How Return-To-Work Status Might Affect Your Need for An MSA
SSDI social security disability insurance MSA Turbo Tagger
Q: I had an MSA prepared on a claimant who has since returned to work. He applied for, and was awarded, Social Security Disability Insurance (SSDI). However, I believe he will lose those benefits shortly now that he is employed full-time and he is not close to becoming Medicare-eligible by age. How will this affect my need to have an MSA prepared?
A: Generally speaking, a person can work for nine months before losing SSDI eligibility. Although there are several different Return-To-Work programs that allow for extensions on SSDI eligibility so it is imperative that you verify his current benefit status with the Social Security Administration. You mention that he won’t become Medicare-eligible by age any time soon. Assuming all of his foreseeable work-related injuries will be resolved by that time, there is no Medicare interest to protect and no need for an MSA. However, if you believe Claimant is likely to treat for his work-related injuries past age 65, you certainly need to consider Medicare’s interests in the future.
For more information on confirming a person’s benefit status or to get further explanations on when Medicare Set-Aside allocations need to be prepared, contact us or post your questions in the Ask Jen column.
MEDVAL 1-888-SET-ASIDE (1-888-738-2743)
Medicare Set-Aside Allocation/Arrangement Recommendations
Submissions to Centers for Medicare and Medicaid Services
Pharmacy Benefit Management