Why Mediation Is Like Sex

YOU THOUGHT MEDIATION AND SEX HAD NOTHING IN COMMON?NOT SO!   Both mediation and sex should: Happen between persons committed to the process as an essential part of the big picture Occur with appropriate frequency Stimulate participants to contribute their best selves Continue until mutual satisfaction Make participants feel better at conclusion Empower parties to […]

Six Biggest Mediation Misconceptions

The Mediator might rule against me. Mediators do not make any rulings. The role of the mediator is to help the parties resolve the issues.   If I go to mediation, I will have to give up something. Negotiation is about compromise. Each side usually gives up something. You won’t give up anything unless you, and only you, […]

Do You Speak MSA?

“MSA” stands for Medicare Set-Aside.  Settling a Workers Compensation claim often calls for consideration of Medicare’s interests.  MSA-speak has its own language.  The problem is that the term “MSA” is used to mean different things.  Understanding the 4 different items which may be referred to as “MSA” is critical to success in this area: MSA […]

Understanding Public Income and Medical Benefits after the Affordable Care Act

There’s a lot more to the Affordable Care Act than buying private health insurance through an exchange marketplace like www.CoveredCA.com. Four kinds of public benefits can help people get the medical care they need: Subsidized premiums and co-pays for private health insurance purchased through an exchange.  Commercial insurers issue these policies, not the government. Medicare, […]

The Elephant in the Room

Sometimes the issues the lawyers and adjusters are discussing are not what is most important to the Applicant. Recently, in a pretty small case, the professionals told me the disagreements were about what had been paid and what was still due. The injured worker told me his biggest concern was that, although he had returned […]

DON’T LET POLITICS GET IN THE WAY

“AFFORDABLE CARE ACT” NOT “OBAMACARE” The term “Obamacare” is a nickname for the Affordable Care Act.  But sometimes politics can get in the way of clear thinking.  Click http://www.hulu.com/watch/539715 to see what I mean. The Affordable Care Act encompasses much more than the purchase of private health insurance on an exchange like Covered California, www.CoveredCA.com. […]

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 […]

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.  […]