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open medical pros and cons - freebird - 04-22-2010

I am looking for pros and cons of accepting open medical to close a WC Case.
If you have open medical or knowledge of this subject please respond.


RE: open medical pros and cons - Bad Boy Bad Boy - 04-22-2010

Plus, if anyone here if Open Medical can speak of any and all Draw Backs they had once on Open Medical with a Settled Case. Then if you can after posting the encounters you went through, explain what it took to fix the problem (s)...

Thank You


RE: open medical pros and cons - Bummer Knees - 04-22-2010

My sister has open medical with a settled case.

For every doctor's visit, MRI, & shot, she must return to court for approval from the judge.

Her attorney, (same as mine) represents his clients with open medical at no charge after a settlement.


RE: open medical pros and cons - Bummer Knees - 04-22-2010

I have always been under the impression that if receiving SSD or SSI an injured worker must settle with a set-aside, open medical is not a choice.

Am I wrong?


RE: open medical pros and cons - freebird - 04-22-2010

Bummer Knees Wrote:I have always been under the impression that if receiving SSD or SSI an injured worker must settle with a set-aside, open medical is not a choice.

Am I wrong?

Never heard of this; What leads you to believe this? Makes NO sense to me but I have been wrong at least once..... LOL
I recieve SSDI...


RE: open medical pros and cons - Bad Boy Bad Boy - 04-22-2010

In correct as Open Medical is the equal to a MSA because CMS is being told the medical portion will be paid by the IC.


RE: open medical pros and cons - AQA - 04-22-2010

I have open medical, but no settlement persae. I am receiving SSDI and have medicare.

Texas is not like other states in respect to settlements. Open medical is not an option. So far there has been no problems with the medical. The IC pays for all tests and meds.. There has been only one time when a requested test had to go to an iro for a ruling. That has nothing to do with the court system. The request went to a panel of three drs. for a ruling as to wether or not is was needed.

The only issue I have is making sure that the drug store runs the prescriptions under wc or medicare. I have only had two issues with that. When the problems happened I would just call the IC and give them a heads up incase they get the bill.


RE: open medical pros and cons - Timothy Belt - 04-23-2010

Bummer Knees Wrote:I have always been under the impression that if receiving SSD or SSI an injured worker must settle with a set-aside, open medical is not a choice.

Am I wrong?

Open medical is a choice (at least in PA). If you do not leave the medical open, then you need to obtain set-aside approval from Social Security. If you leave the medical open, a set-aside is not required.


RE: open medical pros and cons - freebird - 04-23-2010

Timothy Belt Wrote:
Bummer Knees Wrote:I have always been under the impression that if receiving SSD or SSI an injured worker must settle with a set-aside, open medical is not a choice.

Am I wrong?

Open medical is a choice (at least in PA). If you do not leave the medical open, then you need to obtain set-aside approval from Social Security. If you leave the medical open, a set-aside is not required.

What are the pros and cons to having open medical in a WC settlement?
Thank you in advance


RE: open medical pros and cons - Timothy Belt - 04-23-2010

Generally, open medicals provides some security in the future that if you need treatment, payment will be made. Depending on your state law, treatment may still be challenged and possible payment disputes can arise.

Closing medical should result in a somewhat higher settlement figure, and the intangible benefit of being done with the claim completely.

freebird Wrote:
Timothy Belt Wrote:
Bummer Knees Wrote:I have always been under the impression that if receiving SSD or SSI an injured worker must settle with a set-aside, open medical is not a choice.

Am I wrong?

Open medical is a choice (at least in PA). If you do not leave the medical open, then you need to obtain set-aside approval from Social Security. If you leave the medical open, a set-aside is not required.

What are the pros and cons to having open medical in a WC settlement?
Thank you in advance