Workers' Compensation Discussion Forums
MSA fund - Printable Version

+- Workers' Compensation Discussion Forums (https://www.workerscompensation.com/forums/general)
+-- Forum: Category (https://www.workerscompensation.com/forums/general/forumdisplay.php?fid=3)
+--- Forum: Injured Worker Forum (https://www.workerscompensation.com/forums/general/forumdisplay.php?fid=4)
+--- Thread: MSA fund (/showthread.php?tid=16033)

Pages: 1 2


MSA fund - Willis - 02-10-2016

Apparently my w/comp. carrier or attorney has determined to set me up with a structured MSA instead of a lump sum MSA.

Do I or shouldn't I get a choice in the matter?

If I pass away during the payment period ( my estimated lifespan)  will my estate get the balance of undeposited funds?

Now I know my attorney is planning on taking his fees from the total settlement amount including those that could turn out to be unpaid. How can he be entitled to  collect his percentage of funds that are TBD?

Can anyone tell me what my options on this are?


RE: MSA fund - 1171 - 02-11-2016

of course you have a choice; they need your signature on the settlement.
beneficiary wording should be part of the terms of the settlement; don't assume it or leave it to interpretation.
generally fees are determined by what benefits were negotiated not what is necessarily by what is paid or received.
atty fees are up to the rules of your state's comp court. I don't know your state.

options for what?
you can change attys at any time. some attys are more willing to listen to their clients then others; depends on how it'll affect their workload and fee.
options also depend on what your state's comp laws are.
every state is different; without knowing yours no one can tell what options you have.

you can find out more about MSAs from the CMS reference guide:
https://www.cms.gov/Medicare/Coordination-of-Benefits/Workers-Compensation-Medicare-Set-Aside-Arrangements/WCMSAP-Overview.html


RE: MSA fund - Willis - 02-11-2016

(02-11-2016, 12:33 AM)1171 Wrote: of course you have a choice; they need your signature on the settlement.
beneficiary wording should be part of the terms of  the settlement; don't assume it or leave it to interpretation.
generally fees are determined by what benefits were negotiated not what is necessarily by what is paid or received.
atty fees are up to the rules of your state's comp court. I don't know your state.

options for what?
you can change attys at any time. some attys are more willing to  listen to their clients then others; depends on how it'll affect their workload and fee.
options also depend on what your state's comp laws are.
every state is different; without knowing yours no one can tell what options you have.

you can find out more about MSAs from the CMS reference guide:
https://www.cms.gov/Medicare/Coordination-of-Benefits/Workers-Compensation-Medicare-Set-Aside-Arrangements/WCMSAP-Overview.html

Thanks for your response.

I'm in California. Sorry about that. This is my first post.

Your response is what I'd have thought.
I e-mailed my attorney but he hasn't gotten back to me. At least not yet.
We do have a status conference for next month.

If a lump sum is my choice can Carrier deny and essentially stall  this settlement?

Also can a judge, possibly at the status meeting, make or force any ruling?

Thank you in advance. 1171


RE: MSA fund - Timothy Belt - 02-11-2016

I can't speak for CA, but I would think MSA rules would be basically the same nation wide. Here in PA, the attorney's can not take a fee from the MSA amount. We can negotiate a fee on top of the MSA or take a fee from the lump sum separate from the MSA, but not from the MSA itself.

As to how any residual is treated, I agree with 1171 that this term needs to be negotiated. Read the documents carefully. I have seen several agreements where the residual is assigned to the WC carrier or where the annuity simply stops upon the death of the claimant.


RE: MSA fund - 1171 - 02-11-2016

Yes, at any time either party can decide the proposed lump sum is not in their best interest.
Lump sum buyout is not guaranteed. If the parties don,t agree on the terms, it doesn,t happen.
Benefits continue until there is an agreement or the court decides the future benefits.
The fee issue on MSA funds is unsettled in California.
There also is no guarantee that the worker will only use the structured amounts for necessary medical treatment.


RE: MSA fund - 1171 - 02-11-2016

(02-11-2016, 11:39 AM)Timothy Belt Wrote: I can't speak for CA, but I would think MSA rules would be basically the same nation wide.  Here in PA, the attorney's can not take a fee from the MSA amount.  We can negotiate a fee on top of the MSA or take a fee from the lump sum separate from the MSA, but not from the MSA itself.

As to how any residual is treated, I agree with 1171 that this term needs to be negotiated.  Read the documents carefully.  I have seen several agreements where the residual is assigned to the WC carrier or where the annuity simply stops upon the death of the claimant.

Tim,
If the client gets a self-administered MSA and later uses those funds for other purposes, isn't the atty cut out of what otherwise would have been their usual amount for non-MSA settlements ?


RE: MSA fund - Timothy Belt - 02-12-2016

(02-11-2016, 03:08 PM)1171 Wrote:
(02-11-2016, 11:39 AM)Timothy Belt Wrote: I can't speak for CA, but I would think MSA rules would be basically the same nation wide.  Here in PA, the attorney's can not take a fee from the MSA amount.  We can negotiate a fee on top of the MSA or take a fee from the lump sum separate from the MSA, but not from the MSA itself.

As to how any residual is treated, I agree with 1171 that this term needs to be negotiated.  Read the documents carefully.  I have seen several agreements where the residual is assigned to the WC carrier or where the annuity simply stops upon the death of the claimant.

Tim,
If the client gets a self-administered MSA and later uses those funds for other purposes, isn't the atty cut out of what otherwise would have been their usual amount for non-MSA settlements ?
They would be, but the general logic is that the approved amount is what is required to fund the MSA, so any reduction for attorney's fees would result in the MSA not being fully funded.  If the client decides to buy a new car rather than the projected treatment, they will still have to document exhaustion of the full MSA before Medicare will pay related bills.  In other words, the injured worker will have to make up the short fall out-of-pocket so even if the original money is not properly spent the claimant will eventually have to document equivalent sums so it is still inappropriate for the attorney to take a portion of that amount.


RE: MSA fund - 1171 - 02-12-2016

(02-12-2016, 11:46 AM)Timothy Belt Wrote:
(02-11-2016, 03:08 PM)1171 Wrote:
(02-11-2016, 11:39 AM)Timothy Belt Wrote: I can't speak for CA, but I would think MSA rules would be basically the same nation wide.  Here in PA, the attorney's can not take a fee from the MSA amount.  We can negotiate a fee on top of the MSA or take a fee from the lump sum separate from the MSA, but not from the MSA itself.

As to how any residual is treated, I agree with 1171 that this term needs to be negotiated.  Read the documents carefully.  I have seen several agreements where the residual is assigned to the WC carrier or where the annuity simply stops upon the death of the claimant.

Tim,
If the client gets a self-administered MSA and later uses those funds for other purposes, isn't the atty cut out of what otherwise would have been their usual amount for non-MSA settlements ?
They would be, but the general logic is that the approved amount is what is required to fund the MSA, so any reduction for attorney's fees would result in the MSA not being fully funded.  If the client decides to buy a new car rather than the projected treatment, they will still have to document exhaustion of the full MSA before Medicare will pay related bills.  In other words, the injured worker will have to make up the short fall out-of-pocket so even if the original money is not properly spent the claimant will eventually have to document equivalent sums so it is still inappropriate for the attorney to take a portion of that amount.
Thank you. Makes sense as long as the client eventually has to dip into their own funds for treatment or when it's a medical only settlement.


RE: MSA fund - California_Help - 02-12-2016

Some applicant attorney's are getting fees off of the MSA while others have stated they cannot in CA. I am curious if there is a rule on this for California?


RE: MSA fund - 1171 - 02-12-2016

To my knowledge this fee issue is unsettled in California; especially since MSA are optional/at the workers own risk.