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Can SSDI approval help with Comp case?
#1
Brand new to the forum.

I have a New York State case in the works. Been going on for approx. 1 1/2 years. I believe I've reached MMI and I think my Drs and the IME agree. I expect the RFC's from both sides to be submitted and some type of final ruling to be made in the next 6-8 months.

This is a non-scheduled loss case. 4 body parts are involved (neck, back, shoulder, knee). Currently, my 3 treating physicians all have me at temporary total disability (100%). The IME has me at temporary moderate to marked partial disability (67%).

I was just approved for SSDI on the initial level. The conditions that I listed on the SSA initial form were all worker's comp related. My current career-ending injury, plus 3 or 4 other previously settled scheduled loss cases.

I was only able to find one article that covers using an SSDI approval as evidence in a WC case. I do understand that WC and SSDI use different methods to make their determinations. But in my situation...it seems like they are pretty much exactly the same.

It was my job-related injuries over the last 10-15 years that led to my SSDI approval, which basically says that I can no longer perform SGA (substantial gainful activity). Which translates into...I am unemployable.

So when it comes to the final determination on my current (and last) case...I am wondering if I can use the SSDI decision to bolster my case. Especially when LWEC (loss of wage earning capacity) basically means the same thing as the inability to perform SGA...if I'm unemployable, then I've lost 100% of my LWEC.

And input / comments / insight would be greatly appreciated.
 
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#2
Sure.
Have the ssdi decision entered into the WCB court record.
The final disability award has to be supported by the work comp medical evidence.
If they use anything else, the employer carrier has valid grounds to oveturn on appeal.
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
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#3
(07-23-2018, 03:34 PM)1171 Wrote: Sure.
Have the ssdi decision entered into the WCB court record.
The final disability award has to be supported by the work comp medical evidence.
If they use anything else, the employer carrier has valid grounds to oveturn on appeal.

100% of the documents submitted to SSDI were directly from my current and previous WC cases.
 
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#4
Great.
I have no idea whether they will support a finding of 95% wage loss under NYs rating guidelines:
http://www.wcb.ny.gov/content/main/onthe...yClass.jsp
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
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#5
(07-23-2018, 03:54 PM)1171 Wrote: Great.
I have no idea whether they will support a finding of 95% wage loss under NYs rating guidelines:
http://www.wcb.ny.gov/content/main/onthe...yClass.jsp

I understand that. But right now, the half way point between my doctors and the IME is 83.5% on my disability rating. That's the link you posted.

But LWEC is a different animal. They can go hand-in-hand, but from what I've read...they don't have to.

For arguments sake, let's say after testimony...the judge rules 83.5% disability. Based on that AND the SSDI approval...couldn't the judge rule 100% LWEC, which could potentially lead to lifetime benefits?

Unless the two are the same. And if they are...why two different categories?
 
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#6
as the link also states, if you were injured after 3/2007 you get LWEC schedule.
if you have an atty, you should have this discussion with them.
an SSDI determination is no where part of the NY work comp. disabiltiy rating laws.
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
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#7
(07-23-2018, 05:18 PM)1171 Wrote: as the link also states, if you were injured after 3/2007 you get LWEC schedule.
if you have an atty, you should have this discussion with them.
an SSDI determination is no where part of the NY work comp. disabiltiy rating laws.

Of course I can talk with my attorney. But then why would you have this website?

:o)

And I will have that discussion with my counsel when I'm much closer to the end of the road.

I was hoping someone in a similar situation might provide some insight. I was hoping that a WC judge would give weight to the SSDI approval. The rating will be determined by the judge if my attorney and the insurer's attorney can't negotiate a %.
 
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#8
I’m in NYS and have been on workers comp for almost 10 years and the numerous trips to court there has never been a mention of my SSDI from the judge or my lawyer. Two completely different systems and the workers comp judge is going to go by medical evidence from your doctors and the carriers doctor regardless of whether or not your on SSDI.
 
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#9
(07-23-2018, 06:47 PM)redsoxfan Wrote: I’m in NYS and have been on workers comp for almost 10 years and the numerous trips to court there has never been a mention of my SSDI from the judge or my lawyer. Two completely different systems and the workers comp judge is going to go by medical evidence from your doctors and the carriers doctor regardless of whether or not your on SSDI.

I'm a Mets fan, so by default...I'm also a ResSoxfan. LOL.

I hear what you're saying. But every case is different. Check out this link...

https://www.lexisnexis.com/legalnewsroom...-case.aspx

And please remember...my SSDI approval was 100% based on my Worker's Compensation case(s). All my comp doctors reports, past scheduled loss cases, etc...
 
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#10
My SSDI approval was also 100% based on my workers comp case and my comp doctors reports. But every state is different as far as workers compensation laws and the link you posted is mostly for California workers compensation law. Like I said before my SSDI has never once been brought in comp court in 10 years and my case is winding down. Like 1171 said maybe your lawyer can shed a little more light on it for you. One other thing you might want to look into is “Extreme Hardship Redetermination Procedure.” Not sure if you would qualify for this but it’s worth looking into.
Good luck
 
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