NY Workers Compensation FAQ | Klein Wagner & Morris LLP, Attorneys at Law

Some Common Questions Dealing With Social Security Disability Benefits

The following is a sample of commonly asked questions and their answers regarding Social Security Disability:

Q. What is social security disability?

A- Social security disability is a benefit received from the Social Security Administration by disabled workers and/or their dependents, similar to that received by retired workers.

Q. Who is eligible for social security payments?

A- Any disabled worker, a worker's wife and minor children may be eligible. In addition, a child who is disabled may be eligible on his parent's account if his parent is a deceased or a disabled worker, and a disabled widow or widower may be eligible based on his or her spouse's account.

Q. What must one prove in order to be eligible for social security disability payments?

A- One must be prepared to prove he is disabled from performing any substantial gainful work activity found in the national economy, and that this disability has lasted or can be expected to last for a continuous period of at least 12 months or lead to death. In addition, generally, one must have worked at least five out of the ten years preceding the date of onset of disability.

Q. If I am receiving workers compensation benefits, am I eligible for social security disability benefits?

A- You may be, but remember, in order to receive workers compensation benefits, you must have an injury while working, and your injury must prevent you from performing your usual job. To receive social security disability benefits, you must be so disabled as to be unable to perform any work found in the national economy.

Q. How much money will I receive if found to be eligible for social security disability payments?

A- A disabled claimant will receive the same monthly benefits that he would receive had he retired at age 65. The sum of money received will depend on one's previous work record, and often on one's other disability benefits.

Q. To whom does one apply for social security disability?

A- One may fill out an application for benefits at any of our offices or at the neighborhood social security office. When making your application, be prepared to explain why you are unable to work, and be prepared to give a list of doctors who have treated you for the condition of which you are afflicted. If your claim to these benefits is denied, you are entitled to ask for reconsideration, and if denied again, to a hearing before an administrative law judge.

Q. Does my disability have to have been caused by a job-related accident?

A- No. As long as you worked the required period of time, almost any impairment cause by accident or illness, if severe enough, may qualify you for social security disability benefits.

Q. If it takes a long time to decide my case, will I receive retroactive payment?

A- Yes. Benefits are retroactive to the first day of the sixth month of your disability, or one year prior to the date on which you applied, whichever is later.

What Every Injured Workers Should Know

The following is a sample of commonly asked questions and their answers regarding workers' compensation:

Q. What must I do if I am injured at work?

A- You should immediately notify your supervisor.

Q. Do I have to file a formal application for workers compensation benefits?

A- Yes, an application must be filed by you in writing within two years of the accident. The application form (C3) may be obtained from any of our offices, your employer, or the Workers' Compensation Board.

Q. To what does workers compensation in NY entitle me?

A- You are entitled to be reimbursed for all reasonable and necessary medical treatment, including chiropractic care, a percentage of your lost wages, and various expenses such as medication bills.

Q. Do I have to pay my doctor for his services?

A- No, your doctor will be paid by the insurance company for your employer or directly by your employer if self-insured.

Q. Do I need to be represented by an attorney?

A- The law does not require that you be represented by an attorney, but it is recommended since the workers' compensation law is quite complex, and the insurance companies are represented at hearings.

Q. How do I pay my attorney?

A- You do not pay your attorney directly. Your attorney must have a fee approved by the Workers' Compensation Board. If a fee is approved, it will be paid to your attorney directly by your employer, or your employer's insurance company from your benefits.

Q. In addition to benefits for lost wages from workers compensation, am I entitled to other benefits?

A- Maybe. Depending on the circumstances, you might be eligible for the following benefits in addition to workers compensation: no-fault insurance benefits (if your accident arose out of the use and operation of a motor vehicle while you were working); social security disability benefits (if you were unable to work for at least six months due to a condition which is expected to last at least twelve months); long-term disability (if your employer, or you, have purchased an insurance policy to provide same); disability pension from your employer (if same is a benefit of your job).

Q. If I am receiving workers compensation benefits, am I eligible for social security disability payments?

A- You may be, but remember, in order to receive workers' compensation benefits, you must have sustained an injury while working, and your injury must prevent you from performing your usual job. To receive Social Security Disability benefits, you must be so disabled as to be unable to perform any work found in the national economy.