SSA - POMS: DI 52120.010 - Alaska Workers’ Compensation (WC)

A. Processing Alaska WC offset cases

Alaska reduces its WC due to Social Security disability insurance benefits. Based on Office of General Counsel (OGC) opinions dated December 30, 2008 and April 13, 2009 regarding Alaska’s WC reverse offset provisions (AS §23.30.225(b)), reverse offset applies to some, but not all types of Alaska WC payments. The application of reverse offset to Alaska WC is a Change of Position (COP) from previous POMS instructions. The COP is effective 07/2009 (see GN 04001.100 Reopenings – Change in Ruling or Legal Interpretation – Change of Position). Also see the example in DI 52120.010B.2 in this section illustrating how to apply COP guidelines.

B. Types of WC payments

Benefits are payable every 14 days unless the WC Board permits a different schedule. Payment is due on the last day of the 14-day period. When requesting WC payment information from Alaska WC Board, use their form Request for Release of Information (Form 07-6121) . SSA employees do not need to pay a fee, submit a photocopy ID, or obtain the claimant’s signature as stated on the form.

1. WC types and reverse offset applicability

The following lists the types of Alaska WC and whether reverse offset applies:

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Temporary Total (TT) – Reverse jurisdiction applies. Do not impose offset.
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Temporary Partial (TP) – Reverse jurisdiction applies. Do not impose offset.
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Permanent Partial Impairment (PPI) – (code as PP); paid in addition to temporary disability. Paid in a lump sum unless the worker is in the reemployment process (job training), then paid biweekly at the established weekly WC rate. – Reverse jurisdiction does not apply. PP WC is offsettable.
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Permanent Total (PT) – Reverse jurisdiction applies. Do not impose offset.
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Reemployment (vocational rehabilitation) benefits - payable only under an approved rehabilitation plan; a worker under a reemployment plan is first paid any TT, TP, or PPI that is due, followed by a stipend paid at a percentage of wages if the worker is no longer temporarily disabled and PPI benefits have been paid in full. Reemployment benefits are reduced by the worker’s wages to the extent that the wages plus the benefits exceed the TT rate. Reverse jurisdiction does not apply. Reemployment benefits are offsettable. If reemployment benefits are paid as part of a lump sum settlement, see (DI 52110.005B).
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PP and reemployment (vocational rehabilitation) benefits, or any other types of settlements and ratings that do not specify the type of payment involved, are offsettable under the DIB provisions. Also, any added WC benefit types or categories created after enactment of the reverse offset provisions are subject to DIB offset by SSA, per Reverse Offset Plans in DI 52105.001.

2. Example – Postentitlement action involving WC payments affected by Alaska reverse offset change of position (COP)

Case scenario:

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DIB is offset effective the MOET of March 2007 based on receipt of Alaska WC. The file reflects the WC amounts but not the type of compensation paid.
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In May 2010, a triennial redetermination alert is produced. The claims authorizer (CA) starts working the alert in August 2010, more than a year after the Alaska WC COP is published. The CA must develop for updated WC verification. Verification is received in September 2010, revealing that all Alaska WC payments have been either TT or PT, but the WC rates paid do not differ from those already used in previous offset calculations.
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Offset is removed (i.e., reverse offset begins) effective January 2010, the month of the redet, since there are no changes in WC rate amounts prior to January 2010, and the redet represents a new initial determination.

NOTE: A change in the WC rate also represents a new initial determination since it is a change in the factual situation (see GN 04001.030, Relationship Between Initial Determination and Administrative Finality and GN 04030.080, Reopening When Workers’ Compensation/Public Disability Benefits Offset is Involved). Using the same case scenario above, reverse offset could be imposed prior to January 2010 (but no earlier than the COP date of July 2009) if development reveals a change in the WC rates paid prior to January 2010. In this situation, the reverse offset effective date is the date of the WC rate change or July 2009, whichever is later.

C. Cost-of-living adjustments (COLAs)

Alaska does not provide for cost of living increases for any type of WC payment.

D. Attorney fees

Alaska requires that the Workers’ Compensation Board approve attorney fees. EXCEPTION: One-time consultation fee up to $300.00 does not require approval.

E. Retirement Insurance Benefit (RIB) considerations

Alaska reduces weekly WC payments by an amount equal as nearly as practical to one-half of SSA RIB for a given week.

F. Interest and penalties

Benefits may include interest or penalties, which are not considered WC and therefore not offsettable. For list of payments not considered WC, see (DI 52105.015).

G. Advances and overpayments

Benefits may be reduced up to 20 percent (more if approved by the Board) for advances or overpayments. Use the full, correct WC rates and periods as determined by the insurer for offset. For more information on unique lump sum settlement provisions, see (DI 52150.065).

H. Compromise and Release (C & R)

Even if claimant signs the C&R, it is not binding and legal until the WC Board approves it. Once the WC Board approves a C&R, it is final.

I. Fishermen’s fund

The Alaska Fishermen’s Fund provides for the medical treatment and care of Alaska licensed commercial fishermen injured while fishing on shore or off shore of Alaska. These are medical benefits only and not offsettable.

J. Exhibit

Example of form used by the State WC agency.

Compromise & Release Agreement Summary; http://labor.state.ak.us/wc/forms/wc6117.pdf

Alaska WC Request Form —

Request for Release of Information (Form 07-6121)

K. References

Alaska Division of Workers' Compensation

http://www.labor.state.ak.us/wc/wc.htm

Alaska Fisherman’s Fund

http://www.labor.state.ak.us/wc/ffund.htm

Alaska Workers’ Compensation Act, Title 23, Chapter 30

http://www.touchngo.com/lglcntr/akstats/Statutes/Title23/Chapter30.htm

Social Security

Program Operations Manual System (POMS)

DI 52120.010 Alaska Workers’ Compensation (WC)