Ohio BWC Settlements & Medicare

by michael on January 22, 2011

Attorneys for Ohio injured workers need to take extra precautions in filing a settlement application on a state fund claim with the Ohio Bureau of Workers’ Compensation according to Tina Kielmeyer, Chief of BWC Customer Services. Where the injured worker is a Medicare recipient(65 or older or on Social Security Disability for at least 24 months) the BWC is requesting that the injured worker’s attorney obtain a Conditional Payment Letter(CPL) from the Medicare Secondary Payer Recovery Contractor(MSPRC) which includes an interim  conditional payment amount before approving final settlement of the claim. MSPRC does not provide a final demand amount until after the case settles. Conditional payments are those payments made by Medicare from the date of the incident(accident) through the date of settlement which have been made or can reasonably expected to be made under the workers’ compensation law.

Obviously, obtaining a CPL for the BWC will require additional effort by the attorney along with creating further delays on final BWC settlement approval. Obtaining a CPL can often take up to 2-3 months and a final demand amount can often take an additional 2-3 months. It is therefore recommended that the initiation process with the Coordination of Benefits Contractor(COBC) commence prior to filing the application for settlement approval.

Click here for CMS website


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