(6) Death claims
(7) Claimant dies at time of settlement
(8) Minor Children
(9) Claims involving fraud
(10)Discrimination under §120
Issues that can not be resolved
(11) Sites of injury
(12) Quitting, resigning, or retiring
(13)Reapplying for employment
(14) Make a third party part of the agreement
(15) Other jurisdictions
(16) Future injuries or claims
Settling a claim versus keeping it open
Stipulations
Summary
CHAP 6 - WHAT IS A GOOD DOLLAR VALUE
COMPENSATION AND MEDICAL EXPENSES
COMPENSATION
Established and claimant classified
ATF (Aggregate Trust Fund
Mortality Tables
Established but compensation rate not yet fixed
Controverted, i.e., not yet established
Claim established but not anything else
Established but compensation rate not yet fixed
Some prior settlements as a guide
Summary
CHAP 7 - MEDICAL EXPENSES
Established Sites of Injury
Bills for disputed sites of injury
Expenses for expected future medical treatment
Expenses for unexpected future medical treatment
Other medical insurance the claimant may have
Medicare
Summary
CHAP 8 - AGREEMENTS WHICH EXCLUDE MEDICAL
Options
CHAP 9 - §32 LEGAL FEES
What is the law on fees?
From whose money is the fee paid?
Who writes out the check for the fee?
What is a fair fee?
If the claimant thinks the fee is unfair?
Can an attorney not in the agreement ask for a fee?
• Prior attorney seeks a fee
• Current attorney is left out of agreement
Law judges and legal fees
Summary
CHAP 10 - HEARINGS
Pre-Hearing Coaching
Summary
CHAP 11 - IS THE MONEY ALL YOURS
Child support liens can be deducted
Disability Claims & Liens can be deducted
Taxes or credit card bills can not be deducted
Third-party law suits
But ... after the check is deposited
Monthly Payments
Annuity Accounts
Other investments
CHAP 12 - WHO PARTICIPATES IN THE AGREEMENT?
Parties of Interest
• UEF: Uninsured Employers Fund
• Special Funds
• Second Injury Fund
• Another Carrier
• Self-Insured Employer
• Self-Insured Group Trusts
• New York City, counties, towns
• Guardianships
Interested Parties
• Claimant’s attorney
• Medical provider
• Claimant’s spouse and/or children
• The employer
CHAP 13 - MEDICARE & SET-ASIDES
Medicare Set-Asides
Medicare set aside disclosure form
Medicare Regulations
Medicare Review
How is the Set-Aside calculated?
What happens to the Set-Aside funds?
None-work related medical needs
When the Set-Aside is gone
Summary
CHAP 14 - FREQUENTLY ASKED QUESTIONS
• What if I have more than one case?
• What if more than one carrier is involved?
• If I am a widow(er) can I settle my portion and not my children’s portion of the claim?
• Can I Settle only one of two cases
• ‘Consequential’ injury and a ‘Casually Related’ injury
• What happens if there is an appeal in process on an issue being resolved with the §32
• Can I change my mind once the settlement is approved?
• Can I ever get my case reopened?
• What if there are questions about the interpretation of the agreement?
• Out-of-pocket expenses
• What if my medical provider has not sent in all his bills by the date of the settlement?
• What if I need expensive surgery which no one contemplated at the time of the settlement?
• What if my private health carrier or Medicare insist that the treatment I need is covered by
my §32 settlement and they won’t pay for it?
• What if they insist I pay for my treatment & I don’t have the money?
• If I accept an agreement, what is the latest I can change my mind?
• Can anyone stop me from getting the settlement or interfere in the negotiations?
• Can anyone take the settlement money away from me?
• Do I pay income taxes on the money I get from a settlement?
• Can anyone find out the size of my settlement or see the actual agreement?
• Can I return to work?
• Does the settlement effect my Social Security or Medicare?
• What is “Money Moving”?
CHAP 15 - A FEW FINAL WORDS
APPENDIXES
Appendix A: The 10 Basic Questions for the §32 Hearing
Appendix B: My Lump Sum Speech
Appendix C: My Lump Sum Hearing Questions
Appendix D: WAMO Guidelines
Appendix E: A Generic §32
Appendix F: C-4 Medical Report & Bill
Appendix G: Social Security Mortality Table
Appendix H: Annuity Agreement
Appendix I: NYCRR §300.36
Appendix J: Closed means "CLOSED"
Appendix K: Medicare SetAside Disclosure Form