An attorney asked us, "How does the Social Security Administration treat Worker's Compensation benefits for SSI eligibility purposes?"
WC weekly wage replacement payments. The SSI financial eligiblity rules require that a claimant have low income and few assets, which they call "resources." Weekly worker's comp wage payments are treated as "unearned income" for SSI monthly income eligibility purposes, and except for a $20 general income disregard, the full amount of the worker's comp payments are subtracted from the potential full SSI benefit of $637. Thus, an injured worker who receives worker's comp payments of $657 or more in a month, would not be eligible for SSI for that month. See the SSI federal income regulations on unearned income. Whether the income stream from WC payments can be irrevocably assigned to a Special Needs Trust, is a matter of state law that varies from state to state. The SSI POMS at SI 01120.201.J. do NOT list WC payments as income items that cannot be assigned to a trust.
WC Wash-out Settlements. Sometimes workers "wash out" the settlement, taking a lump sum and foregoing any additional payments from the worker's compensation insurance company. These settlements can range from a few thousand dollars, to hundreds of thousands, depending on the seriousness of the injury. The SSI rules would treat the lump sum settlement as "income" in the month received, probably knocking out SSI and SSI-related Medicaid eligibility for the month of receipt of the settlement check. However, what happens next? Teh retained funds become a resource (asset) that is usually over the $2,000 limit. If the worker keeps the settlement money, and the amount is over $2,000, SSI eligibility is lost, and SSI-related Medicaid is lost, UNLESS the worker places the funds in a Special Needs Trust. A trust will solve the problem.