Back to Columns | Print Column | ||
State: Ariz. Goldstein: Full and Final Settlements: [2018-08-16] |
||
|
||
The Administrative Law Judge Division of the Industrial Commission of Arizona has issued guidance for cases involving full and final settlements, in the form of an informative and suggested best practices document. The document applies to full and final settlements that take place on or after Aug. 3, 2018. You may recall a recent blog entry on a modification to the 2017 Arizona law that enabled full and final settlements, or the permanent closure of claims. Prior to the 2017 law, a claimant could reopen a claim at any time, despite the finality and resolution of the claim. The 2017 law allows for future medical claims to be completely resolved, meaning claims cannot be reopened once settled, even if medical treatment has changed or additional medical treatment is required. The most significant points of the recently issued guidance, as related to Medicare Secondary Payer compliance, include:
Takeaway and commentary This “best practices” document, in addition to the clear and plain language of the Arizona law, indicates the need for a thorough and accurate projection of a claimant’s future medical needs, best done through a reasonable Medicare set-aside allocation. A reasonable allocation is one that clearly documents the claimant’s medical condition, includes a clinical analysis supported by legal evidence and provides an accurate breakdown of all future costs, including medical and prescription drug treatment. This advisory document further suggests that settlement documents should outline the steps and actions taken to attain MSP compliance. Using appropriate settlement language and papering your file is of utmost importance. In the process of doing so, a claimant’s Medicare or Social Security Disability status should be determined and adequately reflected in the settlement. As further suggested in the document, the interests of all secondary payers must be considered. This means that in addition to setting aside appropriate future medical costs, the parties should remember to conduct a conditional payment inquiry to ensure that all conditional payments and liens have been resolved and satisfied, prior to settlement. Jean S. Goldstein is senior legal counsel for Medval. This post from the Medval blog is republished with permission. |