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Why is my lawyer going to take off the top of the settlement check, the already paid medicare bills, and reimburse them?

Allentown, PA |

i'm suing for a dog bite, medicare paid the medical bills, and my lawyer now says their reimbursement money comes off the top of the settlement check? is this a normal practice?

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Attorney answers 10

Posted

You must read over the written agreement you have with the lawyer. There lies the answer.

Posted

I agree with the other attorney, review your retainer agreement. However, I will say that it is not uncommon for liens to come of the top. my best advise is confer with your attorney. Ask them why that is the practice.

Posted

If Medicare paid your medial bills, your lawyer is required to pay them back from the settlement the "conditional payments" utilizing Medicare's reimbursement formula. If Medicare is not paid back they can come after the lawyer and you for those payments along with potential interest and penalties.

Comments made in this posting are general in nature and not intended to be legal advice nor are they intended to specifically apply to your particular situation. I would encourage you to meet with a lawyer in your area who can review in detail the specifics of your case and provide advice that applies to your particular situation.

Posted

Yes. Medicare will have an absolute right to reimbursement. It is typical in an injury case for this to occur with a Medicare recipient.

Posted

Actually, normal practice is to deduct all unpaid medical expenses and liens from the client's share of the recovery, not off the top.

In any event the liens must be repaid prior to distribution.

Discuss any questions or concerns that you may have with your attorney.

Posted

Read over the agreement you signed with the attorney, that governs.

The above answer is for information only; and does NOT constitute legal advice. This answer does not constitute, nor does it create, an attorney-client relationship between KaplunMarx, PLLC, Theodor Kapun and any receiver. The information provided on these pages is general only, and you should not act upon this information without consulting with a qualified attorney.

Posted

I suggest you carefully read the fee agreement you signed for your lawyer at the beginning of the case. That should tell you what will come "off the top". But as a side note, Medicare must be repaid by law if you receive monies from a claim like this.

Sometimes the homeowner's insurance has something we call "med pay" or premises medical coverage of an amount between $1000-$5000. When I am handling a dog bite case I try to get the adjuster to use the med pay coverage to take care of at least part of the liens and bills if possible because the insurance company will pay it fairly quickly once they have the bills. It is a good way to get rid of at least part of the lien or to cover bills for people who have no other insurance to cover their care. I just did this in a case I recently settled to obtain reimbursement for the bite victim's co-pays which were about $1500. It is not on every insurance policy though and if you don't ask, the company may not tell you about it. Before you sign anything, ask your lawyer if there was med pay as it may cover part of the medicare lien.

Legal disclaimer: The statement above provided by Sandra Worthington, Esq. is general information and not intended to be a legal opinion because not all the facts are provided. The person requesting information and all others reading the answer should retain an attorney who is permitted by the state bar within the jurisdiction who can examine the complete facts and provide a legal opinion on your case. All information provided in the above answer and other information provided by Sandra Worthington, Esq. and Worthington Law Group does not create an attorney/client relationship within any state or under Federal law.

Posted

If your attorney is deducting the medicare lien off the gross amount received you are putting more money in your pocket than you normally would be.

In seeking an attorney on this site, beware of limiting your search to attorneys with a 10 rating, and carefully read the AVVO disclaimer regarding their rating system. There are certain factors that are given great weight which do not necessarily have any bearing on an attorney's experience, abilities, and results with certain types of cases. Accordingly, the rating numbers can be misleading. Also beware of basing your choice on the fee charged, as a low fee, depending on the skill, experience and determination of the specific attorney handling your case, could actually have an inverse relationship to the amount actually put in your pocket.

Posted

Review your fee agreement and see if it discuses how the fees and reimbursements are calculated. It is quite common for the value of the fee to be calculated as a percentage of the total settlement.

I am licensed in Pennsylvania. Members of my firm are licensed in various states, including Pennsylvania, New Jersey and New York. We handle cases involving personal injury (car accidents slip and falls, etc.,) medical malpractice, nursing home abuse, workers' compensation and social security disability. This post is not legal advice, but instead contains general educational information. Please do not act or refrain from acting based upon what you read in this post. Also please remember that this post does not form an attorney/client relationship between you and me. If you have specific legal questions, you should contact an attorney in your state for assistance.

Posted

Your lawyer has to do it - it is the law. It is called subrogation. If a third party is liable for causing your injuries, and Medicare paid for your medical treatment, then you have to reimburse Medicare when you recover the money from the third party.

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