Workers Comp Lawyer

A local 250 union carpenter was knocked off a ladder while constructing a highway retaining wall, injuring his right thumb and index finger. After three surgeries, he faced the possibility of more medical care.

Where a workers compensation claimant has injuries that might require future treatment and the claimant is either on, or might soon be, eligible for Medicare benefits, Medicare has to be consulted before the workers compensation case is settled. The reason is that Medicare does not want to get stuck paying bills that are really the responsibility of workers compensation. Thus, the workers compensation parties have to submit claimant’s medical records to Medicare for review, and Medicare will require that a certain amount of money be set aside from the workers compensation settlement to be used to pay for future medical expenses before Medicare becomes obligated to pay. This is known as a “Medicare Set-Aside” (MSA). The MSA funds have to be held in a separate bank account. The claimant also has to provide an annual accounting in writing to Medicare, to prove that the funds have been used only for accident-related medical expenses.

In this case, attorney Douglas Rallo negotiated a settlement of $348,000 including an MSA. “We made sure that our client received all the disability and other benefits he was entitled to receive, which amounted to $610,000”, said Rallo. “This very large workers compensation settlement with MSA, plus his union retirement check, have provided claimant with the life-long financial security and protection he deserves”.