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  1. #1
    Join Date
    Sep 2009
    Posts
    2

    Default Medicare Set-Aside Account

    Please help.

    My lawyer has vehemently encouraged me to NOT approve of a settlement that requires that I put a substantial amount of money (6 figures) into a 'Medicare Set Aside Account' for my future medical care. Not only has he encouraged me NOT to approve, he actually declined the settlement offer before I was ever made aware of the offer being on the table (isn't that ILLEGAL?)--he said that he did this 'for my benefit' and I found out about the contract only after he requested that the terms be changed. I believe that I may need this money for my future medical care, and medicare is likley to not approve of my settlement if their interests are not fully addressed and delay this even longer, so I'm not opposed to it at all and just want to settle my claim.

    Which makes me wonder, could it be that my lawyer will not get his 20% commission for the money that medicare requires be set aside since according to the Social Security Administration, no legal fees can be taken from that agreed amount to go into an MSA???? Or is it that he can't take commission on 'undisputed medical fees' even if they are in the future? My feeling is that this man would not threaten to go to trial, to work on this case even a moment longer, if he didn't have a financial incentive to do so.

    Thoughts, ideas, answers?

  2. #2
    Join Date
    Oct 2006
    Posts
    9,108

    Default Re: Medicare Set-Aside Account

    here are the rules of professional conduct for Illinois atty
    https://www.iardc.org/newrules-Table...0Contents.html
    you can file a complaint with the registry.

  3. #3
    Join Date
    Sep 2009
    Posts
    2

    Default Re: Requesting correspondence from own lawyer

    Update: I ordered my lawyer to settle this contract in writing, told him it was in my best interest, I signed it and had it notarized (and verbally told him to settle under the terms in which my future medical care is protected), ordered him to sign it and send it to the opposing lawyer. He told me he would honor those terms, but needed to add one thing...and then he proceeded to continue to try and change the terms of the agreement to reduce my MSA and he even went so far as to tell the opposing counsel that he finds nothing to support that I need lifetime medical care (in spite of what I said and my doctors have said)--tell me he is not acting for his own financial benefit?!

    My feeling is this is both illegal and unethical, is it not? I am in the process of having him dismissed as my attorney and reporting him to the ethics board--however, does anyone know if I have the legal right to request all his correspondence that he has sent or received on my behalf?

    Quote Quoting Confused MSA View Post
    Please help.

    My lawyer has vehemently encouraged me to NOT approve of a settlement that requires that I put a substantial amount of money (6 figures) into a 'Medicare Set Aside Account' for my future medical care. Not only has he encouraged me NOT to approve, he actually declined the settlement offer before I was ever made aware of the offer being on the table (isn't that ILLEGAL?)--he said that he did this 'for my benefit' and I found out about the contract only after he requested that the terms be changed. I believe that I may need this money for my future medical care, and medicare is likley to not approve of my settlement if their interests are not fully addressed and delay this even longer, so I'm not opposed to it at all and just want to settle my claim.

    Which makes me wonder, could it be that my lawyer will not get his 20% commission for the money that medicare requires be set aside since according to the Social Security Administration, no legal fees can be taken from that agreed amount to go into an MSA???? Or is it that he can't take commission on 'undisputed medical fees' even if they are in the future? My feeling is that this man would not threaten to go to trial, to work on this case even a moment longer, if he didn't have a financial incentive to do so.

    Thoughts, ideas, answers?

  4. #4
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,011

    Default Re: Medicare Set-Aside Account

    You have a right to your file from your attorney.
    From what you are posting though, you are receiving 'legal advise' from your attorney... I don't see where he is acting illegally. The fact you disagree with the advise, doesn't mean it is unethical, or illegal. So far, you are getting the attys 'opinion'.

    The claim can't be settled until you sign the agreement/documents.

    In a claim with the IW is Medicare eligible within 30 months of a settlement that affects the medical benefits... a WCMSA must be considered. There are threadholds that trigger a review by CMS. Review this chart to see where you fall...http://www.wcc.ne.gov/legal/medicare...guidelines.pdf

    If you are currently receiving SSDI, and/or Medicare, the threashold is about 25K. You should have a MSA vendor compile a proposal, and life care plan to determine the amount necessary to protect Medicare interests. CMS will review if necessary, and tell you IF and HOW MUCH is required. There is no negotiation or appeal process once CMS issues an approval letter.

    IL has some different rules on atty fees. But generally with a C&R, the atty fees are based on the entire settlement amount. The fact there is a MSA, or how the funds are allocated doesn't really matter. The settlement/C&R is treated as though there are no other issues... just a lump sum consideration. The allocations in the documents...how the money is to be paid/used doesn't affect the atty fees. With a WCMSA, the IW sees less money in the indemnity amount as the fees associated with the MSA amount come from that indemnity.
    he actually declined the settlement offer before I was ever made aware of the offer being on the table (isn't that ILLEGAL?)--he said that he did this 'for my benefit' and I found out about the contract only after he requested that the terms be changed.
    It's just negotiation...there could be many offers that go back and forth between the attys until yours sees something that is in your best interests.
    Attys are there to run interference for you...they are not emotionally involved...you are however because you WANT to see a settlement sooner than later.

    Be careful of what you ask however... settleing with a WCMSA isn't always what the IW may think. What it does is shift the medical liability to you. You become the "claim administrator', and you are liable for payment of the bills.

    You should also consider settlement by a Structured Agreement. Annuities would be purchased to fund a tax free stream of income for you, the WCMSA, and one for the 'non-Medicare' medical you may need. Important considerations...and possibly more money for you.

  5. #5
    Join Date
    Oct 2006
    Posts
    9,108

    Default Re: Medicare Set-Aside Account

    yes you can pick up his file from his office or have it sent to another atty.

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