A work-related injury or illness can affect your ability to do your job. Taking time off work while dealing with expensive medical bills can lead to economic strain. However, workers’ compensation and disability insurance can provide sick and injured workers with the financial support they need for their medical expenses and to help make ends meet. Both replace part of an employee’s lost wages for a specific duration.
The primary differences between workers’ compensation and disability insurance are who and what they cover. Workers’ compensation benefits are available to covered workers who suffer job-related injuries and illnesses. Disability insurance covers qualifying medical conditions that prevent workers from earning their usual income.
What Is Workers’ Compensation?
Workers’ compensation insurance provides benefits to employees who get hurt or sick while performing their job-related duties. In Georgia, workers’ compensation laws require employers with three or more employees to carry workers’ compensation insurance. Benefits cover both part-time and full-time employees, including minors.
The benefits available through workers’ compensation include:
- Medical care – Workers’ comp covers the costs of all necessary medical care, including surgery, physical therapy, hospitalization, and pharmaceutical prescriptions.
- Temporary total disability – If you are temporarily unable to work in any capacity, you can receive TTD benefits. Payments are two-thirds of your average weekly wage before the accident, subject to a state-imposed cap.
- Temporary partial disability – If you can work in some capacity, but at a lower rate, you can receive TPD benefits. Payments are two-thirds of the difference between your current average weekly wage and your pre-injury wage.
- Permanent disability – Payments are two-thirds of your average weekly wage before the accident and last for a duration based on the affected body part.
Benefits can also include reimbursing expenses such as meals, mileage, and lodging, which are necessary to receive quality treatment. Job retraining is available to employees whose injuries prevent them from returning to their same position.
Death benefits are available to surviving dependents of the deceased worker. Coverage includes medical bills related to the final injury, up to $7,500 in funeral costs, and two-thirds of the deceased’s average weekly wage, subject to a cap.
What Is Disability Insurance?
Disability insurance replaces part of a worker’s lost income due to an illness or injury. Workers’ compensation covers only conditions stemming from work-related tasks, while disability insurance covers injuries and illnesses on or off the job.
Employers might offer short-term and long-term disability insurance. Short-term disability replaces a portion of an employee’s base salary for a specified period of up to one year based on the policy terms. Long-term disability provides wage replacement benefits for longer than a year. Some offer lifetime coverage if a disability prevents the insured from maintaining employment.
A common misconception about disability insurance is that you must have suffered a catastrophic injury, such as an amputated leg, to qualify. However, coverage is available for any condition preventing a person from working.
What Is Social Security Disability (SSD)?
The Social Security Administration helps those who can’t work due to a qualifying medical condition. Those conditions include:
- Alzheimer’s disease
- Epilepsy
- Multiple sclerosis
- Burn injuries
- Inflammatory bowel disease
- Coronary artery disease
- Multiple myeloma
- Autism spectrum disorder
- Chronic kidney disease
- Rheumatoid arthritis
- Thyroid cancer
- Asthma
- HIV.
Social Security disability is a federal program available to those who:
- Have a medical condition meeting the SSA’s definition of disability.
- Paid Social Security taxes while working.
- Earned a specific number of work credits before applying for benefits.
SSD pays eligible workers monthly at a rate determined by their number of years employed and average monthly earnings before getting hurt or sick. Benefits can also extend to family members, such as:
- Spouse
- Divorced spouse
- Children
- Adult children younger than 22 with a disability.
Monthly payments depend on the amount the employee receives for their disability. Each family member is eligible for up to 50 percent of the covered worker’s disability benefits, with a family cap generally between 150 and 180 percent.
What Is Individual Disability Insurance?
Individual disability insurance provides an additional payment each month for covered disabilities. It supplements the benefits received from long-term disability (LTD) since it is subject to maximum benefit amounts. People with high salaries, or who depend on commissions or bonuses, can benefit from individual disability.
You protect a more significant percentage of your earnings when you have coverage through an individual disability insurance plan. Your policy determines the duration of benefits. Some allow you to collect payments until you turn 65, or for life. Others limit the benefits period to between two and 10 years.
You can continue receiving benefit payments if your injury or illness prevents you from working and meets the terms of your policy. However, some plans allow coverage even after returning to work.
Can I Qualify for More than One Form of Coverage at the Same Time?
You can qualify for SSD and workers’ compensation benefits since they are separate types of coverage. Applying for one doesn’t automatically exclude you from the other.
The Social Security Administration limits monthly SSD payments if someone also collects workers’ compensation benefits. Your total benefits cannot exceed 80 percent of your average current earnings (ACE) before getting sick or hurt. The SSA will use a formula to determine your ACE rate when you apply.
Typically, workers’ compensation payments don’t change because of SSD. The benefits are reduced to meet the 80 percent limit.
If your workers’ compensation benefits change, you should notify the SSA. The administration must calculate your benefits to ensure you receive the appropriate payments. Forgetting to inform them can cause an overpayment, leading to suspended benefits to compensate for the overpaid benefits. However, the SSA won’t reduce your SSD payments once you reach full retirement age.
Get Help from an Experienced Georgia Workers’ Compensation Lawyer Today
At Sherrod & Bernard, P.C., we have protected the rights of injured clients for more than 30 years. We understand the toll an injury or illness can take on you and your family. When you cannot work, you cannot afford your expenses. Treating an injury can be expensive and lead to debt if you cannot pay your bills.
Disability insurance or workers’ compensation benefits can provide the solution you need to get your finances in order. Call or contact us online for a free consultation to learn more about your available options.
