Should We Have A MSA For Workers Compensation

Posted by John Cattie

Question:
My old firm is pretty close to settling the civil portion of a workers compensation case that I have. We are probably going to settle the WC case for a dollar with a lien waiver. My client is on Social Security disability. If we settle the WC case for a dollar, do we have to have a Medicare Set Aside? The settlement on the third party will probably be around 200k.

Illinois Attorney

Answer:
We know from the April 2003 CMS Memo that settlements containing both a Workers Compensation component as well as a liability component should be treated akin to WC cases for MSA purposes. Therefore, the fact that the parties in the WC case are settling for a dollar with a lien waiver will not shield the claimant from the MSA requirement. The focus should be on who will be paying for future meds going forward. If the burden of making those payments is being shifted from the WC carrier to Medicare going forward, and the claimant will require future injury-related care, then a MSA may be appropriate.

John Cattie