Workers’ Compensation & Social Security Disability
Social Security Disability benefits are available to those individuals who have a mental or physical disability which prevents them from engaging in substantial gainful employment activity. While Workers’ Compensation benefits are dependent on whether the injury is related to employment, Approval for Social Security benefits does not require any showing that the injury is work related.
However, many of our clients who suffer severe permanent disability from their work injury also qualify for Social Security Disability benefits. Depending on the earning record of the client, Social Security may “offset” or reduce the amount of Social Security benefit paid.
Those who qualify for Social Security Disability benefits may also qualify for Medicare benefits. However, under no circumstances should Medicare be asked to pay for medical treatment related to your work injury. Federal Law prohibits this and such “conditional payments” may be required to be repaid, typically by the workers’ compensation carrier (in the case of a work related injury).
When handling your workers’ compensation claim, it is also important to recognize that Medicare may need to be contacted for approval relative to certain settlements under the workers’ compensation system. Typically, if the beneficiary is in receipt of Social Security Disability and Workers’ Compensation Benefits, you will need to obtain approval from the Center for Medicare Services (CMS) before submitting a settlement to the compensation board for approval. This is a process by which Medicare will agree to cover the work injury treatment if the beneficiary exhausts money set aside for future treatment.
At Gielowski, Federice & Caligiuri, LLP, we have handled issues involving the interplay between Social Security Disability and Workers’ Compensation for many years. We see and address these issues every day in our practice and we can help you should you need to apply for Social Security Disability or if you already have a claim. Given the complexity of the interplay between Social Security and Workers’ Compensation, we urge you to contact our knowledgeable attorneys before taking any action on your own.