Workers’ Comp Settlement and Medicaid: What You Need To Know

Michigan lawyer discusses workers’ comp settlement and Medicaid.

Workers' Comp Settlement and Medicaid: What You Need To Know

Michigan work injury law protects employees hurt on-the-job. It pays lost wages to employees who are disabled from working. It also covers all reasonable and necessary medical treatment without copayments or deductibles being owed. Unfortunately, insurance companies do not always want to pay work injury benefits and file disputes. Here is some information about workers’ comp settlement and Medicaid that everyone should know.

Your Right To Medical Care

Access to medical care is one of the most important benefits after being hurt on-the-job. Employees hurt on-the-job are covered regardless of their fault. The amount paid for medical bills is controlled by a state-wide fee schedule and a patient cannot be charged extra or balance billed. There are no copayments or deductibles owed. Employees can select their own doctor after 28 days from the start of medical care.

Insurance companies frequently dispute medical treatment. This is usually based upon “peer review,” in which a medial professional decides if treatment is appropriate. Our experience shows that peer review is not a fair process, and the treating physician is never contacted for an opinion.

Insurance companies also use the independent medical examination (IME) to dispute medical treatment. These doctors usually take no longer than fifteen minutes to examine someone and write nonsensical reports that answer loaded questions. Insurance companies handpick these doctors because they know what they are getting, and some make careers out of testifying in court.

Many of our clients want to know how to get medical treatment when their worker injury claim has been disputed. This is where a workers’ comp settlement and Medicaid for medical treatment come into play. We recommend they submit disputed medical bills to Medicaid for payment. This ensures our clients have access to medical treatment and ongoing evidence of disability.

Reimbursements

An employee hurt on-the-job can trade their entitlement to work injury insurance benefits for a lump sum cash payment. If they are awarded a workers’ comp settlement in Michigan they must reimburse Medicaid for any related payments it might have made for treatment.

The amount of reimbursement will be limited to 50% of the net settlement so a worst case scenario is money gets split equally.

Medicaid also pays contract rates for charges. These will always be less than if a person was a cash payer with his or her doctor. Medicaid will also subtract an attorney fee from its lien and these savings can be passed along to the disabled employee in the settlement. The amount of payback to Medicaid will usually be pennies on the dollar.

Do not let the insurance company save money at your expense. File an Application for Mediation or Hearing and let the magistrate decide about payment of medical treatment. A workers’ comp settlement and Medicaid can be coordinated in a way that allows for maximum recovery.

Michigan Workers Comp Lawyers never charges a fee to evaluate a potential case. Our law firm has represented injured and disabled workers exclusively for more than 35 years. Call (844) 316-8033 for a free consultation today.

Related information:

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Workers\' Comp Settlement and Medicaid: What You Need To Know
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