Louisville, KY asked in Workers' Compensation for California

Q: Workers Compensation Award of Future Medical Open.

Workers Compensation case settled and I was paid PD Indemnity. I was awarded future medical open. If employer asked me to buy out future medical in compromise & release, does Medi-care get involved and do I need to pay Medi-care from the PD Indemnity I received, although I never used Medi-care for my Workers Compensation injury? All treatment was approved by Workers Comp. If I agree to future medical buy out terms, what can I expect from the Medi-care process?

Related Topics:
1 Lawyer Answer
Nancy J. Wallace
Nancy J. Wallace
Answered
  • Workers' Compensation Lawyer
  • Grand Terrace, CA
  • Licensed in California

A: No matter what you use Medicare for, Medicare will insist upon it's share of your 'cash-out' of future medical rights. It's called a Medicare Set Aside, the MSA. The adjuster will take all of you current and comp medical records and send them to a service that 'guestimates' what Medicare will want to permit you settle out your insurance rights (because once you get cash for your insurance rights, Medicare is stuck with all of your medical costs, including those that used to be the responsibility of the comp insurer). This service should get approval from Center for Medicare Services -- CMS -- to approve the proposed Medicare SetAside. If it's really high, expect the adjuster to decline the lump=sum settlement idea. Just now, the law is set up such that insurers pay next to nothing in future medical treatment costs, because 92% of requests for treatment are legally denied.

Justia Ask a Lawyer is a forum for consumers to get answers to basic legal questions. Any information sent through Justia Ask a Lawyer is not secure and is done so on a non-confidential basis only.

The use of this website to ask questions or receive answers does not create an attorney–client relationship between you and Justia, or between you and any attorney who receives your information or responds to your questions, nor is it intended to create such a relationship. Additionally, no responses on this forum constitute legal advice, which must be tailored to the specific circumstances of each case. You should not act upon information provided in Justia Ask a Lawyer without seeking professional counsel from an attorney admitted or authorized to practice in your jurisdiction. Justia assumes no responsibility to any person who relies on information contained on or received through this site and disclaims all liability in respect to such information.

Justia cannot guarantee that the information on this website (including any legal information provided by an attorney through this service) is accurate, complete, or up-to-date. While we intend to make every attempt to keep the information on this site current, the owners of and contributors to this site make no claims, promises or guarantees about the accuracy, completeness or adequacy of the information contained in or linked to from this site.