Workers’ compensation may be provided for a wide array of injuries or illnesses sustained in the workplace. These injuries include slips and falls, burns, lacerations, and more.
Many employees who receive workers’ comp also receive other benefits at the same time such as Medicare or Social Security Disability. As the age of an employee rises, this is a more common occurrence. The question arises as to whether workers’ compensation benefits will affect the quantity of Medicare or SSD payments an individual may receive.
Social Security Disability
With minimal exceptions, your Social Security Disability Insurance (SSDI) benefits will be lowered if you are receiving workers’ compensation. The reduction will be such that the total monthly amount you receive as a disabled worker will be no greater than 80% of the amount you received at full employment.
This is an offset reduction and depends on certain other complex calculations.
Recipients of Medicare and workers’ compensation
Medicare provides health insurance to many people in the U.S. if an individual has his or her workers’ compensation claim denied, the claimant may ask Medicare to make a conditional payment, providing treatment coverage for the injury. If the individual does receive workers’ compensation, then he or she may be required to pay back the conditional payment to Medicare.
If the work injury is serious enough, the claimant may apply for Social Security Disability. This creates a reasonable expectation of gaining an entitlement to Medicare. During settlement negotiations, a carrier may offer to give the claimant a sum of money in exchange for the claimant agreeing to accept future medical treatment from the carrier.
Recipients of Medicaid and workers’ compensation
There are various ways in which a claimant may gain entitlement to Medicaid. In the majority of cases Medicaid eligibility depends on the individual’s financial situation at the time. Although a claimant’s entitlement to Medicaid will not inhibit the employee from receiving workers’ compensation benefits, this is not the case the other way around. A workers’ compensation settlement can cause a claimant to become ineligible for continuing Medicaid benefits, since Medicaid is a needs-based program.
Options are available to preserve the Medicaid eligibility of the claimant while the claimant is receiving a workers’ comp settlement. However those options are contingent upon certain circumstances.
It is important to get in touch with an experienced workers’ compensation attorney to learn about the various options that may be available in these cases. An attorney with experience in these cases can guide you through all of the challenges and hurdles associated with obtaining the benefits you deserve.
At Mezrano Law Firm, our experienced attorneys understand all the issues surrounding workers’ compensation, Medicaid, Medicare, Social Security Disability, and more. We are ready to fight for you, helping you to obtain the benefits to which you are entitled under the law. Our team serves individuals and families living in Birmingham, Tuscaloosa, Montgomery, Mobile, Florence, and Gadsden. To set up a free consultation about your case, call our team today at 205.206.6300 or complete our contact form.