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Sam Gaylord
Sam Gaylord
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Injured Worker Receives Less Being Totally Disabled

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One of the toughest conversations I have had with a client recently occurred. Congratulations! I had said to my client we were successful in getting for you lifetime benefits, however, since the insurance carrier has been paying you an offer in advance and since you and your children receive Social Security Disability you get less per month then you have been receiving and, oh by the way, you owe money back to the carrier.

In the State of New Jersey, an injured worker receives three very specific benefits when they become injured while working. An injured worker receives medical benefits, which are directed by the carrier, temporary disability benefits, which are 70% of the injured workers gross weekly wage, and an award for their injuries. In certain circumstances an individual is so injured they will be determined to be totally disabled and entitled to receive benefits from workers compensation for the rest of their life. New Jersey is a “reverse offset” state with Social Security Disability. In essence, what this means is that the carrier offsets their payments if an individual receives social security disability benefits. In other words, their payments get reduced.
So, my scenario is while trying to negotiate the claim, the carrier, in an attempt to help my client, makes a voluntary offer towards what will be the inevitable outcome. In so doing, they pay my client not taking into consideration his receiving social security disability benefits. The case finally settles and with the offsets he is entitled to less per week and owes money back to the carrier. My clients’ benefits will not increase until sometime right before his 62nd birthday. He is currently 54 years old. So, it was Congratulations, we won, you get less.