The Philadelphia work accident law firm Pearson Koutcher Law prides itself on representing individuals who have been injured in some kind of work accident and need workers’ compensation benefits. Nevertheless, we are often asked questions about Social Security disability from our clients and must explain the impact receiving Social Security disability benefits has on their pending workers compensation claim in PA.
There is no prohibition in the law to receive workers’ compensation benefits and Social Security disability benefits at the same time.
There is never an offset against Workers’ Compensation benefits when the injured worker is also receiving Social Security disability benefits. There is a reduction in the amount of Social Security disability benefits that same person would receive, however.
Injured workers who receive both Social Security disability benefits and workers’ compensation benefits may have a more difficult time entering into a compromise and release (settlement) of their Workers’ Compensation case. This is because an injured worker who receives Social Security disability benefits will most likely become a Medicare beneficiary at some point. If an injured worker receives a settlement over $250,000 and is likely to become a Medicare beneficiary within 30 months, or receives a settlement over $25,000 and is a already a Medicare beneficiary, the parties to the compromise and release must negotiate a specific amount of money to fund future medical treatment called a Medicare set aside if the case is going to settle properly and consistent with the regulations established by CMS. The amount of money required to fund a Medicare set aside account varies from case to case and can be very expensive based upon the nature of the injuries and the type of treatment received and recommended in the future. Practically speaking, when the settlement is negotiated, if money must be placed into a set-aside account, the insurance company may not offer as much money to the injured worker when settling the case.
One other potential problem for injured workers receiving Social Security disability benefits is the automatic conversion of Social Security disability benefits to Social Security retirement benefits when the injured worker becomes 66 years of age. If this occurs, the Workers’ Compensation insurance carrier can take a credit (reduce)against Worker’s Compensation benefits up to 50% of the amount of Social Security disability benefits.
Philadelphia Union Mechanic with Carpal Tunnel Syndrome obtains $95,000 Lump Sum Settlement
A Union general mechanic badly injured his hands while performing duties for his employer. The injured worker did not have a specific accident; instead, the injured worker developed bilateral carpal tunnel syndrome as a result of the repetitive job duties he performed for the employer over a 10 year period. Philadelphia Workers’ Compensation attorney Jonathan Koutcher of Pearson Koutcher Law previously litigated a Claim Petition on behalf of the injured worker that was granted by the Workers’ Compensation judge. The injured worker was receiving ongoing wage loss benefits and underwent an additional wrist surgery before settling his case. Importantly, the injured worker was nearing retirement age and there may have been a credit against his receipt of wage loss benefits in the near future if social security and pension benefits were received. Thus, Mr. Koutcher was able to maximize the injured worker’s settlement.
$95,000 Worker Comp Settlement for Injured Auto Parts Delivery Person from the Lehigh Valley
A 74-year-old laborer from the Lehigh Valley injured his lower back lifting car and truck batteries. Philadelphia Workers’ Compensation attorney Jonathan Koutcher, a certified Workers’ Compensation specialist at Pearson Koutcher Law, represented the injured worker. The insurance company alleged that the injured worker fully recovered from his lower back injury. Mr. Koutcher presented testimony from the injured worker’s treating pain management specialist who was providing the injured worker with lumbar spine injections in opposition to the petition. The injured worker had a relatively low average weekly wage as he only worked part time when the accident occurred. Nevertheless, Mr. Koutcher was able to negotiate a settlement for the injured worker which provides security and eliminated any risk benefits would be cut off. The settlement included the funding of a Medicare Set Aside as the injured worker was receiving social security when the accident originally occurred.
The coordination of different kinds of benefits is critical when representing a client involved in a work-related accident. The attorneys at Pearson Koutcher Law have over three decades of experience representing injured workers in work-related accidents and understand the complexities of receiving multiple benefits and the importance of coordination of benefits.
Let us put our decades of experience to work for you, helping you navigate the complexities of the Workers’ Compensation laws.