Name

Pratt v. SD Warren

Insurance Company

CCMSI

Date Decided

April 30, 2019

Panel Members

Timothy Collier

Tom Pelletier

Mike Stovall

Categories

Coordination of Benefits

Tags

Social Security Benefits Acceptance of Benefits Denial of Benefits

File Size

388 KB

Download

Summary from the Troubh Heisler Attorneys

Mr. Pratt injured his back at work and the WCB awarded him ongoing partial incapacity benefits. He also received Social Security disability benefits, for which §221 provides employers no offset. When Mr. Pratt reached full retirement age, S.D. Warren duly informed him of his obligation under §221 to apply for Social Security retirement benefits, to allow S.D. Warren a 50% offset against his ongoing partial incapacity benefits.

Mr. Pratt applied for regular retirement benefits, but he also instructed the SSA to suspend his benefit checks until he turned 70, so he could get increased benefits then and avoid the §221 offset now. S.D. Warren filed a petition for approval to discontinue benefits, which Judge Jerome denied, ruling that §221 required the employee only to make application for the benefits but not to accept them. S.D. Warren appealed.

The appellate panel affirmed Judge Jerome's decision. It stated that the WCB must “avoid absurd, illogical or inconsistent results,” and that “a plain reading” of §221 requires the employee only to apply for Social Security retirement benefits but not to accept them. It further held that §221 does not expressly prohibit an employee deferring receipt of benefits until a date after regular retirement age.

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