High-Five Formula

Massachusetts Attorneys Assisting Claimants for Social Security

In certain situations, an individual may be eligible to receive multiple forms of federal benefits, including both Social Security Disability Insurance (SSDI) and workers’ compensation benefits. However, recipients of federal benefits are not entitled to receive more benefits through multiple programs than they would otherwise be entitled to receive under any one system. For this reason, the Social Security Administration has developed several tests to determine when a cap may be placed on SSDI benefits if a recipient is also receiving workers’ compensation. At Kantrovitz & Associates, P.C., our Social Security lawyers can help individuals in Massachusetts determine how workers’ compensation payments might affect their SSDI benefits.

SSDI Offsets

If you receive SSDI benefits, the SSA will also inquire as to whether you are receiving any other benefits through state or federal programs. If so, the amount of these benefits will be factored into the SSA’s calculation of your SSDI benefits. This is known as the “offset” process. Under the offset process, an SSDI recipient cannot receive more than 80% of his or her earnings from prior full employment. This is a total amount, so the 80% considers both SSDI payments and workers’ compensation. For instance, if a worker made $1,000 a week prior to becoming disabled, he or she could receive no more than $800 a week in benefits. If the worker were already receiving $300 a week in workers’ compensation, SSDI payments would be limited to $500 a week.

The most difficult part in determining an offset is the calculation of prior earnings. The SSA typically uses either average current earnings or the total amount of SSDI that was received by all members of the worker’s family in the first month that workers’ compensation was in effect. This is known as the total family benefit. Here, we will focus on average current earnings.

Calculating Average Current Earnings

The SSA considers multiple different factors when determining what an SSDI recipient’s average current earnings are. First, it considers the average monthly wage that the SSDI benefit amount was originally calculated on. Next, it considers the “high five,” and finally it considers the “high one.” The SSA then takes the highest of these three amounts to calculate average current earnings.

The “high five” amount is the average monthly earnings for an SSDI recipient from the individual’s highest five years of wages. These five years must be consecutive, and they are determined by looking at a recipient’s history of employment. While the “high five” amount may sometimes reflect the highest average monthly earnings for recipients, this is not always the case.

Seek Legal Guidance in Massachusetts When Pursuing Government Benefits

If you are concerned about the cap that may be imposed on your SSDI benefits due to payments you are receiving from workers’ compensation or another program, it can be helpful to sit down and calculate the total amount of benefits you are entitled to receive and how your SSDI may be “offset” to stay within this total. At Kantrovitz & Associates, P.C., our government benefits attorneys can guide Massachusetts residents through the SSDI eligibility process, including calculating your average earnings based on the “high five” years of your income. Based in Boston, we serve individuals from Norfolk, Plymouth, Suffolk, Essex, and Middlesex Counties, as well as the Merrimack River area. Contact our office for more information at (800) 367-0871 or online.