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Social Security Vs. Workers’ Compensation

  • By: Tony Adderley
  • Published: July 10, 2013
BACK INJURY BENEFITS IN LOS ANGELES

There’s a big difference between Social Security Disability (SSD) benefits and Worker’s Compensation benefits. The two systems are independent of one another and, in fact, it may be possible for a person to qualify for benefits from both systems.

Government Funded SSD

SSD benefits are controlled and administered by the federal government. These benefits exist to provide financial assistance to individuals who are unable to work for at least one year due to an injury or medical condition. A person who may qualify for SSD benefits must apply through the federal government.

Privately Funded Worker’s Compensation

The worker’s compensation system is administered by private insurance companies but overseen by the state. These benefits exist to provide monetary compensation to individuals who sustain injuries while on the job. In the state of California, employers are required to carry a worker’s compensation insurance policy no matter the number of employees that they have working for them. Even a company with a sole, singular employee must carry worker’s compensation coverage in order to stay within the law. An individual who may qualify for worker’s compensation coverage must apply through the insurance company which carries the worker’s compensation policy for the employer.

The Appeals Process

If a person files an appeal to a decision regarding SSD benefits, the appeal remains within the publicly funded Social Security system. However, since worker’s compensation benefits are an aspect of private insurance, an appeal of a worker’s compensation decision will partially remove the claim from the privately funded worker’s compensation system where it can be reviewed by state appointed regulators. In either case, if a claim is continually denied, then the victim entitled to coverage is allowed to continue to appeal the decision up to the U.S. Supreme Court (for Social Security denials) or up to the California Supreme Court (for worker’s compensation denials).

The Entire Process

Applying for either SSD or worker’s compensation benefits can be confusing, which is why prospective applicants are encouraged to work with a benefits attorney as early in the process as possible. Statistically, benefits applicants who work with an attorney are more likely to win the benefits which they are entitled to than those that don’t.

Overall, the worker’s compensation system is much more adversarial than the Social Security system. In the worker’s compensation system, the insurance company and injured victim must go toe to toe to prove a case – the victim will argue for why benefits should be awarded, and the insurance company will argue for why they should not. SSD benefits, on the other hand, primarily require the injured person to show proof of an injury that hinders the ability to work. As soon as an adequate amount of proof is presented, the federal government will generally extend benefits to the injured person.

Working with an attorney to secure the benefits which a person is entitled to is the best way to approach any claim for benefits. The attorney can prepare the necessary paperwork and help the victim compile the evidence that either system needs in order to make a decision.

Tony Adderley

About the Author Tony Adderley has been working as a professional advocate for
individuals entitled to Social Security Disability (SSD) and worker’s
compensation benefits for more than 20 years.