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

I am very surprised that your attorney was not pro your application of SSDI/ssi!
THis sseems so wrong from many different points of view.
First they do not nessaceraly place a lien, They offset! IF you are receiveing both SSDI and WC, the SSDI will be offset by the workers comp.

IF you decide as in a greatest if not nearly all workers comp claims do come to an end. Except for the older ones. Now I am speaking from PA information of workers comp.

First when you decide to take a settlement from W/c and are on SSDI or will be, they language of the w/c seettlemnt is set up that you receive the lump payment, but it is written in structured for purposes of not having a great if any influance on SSDI.

IF you were to receive a lump w/c and the language to protect you as structured was NOT in it...SSDI could avg it out over their projection and you could be without SSDI benefits until by their calculations you maxe dout your settlement. That could be YEARS!

Also, they avg the amount paid...if you are off work for years from the disability and do not file, it will decrease the amount of total benefits.

I did not complete the first process when I was off ten years for two years with my knee surgery. I went back half time for a year, when I could no longer work, my claim proccessed and now I am recieving 1/3 less what I could have. It was over $960 and now I receive only $603. from not filing that first two years.

I was advised by two attorney's, a case worker for SSA, and a recent workshop presenter that many benefits due my son are being lost due to his NOT applying. I asked the question you just stated.

Also, what protection is there is you lose the w/c and then in hurry and file for SSDI?
I don't know about the others in advice, but this bit me big time by not filing, and all the advice for my son is the same to protect him, his right,s, and screw how inconvient it is going to make ti to w/c to settle.

My son said, but w/c is being nice, they are happy I am not on SSDi. I told him YES, it is to their benefit NOT to care how you are hurt, but how easy it is for them to settle!

W/c is not your friend, I hope that your attorney is not one looking to protect his pocket book by puting you in a bad spot!

Get a second opinion!!!!!!
Call Soc Sec,
and read post here!
Dianne

I think I remember you? Were'nt you the one with the avatar showing a lady standing beside a patrol car with a patrol cap on (something like that!) I loved your posts back then.

Dianne, you said: " First when you decide to take a settlement from W/c and are on SSDI or will be, they language of the w/c seettlemnt is set up that you receive the lump payment, but it is written in structured for purposes of not having a great if any influance on SSDI.

IF you were to receive a lump w/c and the language to protect you as structured was NOT in it...SSDI could avg it out over their projection and you could be without SSDI benefits until by their calculations you maxe dout your settlement. That could be YEARS!"

My question is, HOW is the LANGUAGE written? I mean, I have read and heard, like you have said, that if the lawyer doesn't make sure that the "language" is written into the settlement in such a way, then there WILL be a great diappointment when SSDI becomes involved. My lawyer MAY be looking out for his own pockets, just as you say---but then again he may not know what you know (since he doesn't do SSDI) and how to make sure it is WORDED correctly. What can I tell him? Is there a specific formula that I can copy to show him this?

Thanks for you time and thoughtfulness!

Wink

Hi Wink, Yes that was me....I am retired from Police Chief position after a accident at work.

This is the portion of the C&R that is of interest, IF you receive social security it is written in this amanner...no biggie, just added piece of work to the attorney's to calculate I assume.
Hope this helps...(I am going through this with my son and W/C telling him, oh good you do not ahve SSDI, that makes it easier, LOL for them not him!)



Compromise and Release Agreement (this is Pennsylvania)
By Stipulation Purseant to Section 449 of the Worekers Comensation Act.

1. This agreement in the case of the above listed employee
2. State the date of injury or disease
3. State weekly was of employee
4. State the injury, the percise nature of the injury: (The Diax here)
5. The payable amount
6.State indeminty benefits (non)
7. State the amount of the payment of ideminity benefits to be made at or after the date of the stipulation or agreement or death, and the length of time such as payment of benefits is to continue.$_(amount of setlement)__
for lum sum.
8. (these were not used..it refers to death of employee

9. This compromise and release is for wage loss only. all reasonable and necessary related medical expenses incurred by the claimant, after the date of this agreement the payment of reasonable and necessary with request to the wok injuries in paragraph #4.

10. Sumerize all benefits -Please see paragraph 9 of this agreement

11. IS there acualt or potential lien for this agreement _ yes _ no
(my workers comp agreement stated yes against my car accidnet if I recovered monies)

12. Current child or spousal support orders in place against the client ___yes ____no

13. Claimant is presently receiving Medicaid and Social security disability benefits. Out of the sttlenment amount claimant is paying $XXXX in attorney's fees. Claimant will net the sum $ XX,XXX. Claimants remaining life expectancy, based upon her birthdate of XXXX X, XXXX (according to the National Center for Health Statistics, Vital statistics at the United States 1989, Life table vol. II, section 6 DHHS Publication (no. PHs) 92-1104. Public Health Service Washinton, US Government Printing office 2004) is 52.2 years or 624.4 months. Therefore, even though the above settlement is paid in a lump sum, Claimant's monthly Workers Compensation benefits for the purpose of determining the set-off by the social security Adminsitration shall be $20.75 per month for the 624.4 months, commensing June XX, XXXX. the last day of payment of temporary total disability benefits. See Sciarotta Vs Rowen 837 F 2d 135. 140-141 (3d Cir......unreadable.
(I was not yet receiving Soc sec benfits but, mine was written similary) My structure is $1.44 a month set-off)

Wow, Dianne...thank you. I'm slowly (SLOWLY) beginning to understand. I read a site that Bad Boy over at http://www.workerscompensation.com/c...d_Worker_Forum supplied me with that details something similar to what you're telling me:

http://library.findlaw.com/1999/Sep/...5.html#Scene_1

I need to study all this some more. God, what a headache!

Hi WInk, It is a lot to digest, but I wonder if there would be a legal aid person or the bar association could reccomend a second attorney to consult to your particulars.
Even if they charge for the hour, it will be well worth the explanation and peace of mind.

Also, you can all the soc sec office and remain anonymous for an answer to the questions you ask.

I feel personally, the easier it is to attorney's, the better for them, less work...not always in their clients best interest.
ASK HIM, right out, if I am awarded SSDI tomorrow, write on paper my loses and why?
Then ask Why a structured settlement, as many have, is not applicable to your situation?

Not sure if I said, but the w/c are talking settlement to my son and were happy to hear there is no soc sec as it expidites things.
When I asked my attorney about it, he stated, that they would not be concerned for the verbage being present just write the agreement without structure for swift resolution.

Right now my son is overwhelmed at the application process, he has not returned to work except a month in 1999. It is absolutly his best interest to apply. His fear is that w/c will "Get mad" and start up on him. (ie) P.I.'s following, refuse med's, send to IME's every 6 months instead of two years. etc.

Either he can go to the attorney and give the ehadache to them, but as I told him I did my own after thre years off work, good records, test, and adddress for releases for them. Well worded explanation to how daily life is now with the disability, and how I could no loger do my job. I was approved the first time in just weeks. The only thing slowing me up was writting out the green form...It killed my hands.

But I painted a good picture, how daily life, I can no longer change bed's mylef, laundry i sort but someone has to take it to the washer, and out into the dryer, I can't fold, I hang a few things and my arms are asleep and heavy. Often clothes sit in the basket getting wrinkled before they are used never getting put away. I use lots of paper plates, frozen entree's, 1 quart milk instead of a gallon, cans of soda instead of a two liter.

Brushing my teeth, I have to lean my arm, Where it says can you dress yourself, I explain, to a degree, I have loose fit pull on clothing, often days I don't need to I delay or don't dress, I do not use buttons I can button one or two but it kills my hands.

My hair is difficult to wash I can't hold my arms up. Hurts to sit in movies, last one was in 1991, cape fear! I go to small shop to pick up one or two items, my husband and others have to do the shopping.

This is painting a picture of the new life and restrictions the injury has caused me for them. My son is not ready to face all this, so he will either need an attorney or allow me to help fill it out.

Hope that things work out to your beest,
Dianne

the reason not to file for you ssdi before your claim with wc is settled is wc can hold a large portion of your settlement for future medical payments. I just finished a wc claim and that is what my attorney told me. I went with his advise and it worked out great! had I gone ahead they would have held back alot of the money. thousands!