Articles Tagged with medicare

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Alabama Accident & Injury LawyersIn a prior post, I discussed the secret arrangements where settlement mill lawyers funnel most of their clients to a favorite chiropractor who then runs-up the medical bills for settlement. The downside of this secret arrangement is that the injured person never receives proper care but is left paying the bulk of their settlement money to the lawyer and chiropractor. It’s a bad deal for the personal injury victim. It’s a shameful practice by settlement mill lawyers who neglect their clients.

What about injury victims who have health insurance or health coverage? Here’s a quick scenario. You suffered an injury in a car accident. After the wreck, you go to the local hospital and then follow-up with your doctors. You probably pay some co-pays. But, your health coverage pays many of the bills. If you have health coverage, you should use it to get the treatment you need. You then hire a lawyer to make a claim against the at-fault driver. Medical bills and personal injury claims can be a confusing topic. But, it’s a very important topic if you are facing a serious injury. If you would like more information about medical bills and personal injury cases, click the link below to my article discussing the topic.

The insurance company knows which lawyers go to court. Choose wisely. If you are seriously injured in a car accident, the choice of lawyer can make a huge difference in the insurance company’s offers to you. If you hire a settlement mill lawyer who is not willing to go to court, the insurance company is likely to pay less for your case. Why would the insurance company pay a fair settlement if the adjuster knows your lawyer will not go to court? Why would the insurance company pay a fair settlement if the adjuster knows your lawyer is simply advertising on billboards for volume cases that can be quickly settled? Why would the insurance company pay a fair settlement if the adjuster knows your lawyer is simply using a staff of non-lawyers to push claims through the system. But, getting a smaller settlement from the insurance company is not the only way you can lose with a settlement mill lawyer.

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I recently attended a workers’ compensation seminar in Birmingham. Several speakers discussed the issues involved in closing medical benefits. Here is the backdrop — Injured workers in Alabama are entitled to medical treatment under our workers’ compensation laws. Can an injured worker agree to give up this right to medical care as part of a settlement? Yes, he can. The better question is — Why would an injured worker agree to give up such an important and guaranteed right? Closing medical benefits can raise many complicated issues for injured workers who receive (or may receive) important government benefits like Medicare.

The seminar was very informative. My problem is with the presumption expressed by the speakers that closing medical benefits was now the new normal. It should not be.

Do I ever recommend to clients that they close medical benefits? Yes, sometimes. Does the claim have issues that make success at trial unlikely? That’s when I might counsel a client to consider closing medical benefits in order to settle. If you have a good claim, the court must provide medical benefits. And, in that situation, you should be extremely hesitant to give up that right.

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Untitled-design-3-300x300Subrogation. Reimbursement. What do these concepts mean for personal injury cases? When you suffer a personal injury, your health insurer (or plan) pays your medical bills. For many people in Alabama, this means Blue Cross. It may also mean government programs like Medicare, Medicaid or Tricare. These health plans pay your bills. But, they usually have rights to recover their payments from your personal injury settlement. Their rights vary between private and government plans. I’ve addressed that issue in other articles.

The legal issues can be complex. And, understanding the rules (which differ between private and government plans) can make a huge difference in how much money you actually keep. This is an area where a skilled lawyer can really help you save money and maximize your final recovery.

What about wrongful death cases? Do health plans and programs have rights to reimbursement from wrongful death settlements? Does Medicare have reimbursement rights in Alabama wrongful death cases? I mention Medicare specifically because it covers so many people and also carries the weight of the government. While these insurers and plans do have reimbursement rights in personal injury claims, they don’t have the same rights in wrongful death claims.

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In Alabama (and most other states), a primary goal of workers’ compensation is to provide injured employees with needed medical care. The first goal, when possible, is to treat and rehabilitate the injured person so that he or she may return to gainful employment.

By law, employers must have coverage which provides needed workers’ compensation benefits to workers. In the past, I have written about workers’ compensation insurance carriers collecting profits for providing coverage and then trying to shift costs to other sources. Often, cost-shifting means the government pays for the benefits. That costs all of us.

In many workers’ compensation cases, the insurance carrier’s attorneys will want to close medical benefits. That is, they will want you as the injured worker to give up your right to medical treatment for some sum of money. I usually advise clients to resolve only the portion of their claim for disability benefits and to leave medical benefits open.

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Alabama Wrongful Death Attorneys (Blackwell Law Firm)I’ve written some prior articles discussing Medicare’s rights to be reimbursed for medical payments from settlements or judgments in personal injury claims. It’s a topic lawyers should take seriously. As I stated in the past, dealing with Medicare can be an extremely frustrating experience. So, I am happy to report a recent court decision that, to some degree, requires Medicare to play by rules that apply to the rest of us.

On September 29, the United States Court of Appeals for the 11th Circuit issued a decision in Bradley v. Sebelius. The case involved reimbursement claims by Medicare arising out of a wrongful death settlement in Florida. This case is a welcome decision for attorneys frustrated by the experience of dealing with Medicare. On his blog, Tennessee attorney John Day wrote a great analysis of this decision. I agree with John that the case involved some great lawyering by plaintiffs’ counsel.

In the case, the Federal Court rejected Medicare’s far-reaching argument that its own field manual was basically entitled to the force of law. In rejecting those claims, the Federal Court actually stated:

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