Puzzled over Workers' Comp and when to file for SSDI

[Wink]

Hey, Everyone.

This is my deal: The Workers' Comp Commissioner recently awarded me Permanent Total Disability with the maximum 500 weeks...AND Lifetime Open Medical Benefits! My lawyer said that the defense would more than likely appeal, but not to worry. OK..So I wait and see what happens with that.

Now...what I'm concerned about is this: a few months before my WC Hearing I emailed my lawyer and mentioned that I wanted to file for SSDI. The answer I received back via email was, "It will cost you THOUSANDS of dollars and the Insurance Carrier will not settle with you as Medicare will place a lien on your file. In essence, you will be SCREWED if you file for SSDI before your WC case is over. You will file for SSDI AFTER you're settled with Workers' Comp, then we will work on the SSDI". How will I lose thousands if I file for SSDI before the WC is settled?

What is everyone's take on this? 0f course, I have more questions, but later on.

Thanks for your time and thoughts!

Wink
South Carolina

[Shown]

Those are good questions and I will be awaiting someone to answer them for you. You see we are doing the same thing, my husband has filed for SSD and he is in the middle of a WC case. He had his medical exam for SSD last week and next week he finally gets to go see a WC doctor. I am sorry, however WC has denied benefits and I am not waiting on the insurance companies and the courts to decide what to do with our financial life.

If I lose money then so be it, right now we are 6 weeks without any paychecks. For us WC could deny it being work related and I would then have to start with SSD and we would be so far behind at least this way we filed just as soon as he was unable to go to work. This was on the recommendation of our family doctor.

Shown

[cindybear]

From what I understand- you can't get paid by both.....It's one or the other...So....If you win WC after winning SSDI. I beleive you don't get it...You have to pay So much back or something like that..But from what I understand..you can't get both..Why they ALLWAYS go for WC first...then SSDI next....ALLWAYS....I have never seen it done the other way..SSDI then WC...But Thats what I heard...Don't take me for gold...Hugs, Cindy

[caudaequinasyndrome]

you can get both , at least in NY state .
every state is different as far as wc , so you need to talk to lawyer from your state

[Wink]

...but my question is a bit complicated, not to mention confusing, huh? I wish Tamarashadow was still around like she use to be (I know she's not feeling too well these days) but she always had the answer.

[caudaequinasyndrome]

the problem is WC is different state by state. lawyers wont even advise someone that is outside their practicing state. i would assume your lawyer knows the correct answer. much better than someone from the online world that is familiar with another state. i think tamarshadow was from California.
as far as ssdi , if you do a settlement sec 32 in ny state, you have to set aside monies for medicare for future medical for your wc injury.
that may be the thousands your lawyer speaks of.
i dont think you ever get that mony even if you never spend it,

[wildone2mo]

Hey WINK and everyone else you can get SSDI and worker COMP I think you guys are thinking of SSI wich is alot diffrent SSI is for people who do not have enough credits for SSDI go to SSDI site and read you can recieve up to 80% of you wage before so SSDI and WC cheaks together cannot go beyond 80% of your previous wages plus they are nice people to talk with also, at the IRS and SS office trust me I looked into this, oh I called IRS to make sure WC was not taxable and guess what it wasnt felt uncomfortable at first as they ran my name ans S.S # and I exsplained my situation was put on hold for a long time but guess what everything is A OK.. again SSI is diffrent than SSDI

[Wink]

Hey, backless~
It's real good to hear from you! Backless, I have always been in South Carolina--and my case is here too. Yep, the Commissioner handed me a good decision. I'm just waiting to see what's going on with the appeal from the "other side". My lawyer said not to worry...that they appeal for the **** of it.

As you know, I'm concerned about what my lawyer told me regarding me filing for SSDI. I want to trust him, but I can't help but question him anyway. I just don't want to SCREW myself by making the wrong move. It's like Bad Boy said over at: http://www.workerscompensation.com/cgi-bin/teemz/teemz.cgi?board=_master&action=opentopic&topic=6051&forum=Injured_Worker_Forum "Well, I have to say since Winky brought up such question, I have spent hours on end trying to find the answer. Can always find the answer if one is on SSDI before their settlement, but never anything to the fact if one waits till after their settlement to apply for SSDI. Once found a small reference point on reduction, and Medicare reduction where the injured worker then pays all medical in regards to such injury. But was to vague to mention. Not enough material to base a fact on.Now I have been hearing people say their Attorney said not to apply for SSDI at this time, or wait till after they settle their WC case. Why I have not one single idea. Is it the work it takes if one is one SSDI they don't want to deal with. Or is it truely a fact you will save money by waiting. We don't know, nor have we had any person yet come forward and say they done that that way. Will one gain, or will one lose. We are simply now got to the point of wanting to find out, to share the knowledge of wealth with many others. It surely will help others someday down the road. Join in if you all like, for Winky and I have been driving ourselves crossed eyed trying to find this information. So we welcome anyone to help".

BTW, my screen name is "Winky" over there.

I hope you're doing alright these days! Talk to you later!

Also, Thanks everyone for you thoughts!

[caudaequinasyndrome]

Hey WINK I think you guys are thinking of SSI wich is alot diffrent SSI is diffrent than
you can collect ssdi and wc,
i do. your wc and ssdi paymant combined cant exceed 80% of the average wage that ssdi figures out.

[Wink]

Thanks, yonkersguy~
No...I am and we are definitely talking about SSDI (Social Security Disability) and WC--NOT SSI (Social Security Insurance). I know about the 80% also, and I know that you can collect both.

Again...my question is summed up pretty well by Bad Boy, which is: "Well, I have to say since Winky brought up such question, I have spent hours on end trying to find the answer. Can always find the answer if one is on SSDI before their settlement, but never anything to the fact if one waits till after their settlement to apply for SSDI. Once found a small reference point on reduction, and Medicare reduction where the injured worker then pays all medical in regards to such injury. But was to vague to mention. Not enough material to base a fact on. Now I have been hearing people say their Attorney said NOT to apply for SSDI at this time, or wait till AFTER they settle their WC case. Why, I have not one single idea. Is it the work it takes if one is on SSDI they don't want to deal with? Or is it truely a fact you will save money by waiting? We don't know, nor have we had any person yet come forward and say they done that that way. Will one gain, or will one lose? We are simply now got to the point of wanting to find out, to share the knowledge of wealth with many others. It surely will help others someday down the road. Join in if you all like, for Winky and I have been driving ourselves crossed eyed trying to find this information. So we welcome anyone to help".

[Jim5523]

You can receive a maxium of 80% average weekly pay for both SSDI and WC. WC is tax free and SS can be partially taxable depending on your income. At age 62 You can receive full WC pay and full early retirement SS pay with no offset. At age 65 or your normal retirement age you will then receive Full WC pay and then full SS pay with no offset. If you do not work for 20 of the last 40 quarters representing 10 years you cannot collect SS unless you prove your disability for SS within that time frame. You can not use medical evidence for your SS claim after that time frame. It is important to file within the time frame because that is your Last Date of insurability for SS. There was never a concern for medicare or WC in my case but I was adwarded PTD with WC and SSDI. I also was adwarded SSDI so at this time full pay from both WC and SSDI are paid because of my age being more than 65. Attorney fees was maxed out for WC at $8,000 and also $4,000 for SSDI. (It is now $5300). I live in the state of Ohio and some states such as Ohio pay lifetime WC payments, and some have a maximum of so many months (Example 500 months). I paeronally believe that SSDI should be filed ASAP. SSDI considers all conditions not only WC allowed conditions. If you win SSDI I believe it may help to win WC PTD, but both have different rules to be awarded a favorable decision. As far as I realize the only loss of both awarded together is a maximum of 80 payments between both until age 62. Partial total disability awards from WC is different.

[caudaequinasyndrome]

i think wink is trying to find out why some lawyers say to wait until you finish with WC before you apply for ssdi.
i doubt for most people this would make sense since , wc cases may take many years to setle, and like jim said , if you dont apply for ssdi in a timely manner after stopping work due to illness or injuiry , you will be screwing yourself out of any ssdi payments.

if you settle with wc , most likely your medical will be closed , end of wc paying for your wc medical.
medicare does not want to become liable for the wc injuries due to the closed medical, so all settlements have to be approved by ssdi if you are on ssdi. ssdi will require a sum to be withheld from your settlement to pay for future medical on the WC portion of your medicare.
lets say your settlement was 40,000 medicare may say that they want 10,000 withheld for possible future medical care. you will never see this money if you never use it up. when you settle the medicare withholding and your lawyers fee come out of the settlement.
in NY state there is no termination on WC payments, and the injured party never has to settle.

[caudaequinasyndrome]

i just reread your first post, you speak of open medical.
i would contact your attorney again and ask him why? that doesn't make any sense, unless the 500 weekly lump sum will put you over the 80 percent of average weekly wage,
again he should explain that ..