Set Asides No Longer Used For Workers Compensation Settlements

As many Philadelphia workers know, workers compensation can often be difficult to get, even when it’s completely deserved and there should not be any issues. Often times, just to get what is right, a workers’ compensation settlement may be the best course of action to ensure the necessary benefits are received. A recent case, however, should make receiving benefits a little bit easier.

A large insurance company recently settled a case and agreed to pay $3 million to avoid facing criminal proceedings because they were “inappropriately accessing” Medicare records for their own benefit. What the company would do is check the Medicare eligibility for a worker’s compensation client and then offer a “set-aside arrangement” with the company to pay future medical costs for Medicare-eligible workers. The primary purpose of accessing these files was to give this company an unfair advantage in the insurance industry. In addition to being forced to pay the $3 million, the company is also going to provide private training to their employees who have access to government files. This is good for claimants because it now makes the process not only easier, but takes better steps to ensure their privacy.

Workers’ compensation claims are important to injured employees. Employers are barred by law from discriminating against or unfairly firing a worker for filing a worker’s compensation claim. Many times, worker’s compensation is the best way an injured employee can get compensation when injured on the job and the funds in the Medicare set-aside are used for future medical needs in these claims.

It’s very important for injured workers to have access to workers’ compensation funds. Discrimination based on workers compensation filings can come in many forms, including firing demotion or losing salary. An injured worker should not face these issues alone as the claims filing process may be complex. Injured workers and their families should be free to focus on recovery.

Source: Business Insurance, “Coventry to pay $3 million to settle Medicare set-aside investigation,” Nov. 21, 2012