SSR 70-57a: SECTIONS 223(a), 224(a) and 224(g). -- DISABILITY INSURANCE BENEFITS -- RECEIPT OF BENEFITS UNDER THE JONES ACT (INJURIES TO SEAMEN)
20 CFR 404.408(a)
- Where a worker, entitled to disability insurance benefits, was paid $42 per week pursuant to provisions of the Jones Act (Injuries to Seamen), 46 U.S.C. 688, based on an injury incurred as a seaman aboard a tugboat, held, the worker's disability benefits are not subject to reduction under section 224 of the Social Security Act since the Jones Act, unlike the Longshoremen's and Harbor Workers Compensation Act, is not a workmen's compensation law or plan of the United States or a State
R, age 42, filed application for disability insurance benefits on May 28, 1968, alleging that he became unable to work because of an injury received on December 1, 1967, and that he was receiving workmen's compensation payments of $42 a week. R was found entitled to disability insurance benefits, and his wife and two minor children entitled to monthly benefits.
Conflicting allegations as to the nature of R's employment at the time of his injury were submitted with his application. Initially he stated that he was a crewman and roustabout (deckhand, longshoreman) working on an oil rig when injured. His attorney maintained that the payments to R were not workmen's compensation payments since he was employed as a seaman and captain of a tugboat at the time of the accident. R's employer corroborated the fact that the $42 weekly payments were not made under a State workmen's compensation law or under the Longshoremen's and Harbor Worker's Act but were paid pursuant to the provisions of the Jones Act pending a later settlement.
The issue thus presented is whether the disability insurance benefits payable to the claimant, and the benefits of his wife and children, are subject to reduction pursuant to section 224 of the Social Security Act by reason of the amounts received under the Jones Act (46 U.S.C.A. 688).
Section 224 of the Social Security Act provides, in pertinent part, as follows:
- (a) If for any month prior to the month i which an individual attains the age of 62 --
- (1) such individual is entitled to benefits under section 223 and
- (2) such individual is entitled for such month, under a workmen's compensation law or plan of the United States or a State, to periodic benefits for a total or partial disability (whether or not permanent), and the Secretary has in a prior month, received notice of such entitlement for such month, the total of his benefits under section 223 for such month and of any benefits under section 202 for such month based on his wages and self employment income shall be reduced (but not below zero by the amount by which the sum of --
- (3) such total benefits under sections 223 and 202 for such month, and
- (4) such periodic benefits payable (and actually paid) for such month to such individual under the workmen's compensation law or plan, exceeds the higher of --
- (5) 80 per centum of his "average current earnings," or
(6) the total of such individuals's disability insurance benefits under
section 223 for such month and of any monthly insurance benefits under
section 202 for such month based on his wages and self-employment income,
prior to reduction under this section
* * * * * * *
- (g) Whenever a reduction in the total of benefits for any month based on an individual's wages and self-employment income is made under this section, each benefit, except the disability insurance benefit, shall first be proportionately decreased and any excess of such reduction over the sum of all such benefits other than the disability insurance benefit shall then be applied to such disability insurance benefit.
Clearly disability insurance benefits under section 223 of the Act are subject to reduction only if the individual is entitled to periodic benefits under a workmen's compensation law or plan of the United States or State.
The Longshoreman's and Harbor Worker's Compensation Act (33 U.S.C.A. 903) provides, pertinent part, as follows:
- Compensation shall be payable under this chapter in respect of disability or death of an employee, but only if the disability or death results from an injury occurring upon the navigable waters of the United States (including dry dock) and if recovery for the disability or death through workmen's compensation proceedings may not validly be provided by State law. No compensation shall be payable in respect to the disability or death of --
- (1) A master or member of a crew of any vessel, nor any person engaged by the master to load or unload or repair any small vessel under 18 tons net. . . .
However, the Jones Act relating to injured seamen (46 U.S.C. 688, Chapter 18] provides, in pertinent part:
- * * * Any seaman who shall suffer personal injury in the course of his employment may, at his election, maintain an action for damages at law, with the right of trial by jury, and in such actin all statutes of the United States modifying or extending the common-law right or remedy in cases of personal injury to railway employees shall apply; . . . jurisdictions in such actions shall be under the court of the district in which the defendant employer resides or in which his principal office is located.
Since R is excluded from workmen's compensation payments under the Longshoremen's and Harbor Worker's compensation Act because he was a member of the crew, he had recourse to file for damages under the Jones Act which is not a workmen's compensation law or plan of the United States or of a State, but is a statue permitting judicial action for payments on account of a work-related injury. Pending such action by R, the employer's insurance carrier paid him $42 weekly.
Accordingly, the Appeals Council held, that the disability insurance benefits of R, and the benefits payable to his wife and children, are not subject to reduction under section 224 of the Social Security Act on Account of the payments he received under the Jones Act.