Social Security offset issues (California)

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Social Security offset issues (California)

Postby speropotus@yahoo.com on Tue Jun 09, 2009 4:12 pm

I am preparing a C&R for final approval.
PD was previously resolved by Stip and Award at 57%.
Carrier is paying $150,000 new money for C&R. There is no claim for or evidence of an increase in PD.
The new money offer will partially go to WCMSA, i.e. $45,000, and the remainder will be paid to applicant in structured fashion.
Will the Social Security Administration offset his disability benefits for this new money? I don't think that they will as this money is for non-medicare covered items and closure, not for disability payments.
Any information, input, and/or points/authorities would be much appreciated.
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Re: Social Security offset issues (California)

Postby stevepsca on Tue Jun 09, 2009 4:25 pm

Will the Social Security Administration offset his disability benefits for this new money? I don't think that they will as this money is for non-medicare covered items and closure, not for disability payments.
If the indemnity has been satisfied/paid out, and you have an allocation in the language for medical only, there should be no offset to the SSDI monthly award.

However, this 'new money' for medical only, non Medicare, should be deposited in an interest bearing account the same as a WCMSA would be.

There are some bulletins here you may be interested in ...THE SETTLEMENT PROCESS and Medicarehttp://www.jjcelderlaw.com/SettlementProcessMSABull.htm
HOW TO ADMINISTER A MEDICARE SET ASIDE.http://www.jjcelderlaw.com/MSAAdminMSABull.htm
THE SSDI OFFSET IN WORKER'S COMPENSATION SETTLEMENTS.http://www.jjcelderlaw.com/SSDIOffsetMSABull.htm
Structured WCMSA https://www.cms.hhs.gov/WorkersCompAgen ... wcmsas.pdf

And a multitude of info/bulletins for Medicare Set-Aside professionals, WC and PI Attorneys and Structured Settlement professionals. here http://www.jjcelderlaw.com/MSABulletin.htm
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Re: Social Security offset issues (California)

Postby speropotus@yahoo.com on Wed Jun 10, 2009 9:59 am

steve,
Thank you for your reply. There is a wealth of information at that jjcelderlaw website...many thanks.
You indicated that the money being paid for non-Medicare covered items should be placed in an interest bearing account as well. Is that a requirement or recommendation? I believe it is a good practice; however, in advising my client, I need to be able to cite some authority if such authority exists.
Thanks again...
dp
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Re: Social Security offset issues (California)

Postby stevepsca on Wed Jun 10, 2009 11:10 am

I don't think there is any mandate to the non-Medicare funds regarding a seperate account. Those non-Medicare monies could remain in the WCMSA account...as long as the allocation is clear.
Transfer Mechanism for Items and Services Not Covered by Medicare(Ref: 7/11/05 Memo Q15)
Should a WCMSA provide for items and services that are not covered by Medicare but later become covered, those funds should then be considered part of the set-aside and treated accordingly, i.e., used to pay for any services as they were designated in the non-Medicare portion of the set-aside included in the WC settlement. These funds do not have to be transferred to a separate WCMSA bank account or be included in the annual WCMSA accounting. http://www.cms.hhs.gov/WorkersCompAgenc ... #TopOfPage

In my own proposal (C&R), there are allocations for PD indemnity, WCMSA & Medical (non-Medicare). It's important to include money in a medical allocation for services that Medicare is not ''normally responsible for''....those allocations are funded by annuities, as that provides a tax free stream of income. Also alleviaates the need to address income taxes on the setaside funds.

Also...Medicare Part A covered items and services may not be paid from the MSA if the claimant is only enrolled in Medicare Part B, and vice versa....we know there have been changes since Medicare Part D drug coverage came into play...there could be issues with Rx drugs that Medicare doens't normally pay for, eg. the 'donut hole' period.

My MSA vendor reccommeded a seperate account for the non-Medicare annuity money only to help keep track of those funds. They are not accountable to CMS in the annual attestation, CMS/Medicare actually has no interest in those funds. IW is free to spend that money at will. It's just a way to cover TrOOP/TrueOutOfPocket costs if there are any.

A fully Structured Settlement agreement, with annuities is a great way to resolve a comp claim... tax free stream of income for life, periodic lump sum payments if necessary... potentially more money in the long run for the IW, less cost up front for the IC.


The bulletin HOW TO ADMINISTER A MEDICARE SET ASIDE should be reccommended reading for your client...http://www.jjcelderlaw.com/MSAAdminMSABull.htm, as well as the information at http://www.cms.hhs.gov/WorkersCompAgenc ... #TopOfPage
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