Legal Question in Workers Comp in California
Hello, I agreed to a settlement with my past employer in Dec. 2012, a workman comp. case. My attorney asked me if I received medicare or medical and I said yes medicare because I am permanently disabled but it is not my primary insurance. hE TOLD ME that no you don't so when I signed the settlement agreement the way he said to I was supposedly saying i did not have medicare.In Jan. 2013 Feb. 2013 no settlement check. Feb. I am told to come into the office and was told that we now had to start over and say yes I do get medicare and that it now has to go before the Medicare/Medical Judge for approval of the amount set aside for any further medical needs for the workman comp. injury. I was told it would only take 8 weeks (two more months) because it's dealing with the government agency and they suck. Every time I call my attorney's they we don't know when. I've asked for a phone number to call but they say there is not one. It is now almost June and still no one knows. Is there someone or something that can be done about this? The time frame is a bite unbelievable. Don't think I'll ever see that money? Thank you so much for all you do you guys are simply amazing.
1 Answer from Attorneys
SADLY I've lost dozens of clients because of the horrendous wait for the federal government.
The Truth is: WE NEVER KNOW WHEN THE CENTER FOR MEDICARE SERVICES (CMS) might get to out proposal for a Medicare Set Aside (MSA) and whether CMS will approve the chunk of money we've pulled out of the settlement to get ready to hand to Medicare or not.
You will see some money, but not the money you initially expected to see.
You or a Trust Company holds a chunk of 10s of 1,000s of dollars 'in trust' for Medicare. When Medicare demands payment of this chunk in 4 or 5 years, then you hand over this chunk of money to Medicare and it's gone (but you still get Medicare benefits).
It's sad you and your attorney failed to communicate at the beginning of the claim that you received Medicare...but it happens.
TELL YOUR ATTORNEY you want a Status Conference scheduled before a WCAB Judge and you want the defense attorney to show the WCAB judge when the MSA Proposal was finished and sent to CMS for approval.
MANY TIMES when the defense attorney is forced to a Status Conference, a series of phone calls is made to the Medicare Coordinator for the comp insurer and the application process gets finished a little faster.
AND IF THE APPLICATION is just sitting on a desk because one signature is missing or some records were never delivered, that gets discovered sooner when a Status Conference is scheduled.
TELL YOU ATTORNEY if you don't have a Status Conference on calendar at the WCAB by Aug. 1, you are dismissing his as counsel and representing yourself.
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