Hello, can someone tell me about the 30 month clause when submitting a medical set aside for approval by the CMS?

Question

Do you have to have an open application to apply or does that "expectation of 30 months" mean it can be submitted and you can apply for SSDI within 2 or 3 months? 
I want to settle my WC case but was informed if I apply for SSDI now I will not be able to until SSDI makes a decision and that leaves me with no income for a very long time. Any information is helpful thank you.

James L. Arrasmith · Answer

Let me help you understand the CMS Medicare Set-Aside (MSA) submission process regarding the 30-month rule. 
 
The 30-month rule refers to having a "reasonable expectation" of Medicare enrollment within 30 months of the settlement. You don't need to have an active SSDI application when submitting your MSA for approval. However, you should have documentation showing why you expect to become Medicare-eligible through SSDI within that timeframe, such as medical records supporting your disability claim. 
 
Your concern about income during the SSDI waiting period is valid. One possible approach is to complete your workers' compensation settlement first, which can provide some financial stability, and then submit your SSDI application. This way, you'll have settlement funds to sustain you during the SSDI determination period. Consider discussing this timing strategy with your workers' compensation attorney to ensure it aligns with your specific situation and state laws.

Q: Hello, can someone tell me about the 30 month clause when submitting a medical set aside for approval by the CMS?