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  1. #1
    Join Date
    May 2009
    Posts
    13

    Default Settlement Check

    I had my mediation on 9/26/09 and we all agreed on a settlement (C&R). The attorney for the insurance company said they would get everything done asap.
    Now, almost 3 months later my attorney keeps telling me that because I was on Medicare at the time of the injury (I am no longer on Medicare) they are waiting to see if any claims are outstanding that were billed to Medicare for any of my injuries that were covered by WC.
    Every time I call my attorney to check on the status of the settlement check she has no explaination and always has a client she is with or on her way out the door to an appt. I feel like I am getting the royal run around.
    Is it normal to take this long after a mediation when we all came to an agreement?

  2. #2
    Join Date
    May 2008
    Posts
    237

    Default Re: Settlement Check

    hi-not sure what state ur from, but in Pa you need to have a c & r hearing in front of the judge to make it final, then they send your check out from some point after that. did you have a settlement hearing? or just a mediation?

  3. #3
    Join Date
    May 2009
    Posts
    13

    Default Re: Settlement Check

    The state is NC. We had mediation and I was told that since we reached a settlement agreement I would be issued a check. There was no mention of a hearing with a judge. My attorney keeps telling me "No check yet"

  4. #4
    Join Date
    May 2008
    Posts
    237

    Default Re: Settlement Check

    that is so frustrating- I would check your laws in your state to see if a hearing in front of a judge is required to get your settlement- to seal the deal.
    I know here is pa after mediation, we still needed to set up a final compromise and release hearing based on the mediation agreement. or maybe you can call another attorney's office in your area and just ask them if after mediation do you get your check? or do you need a final hearing in front of a judge....

  5. #5
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    17,943

    Default Re: Settlement Check

    I feel like I am getting the royal run around.
    Is it normal to take this long after a mediation when we all came to an agreement?
    Your AA/atty has no reason to give you any runaround, the sooner your check gets cut, the sooner s/he will get the money due for fees. AA can't give an answer they don't have.
    Your AA/DA/CA should have had you sign off on the release of information/records for SSA/Medicare BEFORE you entered into any settlement agreement. If CMS demands a WCMSA, you could potentially see that C&R go out the window. CMS determines how much money must be setaside to fund the MSA...not you or the carrier.

    When you toss Medicare into the equation of a settlement/C&R, its' not going to matter what happened at mediation OR hearing OR what a judge has to say... a judge isn't going to sign off on any C&R where the potential of a WCMSA is hanging in the balance.

    There can be HUGE penalties on all parties involved in the claim if you do not address CMS/Medicare interests. Medicare has the right to pursue up to THREE times the amount of any payments that could have been made by another party, AND up to $1000/DAY...yes DAY, in penalties for not doing as required under the MSPA/Medicare Secondary Payor Act. ALL claims are now being reported to CMS for tracking...so whatever happens in the settlement now, will be address when you become Medicare eligible.

    Now, almost 3 months later my attorney keeps telling me that because I was on Medicare at the time of the injury (I am no longer on Medicare) they are waiting to see if any claims are outstanding that were billed to Medicare for any of my injuries that were covered by WC.
    You aren't going to do anything to rush CMS/Medicare in their providing the information regarding conditional payments Medicare may have made. It's juist going to take time.
    And, once ou are Medicare eligible, that doesn't just stop. If you are not receiving SSDI any longer, the Medicare coverage stays in place up to 39 months. So you are still Medicare eligible...and depending on the facts surrounding your claim, you could be looking as a MSA proposal submission to Medicare for review.

    When SSA/SSDI and Medicare are issue to be addressed in a comp claim... it's not over 'til CMS/Medicare sings... you can forget the ''fat lady'' on this.

  6. #6
    Join Date
    May 2009
    Posts
    13

    Default Re: Settlement Check

    No I am not on medicare anymore. I got a letter that said I am no longer eligible for medicare and my coverage had ended. I had medicare for 8 years after going off disability. The disability and medicare had nothing to do with the workmans comp injury.

  7. #7
    Join Date
    Dec 2009
    Posts
    15

    Default Re: Settlement Check

    And what about my case? State was PA...had the c and r and recieved papers from the judge saying it was approved? That was on the 2nd of December. What is my chance of getting the check next week on week 2?

  8. #8
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    17,943

    Default Re: Settlement Check

    The disability and medicare had nothing to do with the workmans comp injury.
    Doesn't matter, and that's not the point. Medicare, SSA/SSDI is not related to your comp claim. BUT, when you close out the medical benefits, CMS can and will get involved in the settlement. ALL claims that include medical treatment are now reported to CMS/Medicare and will be tracked. If there is future medical treatment compensation in the settlement agreement/allocations... that money should, possibly must, be deposited in a seperate interest bearing account and used ONLY for treatment to your work injury.

    And what about my case? State was PA...had the c and r and recieved papers from the judge saying it was approved? That was on the 2nd of December. What is my chance of getting the check next week on week 2?
    You should allow 30 days for the IC to cut the check. That's just normal procedure for carriers. They have that amount of time, and they'll take it.
    It's not like you getting a bill with a due date 25 days out, and you pay it as soon as you have the money... IC's are not operating on the scale we do.

  9. #9
    Join Date
    May 2008
    Posts
    237

    Default Re: Settlement Check

    Heather, I say "keep the Faith"

  10. #10
    Join Date
    Dec 2009
    Posts
    15

    Default Re: Settlement Check

    I plan on it...My kids are counting on that money...after all most of the time the IC has between Christmas and Jan 2nd is holidays and the mail doesnt run so Im gonna keep my fingers crossed that it comes next week..My attorney has said that the average is 2 weeks and I have to have it by Jan 2nd...Thanks for some uplifting thaughts! Makes me feel like maybe I shouldnt give up yet!

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