Workers’ Compensation Document Preparation Services

If you are settling a workers’ compensation claim you need your client’s settlement documents carefully drafted to not only include the terms and conditions of the settlement but language provisions that consider the implication of the workers’ compensation settlement on important collateral benefits such as Social Security Disability, Supplemental Security Income, Medicare, Medicaid, federal/state cash or medical assistance, short or long term disability benefits or public or private pension plan benefits.

Consideration is also given to any potential offset to Social Security Disability benefits due to receipt of concurrent workers’ compensation periodic or lump sum proceeds; Medicare and the need for a Medicare Set-aside analysis; whether or not the settlement meets current review thresholds issued by The Centers for Medicare & Medicaid Services (CMS); and Special Needs Trust implications where your client’s settlement proceeds may render the client ineligible for Supplemental Security Income or Medicaid benefits.

This service provides tailored drafting of settlement documents including important disclosure documents for your client which include the “Informed Consent as to Medical Expenses or Care” and “Notice of Consequences of Your Settlement” forms. These latter two forms provide important plain English disclosure information advising your client of the consequences, obligations and responsibilities which come with the settlement of the claim and how collateral benefits may be impacted.

To request this service please complete and return the Workers’ Compensation Settlement Document Request Worksheet (PDF). Normal turn-around time is 10 business days from receipt of the completed Workers’ Compensation Settlement Document Request Worksheet. The normal charge for preparation of the settlement document and supporting Notice of Consequences of Your Settlement and Medical Informed Consent as to Medicare Expenses or Care forms is $975. Information to secure your client’s Social Security information is an additional $175 charge.

This fee does not include services for preparation of a Medicare Set-aside, Medicare conditional payment notice, investigation or reconciliation, referral of a submission to CMS or to obtain Social Security Administration information. If you need information regarding any of these additional services or fees please refer to the links below.

For additional services and charges see:

1. Medicare Set-aside analysis Medicare Set-aside Services.

2. Medicare Conditional Payment Search/Reconciliation Medicare Conditional Payment Services.

3. CMS Referral Request CMS Referral Services

4. Securing Client Social Security Information Form for Requesting Social Security Information

Contact Information

For a free initial telephone consultation contact me at 860-870-3803.

* Connecticut does not certify lawyers as specialists in Medicare law.

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