United States: Employer May Offset Workers’ Comp Benefits Against Amounts Owed Under Long-Term Disability Plan

The 9th Circuit Court of Appeals affirmed a decision by a U.S. District Court judge that held, as a matter of law, that an employer was entitled to offset an injured worker’s PPD workers’ compensation benefits against the worker’s long-term disability benefits owed under an ERISA plan (“the Plan”). The Plan provided that any long-term disability benefits owed would be reduced by “Other Income Benefits”—including workers’ compensation payments—and also indicated that “[p]eriodic benefits and substitutes and exchanges for periodical benefits” were to be offset against any long-term disability benefits owed. The 9th Circuit indicated the Plan’s terms were not ambiguous. According to the Court, a “person of average intelligence and experience,” would understand that “periodic benefits” include benefits paid in weekly increments, such as those due under workers’ compensation law.

Thomas A. Robinson, J.D., the Feature National Columnist for the LexisNexis Workers’ Compensation eNewsletter, is the co-author of Larson’s Workers’ Compensation Law (LexisNexis).

LexisNexis Online Subscribers: Citations below link to Lexis Advance.

See Gallego v. Wells Fargo & Co. Long Term Disability Plan, 2017 U.S. App. LEXIS 2753 (9th Cir., Feb. 16, 2017)

See generally Larson’s Workers’ Compensation Law, § 157.05.

Source: Larson’s Workers’ Compensation Law, the nation’s leading authority on workers’ compensation law