Medicare Set Aside Workers Compensation Claim Project in New York, NY

We were recently asked to assist with claim management monitoring of a case for one of our customers who was having difficulty moving towards a settlement resolution. The claim involved a Maintenance Service worker who was injured in 2006 while unloading carpets from a company service truck. The Claimant allegedly slipped and fell injuring his Lumbar Back and Coccyx area. The Claimant was on Temporary Total Disability since the date of injury, and remained in this status since the Customer unable to accommodate any light duty work restrictions. The Claimant was 48 years old at the time of the accident. The Workers Compensation Board eventually classified the Claimant at $400 week Permanent Partial Disability with symptomatic medical conditions treated with pharmacological interventions. It was our immediate recommendation to consider new Counsel who would seek a final settlement.

At this point, we recommended that the Customer have a Medicare Set-Aside (MSA) completed by us to lessen the value further. We then completed an MSA with Centers for Medicare and Medicaid Services (CMS) Approval. The Claimant was found to be Medicare eligible, which amounted to $12,000 for the future Medicare Set Aside. With the MSA, the final settlement amounted to $147,000. This was a savings of $53,000 off the original $200,000 offer. Our Customer was very pleased, and uses us for all cases where there are significant medical and indemnity matters.