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Social Security and Workers’ Comp – can you get both?


     Did you know that you may qualify for Social Security Disability benefits while receiving benefits under a workers’ compensation claim? Obtaining both may result in greater total compensation.  Medicare benefits may also be available.

     Workers’ compensation and Social Security Disability benefits can be paid at the same time.  Between Social Security and workers’ comp, you can keep up to 80% of your highest year of earnings, with some exceptions.  Either Social Security Disability or workers’ comp can reduce benefits if you go over that 80% figure.  You will never get less than your workers compensation or Social Security benefits alone, whichever is higher.

     Medicare is the federal health insurance program for those entitled to Social Security Disability.  Medicare coverage starts two years after Social Security Disability benefits are granted.  Medicare Part A covers hospital care, limited nursing-home care, and hospice care.  Medicare Part B covers physician services, outpatient hospital services, and durable medical equipment.  Medicare Part D covers some prescription medications.  Check online at http://questions.medicare.gov for answers to questions you may have about Medicare.

     Medicare is cheap insurance and one of the primary reasons you should apply for Social Security Disability if you are unable to work.  Medicare covers medical conditions not allowed under your workers compensation claim.  It can be used when your workers’ compensation claim closes, allowing you to continue treating, which may help overturn claim closure.  Medicare is very important if you become totally permanently disabled as a result of your workers’ compensation injuries.  Ongoing treatment is typically not covered after a workers’ compensation pension, but treatment can be continued through Medicare.

     You can apply for Social Security disability over the phone, in person, or online.  However you start the process, the application is not complete until the forms are signed and returned the local Social Security Office.  The initial approval or denial is made by a state agency, Disability Determination Services (DDS).  DDS will review the application, order medical records, and sometimes schedule examinations.  The initial decision will take about 90 to 120 days and then Social Security sends a “Social Security Notice” advising whether benefits are approved or denied.  If the claim is denied, a Request for Reconsideration must be filed within 60 days.  If you are denied benefits at this stage, you should contact an attorney immediately.

     Please call us if you have any questions about your workers’ compensation or Social Security disability benefits.

     Michael Costello is a partner at The Walthew Law Firm and practices Social Security Disability and workers’ compensation law.

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