Dec 21, 2022

Change In Workers Comp Offset Computation -- This Is The Sort Of Arcane Stuff That Can Make A Difference Of Tens Of Thousands Of Dollars To A Claimant

    From a newly added changes to POMS (Program Operations Manual Series) §DI 52150:

... A lump sum award may specify a payment amount based on the number holder’s (NH) life expectancy determined by insurance life expectancy tables. The life expectancy of the NH is often given in weeks, months, or years. These awards usually specify a life expectancy (LE) rate. ...

If the award indicates it should be prorated over the claimant's lifetime but does not specify a rate or time period, and the development proves unsuccessful, following is a link to a table provided by SSA's Office of the Chief Actuary to assist in determining the life expectancy:

https//www.ssa.gov/OACT/HistEst/CohLifeTablesHome.html ...

    This doesn't help if the workers compensation settlement agreement says nothing about proration but it helps in cases where there has been a simpler mistake in settling a workers compensation case, a failure to include specific language giving the proration formula. They're continuing with the no amendment provision. That needs to be changed. Don't punish claimants for failing to have an experienced workers comp attorney.

    This is also an example for ALJs. If this seems incomprehensible, it's because there's a lot more going on with Social Security disability cases than you're aware of. I have seen former ALJs struggle to represent claimants because they didn't realize that they would face a significant learning curve.


8 comments:

Anonymous said...

Hahahahahahaha!

Thanks for the laugh, with the total media hype on the weather this week, I needed a good laugh today.

Merry Christmas Chuck.

Anonymous said...

So if a claimant has a poor Worker’s Comp attorney, the government should do what exactly?

Anonymous said...


But should life expectancy clauses even be accepted by SSA, in computing workers' compensation (WC) offset?

These life expectancy clauses seem to be written into the WC settlements just to enable the claimant to escape offset, thus subverting the intent of Congress to offset WC when a claimant is receiving SSA DIB.
Removing offset depletes the trust fund

Also some areas such as Puerto Rico have no life expectancy clauses in their settlements. Why should some claimants escape offset based upon life expectancy clauses, while others are in full offset?

Drew C said...

How does SSA justify the "no amendment provision."? There is no policy basis for this rule other than to save SSA $$ at the expense of claimant's who were represented by Workers Comp attorneys that have no interest in learning about SSA offset rules. It is extremely unfair to those claimants, who should not be expected to know anything about POM provisions when they settle their workers comp claim. SSA is simply choosing to punish claimant's who were poorly represented in their settlement of an unrelated state benefit.

Anonymous said...


I work for SSA and I once argued with an attorney because he wanted me to use the life expectancy clause to calculate offset, even though there was no life expectancy time period specified in the workers compensation settlement.

We were specifically instructed not to use life expectancy if there was no time frame specified. There was nothing in POMS to allow us to do so without a time period specified, until this change.

The attorney had to go back to the WC judge, and have the settlement rewritten with a specified period of time for the life expectancy.

anonymous said...

Claimants use the life expectancy award to avoid workers compensation offset. What happens is that using life expectancy for a lump-sum award creates an artificial weekly workers compensation rate that is lower than the minimum weekly rate payable under a state's workers compensation law. Charles is correct in that a good workers compensation attorney would use this to the benefit of his client.

Anonymous said...

It's a dumb and harmful rule (WC offset) but if it's in place, I don't see how not giving people trying to skate around WC offset more free chances at the gambit is SSA's or the government writ large's problem.

Also, they got a lump sum! We're talking about a legal fiction by "amortizing" it in the settlement in the first place! They got a lump sum!

Anonymous said...

The offset law is to encourage people to return to work, if possible and a matter of fairness. It's not unusual for a person's SSA and WC to be 25% or more greater than their previous salary. Some WC is fairly short term but DOL isn't.