According to a paragraph in the Social Security Administration’s (SSA) proposed fiscal 2016 budget, SSA would require “private insurers that administer” workers comp and public disability benefits to report data on those benefits to SSA. This reporting requirement would be a new mandate placed on workers compensation insurance carriers.
“It would require insurers or others covered under this proposed rule to determine the Social Security status of a particular workers compensation claimant. So it would certainly add a burden in that regard,” Mr. Peterson said.
The reporting requirement shifts a burden to the employer and insurance carrier.
Experts say the proposal echoes Medicare Secondary Payer rules used by CMS, which requires insurers and self-insured employers to report workers comp benefits to that agency. It helps determine whether a claimant must repay Medicare for medical care that should have been paid by a comp policy or whether payers should set aside money to pay for future medical care related to an occupational injury.
Currently, there is no reporting system. If an injured worker is receiving workers compensation wage loss benefits and SSD benefits, the SSA relies on the injured worker to report receipt of wage loss benefits. You can likely guess that many times this may go unreported, not usually trough intentionally hiding such benefits, but lack of understanding of the injured worker.
If enacted, a system would be created for governments and insurers to report the benefits received by any social security disability beneficiary who is also receiving workers compensation benefits. The proposal is substantially similar in principle to mandatory reporting requirement for reporting benefits and settlements to Medicare.
The end result — a burden shift. The burden shifts from the injured worker to to the government entity or private insurer to report.
