You need to be very careful about applying for Social Security disability if you have an active Georgia workers’ compensation case. There are two main areas of concern:
Medicare Set Aside
When you settle your workers’ comp. case – as you may know, if you are approved for Social Security disability, you also become eligible for Medicare 24 months after your first SSDI payment. Medicare takes the position that if your settlement reaches a certain size (and the number changes frequently), some of the settlement proceeds need to be set aside to cover the cost of future medical care.
Sometimes the Medicare “set aside” is applicable and sometimes it is not. Generally you will end up with more money in your pocket if you do not have to allocate a portion of your settlement to future medical care.
If you apply for Social Security before your case settles, Medicare will insist on a set aside review. Therefore I tell my clients that they should never apply for Social Security without first discussing the implications with me. I have been involved in several cases where my clients did not follow this advice and they ended up with tens of thousands of dollars less in settlement, a result that was totally unnecessary.
So, if you are receiving workers’ compensation benefits and someone tells you to apply for Social Security disability – do not do so without first talking to a workers’ compensation lawyer.
Workers’ Compensation Offset in Social Security
Another place where Social Security and workers’ comp do not fit well together is on the Social Security side of things. If you are receiving weekly wage benefits and you are awarded Social Security disability, your worker’s comp payment will reduce your right to Social Security dollar for dollar.
In other words, Social Security will not pay you (or will reduce your monthly benefit) for any month that you also receive workers’ compensation.
As you probably sense, Medicare set-aside issues and offset problems can become very complicated quickly. I regularly get calls from potential clients who have not yet hired a lawyer because the insurance company has been cooperative and has paid lost wage benefits and has provided reasonable medical care. Now it is time to settle and the issue of Social Security disability has come up.
If you are confused about the interrelationship between these two complicated areas – one being state law and the other being federal law – please don’t guess about what to do. I am happy to explain how these two different benefit programs work and offer suggestions about how to avoid losing thousands of dollars of settlement money.