BASIC (09-08)

Workers injured on the job may qualify for Social Security disability insurance (DI) benefits in addition to benefits under Federal and State WC/PDB programs. When an injured worker qualifies for Federal or State WC/PDB and Social Security DI benefits, the combined benefits can result in the worker receiving more in disability payments than he or she earned before becoming disabled.

Therefore, the Social Security Act requires SSA to reduce Social Security DI benefits when the worker is also eligible for periodic or lump-sum WC/PDB benefits so that the combined amount of WC/PDB and Social Security DI benefits does not exceed 80 percent of the worker’s average current earnings.

The DI benefits are not reduced if the State WC/PDB law or plan provides for a reverse offset (a reduction of the WC/PDB benefit to a worker also receiving Social Security DI benefits).

A. Definition – Offset

Offset is the reduction in SSA benefits to a worker and/or entitled auxiliaries when the total of the benefits plus WC/PDB exceeds the limit provided in the Act. WC, PDB, or both can cause offset.

NOTE: Social Security DIB and WC/PDB do not have to be based on the same injury or illness for offset to apply.

B. Offset provision

Social Security DI benefits may be reduced or totally offset if the worker is also entitled to:

• Federal or State WC payments; and/or

• Federal, State, or local government PDB payments.

This does not apply if the worker is a disabled widow(er) or a disabled child.

NOTE: For WC/PDB offset purposes, “State” includes the District of Columbia, American Samoa, Guam, Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands.

C. Determining offset

1. Determine if offset applies, using the:

   • Monthly payment amount of WC/PDB. To determine WC/PDB offset, see DI 52150.035.

   • Total family benefit (TFB) amount. See DI 52150.005.

   • Average current earnings (ACE) amount. See DI 52150.010.

2. Determine the applicable limit:

   • Compare the 80 percent ACE and the TFB.

   • The higher amount is the applicable limit.

3. Subtract the monthly WC/PDB payment from the applicable limit.

   Reference:

   DI 52150.015 – Determining the Applicable Limit.