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  1. #1
    Join Date
    Nov 2006
    Posts
    16

    Default Average Earnings Calculated by SSDI on Workers Comp Cases

    Hi, can someone advise me.

    I'm referring to SSA Pub. No. 05-10018, dated Jan. 2004.
    Workers' Comp MAY Affect SSDI

    I was treated rudely at the SSA office in the city I live. Went to another neighboring city. They're not rude, but don't have answers; regarding SSDI overpayments/offsets as related to WC.

    They give an example of the 80-20 rule in the publication. They use your *average earnings* before you became disable.

    After the example; they say, "how we determine* your average earnings*??

    They say, **they use different formulas to calculate average earnings** which formula we use depends on you specific circumstances. Contact SSA for the information...??

    I have NOT been able to get the answer, what is wrong w/SSA, why do they provide the info, every person I've asked, does not know??

    I have a huge overpayment, and I don't know this important info, my *average earnings figure*.

    Average Earnings... does anyone know the formulas that can be used by SSA, I want to know what figure they're using on my claim.

    Thanks so much,
    Star
    Last edited by Beachstar; 10-11-2007 at 10:56 AM.

  2. #2
    Join Date
    Apr 2007
    Location
    cincinnati,ohio
    Posts
    768

    Default Re: Average Earnings calculated by SSDI on WC cases.

    i do not really know, but i have been told they take the average of your best 5 years, then i been told they also take the worse 5 and split the difference. my case worker told me they are going off my last year of work. so best i can say is, it depends on who you talk to. i be surprised if anyone knows how they figure any thing.

  3. #3
    Join Date
    Apr 2007
    Posts
    186

    Default Re: Average Earnings calculated by SSDI on WC cases.

    In my case they took my highest earnings from the past 5 years and took 80% of that figure then they subtracted what work comp was paying me from that figure and SSD paid me the difference.
    Say my highest salary was 55000.00 x80%=44000.00 And if work comp was paying me 667.00 per week or 34684.00 per year they subtracted 34684.00 from the 44000.00 leaving 9316.00 which is a monthly benefit of $776.00. When WC is settled the SSD benefit would go higher based on your statement that you get in the mail each year. It tells you what your disability monthly benefit would be if you were disabled.

  4. #4
    Join Date
    Dec 2006
    Location
    Pa.
    Posts
    929

    Lightbulb Re: Average Earnings calculated by SSDI on WC cases.

    Maw, they do use Your last 5 Years Highest earnings to calculate Your Average Yearly, and then divided into Your Monthly Rate. The 80% rule, is saying that You are Paid 80%, due to Taxes not being Deducted. If Your w/c Earnings are not at Your SS amount of 80%, they will Supplement you until You are to the 80%. I don't want to use My actual Figures, but as an example: If My 80% was 2000.00, and in Pa. I believe the cap right now is 710.00 per Wk. and I received that, I would be over my 80%, and receive no Monies from SS, but My Medicare would come into Force after the waiting Period. now if I only received 350.00 per Wk. from w/c, and My 80% were 2000.00 they would Pay Me the Difference, or 150.00 per Week. I Hope that makes sense, and answers Your Question!!

  5. #5
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,045

    Default Re: Average Earnings calculated by SSDI on WC cases.

    Your 80% is taken on your wage when you stopped working. This is taken from the reported wage by your employer. Or, sometimes if the information is not up to date, take the SSA office your pay check stubs, or tax return. It is not a average over the last 5 years of employment. SSA is not going to reduce your entitlement because you had a few years of lower wages, and now make substantially more...

    Your SSA benefits are based on your qualified wages...which are taken as 'points', you get so many points for each year you pay into SSA(FICA tax), and the maximum points per year is 4. Your SS benefits are calculated based on 40 points, which you would accumulate over a 10 year period, or what used to be 'quarters', it's just a change in terms used by the SSA.
    So you have a maximum SSA benefit whether it's SSA retirement benefits or SSDI. You can have 'earnings' from any source, but the total cannot be more than 80% of your average wage when you stopped working.

    IF you are receiving SSDI at your normal retirement age, your retirement benefit will be the SAME amount as your SSDI benefit. What you are basically doing is taking 'retirement' early...the only increase to your benefits is the annual COLA change in January.

    SO, if your average wage, when you stopped working was $800/wk,($3200). WC is paying TTD at $400/wk,($1600/mo) the 80% is $2560. If your SDI benefit is $1200/max there will be an "offset'' to your SSDI benefit of $240.00. ( take the TTD ($1600) plus the SSDI ($1200) and you have $2800/mo, you max under the 80% rule is $2560, so that leaves an 'overpayment' of SSDI of $240..which will be the 'offset'...)

    When you go to, or call the SSA, you won't get answers that actually make sense. The "social service" EE's there are not familiar with the offset rules used for SSDI benefits. And there are about 5 ways to calculate your 'average weekly wage'. So all you can do is submit the paperwork, wait to get the first checks and if you feel that there is a mistake, notify them and ask for an audit of your account/benefits. Do not be suprised if you get a letter that there is an overpayment. Go back again, with the appeal, and sit down with a SS representative and go over the figures that have in your records...with your own records. This can take several months or years to get straightened out. It is also VERY important to notify SSA of ANY change in your income. It can/will take several months to get the adjustment in your check, usually causing another over/under payment of your benefit.
    IF you have a overpayment, just because SSA didn't adjust your benefits on time is NOT a valid reason to not have to give the money back.
    It all take time, and energy, but remember you are dealing with "social service", "government' employees...they are not all the same.

  6. #6
    Join Date
    Mar 2007
    Posts
    89

    Default Re: Average Earnings calculated by SSDI on WC cases.

    AWW of 800 = 41600, 80% of that is 33280 , 400 from comp is 20800


    That leaves $12480 you may receive from SSD to total 80% of pre disability wage.

    At least I believe those numbers are correct. I just don't know for sure how SSD figures a wage for a disabled worker.
    Is it the last full year or is it an average of the last 5 years or is it an average of everything....I haven't found it on the SS website.

    some things we know and some things we don't

  7. #7
    Join Date
    Jul 2007
    Posts
    18

    Default Re: Average Earnings calculated by SSDI on WC cases.

    http://www.ssa.gov/OP_Home/handbook/...book-0504.html


    504.3 What is "average current earnings?"

    "Average current earnings" is the highest of:

    Your average monthly wage upon which your un-indexed disability primary insurance amount is based (see Chapter 7);

    Your average monthly earnings from covered employment and self-employment during the highest five years in a row after 1950; or

    Your average monthly earnings based on the single calendar year of highest earnings from covered employment. This single calendar year can be the year that your disability began or any of the five years before.

  8. #8
    Join Date
    Jul 2007
    Posts
    18

    Default Re: Average Earnings calculated by SSDI on WC cases.

    Here are some benefit calculators that you may find helpful:


    http://www.ssa.gov/planners/calculators.htm

    http://www.ssa.gov/planners/morecalculators.htm

  9. #9
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,045

    Default Re: Average Earnings calculated by SSDI on WC cases.

    Thank you for the links to SSA's planning calculators, those are for figuring your "retirement' benefits, and are not dependant on your average wage upon becoming 'disabled'. At retirement you receive your full entitlement/benefits.

    In the 'average weekly wage', SSA is looking for your highest earnings to ensure you receive the highest possible benefits...which in most cases would be your 'current wage' at the time you stopped working...your last pay stub. Or, the HIGHEST of the previous 5 years before your injury, NOT an 'average' of the previous 5 years.




    For those considering a C&R/lump sum settlement of your case, here is the way SSA/SSDI looks at your settlement, which is basically taking into consideration the Utica/Mohawk issue as being discussed on this board.

    504.9 How are lump-sum payments considered when computing the amount of offset?
    Sometimes a State Workers' compensation law or a Federal, State, or local public disability benefit law/plan permits a lump-sum settlement. The lump-sum settlement can be in the form of a commutation or compromise agreement and releases the insurer or the employer from liability. Such a settlement is a substitute for periodic payments and is subject to the offset. In this situation, the lump-sum is prorated to reflect the monthly rate that would have been paid had the lump-sum award not been made. Medical and legal expenses incurred by the worker in connection with the workers' compensation/public disability benefit claim may be excluded from computing the offset. (A check representing past due periodic payments which simply brings payments up to date is not a lump-sum.).

    For additional information about Workers' Compensation go to: www.workerscompensationinsurance.com/index.htm.

  10. #10
    Join Date
    Jul 2007
    Posts
    18

    Default Re: Average Earnings calculated by SSDI on WC cases.

    I thought the original question was:

    "Average Earnings... does anyone know the formulas that can be used by SSA, I want to know what figure they're using on my claim."

    The information that I posted came from the Social Security site - I included the link at the top of the previous post. It is called SOCIAL SECURITY HANDBOOK - 504. REDUCTION TO OFFSET WORKERS' COMPENSATION

    http://www.ssa.gov/OP_Home/handbook/...book-0504.html

    I used the benefit calculator (downloaded the one also) and put in my earnings using the three ways SS uses to determine "Average Earnings". The third one came out to my benefit (average monthly earnings based on the single calendar year of highest earnings from covered employment. This single calendar year can be the year that your disability began or any of the five years before). When I was at the SS office last week it was $2 higher than what I had figured w/ the calculator.

    Please excuse any erroneous information that you feel that I may have given.
    Last edited by clydeq; 10-12-2007 at 06:38 AM.

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