Benefits: Social Security Offset

Siaperas v. State Fund [01/15/04] 2004 MT 264N An insurer is not required to reduce the social security offset because physical conditions unrelated to an industrial injury prevent claimant from performing some jobs. As held in Watson v. Seekins (1988), 234 Mont. 309, 763 P.2d 328, the offset statute does not allow for reductions or modifications to the proportion of the social security offset; the legislature fixed the setoff amount at 50 percent of Social Security Disability benefits. (Note: Siaperas is a non-citeable opinion.)
Siaperas v. State Fund [01/15/04] 2004 MT 264N Section 39-71-702(4), MCA (1995), which allows a workers' compensation insurer to decrease permanent total disability benefit payments by 50 percent of the Social Security Disability benefits a claimant is receiving, does not violate constitutional equal protection provisions, as already decided in McClanathan v. Smith (1980), 186 Mont. 56, 606 P.2d 507, where the Court held that "the avoidance of duplication or overlapping of benefits is indeed a reasonable and permissible legislative objective." (Note: Siaperas is a non-citeable opinion.)
Flynn v. State Fund [5/18/01] 2002 MT 279 Pursuant to common fund doctrine, State Compensation Insurance Fund required to bear a proportionate share of attorney fees incurred by claimant to recover social security disability benefits.
Broeker v. State Compensation Ins. Fund, 275 Mont. 502 (1996) (No. 95-221)Where a claimant is receiving both total disability benefits and social security disability benefits, the amount by which the claimant’s workers compensation benefits should be offset under sections 39-71-701(2) and -702(2), MCA (1979) is based on the social security disability benefit as indexed to the date on which claimant became eligible to receive those benefits, not the date of his injury. Affirming decision of Workers’ Compensation Court, Broeker v. State Compensation Insurance Fund, 1995 MTWCC 17 (1995).

MACo Workers' Comp. Trust v. Klinkam [12/13/11] 2011 MTWCC 26 Where the claimant’s work-related injury was only one of a list of severe physical and mental impairments that contributed to her entitlement to social security disability benefits, the Court concluded that claimant’s receipt of those benefits was not “because of the injury” and therefore the insurer was not entitled to offset workers’ compensation benefits under § 39-71-701(5), MCA.

Siaperas v. State Fund [1/15/04] 2004 MTWCC 4 The social security offset provisions require that the claimant's total disability benefits be reduced by one-half of the social security benefits she receives. 39-71-701(5) and 39-71-702(4), MCA (1995).
Siaperas v. State Fund [1/15/04] 2004 MTWCC 4 The social security offset does not violate the claimant's equal protection rights and is constitutional. McClanathan v. Smith, 186 Mont. 56, 606 P.2d 507 (1980).
Flynn v. State Fund [5/18/01] 2001 MTWCC 24 A claimant cannot frustrate recoupment of a social security disability (SSD) overpayment by refusing to agree to a reduction in biweekly benefits. There is nothing in the offset statutes precluding the insurer from reasonably reducing benefits to recoup an SSD overpayment. A subsequent, 1993 statute authorizing termination of all benefits to effect recoupment is not inconsistent with this holding. (Note: The WCC decision was affirmed on this point in Flynn v. State Fund, 2002 MT 279.)
Flynn v. State Fund [5/18/01] 2001 MTWCC 24 The social security offset is not reduced by the attorney fees claimant has paid to secure social security disability benefits. 39-71-701(5) and 39-71-702(4), MCA (1991); Stahl v. Ramsey Const. Co., 248 Mont. 271, 274-276, 811 P.2d 546, 547 (1991). Murer v. State Fund, 282 Mont. 210, 942 P.2d 69 (1997), does not overrule Stahl or the statutes and is inapposite. (Note: The WCC decision was overruled on this point in Flynn v. State Fund, 2002 MT 279.)
W.R. Grace & Co. and Transportation Ins. Co. v. Riley [3/23/98] 1998 MTWCC 26 Insurer paying death benefits to widow was not entitled to offset those benefits by amount of social security benefits decedent would have received had he survived and been permanently totally disabled.
Filcher v. National Union Fire Ins. Co. [4/15/96] 1996 MTWCC 30 An insurer has a duty to investigate prior to applying a social security offset. Lovell v. State Compensation Mut. Ins. Fund, 260 Mont. 279, 288-289, 860 P.2d 95, 101-102 (1993). That duty arises because the offset is limited to disability benefits payable because of the workers' compensation injury.
Filcher v. National Union Fire Ins. Co. [4/15/96] 1996 MTWCC 30 The fact that a social security offset was not contemporaneously taken when biweekly benefits were paid does not alone preclude the insurer from recovering overpayments resulting from the failure to contemporaneously take the offset. In Belton v. Carlson Transport, 220 Mont. 194, 196, 714 P.2d 148-149 (1986), the Supreme Court affirmed a decision of this Court permitting an insurer to recoup overpayments totalling $18,461.58.
Filcher v. National Union Fire Ins. Co. [4/15/96] 1996 MTWCC 30 Insurer estopped from recouping social security offset where claimant relied on income without offset and where insurer, which did not take offset earlier based on erroneous information from the federal Railroad Retirement Board that claimant's federal benefits were retirement benefits, had ample information to put it on notice to investigate whether claimant's benefits were in fact disability benefits allowing an offset.
Broeker v. State Compensation Ins. Fund [03/24/95] 1995 MTWCC 17 Where evidence indicated that claimant’s social security disability award was based on the same low back condition for which he is receiving total disability benefits, the social security benefits claimant is receiving are “payable because of the injury” entitling the insurer to the statutory social security offset, whether the language of the offset statute is interpreted as requiring the workers’ compensation injury to be the sole basis for the social security benefits, or as requiring that the injury contribute to the award on a “but for” or some lesser basis.