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  1. #1
    Join Date
    Sep 2011
    Posts
    33

    Question Msc, Trial and MSA

    Iím going to an MSC hearing next month and I have a question that I hope someone can answer. I am on SSDI and I have read that if I am offered a C&R that my future medical would need to be an MSA due to me receiving Medicare. My question is if I donít except anything they have to offer because I still have 2 denied claims and we end up going to trial what will happen at that point? I have read that more than likely C&R will be off the table and I will just be receiving PD payments, but what happens to open future medical? I now live in another state so open future medical probably wonít help me because it will be hard to find a doctor since itís a California claim. Will I receive an MSA in place of open future medical? Thank you and I hope I explained this right.

  2. #2
    Join Date
    Jul 2008
    Location
    California
    Posts
    1,900

    Default Re: Msc, Trial and MSA

    Quote Quoting upsetIW View Post
    Iím going to an MSC hearing next month and I have a question that I hope someone can answer. I am on SSDI and I have read that if I am offered a C&R that my future medical would need to be an MSA due to me receiving Medicare. My question is if I donít except anything they have to offer because I still have 2 denied claims and we end up going to trial what will happen at that point? I have read that more than likely C&R will be off the table and I will just be receiving PD payments, but what happens to open future medical? I now live in another state so open future medical probably wonít help me because it will be hard to find a doctor since itís a California claim. Will I receive an MSA in place of open future medical? Thank you and I hope I explained this right.
    Do you have an attorney because he would be the best person to ask?

    I have no idea what would happen at your trial. They do not have to offer you a C&R, even if you moved out of state. Some injured workers have been able to find doctor's out of state to treat them. Have you tried this? Are you getting treatment now? The longer you go without getting treatment for your injury, the more difficult it may be to get it in the future,( unless all of your claims are being denied, then you can treat out of pocket wherever you want). The adjuster can move to close your claim if you have not been actively receiving treatment after a certain time period. Be careful of that.

    You should ask your attorney if you have one if he can try to negotiate a MSA with a C&R if that is what you want.

    I wish you good luck at your trial.

  3. #3
    Join Date
    Sep 2011
    Posts
    33

    Default Re: Msc, Trial and MSA

    Thank you Kelly, but I know and said IF they offer a C&R at MSC. My main question was, is there a chance at trail to get an MSA instead of open medical along with the standard PD payments? I would ask my AA, but as we all know it's very hard to get a hold of them. Thank you though for your time to answer what you could. I do appreciate it very much.
    Last edited by upsetIW; 08-09-2013 at 08:27 PM.

  4. #4
    Join Date
    Jul 2008
    Location
    California
    Posts
    1,900

    Default Re: Msc, Trial and MSA

    Quote Quoting upsetIW View Post
    Thank you Kelly, but I know and said IF they offer a C&R at MSC. My main question was, is there a chance at trail to get an MSA instead of open medical along with the standard PD payments? I would ask my AA, but as we all know it's very hard to get a hold of them. Thank you though for your time to answer what you could. I do appreciate it very much.
    A MSA would happen only if you C&R your claim. If you get a C&R,your claim is over and the IC will not pay you PD payments on top of that afterward.

    I understand your attorney is busy, but I recommend making a phone appointment with him so you can discuss these issues. If he has an idea on how you want to settle, he can work toward that.

    It is completely up to the insurance carrier if they want to C&R your claim.


    If you are owed PD, then the insurance company should begin to pay that out. Sometimes after the PD rating is given the insurance company may offer a C&R with MSA to close the claim.
    Last edited by kelly38; 08-09-2013 at 09:10 PM.

  5. #5
    Join Date
    Feb 2007
    Location
    Charlotte, NC
    Posts
    2,971

    Default Re: Msc, Trial and MSA

    The only time a MSA is needed or appropriate is when future medical is settled, as in a C&R. You don't get awarded MSAs in work comp hearings.
    The North Carolina Court of Appeals has held that "In contested Workers' Compensation cases today, access to competent legal counsel is a virtual necessity." Church v. Baxter Travenol Labs, Inc., and American Motorists Insurance Company, 104 N.C. App. 411, 416 (1991).

    Bob Bollinger, Attorney at Law

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