SSR 79-20: TITLE II: INTERRUPTED WORKERS' COMPENSATION OFFSET

(PPD-35)

SSR 79-20

PURPOSE: To state the policy regarding the effect of interrupted

workers' compensation (WC) offset on statutory increases in Social

Security benefits and the requirement that the Social Security

Administration be on "notice" of the receipt of WC payments.

CITATIONS (AUTHORITY): Social Security Act, sections 224(a)(2) and

224(a)(8); Regulations No. 4, sections 404.408(c)(2)(ii) and

404.408(i).

PERTINENT HISTORY: There is no statement of policy providing for

the protection or lack of protection of statutory increases in Social

Security benefits during a period of interruption in WC offset.

Operational personnel have requested formalized policy which will enable

them to be assured that cases involving the same set of facts are being

processed uniformly.

POLICY DIRECTIVE STATEMENT: Where WC payments are interrupted in

Disability Insurance Benefit cases because of a break in WC entitlement,

offset will be reimposed beginning with the month after the month the

Social Security Administration (SSA) receives notice of the new WC

entitlement. In such cases, any statutory increases in Social Security

benefits which became effective prior to the month offset is reimposed are not protected from the WC offset provisions of the Social Security

Act. However, if WC entitlement is continuous, even though WC payments are

stopped and resumed (e.g., temporary payments were stopped pending a

permanent disability rating), Social Security statutory increases are

protected from the first month of offset imposed.

h became effective prior to the month offset is reimposed are not protected from the WC offset provisions of the Social Security

Act. However, if WC entitlement is continuous, even though WC payments are

stopped and resumed (e.g., temporary payments were stopped pending a

permanent disability rating), Social Security statutory increases are

protected from the first month of offset imposed.

The crucial determination to be made is whether the interruption in WC

payments represents a "break in entitlement." Determining whether an

interruption of WC payments is due to a break in WC entitlement or whether

additional payments are contemplated depends upon the laws, regulations,

policies, and procedures of individual States. These laws, regulations,

policies, and procedures will vary from State to State. Questions

regarding their effect in individual States should be referred to the

Regional Attorney. Some examples of factors that may be relevant to

whether there is or is not a break in WC entitlement in individual States

are:

An interruption preceding a second WC award, unrelated to the original WC

award, is considered to be a break in entitlement. If offset is removed

for a reason unrelated to the WC awards, such as a decrease in total

family benefits, and later reimposed, benefit increases that become

effective during the period of no offset are protected.