By Deedar Hussain 
If you’ve been injured on the job in Washington State, you may already be receiving benefits through the Department of Labor & Industries (L&I). But what happens if your injury or illness is so severe that you also qualify for Social Security Disability Insurance (SSDI)? Can you receive both? The short answer is yes — but with important limitations and rules you need to understand. At Emery | Reddy, PC, can help workers navigate these complex systems every day, ensuring they receive the maximum benefits allowed under the law.
Understanding L&I Benefits vs. Social Security Disability
Before diving into whether you can receive both, let’s clarify what each program covers:
- L&I benefits: Washington State’s workers’ compensation system provides benefits including medical care, wage replacement (time-loss), vocational rehabilitation, and disability awards for injuries or occupational diseases that occur on the job.
- Social Security Disability (SSD): A federal program that pays monthly benefits to individuals who cannot work due to a severe medical condition expected to last at least one year or result in death. SSD also provides access to Medicare after a waiting period.
While both programs aim to support disabled workers, they operate under different rules and eligibility criteria. L&I focuses on work-related injuries, while SSD considers any qualifying disability, regardless of where it occurred.
Can You Receive Both Benefits?
Yes, you can receive both L&I and SSD benefits at the same time. This is not considered “double dipping” because each program serves a different purpose. However, there’s a catch: your combined benefits may be reduced through an offset.
What Is an Offset?
An offset is a reduction in benefits when two systems pay for the same period. Federal law requires that combined workers’ compensation and SSD benefits cannot exceed 80% of your average current earnings (ACE) before you became disabled. Washington State is a “reverse offset” state, meaning L&I usually reduces its payments instead of Social Security reducing SSD benefits, except in certain age ranges.
How the Offset Is Calculated In Washington
Your offset is calculated based on:
1. 80% of your average current earnings (ACE). Your ACE is based on a specified period of your highest monthly earnings. SSA may provide us with your ACE.
2. Your monthly Social Security Benefit for ALL members of your household, also called your Total Family Benefit (TFB).
3. Your time-loss or pension rate from L&I. Your combined benefit limit is the highest of the three numbers above. L&I will reduce your workers’ compensation benefit to meet the combined benefit limit.
Why Apply for SSD While on L&I?
Even with offsets, applying for SSD can be beneficial:
- Additional income: SSD provides monthly payments that supplement L&I benefits.
- Medicare coverage: After two years on SSD, you qualify for Medicare, which can cover conditions unrelated to your work injury.
- Long-term security: If your L&I claim closes or benefits end, SSD may continue for life if you remain disabled.
Challenges and Pitfalls
Offsets can be complicated, and mistakes often lead to overpayments or underpayments. Delays by the Social Security Administration (SSA) in applying offsets can result in large retroactive reductions, creating financial stress for injured workers. Additionally, calculating ACE and combined benefit limits involves technical rules that most workers aren’t familiar with.
How an L&I Attorney Can Help
Navigating two bureaucratic systems is overwhelming, especially when you’re dealing with a serious injury. An experienced L&I attorney specializing in Washington State L&I claims and understands how they interact with federal SSD rules can:
- Maximize your benefits: Ensure offsets are calculated correctly so you receive every dollar you’re entitled to.
- Handle appeals: If your L&I claim or SSD application is denied, an L&I attorney will fight for your rights.
- Prevent overpayments: Coordinate with L&I and SSA to avoid costly mistakes.
- Advocate for your future: Whether you need a lifetime pension or SSD approval, an L&I attorney will build a strategy tailored to your case.
Steps to Take If You’re Considering Both Benefits
- Apply early for SSD: Don’t wait a year to apply, the process is slow, and early filing can prevent gaps in coverage.
- Notify both agencies: Inform L&I and SSA about all benefits you receive to avoid penalties.
- Keep detailed records: Track your earnings, medical reports, and correspondence.
- Consult an experienced attorney: The rules are complex, and professional guidance can save you time and money.
Understand Your Rights
Yes, you can receive both L&I benefits and Social Security Disability, but understanding offsets and eligibility rules is critical. If you’re struggling with an L&I claim or considering SSD, don’t go it alone. Contact an L&I attorney today.