DI 52105.015 Payments Not Considered Workers’ Compensation (WC)
The following payments are not WC. The field office (FO) or processing center (PC) will input a special message to the master beneficiary record (MBR) to alert technicians that the payments are not WC.
Black Lung Part B – DI 52125.020.
NOTE: Black Lung Part C is WC. See DI 52115.015 – Federal Mine Safety and Health Act (FMSHA)
Railroad Unemployment Insurance Act (RUIA) sickness benefits. RUIA sickness benefits are public disability benefits (PDB) and are covered under a reverse offset plan per DI 52105.001.
Railroad injury settlement payments under the Federal Employer’s Liability Act (FELA).
Company or union group disability insurance – short or long term.
Private disability insurance payments regardless of the purchaser.
Sick pay paid by an employer.
Proceeds from third party settlements – DI 52105.010 – Third Party Settlements.
Reimbursements of third party settlement expenses – DI 52105.010 – Third Party Settlements.
Interest or other income generated by WC investments, whether paid or accrued.
Penalties paid by the employer or WC payer to the individual for failing to provide timely WC payments.
Jones Act payments – DI 52105.005.
Proceeds from tort (negligence) lawsuits (e.g., Indiana WC law allows employees to sue the employer for negligence).
Amounts paid directly to dependents. DI 52150.035 – Determining the WC/PDB Amount Used to Compute Offset.
Payments for excludable legal, medical and other expenses per DI 52150.050 – Excludable Expenses.
WC/PDB benefits paid under a law or plan enacted by an American Indian Tribal Government. Such benefits are not within the scope of Section 224 of the Social Security Act as American Indian tribes are not considered political subdivisions.
WC payments made to the employer – DI 52110.010 – Workers’ Compensation (WC) Payments Made to Employer.
WC-Retroactive Termination – if WC is paid and then retroactively terminated back to the date of the award, no offset applies.