A recent ruling concerning a workers’ compensation case in New Jersey reaffirmed that Medicare Set-Aside (MSA) funds should not be included in the calculation of attorney fees. The case involved a reopener application for a settlement stemming from an accident that occurred several years ago. The petitioner’s counsel argued that the MSA funds, which were allocated for future medical expenses and past Medicare reimbursements, should be counted as part of the gross settlement amount used to calculate attorney fees.
The settlement included a lump sum amount for the worker’s compensation and additional funds to address Medicare’s interests, including the MSA and conditional payments. The petitioner’s counsel proposed that these amounts be included in the total settlement figure for calculating the attorney’s fee, which would result in a higher fee. However, the court disagreed with this position, noting that MSA funds are specifically designated for medical care and should not be considered part of the compensation for lost wages or direct benefits.
The court emphasized that the relevant statutes and federal regulations clearly distinguish between compensation for medical care and compensation for lost wages. The Judge referenced statutory provisions and federal regulations, which underscore that funds set aside for future medical care, like MSAs, are not intended for the purpose of calculating attorney fees. The decision also relied on guidance from other legal professionals, which reinforced this distinction.
Ultimately, the ruling concluded that the MSA funds should remain dedicated solely to medical expenses and cannot be factored into the calculation of attorney fees. This decision reinforces the legal principle that attorney fees in workers’ compensation cases should be based on compensation for lost wages and other direct benefits, not medical funds set aside for future care.
I am pleased to have argued this matter and helped secure this significant win for our client.
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