How Mediation Saves Workers Compensation Dollars

Resolving issues in Workers Compensation claims through mediation saves time, money and stress. 

Multiple Appearances with Judge Can Accomplish Little

Multiple appearances which accomplish little costs all parties “opportunity time”, the opportunity to use the wasted time to accomplish something productive.  Parties may become frustrated with the process, and this frustration sometimes impairs the abilities of the parties to move forward.  Wasted time means wasted money.

In contrast, mediation is as fast and efficient as the parties want it to be.  Mediations can be scheduled for a time and place of the parties’ convenience.   As much time as is necessary can be allocated for the mediation.  The issues to be resolved can be as narrow as definition of the industrial injury or as broad as conclusion of all indemnity, medical and penalty claims.

Mediation Facilitates Communication and Settlement

Mediation focuses the parties’ attention.  This contrasts with a court appearance where an attorney may be juggling appearances in multiple courtrooms.

The mediation may be the only opportunity the injured worker gets to tell the story of the injury and treatment.  For many injured workers, relating the narrative allows them to put it in the past and move on, a good result for all concerned.

This is an abstract of an article originally published at AMAXX Workers Comp Resource Center.  Find the full article at http://blog.reduceyourworkerscomp.com/2013/09/how-mediation-saves-workers-compensation-dollars/

FOUR REASONS TO AVOID THE CMS APPROVAL PROCESS FOR MSAs

Many Workers Compensation professionals believe they must secure approval of a Medicare Set-Aside (“MSA”) before they can close out medical benefits.  In California terms, professionals think they cannot complete a full Compromise & Release (C&R) without going through a lengthy administrative process.  This is not true.

1)                   MMSEA reporting makes approval unnecessary for Medicare beneficiaries.  Carriers and self-insureds already report at the beginning of a claim that they are assuming Ongoing Responsibility for Medicals and will report again when the claim is closed.  By the time an MSA is done, Medicare’s systems already block payments for treatment to those body parts.

2)                  Approval is not and never has been required.  The law merely requires that Medicare’s interest be taken into account, which is what you are doing when you incorporate the MSA terms into the C&R.

3)                  Approval does not protect anyone from liability.  When a non-Medicare-beneficiary Applicant self-administers and spends the money incorrectly, all parties could be subject to reimbursement liability.

4)                  The Approval process is unnecessarily torpedoing your settlements.

Do get an MSA Allocation report.  Do create a Set-Aside in accordance with the report.  Consider a structured settlement arrangement to make sure the Medicare Set-Aside is paid over the claimant’s anticipated lifetime.  Consider custodial administration for claims where it is cost-effective.  Seek CMS approval for settlements with a gross amount in excess of $250,000, but don’t let the process ham-string your settlement. 

 

This is an abstract of an article originally published at LexisNexis® Legal Newsroom Workers Compensation Law.  Find the full article at http://tinyurl.com/7f2c8n9.