Important: We updated this article in December 2023 to include the most current income limits and other data from the Social Security Administration. When most people get injured on the job, they don’t anticipate being out of work for very long. Applying for disability benefits is often the furthest thing from their minds. We all tend to think that we’ll heal quickly! And get back to work as usual, even after severe injuries. While it certainly pays to think positively, there are some cases in which a work injury or illness is severe enough that it prevents us from being able to do our jobs for more than a year.
What happens then? Well, in most cases, being unable to work for more than a year means you should apply for Social Security disability benefits. Let’s look at this issue more closely using a recent question from one of our readers:
“I had an accident at work in 2018. In 2019, I had a c5 and c6 fusion with a plate. I haven’t been able to work since the accident. Would I qualify for disability benefits for my work injury?”
Answer: There is good news for this reader. It is very possible!
When Do I Become Eligible for Disability After a Work Injury?
This reader’s disability has already lasted for more than 12 months, which meets one of the eligibility requirements for Social Security disability:
- #1: Prior to your injury, you worked in jobs where you paid Social Security payroll taxes.
- #2: You have a long-lasting medical condition or illness that meets the SSA’s definition of disability (see below).
- #3: Your condition has left you incapable of working for a year or more.
SSA Definition of Disability
If you have done enough work prior to your injury to qualify for disability benefits, it’s time to apply. To assess your eligibility for Social Security disability benefits, the agency uses a step-by-step process with five questions to determine if you have a qualifying condition.
The five questions are:
- Are you working now? If your monthly work earnings in 2023 are, on average, more than $1,470 ($2,460 if you’re blind), you generally cannot qualify for disability.
- Is your condition or illness severe? Does it limit your ability to do basic work-related activities for at least 12 months?
- Is your condition found in the list of disabling conditions?
- Can you do the work you did previously? If the answer is yes, you won’t qualify.
- Can you do any other type of work? The SSA considers your medical conditions, age, education, past work experience, and any other skills you may have when it assesses your eligibility. If you cannot do other work of any kind, it will likely decide you qualify for disability benefits.
What If I’m Still on Workers’ Comp for my Work Injury?
If you’re still on workers’ comp payments from your employer, there is something called the “workers’ compensation offset” that could reduce your SSD payments if you’re approved. According to SSA.gov, companies make workers’ compensation payments to an employee due to a job-related injury or illness. These benefits are paid by federal or state workers’ compensation agencies, employers, or by insurance companies.
Please note that if you receive workers’ compensation or other public disability benefits, AND SSDI benefits, the total amount of these benefits cannot exceed 80% of your average current earnings before you became disabled.
However, most states eventually stop paying workers’ comp benefits. So this reader’s SSD payments would increase once those other payments stop. Also, disability payments from other sources such as private pensions or insurance benefits don’t affect your SSD benefits.
Help Is Available If You’d Like to Apply
If your situation is similar to this reader’s question, it may be time for you to reach out to an expert advocate in our network. Help is available to ensure you receive all the benefits your family needs. Click the link below to connect with a lawyer who specializes in work injury issues.
Ready to see if you may qualify? Complete your free online workers’ compensation case evaluation now!
Laura Schaefer is the author of The Teashop Girls, The Secret Ingredient, and Littler Women: A Modern Retelling. She is also an active co-author or ghostwriter of several nonfiction books on personal and business development. Laura currently lives in Windermere, Florida with her husband and daughter and works with clients all over the world. Visit her online at lauraschaeferwriter.com and linkedin.com.