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  1. #1
    Join Date
    Dec 2009

    Default SSDI Appeal vs. Comp. Settlement

    I applied for SSDI after being on W/C for 3 years. I was denied and I'm appealing the SSDI decision. Atty. told me it would take about 8 months to get a hearing before an ALJ. The I/C has a mediation settlement hearing scheduled next month. Will a W/C settlement be affected by my applying for SSDI? I have read that settlements do have an impact on people already receiving SSDI, but was wondering if that's the case with people not yet receiving SSDI.

  2. #2
    Join Date
    Feb 2007
    Charlotte, NC

    Default Re: SSDI Appeal vs. Comp. Settlement

    No, except for the Medicare Set Aside Trust Account problem. Your application for SSDI triggers the need to consider whether you will have to have a MSA. If you need a MSA established, then that can make it harder to settle the comp case because it is more expensive for the comp carrier.
    The North Carolina Court of Appeals has held that "In contested Workers' Compensation cases today, access to competent legal counsel is a virtual necessity." Church v. Baxter Travenol Labs, Inc., and American Motorists Insurance Company, 104 N.C. App. 411, 416 (1991).

    Bob Bollinger, Attorney at Law

  3. #3
    Join Date
    Feb 2007

    Default Re: SSDI Appeal vs. Comp. Settlement

    While the SSDI may not have affect on the comp settlement... IF you are eventually awarded the SSDI, and retro benefits are due, you could see an overpayment situation... your WC benefits when combined with the SSDI cannot exceed 80% of your pre injury average wage.
    The settlement language should also indicate the allocations to PD indemnity and future medical, ensuring the minimum offsets affected by any lump sum payment on the indemnity. The allocations should indicate a life expectancy, and prorate the indemnity over your lifetime as though you had received the weekly benfits vs lump sum.
    Your attorney should be familiar with this, as well as the defense atty as they are the party drawing up the documents.

    You should be asked to sign a SSA/Medicare release of information form so they can determine your status.
    If a WCMSA is necessary, it would be the carrier who handles this, as well as the cost of a proposal.

    In some areas of the country it's taking more than a year to get a SSA ALJ hearing. Depends on the RO/Regional Office and back logs.

  4. #4
    Join Date
    Mar 2007

    Default Re: SSDI Appeal vs. Comp. Settlement

    And to add to what Bob has said your SSDI benefits and WC payments can only total 80% of your AWW at the time of injury. So when/If you get the SSDI approved any back benefits owed by SSDI that overlaps periods when you also received WC then an offset will be applied.
    Also IF you get to a settlement for your WC being paid in lump sum make sure the settlement has the proper SS language in them, to prorate the settlement over your life expetancy rather than just showing it as a one time lump payment. IF the language is not used you could expect several months or even years of SSDI offset up to and including getting NO SSDI you might be due for that same period of time. Good luck to you.
    "He who is his own lawyer has a fool for a client"
    Abraham Lincoln

    Take Care and Be Well.

  5. #5
    Join Date
    Dec 2009

    Default Re: SSDI Appeal vs. Comp. Settlement

    Thanks to all the Senior members who respond to questions posted on this forum. This site had been a great help to me over the past several years. I have a Atty. for my W/C case and now one for my SSDI appeal. I do ask them questions, but they are busy with other cases, so I don't want to take up too much of their time. I am hopeful that I can get my case settled, just plain tired of the process. I'm also sure that the I/C is aware of their ability to wear down injured workers. My IRE came in at 32%, which I understand is quite high for Pa. I only had a few more years to work before retiring and never thought I would find myself dealing with a life long injury. If and when my case is settled I will post the details of my case. It is very unusual and may help others dealing with the type of injury I received. Happy New Year to all.

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