Medicare Settlement What’s That?

• Lest injured workers forget, Medicare eligibility kicks in at 65. Enrollment is also permitted for other reasons, and workers’ comp is in the mix. That’s why a portion of the workers comp settlement is put aside, to protect both the injured worker and the government.
• A Medicare settlement, sometimes referred to as a Medicare Set-Aside, is a financial agreement that sets aside an amount of the workers’ comp settlement to pay for future medical care, once the workers comp settlement has run out.
• In the case of workers’ comp, a worker is eligible if they can expect to be enrolled in Medicare just shy of three years of the workers’ comp settlement.
• Experts point out that a settlement is not required by statute, but is advisable if a worker has a workers’ comp greater than $25,000.
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City Finally Compensates Firefighters

• Colorado Springs has finally heeded the call of firefighters and will start paying their claims.
• The city is setting aside a trust to pay firefighters for illnesses that are considered work related, including cancer and cardiac-related illnesses.
• Even though state law considers those conditions as work related, the city has been stingy, refusing to pay more than it thinks is necessary.
• The trust is a premium and state funded supply of money that will allow firefighters to forgo the legal process and get their claims paid for conditions considered presumptive by the state.
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Court: Now It’s Double the Amount

• A West Virginia Appellate Court rules that an employee’s work-related injury was not compounded by other factors.
• David Duff , a sheriff’s deputy, was injured at work while lifting a bomb detector out of a truck . The workers’ comp carrier for his employer awarded him permanent partial disability, but only a portion.
• An independent medical examiner for the insurer concluded that a portion of the impairment was due to a pre-existing back condition, concluding that the pre-existing condition was definitely ascertained and could be apportioned. Duff appealed the decision.
• The appellate court quotes the statute: if a worker has a “definitely ascertainable impairment” from  either a work or non-work injury,” unless the prior condition leads to total permanent disability, the prior condition cannot be taken into consideration for apportionment. The court orders the PPD award doubled.
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