Virginia Code 51.1-1167: Adjustments in supplemental disability benefits.
A. In addition to offsets equal to the amount of any benefits paid to a participating employee under the Act, supplemental disability benefit payments shall be offset by an amount equal to any sums payable to a participating employee from the following sources:
Terms Used In Virginia Code 51.1-1167
- Act: means the Virginia Workers' Compensation Act (§ Virginia Code 51.1-1150
- Contract: A legal written agreement that becomes binding when signed.
- Disability: means a partial disability or total disability. See Virginia Code 51.1-1150
- Disability benefit: means income replacement payments payable to a participating employee under a short-term or long-term disability benefit program pursuant to this chapter. See Virginia Code 51.1-1150
- Participating employee: means any eligible employee required to participate in the program. See Virginia Code 51.1-1150
- Program: means the program providing short-term disability and long-term disability benefits for participating employees established pursuant to this chapter. See Virginia Code 51.1-1150
- Service: means a period of service as a participating employee. See Virginia Code 51.1-1150
- Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
1. During the first 12 months the employee receives disability benefits, an amount equal to the employee’s wages and salary from any employment multiplied by the income replacement percentage payable;
2. After the first 12 months the employee receives disability benefits, an amount equal to 70 percent of the employee’s wages and salary from any employment;
3. Disability payments from the Social Security Administration, local government disability benefits, federal civil service disability benefits, or other similar governmental disability program benefits received by the employee or his family as a result of the qualifying disability;
4. Benefits received from any other group insurance contract provided to the participating employee by his employer for the purpose of income replacement;
5. Benefits paid under any compulsory benefits law; and
6. If the participating employee receives a settlement in lieu of periodic payments for a disability compensable under the Act, an amount determined by dividing the workers’ compensation benefit, which such employee would have received had the lump-sum settlement not been consummated, into the settlement actually accepted by the employee.
Notwithstanding the foregoing, supplemental disability benefit payments shall not be offset by military disability benefits payable to a participating employee.
B. If the plan administrator deems a participating employee to be eligible for benefits from any of the sources listed in subdivisions A 3, A 4, and A 5, the plan administrator may direct the participating employee to apply for those benefits and to pursue whatever additional steps are necessary to obtain the benefits. If a participating employee fails or refuses to pursue the available benefits as directed by the plan administrator, supplemental disability benefit payments may be reduced by amounts from any of the sources listed in subdivisions A 3, A 4, and A 5 for which a participating employee is deemed eligible by the plan administrator as if the employee received such amounts. However, if the employee has applied for such benefits, and has reapplied and appealed denials of the claim as requested by the administrator of the plan, and the claim is not approved, the employee’s supplemental disability payments shall not be reduced thereby.
C. If a participating employee’s disability benefit payments are reduced as the result of payments from sources listed in subdivisions A 3, A 4, and A 5 or pursuant to subsection B, the employee’s disability benefits shall not thereafter be further reduced on account of cost-of-living increases in payments from such sources.
D. Participating employees shall be required to repay, with interest, to the Board or the employer any overpayments of supplemental disability benefits on account of the failure of the employee to provide the Board or its designee with information necessary to make any of the reductions required to be made under this article.
E. Any payment to a participating employee that is later determined by the Board or by the employer to have been procured on the basis of any false statement or falsification of any record knowingly made by or on behalf of the employee, or the employee’s failure to make any required report of change in disability status, may be recovered from the employee by the Board, with interest, either by way of a credit against future payments due the employee or by an action at law against the employee.
F. If a participating employee’s payments under the Act are adjusted or terminated for refusal to work or to comply with the requirements of § 65.2-603, his disability benefits shall be computed as if he were receiving the compensation to which he would otherwise be entitled under the Act.