Funded Employment to Reduce PA Workers’ Comp Does Not Derail Social Security Disability Claim

June 2, 2015

Injured worker, Sam, suffered a work injury to his left knee, an MCL tear. He was off all work for a year, and during that time, had left knee surgery, which did not fully heal his knee.

On October 21, 2014, he began funded employment with Vision Resource Center/Employment Alternatives as a sheltered workshop assistant. The job was created by the workers’ compensation insurance carrier, and was not meant to last forever. It is not a position available to the general public or performed by regular employees. The PA workers’ compensation carrier funds the employment (i.e., they pay the employer to employ the injured worker at no cost to the employer). The position was created solely for the injured worker as a way to reduce workers’ compensation benefits. In this position, Sam stands or sits with another individual and inspects candy that has been boxed by blind people. He is able to take breaks when needed and is allowed to produce less “work” than other workers.

Although injured worker Sam receives partial disability workers’ compensation benefits for this injury, we also applied for Social Security Disability benefits to increase his monthly income. The Social Security Administration determined that this “funded employment” is not substantial gainful activity, as it does not involve performing significant and productive physical or mental duties and is performed under special conditions. Social Security Disability benefits were awarded to the injured worker on top of his wages and workers’ compensation. Now, if we reach a settlement of his workers’ compensation, his SSD benefits should dramatically increase. In addition, he will have Medicare health insurance.