5 Steps to Increase Your Workers’ Comp Weekly Checks

5 Steps to Increase Your Workers’ Comp Weekly Checks
Increase Your Workers’ Comp Weekly Checks

You’ve had a covered accident at work and you’ve waited the requisite time period to start receiving your weekly check. Lo and behold, the check doesn’t even come close to your take home pay. In fact it’s a lot less.  What do you do now?

Georgia workers’ comp law states that you are entitled to receive 2/3 of an average of 13 weeks of your gross earnings before your accident.  For example, if you had an accident on June 30, 2016 and average gross earnings of $900, 2/3rds would be $600. Wait, don’t be too hasty. You wouldn’t even be entitled to $600 because there also is a maximum rate of $550.00 for that particular date of injury. (A table of maximum comp rates are below.)* Now going back to our topic on how to increase your weekly check if you are not receiving the max rate.

1.    First, you will want to request a copy of the Wage Statement which is on the back of Board form WC-1 First Report of Injury or the old WC-6 Wage Statement that is sometimes still used. Look this statement over carefully and see if the wages used are yours and whether the gross instead of the net was used. Request your payroll history unless you have your pay stubs so you have them to compare to. If these are your gross wages and are accurately recorded, go to the next step.

2.    Your second step will be to determine whether you worked “substantially the whole” of 13 weeks. Now you’re thinking what the dickens does that mean? Does that mean you had to work some hours each of the 13 weeks? Or at least 12 of the 13 weeks? What if you had a slow-down in the plant? Or your job got rained out for 3 weeks? Well, it does get a bit complicated, but let me try to help make sense of the “substantially the whole” phrase.  If you missed 1 week out of the 13 weeks, it would still be substantially the whole of 13. But, if you missed 2 weeks out of the 13, you can bet the bank it’s not substantially the whole, and ask for the wages of similar employees or your full-time wage if there are no similar employees.  Note, if your hours normally vary, this doesn’t count as not “substantially the whole. However, if there were several weeks where your hours were cut and you worked less hours I’d argue you did not work “substantially the whole” of 13 weeks. If your weekly check is still below the maximum go to the third step.

3.    Tips paid by customers should be included in your weekly wage to increase your weekly check.  Even tips not reported to the IRS can be included.  Still haven’t reached the maximum comp rate, move on to the next step.

4.    The fourth step is to check for bonuses.  Of course bonuses during the 13 weeks before the date of accident are considered.  But, wait for this….end-of-year bonuses are considered even though not paid during the 13 weeks preceding the date of accident. Nifty, huh?  Still not there, one final step…

5.    Fifth and final step is to check for any financial benefit or gain paid to you by your employer including food and housing and automobile expenses.  Keep in mind, the fair and reasonable value of the food and housing will be used. And, only where you received a real economic gain on the auto expenses after deducting for actual costs.

We at Affleck & Gordon are available 24/7 to assist you with any questions you may have on these steps to increase your weekly check.

*Table of maximum temporary total disability rates

1.    $575  July 1, 2016 to present

2.    $550 July 1, 2015 to June 30, 2016

3.    $525 July 1, 2013 to June 30, 2015

4.    $500 July 1, 2007 to June 30, 2013

Can You Collect Both Social Security Disability And Workers’ Compensation Benefits At The Same Time?

This question is one that has no set answer. Sometimes you can and sometimes you can’t. Your ability to draw both types of benefits first depends on how much you earned as an employee in  each of the five years preceding the date that Social Security concludes your disability began. The general rule for you to know is that Social Security Regulations will not allow you to draw more than 80% of the highest earned amount in the 5 year period ending with the date that Social Security found your disability began.

For instance, assume that in the 5 year period before your disability began, your highest year of earnings showed $48,000. That figure represents earnings of $4000 per month. 80% of that amount comes to $3200. If you were receiving $500 a week in workers’ compensation then you take the $500 and multiply it by 52 weeks (one year) and then divide that figure ($26,000) by 12 months and you would get a figure of $2,166.66 a month. That would leave you with a net amount of $1,033.34 ($3200-$2166.66). That net amount is what SSA would send to you, unless your benefit is less than $1,033.34, plus any future cost of living allowances.

Another example, assume your highest year was $24,000. That would represent a monthly amount of $2000. 80% of that amount is $1600. So, if your workers compensation weekly check was $400, then that would mean a total of 52 checks totaling $20,800 and a monthly amount of $1733.33. In this instance your workers compensation amount is higher than the 80% amount so you would not be eligible for any monthly Social Security benefits except for the small cost of living addition that would have been applied to your Social Security amount if workers’ compensation was not involved.

The above example would apply for workers drawing workers’ compensation under the State of Georgia laws. In some states it is the workers compensation amount that is offset. In those situations the workers’ compensation checks would be reduced and then you would draw your  full Social Security disability check.

Your Widow’s and Widower’s Benefits – Social Security Surviving Spouse’s Benefits

The Social Security Act allows for benefits to be paid to you if you are the widow or widower of a deceased worker (insured party) who has paid the necessary amounts into the Social Security system.

Generally, as the surviving spouse and without considering your health, you are entitled to receive benefits at 60 years of age if:

• You were validly married to the deceased, and

• Your marriage had lasted for at least nine months before the insured worker died. If the marriage lasted less than 9 months then there are no available benefits unless at the time of the marriage  the insured worker was reasonably expected to live  for at least 9 months. This would apply where the death was accidental or caused by an event that the insured did not expect. An intentional and voluntary suicide will not be considered an accidental death. Another exception to the 9 month rule is that the insured was serving on active duty as a member of the uniformed services at the time of death and death was occurred in the line of duty,  Additionally, if the marriage did not last 9 months and death was unexpected,  benefits would still be available if you and the insured had been previously married and that earlier marriage lasted longer than 9 months.

For individuals that are 50 years of age but not yet 60, there are also benefits available if you can prove you are disabled under the Social Security Act and its Regulations.

• However, the disability must have become disabling within 7 years of the date of death of the insured or 7 years after you were last entitled to mother’s or father’s benefits, whichever comes later. For example, if a man dies in 2009 and his widow, who is in her 50s, is in a disabling car accident in 2017 and applies for disability on her husband’s account, benefits would not be available because the widow became disabled more than 7 years after her husband’s death. But, if she was receiving mother’s benefits on a minor child until the benefits stopped in 2014 when the child turns 16, the benefits would be available because she became disabled within 7 years after the mother’s benefits stopped.

• The widow\widower does not have to have paid into the Social Security system as long as the insured had paid in enough quarters based upon his\her age at time of death. Generally, if you draw benefits on your own Social Security record, then you only get the higher of the two benefits.

For Surviving Divorced Spouses, benefits can still be available on the insured’s account if the following criteria was satisfied:

• You were validly married to the insured under State law where the marriage occurred.

• You were married to the insured for at least 10 years immediately before the divorce became final.

• You are unmarried at the time of application.

• You are 60 years of age or older.

• There is an exception if you are remarried and the remarriage occurred after age 60.

For individuals who are 50 years of age but under 60, a surviving divorced spouse can still apply and be eligible if they meet the requirements of disability as noted above as it pertains to widow\widowers between ages 50 and 60. If you remarried between age 50 and not yet 60 , generally, you had to already be entitled to widow’s or widower’s benefits as a disabled widower\widower.

Application is Required

• All of the Above Benefits Require an Application.

• Generally any Benefits Will Begin with the First Month Covered by the Application in Which You Meet all Other Requirements for Entitlement.

Special Note on Medicare

Even though you do not have to be disabled at age 60 to draw benefits, if you are disabled you can still apply for DISABLED Spouse\DISABLED  surviving spouse benefits if you want to become eligible for Medicare before waiting to age 65 for automatic eligibility if all other requirements are met. Generally one must be receiving disability benefits for 24 months before Medicare eligibility becomes available. Your disability could have begun before age 60.