QUESTION
What is the best way to handle my case with the Medicaid involved?
Asked on Mar 21st, 2013 on Personal Injury - Massachusetts
More details to this question:
I had a work accident that caused an injury to my left knee in Oct 12th in Oct 15th. I reported the accident to my supervisor and HR person they send me to therapy instead of de doctor, and because my injury was worsening I look for medical help on my own. I contacted a lawyer and he told me to use my own insurance which is Medicare and I did I get surgery and they refuse to pay for the medical treatment. Now they call my attorney and try to make an offer. My lawyer told me that we could make a counter offer, but now he says that because Medicare is now involved that's not possible now and he says that now my chances to have an onset compensation had been reduced. I really will appreciate your advice.
8 ANSWERS
Ronald A. Steinberg
You urgently must speak to a comp lawyer. Every state has different rules and I would hate to give you bad advice based solely on what info you have provided here.
Answered on Mar 26th, 2013 at 11:04 PM
Insurance Defense Attorney serving Oceanside, CA
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Manuel J. Rodriguez
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Your situation is no unusual. Medicare will pay for care in cases such as your's. However, in such cases Medicare's rights must be protected at all times. The point is to take steps to have Medicare reimbursed by the responsible party (which is usually a workers' compensation insurance company). The fact that Medicare is involved does not trump your ability to settle your case. Workers' compensation is not limited to medical care. Workers' compensation includes indemnity payments to the injured worker in addition to medical care. There simply may be a misunderstanding between you and your present attorney. I suggest that you have a meeting with your attorney so that you may receive an explanation of your rights and obligations relative to your work-related injury claim.
Answered on Mar 26th, 2013 at 3:27 AM
I hesitate to get involved with offering advice when you already have an attorney. It's not ethical for one lawyer to second-guess another's advice without knowing more and at least having the lawyer you hired agree for me to express my advice.
Answered on Mar 25th, 2013 at 7:28 PM
Lisa Hurtado McDonnell
Well since this was a work related injury and you used Medicaid insurance to pay your medical Bills. Medicaid will have to be reimbursed and of course it going to reduce your insurance settlement but your settlement isn't any different if you reimburse Medicaid or a doctor/hospital. Your attorney should still be able to negotiate a settlement between two or three times your medical bills. Then you subtract medical costs (what medicaid paid) and your attorneys fee and the remainder is your compensation for pain and suffering.
Answered on Mar 25th, 2013 at 2:13 AM
I am not a workers comp attorney, but I do know from experience that Medicare has what is called a super lien on all personal injury awards and they can take the bulk of a settlement away to repay anything they paid out.
Answered on Mar 25th, 2013 at 1:23 AM
The whole thing should have gone through workers compensation since the injury occurred at work. You should open a workers compensation claim through a good lawyer.
Answered on Mar 24th, 2013 at 9:55 PM
Chapter 7 Bankruptcy Attorney serving Syracuse, NY
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Andrew T. Velonis, P.C.
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Yours is a very strange situation. This should have been handled as a worker's compensation case from the beginning. You go to a doctor of your own choosing (your employer has no say in the matter) and the doctor bills the workers comp carrier. I do not know what state you are in, but in NY, the statute of limitations to file a comp claim is two years. So, I recommend start over. File a comp claim, forget medicare get to a doctor and get the treatment you need. And get a new lawyer while you are at it, this one should have known better.
Answered on Mar 24th, 2013 at 9:50 PM
To answer your question, we would need more information. What is confusing is that you stated it was a work related accident. If you were hurt on the job, then your company's worker's compensation carrier should be paying for all bills for necessary treatment. Did they report this incident to their carrier?
Answered on Mar 24th, 2013 at 9:05 PM