Can EE get both workers comp AND disability?

cebudragonlady

Worker received disbaility payment covering 1/01-1/16. Employee actually
stated in his application for benefits that he did not work 12/25 -1/01,and told me that he was in bed that whole time ( coincidentally, the factory was closed 12/25- 1/01 for the Holidays ).Afterwards , this employee was out 1/03
due to diability, but did work 1/02. Now, he worked from 1/06 - 1/23 yesterday.
Since he received disbility pay for 16 days , I told him that he had ( after surgery today ), to stay home from 1/24 - 2/7...so counting 1/01 & 1/03, he would be out 16 calendar days at least- so that the payment would be for REAL
days missed. Also, I told employee that,no matter what, I needed a doctor release for him to return to work.California has a 7 day waiting period for
disability benefits, which in this case was 12/25 -12/31. In addition to this mess, the employee reported this as a worker's comp case, which the company
disagrees because the injury was not reported for six months and also that the employee went to his own doctor instead of the Industrial Clinic that handles our employee work-related injuries. So, accordingly, I did not fill out the State mandated forms for work comp cases.Now, the WC carrier called asking for details - do I have to tell them that the employee received disability benefits?

Chari

Whatever

1. In NY & NJ, an employee cannot collect both disability and workers comp. for the same incident, same period of time etc.
2. If I have an employee who wants to file with both carriers, I always complete the forms. If the employee hasn't followed procedures or the law, let the insurance company issue a rejection.
3. Therefore, I would let the WC carrier know about the disability benefits and let the disability carrier know about the WC claim.

LindaS

In Wisconsin an employee cannot collect both WC and disability either. I agree with Whatever and would report the injury to the insurance company and let then know the details of the situation. They will investigate and make a determination based on the information they receive. I would also let them know about the disability this person has received. If the insurance company deems that this injury is WC, they will either reimburse you, the employer, or the employee will get the full payment and will have to payback the disability they received in error.

Balloonman

I would tell the WC carrier to look into it. I bet on the doctor's notes is says not work related. Also every disability claim form asks if it is a work related condition. If he checked yes he would not have gotten disability. He probably checked no, bingo you are off the hook. This has saved me 3-4 times in the past.
Give the WC carrier all the info you have tell them to deny deny deny and tell them why.
My $0.02 worth.
DJ The Balloonman