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What constitutes disability? Disability, for legal and social security purposes, is either a medical, physical, or emotional impairment that prohibits an individual from substantial gainful activity. Substantial gainful activity generally means that a disability applicant is unable to perform substantial work in a usual or customary manner.
To qualify for disability benefits, an applicant must provide evidence of physical or mental impairments and how the applicant is limited by the disability. These impairments are known as “functional limitations.”
An important distinction in disability benefits is whether an applicant’s injury is temporary or permanent.
In order to qualify for temporary disability benefits, an individual must be unable to perform substantial gainful activity for more than 3-days. Eligibility for temporary disability benefits starts with a report by a treating physician that details how an applicant is unable to perform substantial work customary for a particular job.
Along with being unable to perform substantial gainful activity for more than 3-days, applicants seeking temporary disability benefits may also qualify through a showing of temporary hospitalization, or by indicating that an employer has not modified an applicant’s work activity in order to adjust to the individual’s temporary disability. If an employer does adjust for an individual’s temporary disability through a modified work practice, then the secondary tasks must be on par with an applicant’s usual wages.
If an applicant qualifies for temporary disability benefits, he or she is entitled to a certain percentage of their original income depending on the state in which the individual is employed. If applicants are injured while in the regular course of their business practices, they are entitled to workers compensation temporary disability benefits. For a chart outlining each state’s temporary disability benefits provided by workers’ compensation statutes, click here.
Most employees entitled to temporary disability benefits receive a check in the mail equivalent to a certain percentage of their weekly earnings, up to a certain maximum delegated by state statute. Applicants who are accepted into the temporary disability benefit program receive checks every 2-weeks until they are declared permanent and stationary.
A permanent disability involves benefits paid to an individual after a permanent impairment renders them unable to work in their own or any occupation for which they are suited. In order to be qualified as permanently disable, an individual must be unable to work in any capacity for which they are suited by training, education, or experience.
To illustrate an example of a permanent disability, think about a railroad conductor. First of all, if a railroad conductor is injured while on the job, he or she will be entitled to worker’s compensation benefits, regardless of the nature of the injury. However, if the conductor injures his or her leg during a pick-up basketball game and is unable to operate the train, the status of the disability benefits get a little bit trickier. A permanent disability to the conductor’s leg would mean that they are no longer able to work in any capacity involving railroad engineering. Therefore, if the conductor in our hypothetical cannot operate a train, but is able to collect tickets from passengers, this is still considered a permanent disability, regardless of the fact that the conductor can continue to work. This is due to the fact that the conductor is trained, educated, and experienced in railroad engineering.
In order to be deemed “permanently disabled,” a primary treating physician must issue a finalized report detailing the extent of the patient’s injuries. The report will contain the physical or emotional impairment that the physician finds to be permanent, rendering the patient incapable of working in a substantially similar capacity as he or she was prior to the injury.
After the final report is issued by the physician, the applicant will either be accepted into the state regulated permanent disability benefits program, or denied. If accepted, the applicant will receive a percentage of his or her average weekly earnings, up to a certain maximum.
Differences Between Workers Comp & Disability Benefits
As with the railroad conductor injured on the job, workers compensation is different than standard disability benefits. Workers’ compensation benefits are alternatives to standard litigation when employees are injured while in the standard practice of their duties.
State disability benefits, on the other hand, allows individuals injured in non-work related accidents to receive state mandated benefits if they cannot work in their normal or customary job. The key difference between the two types of benefits is that workers’ comp covers injuries for which an employer would be liable, while disability is issued to help disabled employees offset lost income.
The Law Practice of Ken Kieklak is dedicated to fighting for hard-working people who have had to stop work due to a serious illness or injury. To schedule a free and confidential SSDI consultation contact us at (479) 251-7767 today or contact us online.
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