Let’s look at a few scenarios to answer the question.
Suppose you have been receiving Social Security Disability benefits for a shoulder injury. You then return to work part-time, four hours a day. (If you return to work full-time, or in any position in which your gross monthly earnings exceeded $1,180, and are able to perform the job for nine months, your Social Security benefits will end.)
But let’s say you’re collecting a monthly Social Security check of $1,000 and then injure your knee while doing your part-time job. If the insurance company accepts your claim and starts to pay you $200 per week in Workers’ Compensation benefits, you will have to notify your local Social Security office. When a person is receiving Social Security Disability benefits and Workers’ Compensation benefits simultaneously, Social Security has a formula which takes into account their earnings in recent years. If the monthly sum of their Social Security benefits and Workers’ Compensation benefits exceed a dollar amount as determined by the formula, their Social Security benefits will be reduced. So that $1,000 you have been receiving in monthly Social Security Disability benefits could be knocked down to $600 if you start to receive Workers’ Compensation benefits.
However, if the insurance company does not accept your Workers’ Compensation claim – and trust us, they usually don’t – then you’ll have to hire a lawyer to file a petition for benefits on your behalf. We strongly recommend that you hire Pearson Koutcher Law because all we do is represent injured workers in their Workers’ Compensation cases. If we can help you secure a settlement in your Workers’ Compensation case, we will include legal language in your settlement agreement that will prevent a reduction in your Social Security benefits.
Now let’s look at a different hypothetical. You injure yourself at work and your claim has been denied, so you are not receiving any income. You apply for Social Security Disability benefits while your Workers’ Compensation claim is pending. This will have no effect on your Workers’ Compensation claim if your Social Security application is denied. But if it is granted before your Workers’ Compensation claim is decided, there could be an effect. If the Workers’ Compensation judge awards you benefits, and there is a period of time in which you receive both Social Security and Workers’ Compensation benefits, the Social Security office will utilize the formula we have described which could result in a reduction in your monthly Social Security benefits. However, as we have emphasized, if you are able to settle your Workers’ Compensation claim by lump sum, then you won’t have tow worry about Social Security talking a piece out of your check.
Another important issue pertaining to Social Security Disability benefits pertains to Medicare. A person who is granted Social Security Disability and deemed disabled for 24 months becomes entitled to Medicare – which is medical insurance. If you have a Medicare card — or are eligible for Medicare – either before you injured yourself at work or after, this will significantly affect your ability to settle your Workers’ Compensation case. Most Workers’ Compensation insurance companies will not enter into a settlement unless the injured worker signs off on their wage loss and medical claims. But let’s say you are on Medicare or are Medicare eligible and the amount of your Workers’ Compensation settlement exceeds $25,000. Under this scenario, the medical portion of your case cannot be settled unless you go through another big hoop. CMS, a division of Medicare, must approve that a certain amount of money is set aside and paid by the Workers’ Compensation carrier to fund your future medical bills related to your work injury. When that money is exhausted, then you can submit your bills to Medicare.
Sound complicated? It definitely is, which is why you should contact Pearson Koutcher Law right away if you have injured yourself at work, regardless of whether you have applied for Social Security Disability benefits.
Let us put our decades of experience to work for you, helping you navigate the complexities of the Workers’ Compensation laws.
Pearson Koutcher Law
1650 Arch St #2501
Philadelphia, PA 19103
Bethlehem Office serving the Lehigh Valley
414 West Broad St
Bethlehem, PA 18018
Cherry Hill Office serving New Jersey
1811 Haddonfield Berlin Road
Cherry Hill, NJ 08003