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  1. #11
    Join Date
    May 2010
    Posts
    665

    Default Re: MSA Self Administer or Professional Administrator

    Quote Quoting jerry68 View Post
    Thank you for this information as well......one of my injuries is my eyes/vision/blurry and the doctors said I can possibly lose the vision in one due to lack of treatment. After seeing your post I will ask for all of the codes pertaining to my vision and make sure Medicare knows those are only for WC insurance coverage. I hope I am not getting out of this crappy system too early!! But with the codes given to Medicare, like you have done, it should be ok. Thanks!!!!
    Few thing here...Medicare dosent cover much on eyes...Unless its like immaculate degeneration or disorders like that...Yes I would look into it, find out the ins and outs.

    Tony I just muddle through the system....If a Dr. or Hospital says that Medicare is saying the treatment is part of my workmans comp claim is when I have given them the medical codes and the settlement agreement.....Now I would find it strange that WC has different codes for the same thing? I have no clue? My other 20% is covered by my union as part of my being retired with a disability.

    My attorneys pushed hard and said it was in my best interest for me to control it, as they fought me(IC) for over 8 years denying me meds, treatment, you name it.....They also said if the insurance company controlled MSA"my money that was set aside from a 3rd party settlement" expect them to screw with me....I took my team of attorneys word for all of it...Be it right or wrong, it is what it is...Everything was finally settled in 2014.

    I am no expert at all, just personal experience from my nightmare that started in 2007!....My mental state is far better not having to deal with WC insurance company.

  2. #12
    Join Date
    Jun 2022
    Posts
    41

    Default Re: MSA Self Administer or Professional Administrator

    Thanks for both of your input! YES, i want my mental state better and dealing with them and being denied or put on hold for months on end is horrible and I am sick of it too. Just curious if the MSA states certain meds in it is that the only meds I can use it for, even if my pain management changes them?

  3. #13
    Join Date
    Jun 2022
    Posts
    41

    Default Re: MSA Self Administer or Professional Administrator

    Hi, I just wanted to know if I am allowed to choose to self administer or do I have to go with what my lawyer has drawn up? In the agreement which I haven't signed yet, they are setting up an annuity to be managed by a 3rd party. In it it says that 3rd party can assess fees for the account whenever they want. It seems that it is too open ended with no cap on what they can charge out of the funds. I wasn't even aware it would be an annuity for the MSA. Now I an hoping there is a way out of it before I sign it. One of the statements on it says the claimant cannot take control of the account. Can you all suggest something.

  4. #14
    Join Date
    May 2010
    Posts
    665

    Default Re: MSA Self Administer or Professional Administrator

    Quote Quoting jerry68 View Post
    Hi, I just wanted to know if I am allowed to choose to self administer or do I have to go with what my lawyer has drawn up? In the agreement which I haven't signed yet, they are setting up an annuity to be managed by a 3rd party. In it it says that 3rd party can assess fees for the account whenever they want. It seems that it is too open ended with no cap on what they can charge out of the funds. I wasn't even aware it would be an annuity for the MSA. Now I an hoping there is a way out of it before I sign it. One of the statements on it says the claimant cannot take control of the account. Can you all suggest something.
    Ok Im sure there is plenty of ways to do the same thing? I will give you my scenario. My MSA was 154k to cover my problems from WC accident. My lawyers pushed for me to control that money so I had flexibility for my care. In all it was approved as a 98k structured settlement that pays once a year till I die. I trusted and let my attorneys do what they do as my case was over 8 years before we settled.

    They said by me controlling it, I could see the Drs I wanted(shrinks) and not have to worry about paying for my meds and switching drug stores for any reason. A few times Medicare questioned paying for other problems. It has happened twice, each time I brought my settlement in(dr office) which clearly states the 4 codes that our my responsibility, and that has been solved it each time. I have had my structured settlement set up since 2014, I have forgotten alot sorry about that thats about all I remember. So I have a special account that The yearly money gets deposited in,and I write checks out of it to pay my bills for ONLY those things Medicare dosent cover.

  5. #15
    Join Date
    Jun 2022
    Posts
    41

    Default Re: MSA Self Administer or Professional Administrator

    Thank you!! That is what I want. All of the legal language in this agreement gives me no control whatsoever and the company they chose to control says I have to submit receipts and then they will reimburse me. Heck no I don't want to be in that scenario. And it says claimant has no control over the account and cannot change it to another. I will hold my ground! appreciate your help!

    Well my lawyer just said the insurance company is making me use and administrator and I don't have a choice. I asked her why not and said they shouldn't control where the MSA is and she said some insurance companies won't allow self admin,. I haven't agreed yet

  6. #16
    Join Date
    Jun 2022
    Posts
    41

    Default Re: MSA Self Administer or Professional Administrator

    Well the lawyers are still holding up sending me the Final Agreement and Compromise to sign because they are trying to get me to sign up for a professional administrator. They all agree it is my choice to make but they won't send the agreement, thus holding up my entire settlement funds now. We are at a standstill and I am not sure what to do now. My wife suggested getting another lawyer to get mine to get this resolved. Any thoughts, or can they legally hold this up forever.

  7. #17
    Join Date
    Oct 1971
    Posts
    5,328

    Default Re: MSA Self Administer or Professional Administrator

    How's another lawyer going to get this resolved, everything is held up because of your indecisiveness'
    You have to decide what to do - discus this today with your lawyer and make a decision.

    Tony
    Moderator Responses are based on my personal bias, experience and research - They do not represent the views of the admin nor may be accepted in the legal community, always consult an attorney.

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