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IMR Applications and Attorneys responsibility
#11
Only if there wasn't enough $$ in the settlement. That's why Medicare wants to review them first.
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
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#12
This why I would not C and R / Set Aside until 62 yrs of age . I would also encourage anyone that has Medicare considering a set aside and under 62 yrs old to think long and hard before C and R with a set aside.

You could find yourself without Medicare .Which was the reason you C and R 'd in the first place.

I figure since all treatment remedies under workers comp are exhausted . I'm just going to shift to Medicare anyway. What a huge waste of money.

Personally I think when medical is awarded that's it .. Non Negotiable .. Too much cost shifting to the public.

Thanks Folks
 
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#13
there are many reasons to buyout your future medical care and to make a blanket statement that those younger then 62 should not settle is overstepping and overlooking the many different situations injured workers find themselves in.

I also think universal health care or medicare for all would remedy many inefficiencies in our current system.
but until then the solutions are situational and one size solutions not only do not fit all but not even a majority.
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
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#14
(12-20-2017, 03:51 PM)Shadow Wrote:
(12-20-2017, 10:58 AM)1171 Wrote: Without Medicare there is no need for a Setaside and the $$ revert to the worker.
Many cases are settled directly with a worker with no Medicare,.

I understand . 

Lets say that a Medicare Set aside is in place assigned to an account administrator.. The injured Workers condition improves and no longer disabled by SSA rules . When this happens to the set aside when  they lose medicare. Medicare is only guaranteed at the retirement age . The IW is only 53.

This could be a disaster .. unless there is something I dont know ?

You can self administer your Medicare set aside, which means you put it in a bank account and as you use it you can send Medicare receipts showing how much you used and when it is used up you can use Medicare. I would not let any company administer my MSA. You have a choice on this. You should discuss with an attorney for clarification.
I am not an attorney.Anything I write should not be considered legal advice.I am writing from my own personal experiences,which is not from any sort of legal background. You should consult with an attorney over legal issues. In California, if you cannot get an attorney you can consult with an I&A officer.
 
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#15
(12-21-2017, 08:17 PM)Shadow Wrote: This why I would not C and R / Set Aside  until 62 yrs of age . I would also encourage anyone that has Medicare considering a set aside  and under 62 yrs old to think long and hard before C and R with a set aside.

You could find yourself without Medicare .Which was the reason you C and R 'd in the first place.

I figure since all treatment  remedies under workers comp are exhausted . I'm just going to shift to Medicare anyway. What a huge waste of money.

Personally I think when medical is awarded that's it .. Non Negotiable ..  Too much cost shifting to the public.

Thanks Folks

I disagree with you. Please consult with an attorney about your options. It appears you do not have full info on this.

I have yet to come across one injured worker who had a MSA and then was not able to use Medicare after it was depleted and in fact I wont say the rest. I think you are cutting yourself short on this issue. Also, in my opinion it is a mistake when injured workers want the largest MSA possible and that leads to less PD money in the C&R and you are basically giving your settlement to Medicare.(JMO)
I am not an attorney.Anything I write should not be considered legal advice.I am writing from my own personal experiences,which is not from any sort of legal background. You should consult with an attorney over legal issues. In California, if you cannot get an attorney you can consult with an I&A officer.
 
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#16
(12-21-2017, 08:42 PM)1171 Wrote: there are many reasons to buyout your future medical care and to make a blanket statement that those younger then 62 should not settle is overstepping and overlooking the many different situations injured workers find themselves in.

I also think universal health care or medicare for all would remedy many inefficiencies in our current system.
but until then the solutions are situational and one size solutions not only do not fit all but not even a majority.

Where exactly do you see a blanket statement ? 

Statement made was to my specific situation and advise to think long and hard before accepting a C and R. / Medicare Set-Aside before the age of 62.

Didn't say anyone under 62 should not accept a C and R ..Where did you get that from?

Actually ... I did speak with a lawyer and advised him that because of this scenario not to proceed with a Set Aside submitted to CMS ( however all of that works ) . Because the above described scenario can if fact happen to a Medicare Insured under 62 years of age...Applicant Attorney agreed .

I'll say it again ...anyone under 62 years old that receives Medicare should think long and hard about a Compromise and Release / Medicare Set Aside due to the fact the the Social Security Administration /CMS could find in fact that the Applicant is no longer eligible for Medicare and they will discontinue that Insurance Benefit.

Anyone under 62 years of age that is not eligible for Medicare or Receiving Medicare this conversation does not apply to.

Sorry to offend anyone . I certainly didn't mean too and don't think I made a " blanket statement". I take full responsibility for my post.

I am only here for help.

Merry Christmas

Shadow
 
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#17
Shadow
(12-21-2017, 08:42 PM)1171 Wrote: .


I'll say it again ...anyone under 62 years old that receives Medicare should think long and hard about a Compromise and Release / Medicare Set Aside due to the fact the the Social Security Administration /CMS could find in fact that the Applicant  is no longer eligible for Medicare and they will discontinue that Insurance Benefit.



If you self administer your Medicare set aside and for some reason go back to work or SSDI finds you are no longer disabled and no longer can obtain Medicare, it is my understanding the patients gets to keep that MSA money (if you self administer it). If you have questions there are a lot of resources on the internet. 1171 what are your thoughts on this?

I am no expert but I have talked to patients who are self administrating their MSA, meaning they do not agree to have a company hold those funds and manage them for them. I recommend talking to Medicare about this, again I am not an expert.

Happy Holidays!
I am not an attorney.Anything I write should not be considered legal advice.I am writing from my own personal experiences,which is not from any sort of legal background. You should consult with an attorney over legal issues. In California, if you cannot get an attorney you can consult with an I&A officer.
 
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#18
Self-administered or not the MSA $$ are always the  workers. The fact that they may no longer qualify for Medicare does not change that fact.
A worker should always think seriously about any settlement whether they are under or over 62.
Many believe the freedom to chose their own treatment is a bigger factor then whether they may need Medicare as a backstop. Each workers situation is different and each has to weigh the pros and cons of any settlement.
A Settlement can be in a workers best interest at any age; Medicare availability is just one factor.
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
Reply
#19
(12-23-2017, 03:13 PM)1171 Wrote: Self-administered or not the MSA $$ are always the  workers. The fact that they may no longer qualify for Medicare does not change that fact.
A worker should always think seriously about any settlement whether they are under or over 62.
Many believe the freedom to chose their own treatment is a bigger factor then whether they may need Medicare as a backstop. Each workers situation is different and each has to weigh the pros and cons of any settlement.
A Settlement can be in a workers best interest at any age; Medicare availability is just one factor.

I agree. Every situation is different. Some patients also have very little difficulties obtaining medical treatment in the WC system, while others are being screwed with on a regular basis with denials.

I have also seen patients get over treatment as their providers use their bodies as a means to make money when the patient's condition does not warrant it. One patient told me when he listed how many surgeries he had had in the past, his new surgeon replied "you are the gift that keeps on giving". What a slime ball! I would have ran right out of there. He ended up doing a very evasive surgery on him too.

If a patient is being denied needed medical treatment or having to fight for it on a regular basis, this in my opinion is not a healthy way to live and why getting out of the situation by C&R can be an option, if IC agrees. (JMO)
I am not an attorney.Anything I write should not be considered legal advice.I am writing from my own personal experiences,which is not from any sort of legal background. You should consult with an attorney over legal issues. In California, if you cannot get an attorney you can consult with an I&A officer.
 
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