Monday, December 5, 2016

Medicaid and Workers Comp Settlements

Suppose you get hurt at work and Medicaid pays for your medical treatment.  Your workers comp lawyer is required to notify the Medicaid Office of Recovery Services (ORS) so they can get reimbursed.  In legal terms, Medicaid has a statutory lien on the workers compensation settlement.  After all, since you got hurt at work, the workers compensation insurance carrier should be paying the bills, not Medicaid.  So, when you visit your attorney, he/she will need your Medicaid recipient ID number.

Before we settle a workers comp case, we will find out how much the final ORS lien is, and then make sure we settle for enough to pay the ORS lien, the other medical bills, the attorney fee and still leave enough for the client to feel that the settlement was in his/her best interest.  For example, if ORS gets $5,000 and there are other doctors' bills of $7,000--a total of $12,000--then it would be silly to settle the case for $15,000 because that would hardly leave anything for attorney fees and the client's take-home share.  In a situation like this, the attorney may see if ORS can reduce or waive their lien.  And, sometimes doctors or clinics are willing to reduce their bills.

In summary, having Medicaid is a blessing for many clients who do not have other health insurance, but it is very important that we consider Medicaid's lien when deciding whether to settle a case.

Note:  If you get hurt at work and do not have private health insurance, consider applying for Medicaid ASAP.

For personalized advice, contact an experienced workers comp attorney.  Tim Daniels Law Services offers a free initial consultation.  For more information call (435) 592-1235 or visit www.timothydanielslaw.com.

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