Permanent Total Disability and Life Pension Benefits (Workers’ Comp)
If you have a serious and permanent disability from your work-related injury, you may be eligible for a life pension payment from workers’ comp.
If you are permanently, totally disabled as a result of your work-related injury or occupational disease (an illness or condition caused by your employment), you will likely be entitled to a lifetime pension under your state’s workers’ compensation system.
Workers’ compensation laws are different in every state, but each state has criteria for awarding a lifetime pension. If you meet the criteria for permanent total disability, and can prove this fact to your employer (or your employer’s workers’ compensation insurance carrier or your state), you will receive lifetime permanent disability benefits. In a few states, such as California, you can get a lifetime pension even if you are not totally disabled–if you were given a permanent disability rating of 70% or more, you can get a lifetime pension in California.
In many states, you do not need to prove that you cannot work to be eligible for a lifetime workers’ compensation pension. In some states, your ability to work is a factor, but in others, it is not a factor. It is important to note that this is different from the criteria required to obtain Social Security disability or SSI benefits. (To be eligible for Social Security disability benefits, you must not be able to work.)
Who Qualifies for a Life Pension?
State law varies, but to qualify for a lifetime workers’ compensation pension, you will need to meet your state’s criteria for “permanent and total disability.” This is a legal term with a specific, statutory meaning in your state. In most states, the standard for what is permanent and total disability is quite high; many states require the loss of both eyes, both hands, total paralysis, or a brain injury resulting in mental incapacity. (If your injury is permanent but not total, you’ll be entitled to permanent partial disability benefits, which will be paid over a number of weeks or years, but not for your lifetime.)
If the doctor treating you for your workplace injuries or occupational disease is familiar with workers’ comp cases, he or she may be can assist you in evaluating whether you qualify as permanently and totally disabled.
When Do You Qualify for Permanent Disability Benefits?
You will likely not qualify for a permanent total disability benefits (a lifetime pension) until your medical condition is fixed and stable. This means that as long as there are additional, curative treatment options available, or your doctor thinks you may improve medically over time, you will not be considered “permanently and totally disabled.” That does not mean you will not receive a lifetime pension; it means only that you will not be eligible for a pension until your treatment is complete.
What Benefits Come With a Lifetime Pension?
The predominant benefit of a lifetime workers’ compensation pension is regular payments of a set amount. The payments can be monthly, twice monthly, or some other schedule, depending on the law in your state. The amount usually rises periodically to account for increased cost of living over time.
You may also be eligible for continuing medical benefits, although usually only on a limited basis once you begin receiving lifetime pension benefits. You will likely not receive as extensive of medical benefits as when your workers’ compensation claim was open, prior to the start of your pension benefits. Typical medical expenses that continue to be covered are new hearing aids if your hearing loss is related to your workers’ compensation claim and new prosthetic devices if your amputation was caused by your industrial injury.
How Do I Obtain a Lifetime Pension?
If your doctor or an independent medical examiner thinks you are permanently and totally disabled, you should strongly consider speaking to an attorney. Lifetime pension benefits are expensive, and your employer, or their workers’ compensation insurance carrier, will not likely grant you a lifetime pension without some attempt to fight it. An attorney can advocate on your behalf to ensure your interests are well represented.
Your employer, their insurance company, or the state will make an initial determination regarding whether you are permanently and totally disabled and you should receive a lifetime pension. You have a right to appeal that determination if you are not granted a lifetime pension.
Receiving Pension Benefits
Once you receive notice that you have been awarded a lifetime pension, that notice will likely contain information about the benefits you will receive and when you will receive them. Typically, benefits begin within a month of the lifetime pension notice. You will receive regular payments, usually in the form of a paper check, at fixed intervals, such as once per month or every other week.
In many states, your surviving spouse will continue to receive some amount of workers’ comp benefits after you die. This is often contingent upon the spouse not remarrying, and other qualifications. If you have questions, talk to an attorney experienced in workers’ compensation in your area.