Well here I go again confused as normal. I have been on comp on and off for a year and a half (total time out of work) with returns to work in between surgeries. This started in 2006. So I get fired in August 2010 for being out to much, in a cumulative sense. Civil service allows one year out whether it is all at once or an accumulation of time. Since my recoveries have been getting longer and worse, add in now major depression with major panic attacks, my attorney tells me to file for NYS SSD. I did that back in October 2010. I understand (but do not agree with) any $$$ i may receive in an award, the IC recoups all they have paid me up front for wages. Now I hear that if approved for SSD they offset my award with what my monthly "allowance" would be until it is all evened out??????? So would this even leave me with enough $$$ to buy a postage stamp? I do not get this part, so i will throw out an example of how i interpret it to be.

EX: i get 50,000 awarded for wc case, SSD with holds all payments until it covers the 50,000 i received in my award? I thought that ssd was for people who have disabilities and cannot work period. And that WC award was for future loss of earnings because you either can't work or cannot make the same $$$. How do the two relate...I paid into SSD and I also pay taxes to cover the companies WC insurance coverage. Even if i was able to keep all $$$, it still would not bring me to my standard of living and/or remove pain, trama etc.
Please any insight would help!! My attorney has tried to explain some of it to me, but my mind wanders and I cannot concentrate by just words, i now need things in writing so i can read and re read them.

One more ???? while i am ranting. So I applied for SSD, however in order to maintain my WC benefits I must look for employment! So if SSD sees me looking for employment do they now say....your fine you lose? it is a catch 22 and maybe that is their secret plan...to confuse and frutrate people like me!!

I thought only getting unemployment benefits require you to look for work?

I haven't heard that wc requires looking for work....

I would ask the atty to send you a letter explaining how the wc payments & SSDI would affect you. Tell atty you need it in writing due to concentration problems, and that you will need to re read it a few times to understand it.

Once you come down from TTD (in NY) while on comp, they want you to look for work, no matter what it is, since "you can work". As per my Dr. I am still currently 75% impaired from last surgery...so comp/IC says, you can go get a job. I have to report like unemployment that i am looking for work. The best part is my restrictions are as follows" No pinching, gripping, grasping, twisting wrists, pushing, pulling, lifting. (which if you think about it, holding a pen is gripping/pinching) IC claims ther are many jobs out there for me to do within my restrictions, not taking into account my CRPS pain. If I do not provide what they want, then they can terminate the peanuts they give me for pay.

LOL - yup nothing is simple.
I had similar restrictions at one point and was patrolling the employers parking lot as security.

The HR lady wouldn't even let me take short notes as "no arm use" was my restriction at the time - but I still had to drive 22 miles to get to work .
plus open doors, use restroom, eat etc...

My shoes laces always came loose because I had lost the coordination in my hands/fingers.
Had to retie them often- HR lady says - "oh so you can tie your shoes!!" for a a temporary injury.

Turned out to be chronic but is much milder now since not working.
I can tie my shoes just fine now, but still not fully coordinated for writing neatly though.

But that ' no use' restriction was because I had limited use of hands/arms previously and HR lady had me sorting stacks of papers and filing them in a overstuffed 4" ring binder.
opening & turning the heavy pages made me flare up after 6 hrs.
so dr made the stricter limits...

I am amazed @ the things I took for granted before the physical limitations, not to mention the constant burning pain.Tying my shoes, I have just been able to do that however, I cannot tie them tight enough, so back to the slip on shoes. Can't button pants, zipper jackets etc. I love working, the structure of daily life keeps me in a good balance, HOWEVER, I could not imagine working now, with all of this going on. If the IC or anybody else wants me to work, then I am willing to let them find me a job within my restrictions (not even taking in account the CRPS) and see if I would last a couple hours. When you struggle to wipe your backside.......I would love to see what would fit my restrictions, taking all into account. I am 40 years old and have worked for 25 years and have a college degree, I would think that would show that I am not lazy or out to get the system...god knows, ten surgeries between both hands with permanent fusions, joints replaced, etc...is not my idea of a good time to sit home and collect half of what my paycheck was. Oh yea, then throw in the severe depression/anxiety...I would not wish this on anyone.....

Hi (again) Sonny,

I have no words of wisdom to convince the disability co that you CAN'T work. The problem is obviously that their docs say you are only 75% disabled. YOUR doc says 100% so that's what I'd go by. I would consider "trying" to find a job. If you can get to an interview, explain ALL of your limitations. No offense, but would you hire you ? If they don't hire you, you still "tried", right ?

To try to explain the whole WC, disability ins, and SSDI payments/pay back.......For SSDI, the government looks at it as a monthly % of what you used to make based on your years of service. The goal is to try to keep your head above water, but not to supply a luxurious livestyle. Forms that you receive every few years from the SSA indicate what your 'amount' is if you retire and survivors benefits for kids if you die, etc. If your amount is $1000 per month that is what your monthly checks 'should' be for. If you are receiving $800 per month from other public disability programs (like WC), SSDI may be lowered.

SSDI/disability total income cannot be more than 80% of what you made pre injury. That includes your family benefit from SSDI and all other public disability payments you get.

Do you have kids ? Using my made up numbers from above.....if you get $1000 per month for SSDI and have 2 kids under 18 that are your dependents, they would (together) get 50% of your benefit....so each kid would get $250 per month.

All together you 'could' be getting $1000 (your ssdi), $800 (other disability), $250 (kid a) and $250 (kid b) for a total of $2300/month

BUT.......

Again....making up numbers, say you used to make $2000/month. 80% of that is $1600. SSDI will adjust your numbers down so that your total disability income will be $1600/month instead of the $2300.

Further complicating your case is the WC money. Do you know if it is specifically earmarked for future loss of wages or were you just assuming that ? If it is free for you to spend, different states do it differently, but in Mass they spread of that $50,000 over so many years and determine that it is, say, $300 a month......and then that gets deducted too from your SSDI to keep your total at $1600. If the WC settlement is for future medical, that's a whole different deal and can be written into a medical trust so it is just used for medical bills and wouldn't affect your SSDI total, but you would have to spend down that amount before utilizing MC for any medical bills related to your WC.

Regarding the 'payback' issue.....that differs by state and what the disability program is too. I was just WC in Mass. I did not have to pay WC back, but my backpay amount was lessened to reflect that I had already received some 'pay' during that time period. My kids backpay amount was decimated by that factor, so they just got small amounts. Sounds like in your case maybe you will get ALL the backpay 'awarded' and the payback comes from that. I think SSA sends the money to them after deducting from your total.

*sigh*

So....there ya go....clear as mud, huh ?

Hey Finz, thanks for all of that good information. I may not have been clear on the 75% thing. I am not at MMI yet but not 100% TTD either. So for now I am 75% impaired. I have just begun pain management treatment. I am required by WC to look for work and I have been looking. Yet the flip side of this is I did apply for SSDI as per attorney because I also have severe depression/anxiety. I had depression/anxiety b4 the WC case, yet I was functional.We did begin the process of incorporating the additional dep/anxiety into the WC folder (my therapist gave a report) however in the end (as per attorney) it would not make a difference in the award amount when I reach MMI. Also I would have had to switch physc doctor as she does not accept WC. It took me 3 years to get fully comfortable with her through all of this, that is why i would rather not switch. It is noted by judge that at any time we could re introduce it to the WC folder. So that is what leaves me confused. If SSDI sees me looking for work per WC, then they can say go to work...it just gets to be a bigger darker hole with tons of paperwork!

I have no idea what will happen come the end of this mess, but I will not close out medical no matter what. In NYS what ever award you get, they pay it in full (minus what they have already paid in wages and possibly attorney fees). It used to be the way you explained, but in recent years it has changed to one lump sum.

We do not have children a choice we made long ago. I love kids, but glad we stuck to our choice, life throws these curveballs in and they are hard enough to deal with. My husband owns 2 small businesses locally so he works 12-14 hrs. a day out of the house and then the phone calls, problems when he is not there etc..once he is home. (people hear owning business' and think $$$$$$$, yea not the case)

We do not have a lavish lifestyle but it has gotten less lavish now with reduced earnings and now having to pay $800 a month for our medical. Fortunately 2 years ago we bought a new house (well not brand new) and pretty much based it on 1 income, just incase. WHEW!! So all I can hope for is this all ends soon so i can really focus on my pain and healing the best i can.

thanks!

I would be first in line to get WC to close out my medical. It has been like pulling teeth to get them to agree to any treatment. If I had a settlement, I could pay for whatever my doc recommended....and when that money was gone, I could use my regular insurance (through hubby's work) or activate my MC through SSDI.

Really, you would close it out? I have heard that is a bad thing to do because the $$ they put away for that usually doesn't cover a year or two worth of treatment. It is all so confusing.

At this point it is just sit and wait, see how injections go, see when I can get to MMI and take it from there. What state are you in, if you don't mind me asking? I was told in NY any WC injury treatment would be denied by my primary insurance. And not even sure how long it will take to get approved for SSDI.....if I even ever do, and what if I need treatment in between case close out and SSDI or never having SSDI??? These are the things that hinder my ability to concentrate on healing, it overwhelms my brain na d then i shut down because it is to much to think about!!!

hey sonny1 im from ny also and going thru the same exact thing your going thru word for word.and "JoMar" to.i thought my situation was just unque just to me.now to find 2others (especially you sony1)that im not alone or you.hey i asked my lawyer the same thing about me looking for"Work".wont that disqualify me since i can work.well here in ny they dont care.no it does not hurt your case.i know ibeen therei to am on "antiDepresant"(celexa).i have now 4rupture disc in my neck,(Lyrica)surgery on my shoulder and once a month i go in for cortazone shots to my neck.so you see i "Feel"your pain or situation.Emotionally,physically and financially.but where here for you