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When Is The Right Time To Get A Workers’ Compensation Attorney?

People who have sustained a work-related injury, which puts them out of work indefinitely, have immediate concerns.  The first, and probably most important question is, will I be able to sustain myself, financially, while I’m out of work.  This is precisely why Workers’ Compensation benefits exist; to provide financial, and medical, security while the injured employee remains out of work.

However, the period immediately following a work injury is an extremely confusing period.  In addition to dealing with the actual injury and resultant medical care, workers’ compensation insurance companies almost instinctively swarm the injured employee with paperwork, forms, etc.  This is because these insurance companies go to work immediately to try and defend themselves against a potential claim.  That is why it is imperative that any injured employee contact an experienced workers’ compensation attorney as soon as possible.

Part 1 of this blog dealt with how weekly workers’ compensation benefits and monthly Social Security Disability benefits can offset each other.  But what happens if you settle your workers’ comp case?

In Part 1, we used an exmaple of someone in an “offset situation.”  That individual was receiving both weekly workers’ comp benefits at the rate of $500 per week, and a monthly SSD check for $633.35.  In this example, his full SSD rate, or PIA, was supposed to be much higher, at $1,200 per month.  But, because of his receipt of weekly workers’ comp checks, he was in offset, and thus, his SSD benefit was reduced.

If this individual were to “settle” his workers’ comp case, he would cease to receive a weekly workers’ comp check. Rather, he would receive a final lump sum cash payment to close out/settle his case.  The question then becomes, what effect does this settlement have on his ongoing Social Security Disability benefit.

The Short answer is “Yes.”

However, depending upon certain factors, one may not be able to collect his or her Social Security Disability benefit in full.  This is because the receipt of weekly workers’ compensation benefits under M.G.L. Chapter 152 can create an “offset” on Social Security Disability (SSD) benefits.  In other words, workers comp benefits could cut in to and thereby reduce one’s social security disability benefits.  Sometimes, it can eliminate Social Security Disability altogether.

To determine whether or not someone is in an offset situation, you must first determine that person’s high year of income.   This is done one of two ways.  Either, you would take that persons highest year of income within the 5 years prior to being injured, or you would take the average of his income within the past 20 years; whichever is highest.  Let’s say, for example, that an individual were injured in 2011, and between 2006 and 2010, his highest year of income was $42,000mass-state-house

Every year, the Massachusetts Continuing Legal Education (MCLE) hosts a one-day seminar focused on Workers’ Compensation Practice in Massachusetts.  The day is broken into several sessions focusing on relevant topics in Workers’ Compensation Practice, both in Massachusetts as well as on the national level.  For the second year, attorney Adam Troupe, of the Troupe Law Office, was asked to speak on a panel.

This year, he was part of the panel discussing the ongoing paradox of dealing with chronic pain.  Members of this panel included two Administrative Judges from the Department of Industrial Accidents (The Honorable Maureen McManus, and The Honorable Roger Lewenberg), one Administrative Law Judge from the DIA (The Honorable William Harpin), Diane Neelon, also from the DIA, as well as Attorney Edward Moriarty.  Guest speakers included a pain specialist, Dr. David DiBenedetto, MD.

Dr. DiBenedetto gave a general background about the physiology associated with chronic pain, as well as treatment plans, guidelines, and goals.  Attorney Adam Troupe then presented the considerations of the Employee’s attorney when dealing with cases involving chronic pain, with particular focus on the injured employee and how they may respond in these situations.  Attorney Moriarty addressed the Insurer’s point of view, and the Judges then expressed their concerns from a Judicial perspective.

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