Workers Compensation Workplace Injury
If you are disabled because of a work-related injury, you should be getting workers' compensation benefits. However, you may also qualify for Social Security Disability Insurance (SSDI) benefits if you are unable to work because of a medical condition that is expected to last at least 12 months. The SSDI program pays benefits to you and certain family members if you are "insured," meaning that you've recently worked and paid Social Security taxes on your earnings. If you are unsure of your standing, consult with your Montana workers compensation lawyer to understand your rights.
Workers' Compensation Glossary of Terms
You can apply for SSDI as soon as you become disabled. However, there is a five-month waiting period after you become unable to work. SSDI benefits can be awarded retroactive from the date of application for up to 12 months. Therefore, you should typically apply for SSDI within 17 months of becoming disabled to avoid missing out on any retroactive benefits.
For example, if you became unable to work in January 2020, SSDI benefits could potentially start in June 2020. Therefore, you would have to apply for SSDI before June 2021, or you could miss out on some of the retroactive benefits you might be entitled to.
Applying for SSDI may have an impact on your workers' compensation claim. Workers' compensation benefits can be offset and reduced by half of the SSDI benefit. If you get awarded SSDI, you will almost always come out ahead, despite the offset. In some cases though, the offset might completely zero out any workers' compensation benefit.
The timing of your SSDI application might also affect your workers’ compensation benefits. An award of retroactive SSDI benefits might mean that workers’ compensation made an overpayment that would have to be dealt with. Montana law states that the workers’ compensation insurer can suspend your benefits until they have recouped their overpayment. However, it is often possible to negotiate a better arrangement.
Applying for SSDI can also affect a workers' compensation settlement. The workers' compensation system is not supposed to shift the costs of your work-related injury to Medicare. If you settle your medical benefits under a workers' compensation claim, you and the insurance company are supposed to consider and protect Medicare's interests. If you have applied for SSDI, then you may have to take extra steps to protect Medicare's interest. The workers' compensation insurer may require that you establish a Medicare Set Aside account with a portion of your settlement funds. The funds set aside must be depleted before Medicare will pay for treatment related to the workers' compensation injury, illness, or disease.
Your workers' compensation claim might also affect your SSDI application or SSDI benefits. When you apply for SSDI, the Social Security Administration will look at your most recent medical records. So, the timing of your application could affect your chances of getting an award of SSDI benefits.
Meanwhile, the workers' compensation insurer might take steps that will hurt your chances of obtaining SSDI. The workers' compensation insurer will often try to prove that a disabled person can work. They may send you to an insurance-friendly doctor in a process called an Independent Medical Examination. Their doctor might give workers' compensation a medical opinion stating that you are able to work, which could potentially hurt your chances of getting SSDI.
Settling your workers' compensation claim can also impact your SSDI benefits. Just as workers' compensation benefits can be reduce to offset for SSDI benefits, in some circumstances, the Social Security Administration can reduce your SSDI benefits to offset workers' compensation benefits. It is important that any settlement agreement considers the offset for any potential SSDI benefits. If you think that you might qualify for SSDI now or in the future, you should consult with an experienced workers' compensation lawyer before agreeing to any sort of settlement of your workers' compensation claim.
If you are hurt at work, and you are uncertain whether you should apply for SSDI benefits, you should talk to an experienced workers' compensation lawyer. Our attorneys can provide guidance to help you maximize the benefits you may be entitled to.
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