What Is Medicare Set Aside? When a worker’s compensation case settles, Medicare wants to make sure that it will not have to pay for medical treatment that would have been covered by the WC carrier. Consequently, vendors are hired to predict and estimate your annual medical care costs for your work injuries during the remainder of

If your claim is accepted, you are entitled to Temporary Total Disability (TTD) payments in the event you are not able to work due to your work injury. TTD benefits are calculated based on 2/3 of your Average Weekly Earnings based on your earning capacity, not necessarily your actual wages.  TTD benefits continue until the doctor

Your doctor may have determined that you are capable of returning to work but not performing your usual duties. If the doctor has provided work restrictions, then your employer has an affirmative duty to find modified or alternative work that you are physically capable of performing. It requires the employer to discuss with you the limitations

All medical treatment must be recommended by the physician. The physician must submit the treatment request, in writing, on a form called Request For Authorization (RFA).  Once the WC carrier receives the RFA, it may either approve the RFA or send it to its Utilization Review (UR) department. The UR department has 5 business days from the

During the course of your claim, the worker’s compensation (WC) carrier may offer you a lump sum settlement, called a Compromise and Release (C&R). The advantage of settling your claim is that you may choose your own doctor instead of being forced to use the WC carrier’s doctors. You may decide when you get the treatment and