My accident at work was in October 2009, I am not on SSI, SSD or Medicare. I do not qualify for that. I am too young 34 years old, NO, I do not plan to appeal, the decision fro SSI I only applied at that time because my hands and feet were hurting. last month 4-19-2012 at my Workmans comp court in Marina Del Rey California was offered a STIP resolution for MSA??? What do I do?
WHAT YOU DO IS THIS: ASSUMING YOU HAVE NO ATTORNEY (if you do, get off this site and have a face-to-face with the attorney asap or fire him and get one with whom you can communicate!), WRITE THE ADJUSTER that no Medicare Set Aside is required because you (1) are not receiving any medicare benefits and (2) were denied all medicare benefits.
A MEDICARE SET ASIDE is ONLY for a Compromise & Release Agreement. It is a contract with the federal government that a chunk of the case you are receiving to resolve Future Medical rights will be paid to Medicare.
STIPULATIONS WITH REQUEST FOR AWARD do NOT resolve any Future Medical rights.
Medicare should not be attaching or requesting any sums from any Award on Stipulations, because the insurer should be paying all the doctors (not Medicare).
So you got completely confused at your hearing April 19.
There simply is "no such animal" as "a Stip resolution for MSA" (or, if attempted, no workers comp judge would approve it).
Stipulations should only be approved where the permanent disability percentage matches the findings of a believable doctor's report.
The parties "Stipulate" to a percentage of Permanent Disability based on medical evidence, then agree whether there is or is not any requirement for future medical treatment.
So there can be a "Stip resolution for 25%" but never a "Stip resolution for MSA" because MSA is never a measure of a worker's permanent disability.
Hope that's clearer.
You only need an MSA if you are settling out your future medical care. You do not need one if you are settling by Stipulations with Request for Award. It sounds like something here is confused. You may want to talk to a good w.c. attorney to make sure everything is on track.
An MSA is a complicated process. It may be possible to buy an annuity to fund the MSA which should save you some money. I can't see how you can do an MSA by yourself and get it right. Get a good w.c. attorney before you get too deep into this. There are some great ones in SFV and on the west side. Find a good one here at www.avvo.com or at www.caaa.org. CAAA is the association for attorneys here in California who represent injured workers. Or you can call me for a referral. Good luck.
One additional question occurs to me. What percentage of Permanent Disability is being discussed for Stipulation? Are you sure you have not been offered a lump sum settlement by C&R (Compromise & Release)? Depending on your answers to these questions, the answers already given could change.
And, if an MSA is appropriate, you definitely need a good lawyer to be sure it is properly done. Find one here at AVVO or at www.caaa.org
The information given is generic and does not constitute legal advice, which would only be given after a complete review of the specific facts of your case.
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