3 Reasons Why You Should Not Apply For Social Security Disability During Your Workers’ Compensation Claim

Many people apply for Social Security Disability while they are receiving workers’ compensation benefits.  In most instances this is a mistake.  When you are injured on the job in Georgia you will receive medical care and weekly benefits if you are unable to work.  Many injured workers are concerned that they will not be able to return to work because of their injuries.   They worry about their future and decide to apply for Social Security Disability.  For the following reasons the injured worker should wait until his or her claim is settled before applying for Social Security Disability.

1.  You will maximize the amount of money you put in your pocket if you wait to apply for Social Security disability

Normally your workers’ compensation settlement is based on future benefits that may be owed in the future and any future medical care for the work-related injury.  If you have applied for Social Security disability then part of your settlement will have to be allocated for future medical and you will have to use it for medical care for your injury.

I had a client who lost his hand in a work-related injury. He applied for Social Security Disability and as a consequence the workers’ compensation insurance company had to do a Medicare Set-Aside.  A Medicare Set-Aside is an evaluation of future medical needs for the injured worker and that amount must be “set  aside” in a special bank account to pay for medical exclusively.  My client’s Medicare Set-Aside was based solely on the cost of replacement prostheses.  Over $50,000 of his settlement was required to be used for future prostheses and my client did not wear his prosthesis.  It was uncomfortable and it was totally cosmetic and not functional.

The insurance company will have to prepare a Medicare Set-Aside if you have applied for Social Security Disability during your workers’ compensation claim.

The Set-Aside will be a special allocation of money for future medical and will affect how much money you receive and can use for your own purposes.

2.  Your future medical care will be covered by Medicare if you do not apply for Social Security Disability prior to settlement of your workers’ compensation claim.

If you do apply for Social Security Disability during your workers’ compensation claim the federal government requires that the workers’ compensation insurance company consider the future medical costs  and Medicare will not cover any of your work-related injury expenses.

 

3.  Your settlement could be delayed by six months or more.

A Medicare Set-Aside must be approved by CMS, the government agency overseeing Medicare.  The process of preparing the Medicare Set-Aside evaluation, submitting it to CMS and then getting approval by CMS is a six to twelve month process.  You may be ready to settle but cannot because the insurance company must have the CMS approval of the Medicare Set-Aside.

The best advice I can give with regard to Social Security Disability and your workers’ compensation claim is to wait to apply for Social Security.  You have been injured on the job and should receive all of the settlement money you deserve. If you apply for SSDI you will be sharing that settlement with the Federal government.  If wait the settlement proceeds will be yours to use as you wish and the future medical for your work-related injury will be covered by Medicare.  If you have questions don’t hesitate to call Sunne Law—injurylawyeratlanta.com