MSA lump sum (California)

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MSA lump sum (California)

Postby susiearnold on Tue Nov 29, 2016 8:07 pm

Hello, I have an estimated MSA for 98,000 with 11,000 for RX. Currently on medicare. I understand payments will be for medicare only. Would the lump sum be on the estimated CMA amount to be the actual lump sum amount?
Thank you,
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Re: MSA lump sum (California) (California)

Postby Barney5 on Wed Nov 30, 2016 11:17 am

The MSA amount is not the amount of the lump sum but I have seen injured workers settle for just the MSA amount.Hopefully you will get more than the MSA amount. I suggest discussing your situation with an applicant attorney or I&A officer for help.

Here is some info.
https://www.dir.ca.gov/InjuredWorkerGui ... apter7.pdf

http://www.dir.ca.gov/dwc/CaseResolved.htm
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Re: MSA lump sum (California)

Postby LawAdvocate on Wed Nov 30, 2016 1:17 pm

Settlements are based on a number of entitlements:

1. TTD - was it correctly paid, are you entitled to additional sums?
2. PD - your PD as found by the physicians in the matter, less any PD sums previously paid. .
3. VR voucher - some companies won't settle and if your date of injury is after 1/1/13 - they can't settle.
4. Future medical care - this is composed of the MSA set aside for what Medicare will cover. But Medicare does not cover everything, so there should be sums additional for the portions of your future medical care that Medicare will not cover.

Therefore no the MSA should not be the lump sum amount in my humble opinion - even if all that is left to settle is future medical care.
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Re: MSA lump sum (California)

Postby susiearnold on Wed Nov 30, 2016 8:35 pm

Thank you both for your advice. I have reviewed the links sent to me. Defense attorney has been hard to deal with, my D.O.I is CT 2002/2003 and we're using the 2005 rating schedule per AME, even though my injuries began in 1997. AME assigned 3 periods of injury for each body part beginning in 1998, however my attorney said I could receive the TD but my award would be much smaller due to the different D.O.I.s. I agreed to the 2005 schedule.

I'm still not understanding what Law Advocate stated, "Therefore no the MSA should not be the lump sum amount in my humble opinion - even if all that is left to settle is future medical care.

I have contacted my attorney and am still waiting for a return call, however I am very satisfied with my law firm. I live in Nevada and went for a hearing for additional TD due for psyche, (which Def. atty stated I was already paid due to 5 year rule), and noticed my representative had the Medicare Setaside paperwork. It was not to be discussed at that time until settlement. I am 73 with a business career and should be capable of handling the lump sum and accounting. Please clarify paragraph two in this post.
Thank you. Susie
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Re: MSA lump sum (California)

Postby LawAdvocate on Thu Dec 01, 2016 9:56 am

I am saying the MSA buy out of medical care is not adequate, because there are things that Medicare does not cover - your deductibles, your co-pays, medical treatment mileage, long term hospital care, long term inpatient mental health care, over the counter medications, routine screening tests, acupuncture, home health nurse, care outside of the US, home repairs, dental, blood, etc.
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