Why is the Pennsylvania (PA) Workers’ Compensation Company Hassling Me When Social Security Says I Am Disabled?

It is because Pennsylvania Workers’ Compensation and Social Security Disability do not decide your entitlement to benefits the same way. They have different burdens of proof.

Under Pennsylvania law, you receive workers’ compensation benefits if you are injured at work. To determine if you can receive benefits, workers’ compensation only looks at the injury or medical condition that was caused by work, and how that injury or condition is affecting your earning loss. In PA workers’ comp, disability means earning loss. Your earning loss is measured against your not earning what you used to earn doing your job. A barber or concert pianist with a thumb injury is totally disabled under PA workers’ compensation and not entitled to SSD. An attorney with a thumb injury, suffers no earning loss and would not be entitled to workers’ compensation (except payment of the work related medical bills). So it is quite possible to receive SSD, but not receive Pennsylvania workers’ compensation benefits, or vice versa.

However, to qualify for Social Security Disability Benefits (SSD), the Social Security Administration (SSA) looks at all medical conditions and injuries that have lasted or are expected to last more than 12 months, and severely affect your ability to work your old job and ALSO in the general economy. To get SSD, you have to be disabled from substantial gainful employment, including jobs you have never done or heard of. But SSA also looks at your age, education and work experience; whereas, workers’ compensation does not initially look at those factors in awarding initial entitlement to benefits.

Because SSA looks at all medical conditions and workers’ compensation only looks at a specific injury or condition and because they have drastically different definitions of disability, you can receive one benefit and not the other. PA workers’ compensation and SSD each perform their own independent review of whether you can receive benefits based on completely different factors.

If you find yourself in this situation, or need any help or have any questions regarding Pennsylvania Workers’ Compensation or Social Security Disability Benefits, please call Calhoon and Kaminsky P.C., at (877) 291-WORK (9675).