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  1. #1
    Join Date
    Oct 2008
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    22

    Question Social Security Retirement and Lump Sum Settlements

    My workers compensation claim was made in the State of: New York
    I was offered a lump sum a few years ago and did not take it. Now I'm being offered $15,000 more. I am 62 and my award is for life. Does this mean life expectcy or actual death? I asked my lawyer about prorating the lump sum and he said I would have to consult a SSDI lawyer. Where does the prorate clause go? Is it part of the workers' comp settlement?
    How will the lump sum effect benefits like food stamps, medicaid? Will it still be considered "income" or "resources"?
    Does my SS get increased after the proration?

  2. #2
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,017

    Default Re: Ss Retirement and Lump Sum

    I was offered a lump sum a few years ago and did not take it. Now I'm being offered $15,000 more. I am 62 and my award is for life. Does this mean life expectcy or actual death?
    If you take a section 32 cash payment to settle the claim, it doesn't matter what "life" means. You are closing the claim completely. They are paying out the remaining indemnity due, and you are agreeing to assume liability for your medical care.
    That means a WCMSA/setaside arrangement may be necessary, and that should be determined BEFORE there is any settlement negotiation.

    SSA can help with the proration language. There isn't anything specific, only that the lump sum paid should be considered as though the same amount is paid weekly for the duration benefits are due. This is to avoid SSDI offsets.
    How will the lump sum effect benefits like food stamps, medicaid? Will it still be considered "income" or "resources"?
    The settlement of the comp claim doesn't have anything to do with other social benefits, but could affect your food stamps, or Medicade... and you need to be sure Medicare/Medicade has not made any conditional payments for your medical care to the injury.

    You should be asked to sign a SSA/CMS/Medicare release of information document to get that status.
    Does my SS get increased after the proration?
    If there is any offset now... the amount is not likely to change once you move from disability to normal/full retirement age and benefits. SSA can help with those issues too.

    There is more to consider here than a cash lump sum payment to close out the claim entirely. Looks like that 15K extra is for future medical reimbursement, which you will use to pay for medical care out of your pocket.

  3. #3
    Join Date
    Mar 2011
    Posts
    291

    Default Re: Ss Retirement and Lump Sum

    stops when you die.
    yes it is wording contained in the settlement
    you'll have to do a medicare Set aside agreement
    more here
    http://www.cms.gov/WorkersCompAgencyServices/

  4. #4
    Join Date
    Oct 2008
    Posts
    22

    Question Re: Ss Retirement and Lump Sum

    I had a previous quote of $5600.00 for medicare set-aside. Now that the settlement is for $15,000 more, I expect the set-aside will be more. My life expectancy is 80; does the wc end then? That's another 18 years. They are offering about 10 years in the lump sum (without the lawyer's fee and medicare set-aid).



    Quote Quoting BvIA View Post
    If you take a section 32 cash payment to settle the claim, it doesn't matter what "life" means. You are closing the claim completely. They are paying out the remaining indemnity due, and you are agreeing to assume liability for your medical care.
    That means a WCMSA/setaside arrangement may be necessary, and that should be determined BEFORE there is any settlement negotiation.

    SSA can help with the proration language. There isn't anything specific, only that the lump sum paid should be considered as though the same amount is paid weekly for the duration benefits are due. This is to avoid SSDI offsets. The settlement of the comp claim doesn't have anything to do with other social benefits, but could affect your food stamps, or Medicade... and you need to be sure Medicare/Medicade has not made any conditional payments for your medical care to the injury.

    You should be asked to sign a SSA/CMS/Medicare release of information document to get that status.
    If there is any offset now... the amount is not likely to change once you move from disability to normal/full retirement age and benefits. SSA can help with those issues too.

    There is more to consider here than a cash lump sum payment to close out the claim entirely. Looks like that 15K extra is for future medical reimbursement, which you will use to pay for medical care out of your pocket.

  5. #5
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,017

    Default Re: Ss Retirement and Lump Sum

    I had a previous quote of $5600.00 for medicare set-aside.
    From where? That would mean the future medical needs are but $311/year...or about $25/month... that doesn't cover a office call. Even at Medicare approved charges.
    Was there ever a MSA proposal submitted to CMS/Medicare for review/approval.?
    I am 62 and my award is for life.
    My life expectancy is 80; does the wc end then? That's another 18 years.
    Doesn't matter what your award is, or life expectancy... IF you take the cash payment, you are closing out the claim.
    What they are paying for is the estimated remaining PD indemnity, at a reduced amount or "todays dollars", and money to fund a WCMSA.
    I don't see a MSA being $5600 for 18 years.
    They are offering about 10 years in the lump sum (without the lawyer's fee and medicare set-aid).
    Ten years of what?
    And, the atty fees are going to come out of the indemnity allocation. You cannot reduce the MSA for atty fees. The atty fees are not going to be added on by the ER/IC.
    I expect the set-aside will be more.
    Future medical/WCMSA is not going to be more that previously estimated, or approved by CMS... if anything it would be less...you are older now than when the offer/approval was made.

  6. #6
    Join Date
    Mar 2011
    Posts
    291

    Default Re: Ss Retirement and Lump Sum

    Quote Quoting LisaBlue View Post
    I had a previous quote of $5600.00 for medicare set-aside. Now that the settlement is for $15,000 more, I expect the set-aside will be more. My life expectancy is 80; does the wc end then? That's another 18 years. They are offering about 10 years in the lump sum (without the lawyer's fee and medicare set-aid).
    if you are buying out or settling all future comp benefits, then comp ends when you get your check.
    if you don't settle comp ends when you die, as i indicated in my last post.

    life expectancy is only used for estimating purposes not for payment ending dates.

    if you know your date of death then let the carrier know so they can compute your future benefits more accurately.
    Last edited by SH.; 04-18-2011 at 10:33 AM.

  7. #7
    Join Date
    Feb 2007
    Location
    Western New York State
    Posts
    1,340

    Default Re: Ss Retirement and Lump Sum

    When was your injury and what was injured, it matters. If the injury was before March 17, 2007 then you would be eligible for life time cash payments, and medical services, if you don't settle. You have to answer this, what is the monthly WC payment going to be, the max is $1733.3334 to equal $20,800 per year (tax free). You also will not be responsible for medical treatment costs! You also do not have to settle as it appears the IC wants you to settle, also you could settle the cash portion of your case and leave the medical open, so the IC would have to pick up the medical costs, this is done through negotiations.
    A section 32 settles the whole claim, the cash and medicals together and you'll need a WCMSA/setaside arrangement prior to any section 32 completion. I don't know the dollar figure that your suppose to get but if you stated that $5,600 is for medical set aside and not counting the attorney fees plus the extra $15K (would be less than one years total if receiving the max of $20, 800 per year)it sounds as if they are really putting the best carrot before the horse to get you off the comp rolls by the IC. What has your attorney said about this, he is best suited to answer any of your questions as he knows your case in and out and we don't give legal advice on this forum. As your attorney, look at what SH and BvIA has written and there is a NYS forum on this board (scroll down the page) where similar questions may have been asked and answered. Keep us informed!WCMSA/setaside arrangement
    Knowledge is a beneficial tool for the injured worker!

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