Third Party Credit (California)

[ocesquire]

SCENARIO:

1. The workers compensation case resolves by life pension Stipulated Award.

2. Next, the Third party civil case goes to trial. It is a very large trial result. The judgment is more than the value of the workers compensation case. The workers compensation carrier works out a deal on the amount of reimbursement they want and gets paid.

3. The workers compensation carrier keeps paying the applicant PDA's on the life pension. The workers compensation carrier has talked about a Third Party C&R or Petition for Third Party credit , but does zero.

4. As applicant attorney I am concerned that the carrier might do the following:

4.1 File for third party credit requesting the judge do the following:
Order Applicant to pay back all PDA's received after the Third Party case went to judgment.
Order Applicant to resolve all medical bills incurred after the date of the Third Party case went to judgment.

5. If the Judge orders the Third Party Credit is increased by medical expense and PDA's post third party case judgment that is not a problem. Applicant will likely never get past the credit anyways. I am concerned on a judicial order where the Applicant has to pay reimbursement out of his pocket to the insurance carrier for PDA's and medical providers on medical expense incurred post third part civil case judgment.



QUESTION:
1. Is the amount applicant receives from workers compensation carrier in PDA's and medical expense from the date of third party civil trial subject to actual reimbursment by applicant OR, if filed, just subject to increased Third Party Credit?

[jpod]

While I can not cite authority, I beleive the court can only order a credit for those overpaid sums against future benefits that may be owed or awarded. I have never seen a WC court order applicant to repay funds. I think the WCJ is limited by LC 4909. That section says the judge can take into consideration funds that were paid, but not due, when fixing compensation.

While you didn't discuss it in your post, did you protect Medicare's interests with repsect to the third party recovery?

[laesquire]

Hi Jpod

Thank you for your post.

In theory the defense is getting an MSA.