If the NH is receiving WC or other PDB provided for under Federal, State, or local
laws or plans, the DIB and auxiliary benefits payable may be subject to offset.
Private companies or carriers may pay some WC/PDB benefits, but benefits are required
under Federal, State, or local laws or plans (e.g., State temporary disability insurance
benefits). Such benefits are not “private” benefits when deciding if we need to develop
these benefits further.
On a paper application, if the NH indicates they have filed or intend to file for
a “PDB” which is not VA, SSI, or welfare benefits (i.e., the “other” block is checked),
have the NH complete an SSA-546 (Workers' Compensation/Public Disability Benefit Questionnaire).
If the NH filed for a private disability benefit (one paid under a private company's
plan or paid under the terms of a private disability insurance policy purchased by
the NH) do not have the NH complete the SSA-546.
In a Modernized Claims system (MCS) claim, the WC01 screen generates if the NH answers
“yes” to the question, “have you filed for or do you intend to file for WC or PDB”
on the DISB screen. This information will result in calculation of any applicable
offset.