widow will be entitled to the same monthly benefit payment. If the miner has no surviving widow, his single surviving child will also receive the same monthly benefit amount. The benefit amount increases incrementally with each subsequent surviving child. Finally, if there is no surviving widow and no surviving children, the miner's dependent parents or siblings will receive a monthly benefit amount at the children's rate. The receipt of payments pursuant to workers' compensation or unemployment insurance may reduce these beneficiary amounts.