Jeffrey P. Gale, P.A. // Quirk in Law Puts Private Insurance Companies Ahead of Taxpayers

greedSome catastrophically injured Florida workers qualify for both workers’ compensation permanent total disability benefits (PTD) (F.S. 440.15(1)) and taxpayer funded Social Security Disability (SSD) benefits (42 U.S.C. s. 423).

The compensation rate for PTD is 66-2/3% of the claimant’s average weekly wage (AWW) (440.14) payable bi-weekly until age 75. SSD is paid monthly until converting to Social Security Retirement at full retirement age (age 66 if born after 1942, 67 if born after 1960).

With the exception of government employees, PTD is paid by the private employer or its workers’ compensation insurance company. SSD, a Federal program, is paid from taxpayer dollars.

Florida Statute 440.15(9)(a) provides that when the sum of PTD and SSD benefits exceeds 80% of an employee’s Average Weekly Wage (AWW), it is the private employer or its workers’ insurance carrier, rather than the taxpayer, that is entitled to offset (reduce) its financial obligation until the combined payments equal 80%. The offset can be substantial, in some instances reducing the E/C’s share to a nominal amount.

It has yet to be explained to me why the private sector gets the break even though it was the workplace injury that forced the need for both benefits.

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