DI 52150: Factors in Computing Workers' Compensation/Public Disability Benefit (WC/PDB) Offset
The “offset first-considered date” and “offset effective date” (OED) are sometimes erroneously interpreted to mean the same. These terms are not interchangeable, but they can reflect the exact same date (i.e., same month and year).
The offset first-considered date is the first month offset is considered, whether or not offset is actually imposed.
The offset effective date is the first month of disability insurance benefit (DIB) reduction due to the receipt of WC/PDB.
NOTE: The first-considered date is sometimes referred to as the first possible month of offset.
DIB MOET - 08/2008
WC lump sum start date - 06/2008
Offset first-considered date - 08/2008
Excludable expenses postpone offset until 10/2008
Offset effective date (OED) -10/2008
A. WC/PDB Offset First-Considered (OFC) Date
The offset first-considered date (i.e., the first possible month of offset) is the first month offset is considered or imposed, whichever is earlier. Consider offset when offset is possible for a month and is either imposed or not actually applied because high average current earnings (ACE) postpones offset or expenses are credited for the full month. This date determines which monthly benefit amount(s) to use in the Total Family Benefit (TFB) and which increases are protected from offset.
Establish a new offset first-considered date only if there is a break in offset due to a break in WC/PDB entitlement or DIB entitlement. See DI 52150.055 - Protected Increases and Breaks in Workers’ Compensation/Public Disability Benefit (WC/PDB) Payments, Offset, and Entitlement.
B. WC/PDB offset effective date (OED)
Entitlement to, or a change in, WC/PDB may affect receipt of a number holder’s (NH’s) Social Security disability insurance benefit (DIB). The date offset is first considered, imposed, or changed depends on the NH’s DIB onset and month of entitlement (MOET).
NOTE: Because of the various WC/PDB-related Social Security Amendments, look at the onset and MOET of every DIB case involving WC/PDB to determine which criteria apply. This applies for initial DIB claims and any subsequent WC/PDB actions.
C. 1965 Social Security Amendments
Offset DIB only for months after the month SSA receives notice of WC entitlement. Apply any subsequent changes in WC the month after the month SSA receives notice of the change. Because offset is determined by the date we receive notice, these are referred to as “Notice Provision” cases.
WC offset is effective when the following conditions apply:
DIB onset is 06/02/1965 or later, and
DIB MOET is January 1966 or later.
PDB offset does not apply.
NOTE: To apply the notice provisions, follow the instructions in DI 52170.040 - Changes in Workers’ Compensation/Public Disability Benefit (WC/PDB) Paid, Notice Provisions – Pre-1981 Amendment Cases.
D. 1981 Social Security Amendments
Offset DIB any month the NH is concurrently entitled to DIB and WC/PDB regardless of when SSA receives notice of entitlement to, or changes in, WC/PDB.
These provisions are effective if the following conditions apply:
DIB onset 03/01/1981 or later, and
DIB MOET is 09/1981 or later.
E. Offset first-considered date, offset effective date (OED), and reverse offset
When reverse offset (also known as “reverse jurisdiction”) applies, the offset first-considered date or the OED can change and any increases in DIB can be affected. The following describes whether benefit increases during the reverse offset period are protected:
If offset is considered for at least one month before the first reverse offset month:
SSA benefit increases during the reverse offset period are protected. Offset is considered but may not cause benefit reduction due to factors such as a high ACE or excludable expenses. Compute the ACE and TFB effective with the first month offset is considered. The ACE and TFB change only if the conditions in DI 52150.005 Total Family Benefits (TFB) or DI 52150.010 Average Current Earnings (ACE) apply.
Payments from the first WC award end during the period of reverse offset, and the NH then becomes entitled to additional WC payments based on a new WC award (due to a different injury/illness) during the period of reverse offset, a new offset first-considered date and OED for the second WC award is the month of age 62 attainment. The TFB and ACE are established effective with the month of age 62 attainment, and prior SSA benefit increases are not protected.
If the first reverse offset month is the DIB MOET, monthly benefit increases during the reverse offset period are not protected. The TFB and ACE are established effective with the month of age 62 attainment.
NOTE: This situation is a systems limitation. Show the start date of the current action and the offset first-considered month to be the month of age 62 attainment. If the offset first-considered month is shown as the DIB MOE and an indication that reverse offset applies for all months prior to age 62 is shown, ICF erroneously considers the COLA increases prior to age 62 to be protected. For additional information, see Interactive Computations Facility (ICF) Resource Page for WC/PDB Offset Computations
EXCEPTION: The recognized reverse offset plans in Florida, New Jersey, and Washington State continue through the month before age 62 attainment. SSA offset is effective at age 62. See DI 52105.001- Reverse Offset Plans.