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C&R vs. Open Medical
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08-06-2012, 03:05 PM
Post: #1
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C&R vs. Open Medical
I hope someone can give me some guidance. I was wondering what is the benifits to a C&R vs. Open medical? As I understand it the IC does not have to agree to leave medical open and will often try to get the IW to accept the C&R. IT seems to me that as long as you have all your duck in a row the C&R would benift you just as well. I may be mistaken but it seems the IW would have more controll over what is paid or not. If you have a MSA and the IW controlls the MSA then the IW would be the one to decide if the medical is needed and if WC has the athority in the medical then everything would have to be pre aproved through WC to see if it is injury related before WC would pay for the bill/medical And if WC didn't feel it is injury related they could deny this claim. The only thing i don't quite understand is what would happen if say 10 or 15 years down the road something happened and the IW needed a big surgery and the MSA didn't have enough $$ to pay for the surgery could the IW reopen the case to get WC to put more $$ in the MSA to cover the surgery or is a C&R a one time thing? Hopefully some one here can shed some light on this for me.
Thanks, BamaJ |
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08-06-2012, 03:21 PM
Post: #2
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RE: C&R vs. Open Medical
(08-06-2012 03:05 PM)BamaJ Wrote: I hope someone can give me some guidance. I was wondering what is the benifits to a C&R vs. Open medical? As I understand it the IC does not have to agree to leave medical open and will often try to get the IW to accept the C&R. IT seems to me that as long as you have all your duck in a row the C&R would benift you just as well. I may be mistaken but it seems the IW would have more controll over what is paid or not. If you have a MSA and the IW controlls the MSA then the IW would be the one to decide if the medical is needed and if WC has the athority in the medical then everything would have to be pre aproved through WC to see if it is injury related before WC would pay for the bill/medical And if WC didn't feel it is injury related they could deny this claim. The only thing i don't quite understand is what would happen if say 10 or 15 years down the road something happened and the IW needed a big surgery and the MSA didn't have enough $$ to pay for the surgery could the IW reopen the case to get WC to put more $$ in the MSA to cover the surgery or is a C&R a one time thing? Hopefully some one here can shed some light on this for me.The C&R releases the insurance company of all liability for the injuries, they give you a future medical buyout lump sum which gives you control of future medical treatment. I personally like the thought of having medical treatment controlled my me because they are some shystie dont play by the rules asswipes.. |
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08-06-2012, 03:54 PM
(This post was last modified: 08-06-2012 04:10 PM by 1171.)
Post: #3
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RE: C&R vs. Open Medical
basic insurance idea: there is no guarentee you have "all your ducks in a row" i.e. risk of what you don't know is reduced.
not everyone's future medical treatment is predictable. there are many unknowns and high potential for failed surgeries and adverse consequences to treatment. not all settelments have an MSA. after MSA is exhausted Medicare would be liable for treatment -but you don't have a blank check. before paying for treatment medicare will review your MSA expeditures and decide what was appropriate and determine at what $$ point they will pay. more here https://www.cms.gov/Medicare/Coordinatio...taside.asp |
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