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How Retirement Affects Workers Compensation

Suffering a serious injury as you approach retirement age can be scary.  Many people have questions about whether they have to change their retirement plans and whether workers compensation will cover them.  This article addresses a few of the questions that people have about how retirement can affect a workers compensation case.

What happens if I am already Social Security retirement age and get hurt on the job?

You become eligible for Social Security benefits when you reach a certain age.  Your full Social Security retirement age depends on the year in which you were born.

Many people continue working after they reach their full Social Security retirement age.  If you work past your Social Security retirement age and suffer an on the job injury, that injury should still be covered by workers compensation.

Under Georgia’s law, this means that your injury potentially makes you eligible for the three different types of workers compensation benefits:

  1. Wage loss benefits (temporary total and temporary partial disability)
  2. Medical benefits
  3. Permanent partial disability benefits

For the most part, your workers compensation claim will be the same as if you were not retirement age.  If your injury takes you out of work, you should receive wage loss benefits.  If you require medical treatment or testing for your injury and receive it from authorized doctors, the insurance company should pay for it.

Doctor examining man with shoulder painThere are some things you may run into if you had already reached retirement age before you were injured.  One thing you may run into is the workers compensation insurance company trying to stop your wage loss benefits checks because they say that you would have retired and stopped working anyway.  This is not necessarily the case, and the insurance company should not stop your benefits for that reason.

Another factor that comes up is how Social Security and Medicare interact with workers compensation.  This is a pretty complicated area of the law, but I will touch on some of the interaction below.

Does my workers compensation case end when I retire?

No.  Your workers compensation case does not end when you retire.  But, certain types of workers compensation benefits might stop when you retire.

It is important to clarify that I am talking about actual retirement here instead of just reaching retirement age.  Retirement age is just an artificial number, and many people choose to work past retirement age.

On the other hand, actual retirement is different than just reaching retirement age.  It is a choice on your part not to continue working.

Insurance companies try to use this to argue that this choice means that you should not continue receiving workers compensation benefits after retirement.  But, whether that is actually the case or not will depend on several different factors.

The type of retirement

Not all retirements are the same.  The type of retirement is one of the factors that matters in determining whether someone will draw workers compensation wage loss benefits after retirement.  Medical benefits and permanent partial disability benefits should not be affected by retirement.

Sometimes, people retire from one type of job with the intention of continuing to work at another job in the future.  This often happens when someone has a retirement or pension that they can receive for working a certain number of years with a particular employer.

Also, sometimes people retire because of the serious injuries that they suffer at work.  In these cases, the injured individual was not planning on retiring that early but the job injury changes their retirement plans.

Grandmother and granddaughter reading book togetherWill my weekly workers compensation checks stop if I retire?

It depends on a bunch of factors, but the timing of your retirement is one of the main factors.  If you are getting weekly workers compensation checks when you decide to retire, then your benefits will probably not stop.  This is because you already had a loss of earning capacity as a result of your work related injury.  In this situation, the work injury is the reason you were losing income – not retirement.

But, if you were working and not getting workers compensation wages loss benefits when you retired, then you are in a much different situation.  The retirement is the reason that you are no longer earning wages.  So, if you tried to get the workers compensation insurance company to pay workers compensation benefits after retirement in this situation, it would be much more difficult.

Can I start getting workers compensation wage loss benefits after retiring from a light duty job?

Nothing about Georgia’s law says that you cannot, but it is generally harder to do as I mentioned above.  The reason it is harder is that your employer has provided you with a light duty job.  If you choose to retire instead of working that light duty job, a judge is probably going to say that your retirement, not your injury, is causing your wage loss.

But, there are ways that you can still draw workers compensation wage loss benefits after retiring from a light duty job.  This happens when the light duty job is not suitable for you and you have to retire as a result.  I have had some success with proving this in some case I have handled.

Also, if a doctor totally disables you from working as a result of your injury after you retire, this may also make you eligible for wage loss benefits.  This often happens if you end up having some sort of surgery as a result of your workers compensation injury.

How does workers compensation interact with Social Security and Medicare?

As I mentioned above, this is a very complicated area of the law.  Workers compensation interacts with Social Security and Medicare differently.

Social Security is a monthly benefit that is paid to you by the Social Security Administration in certain situations.  One situation is when you reach retirement age and start drawing benefits.  Another situation is when you become disabled and qualify for Social Security Disability benefits.

Social Security Disability benefits interact with workers compensation because both types of benefits are paying for you being unable to work.  If you receive Social Security Disability benefits, many times your Social Security check will be reduced because you are receiving workers compensation.

Senior woman using smartphone and laptopThe Social Security Administration has a formula for determining whether your benefit will be reduced that factors in the amount of your workers compensation checks and a calculation called your “Average Current Earnings”.  Sometimes, settlement of your workers compensation case can reduce or eliminate your Social Security offset.

Medicare is government subsidized health insurance that you become eligible for at age 65 or when you have certain disabilities.  Medicare interacts with workers compensation in two primary ways.  Both ways focus on Medicare not wanting to pay for medical treatment that should be paid by workers compensation.

The first way is conditional payments. Conditional payments occur when Medicare pays for treatment that should be paid by workers compensation.  In this situation, Medicare will want to be reimbursed for the payment it made that workers compensation should have paid.

The second way Medicare interacts with workers compensation is for treatment that occurs after a case settles.  Medicare wants you and the workers compensation insurance company to make sure Medicare’s interests are considered in a workers compensation settlement.  This is often done through setting up a Medicare Set Aside account as part of settlement.

Again, these interactions with Social Security and Medicare are very complicated.  If you do not understand what you are doing, it is very easy to mess something up.

Does retirement prevent me from settling my case?

No.  Retirement does not prevent you from settling your case.  But, it could affect what the insurance company will offer you to settle.  The reason that retirement affects what the insurance company may offer you is what I discussed above – retirement sometimes limits your right to future workers compensation benefits.

In deciding what to offer you in settlement, the insurance company will look at what your case is going to cost them in the future.  If you are going to receive less benefits because of retirement, that can cause the insurance company to offer less money in settlement.

Settlement is also a complicated part of a workers compensation case.  This article I wrote talks more about many of the factors that go into settlement.

What if I have other questions about workers compensation?

Georgia’s workers compensation system can be very confusing.  You have to worry about getting the treatment you need and paying your bills while also worrying about not missing any deadlines that could cause you to lose your right to receive workers compensation benefits.

If you have questions, I would recommend that you try to get answers.  To find out more about how to schedule a time to talk to me about your workers compensation questions, just read this short article.

Jason Perkins is an attorney who specializes in representing injured workers.  He regularly publishes videos and write blog articles about Georgia’s workers compensation system and issues that are important to injured workers and their families.

To be notified of Jason’s new workers compensation videos, subscribe to his Georgia Workers Compensation Video Series channel on YouTube by clicking the subscribe button below.

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Jason Perkins

Workers' Compensation Attorney

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