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Both parties have to agree, and the settlement must be approved by a Worker’s Compensation Appeals Board Judge. If you have a prior settlement, call your attorney. Do not listen to a claims adjuster who tells you to fire your attorney "so you can settle for more money." This is not true, as by law, the WC ins carrier must pay attorney fees on top of the MSA, it doesn't short the injured worker at all. Many injured workers fall for this and then agree NOT to submit the MSA to CMS; without a reported MSA, Social Security will treat your entire settlement as "income" and your Social Security payments will be suspended because of the money.
If you don't have an attorney, I guarantee the WC ins carrier will includes language making YOU responsible for reimbursing Medicare for any treatment related to your work injury. I would never recommend an injured worker try to settle future medical care with an insurance company on their own. If you have an attorney representing you for settlement of medical care, their fee is 15% of the settlement obtained. The insurance carrier is obligated to pay the FULL AMOUNT of the Medicare Set Aside, any attorneys’ fees must be paid by the insurance company on top of the medical settlement. There is no reason to try and negotiate a future medical settlement on your own. An attorney can avoid common pitfalls and loss of your Social Security benefits by advocating for you and guiding you through the process.