Workers compensation refusing to pay. Can I get SSDI?Recently on our legal forum a user asked, I was injured at work. My company is refusing to pay workers compensation for the injury because they said that my negligent actions- horseplay with another employee- negated their legal obligations. I am going to challenge the denial, but if I lose can I still apply for Social Security Disability Insurance (SSDI)?
What is workers compensation?
Workers compensation is insurance purchased by an employer to pay for work-related injuries. Compensation paid through workers compensation can include wage replacement benefits, medical assistance, and death benefits.
Workers compensation can be denied for a variety of reasons. For example, certain actions from employees may negate the legal responsibility for an employer to pay for coverage. Other reasons can include the following:
- The employer does not believe you are really injured.
- The employer does not believe your injury is as serious as you claim.
- The injury did not occur at work.
- The action which caused the injury was not within the scope of your normal job duties.
- No one witnessed your injury or can substantiate it occurred at work.
- You failed to immediately report your injury to your employer.
- Your medical records cannot validate your injuries.
- You were injured while you were intoxicated or on drugs.
- You were not an employee at the time your injury occurred.
Steps after a workers compensation denial
You mentioned your claim was denied. Whether or not the reason for the denial is valid is difficult to say without more information about the cause of your injury. In fact, workers compensation laws regarding Injuries which occurred while you were engaged in misbehavior vary by state. Its best to review your states laws, contact your employers work compensation insurance carrier and discuss your case with them, and if necessary, contact a work comp lawyer to determine if you need legal help.
Can I get SSDI for a work injury?
Now, you asked whether or not you might be able to get Social Security Disability Insurance for your injury. Social Security Disability Insurance is provided by the Federal Government for claimants who have been injured or who have a disease which is so serious that they will not be able to work for at least 12 continuous months. Claimants must also have sufficient work credits to be insured for SSDI.
SSDI and workers compensation are very different. Most importantly, SSDI will not provide any type of short-term benefits. And while you might qualify for SSDI without qualifying for work comp, you will have to meet very specific requirements.
SSDI is also very hard to get. The wait time can be months or years, and most claimants are denied the first time they apply.
With this in mind, it is better to fight to get your work comp benefits if you can. After you have won workers compensation benefits you can then determine the length of your injury and whether or not you need to also apply for SSDI benefits.
Keep in mind, however, getting SSDI benefits can affect your work comp payments. In fact, they can be offset. If you are getting work comp and want to apply for SSDI, you should need to talk to someone familiar with the laws in your state.