Order Recognizing Right To Social Security Offset {WC-1005B} | Pdf Fpdf Doc Docx | Louisiana

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Order Recognizing Right To Social Security Offset {WC-1005B} | Pdf Fpdf Doc Docx | Louisiana

Order Recognizing Right To Social Security Offset {WC-1005B}

This is a Louisiana form that can be used for Workers Comp.

Alternate TextLast updated: 11/8/2010

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STATE OF LOUISIANA LOUISIANA WORKFORCE COMMISSION OFFICE OF WORKERS' COMPENSATION * VERSUS * * SS#: DOCKET NO: DISTRICT: ORDER RECOGNIZING RIGHT TO SOCIAL SECURITY OFFSET This matter is before the Workers' Compensation Judge on the motion of the employer/insurer for recognition of its right to claim the social security reverse offset in this case. The Workers' Compensation Judge finds that the claimant is receiving permanent total disability benefits under the provisions of the Louisiana Workers' Compensation Act in addition to benefits under 42 U.S.C. Chapter 7, Subchapter II, entitled Federal Old Age, Survivors, and Disability Insurance Benefits. The Workers' Compensation Judge further finds the under that provisions of L.R.S. 23:1225(A) the employer/insurer has claimed and is entitled to a reduction in the Workers' Compensation benefits paid to claimant in the amount of . IT IS THEREFORE ORDERED, ADJUDGED AND DECREED that the employer/insurer is hereby allowed to offset the Workers' Compensation benefits paid to claimant in the amount of , beginning on , 20 , the date of employer/insurer's judicial demand. IT IS FURTHER ORDERED, ADJUDGED AND DECREED that the Social Security Administration reverse its social security offset effective employer/insurer's judicial demand. READ, RENDERED AND SIGNED this the 20 at day of Parish, Louisiana. , 20 , the date of WORKERS' COMPENSATION JUDGE LWC-WC-1005B Rev. 7/07 American LegalNet, Inc. www.FormsWorkflow.com

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