Personal Injury and MEDICARE:  What you need to know about your claim.

Victims of personal injury due to auto accidents, premise liability or any other type of negligence, there are some serious hoops that need to be navigated in your claim.  Many attorneys will be hesitant to take a case with a Medicare and/or Medicaid beneficiary.  When dealing with a third-party payer such as Medicare, there are several important aspects of your claim that you should be aware of.

1.) Contact Medicaid or Medicare to Report the Accident Claim

Federal law requires that Medicare and/or Medicaid be notified of any accident that requires medical treatment.  Often this is handled by a third-party, such as Xerox or Humana.  Often it can be difficult to locate the precise Coordination of Benefits Contractor that holds your personal injury lien.  When you contact them you must identify all medical facilities which you sought treatment and the names of any attorney handling your personal injury case. Failure to report a personal injury case may result in loss of future Medicare/Medicaid benefits.

2.) Medicare Reimbursements

After a settlement with the at-fault party is settled, Medicare requires that they be reimbursed prior to any release of funds to you or your attorney.  This is often a sticking point with large personal injury firms and a reason they are hesitant to take cases from Medicare recipients.  Medicare liens are typically non-negotiable and could wipe out a personal injury settlement if not handled correctly.  It is in your best interest to request and carefully examine the COB Contractors list of medical bills.  In some instances, an unrelated medical expense will be added to the personal injury claim.  In those cases, you may need to call the COB Contactor and have them review your lien.  If the Contractor does not agree with your disputed charges, you have the right to file an appeal.

3). Advantages of a Personal Injury Attorney vs. Representing Yourself

Medicare Reimbursements and liens may be handled by an individual who wishes to represent themselves, however this process is very intense and time consuming.  It is very important to keep a log/record of every conversation and item of your claim.  A Personal Injury Attorney who is familiar with this process is often the best way to go.  Few attorneys will charge you for your injury suit up front, and will instead offer a contingency fee if/when you receive a settlement.

If you have been injured in an auto or premise liability and are a Medicare recipient, there are several things you need to know. At the Law Firm of Massey & Duffy, an experienced Personal Injury attorney will review your claim and assist you in dealing with insurance, Medicare, Medicaid and other third-party payers to ensure you receive the medical care and compensation that you deserve.  Call our office today at (352) 505-8900 to schedule a FREE CONSULTATION.

Personal Injury Doctor Questionaire


Doctor Name:____________________________

Doctor Phone:____________________________

Patient Name: ____________________________

1. Based on reasonable medical probability, is the patient’s condition or disability permanent or continuing in nature? ____________

2. Was the patient’s injury, condition or disability (as referenced in the previous question) caused or aggravated by the car accident of ________________? ______________

3. What is the patient’s permanent impairment rating? ____________________

4. What are the patient’s estimated future medical expenses?

Average Per year_________________

For this many years_______________

5. What type of future medical care and prescriptions will the patient need and for how long?

Future medical care_______________________________________

Years of medical care_____________


Years of prescriptions ____________

6. When can the patient go back to work and what are her work restrictions?

When can go back to work_______________

What are work restrictions________________________________

How long will those last____________________________________

7. Date maximum medical improvement reached:_______________________

____________________________ Date:_________________

Doctor Signature

Deposition Notice

In both Florida and Federal cases, Plaintiffs can notice depositions with certain “areas of inquiry”.  Those can be difficult to articulate, so below is a sample.  Please seek legal advise before using such a thing, such as our lawyers.  Our attorneys serve Gaiensville, Ocala, Lake City and the surrounding areas.  The following is from an employment law case, but with modification it could easily be used to help the injured or in a divorce:

1. Each and every issue raised in Plaintiff’s first set of interrogatories.

2. The answers to Plaintiff’s first set of interrogatories.

3. The current location of each and every document requested in Plaintiff’s first request to produce.

4. Any and all issues related to allegations that the Plaintiff’s work performance was good, bad, poor and/or insufficient.

5. Any and all reasons for the Plaintiff’s termination, reprimands and/or demotion.

6. The job description and job duties of the Plaintiff.

7. Each and every one of the Defendant’s affirmative defenses.

8. The Defendant’s answer to the Plaintiff’s complaint.

9. Knowledge of factual circumstances surrounding Defendant’s answer and affirmative defenses.

10. Knowledge of factual circumstances surrounding Plaintiff’s complaint.

11. The job description and job duties of any and all of the Plaintiff’s supervisors.

12. The identify of any and all persons who’s job duties are similar to that of the Plaintiff.

13. The identity of all persons similarly situated to the Plaintiff.

14. All communications between the Plaintiff and any agent, director and/or employee of the Defendant.

15. All documents written by the Defendant (or its agents, directors and/or employees) to the Plaintiff.

16. All documents and/or letters written by the Plaintiff to the Defendant (or its agents, directors and/or employees).

17. All wages, benefits, earnings, and bonuses earned by the Plaintiff during the course of employment with the Defendant.

18. All reprimands provided (either verbally or written) by the Defendant (or its agents, directos and/or employees) to the Plaintiff.

19. All job duties of the Plaintiff’s supervisor.

20. All job duties of the person whom made (or was involved in any way) the decision to terminate the Plaintiff.

21. Any and all facts regarding those documents requested in Plaintiff’s first request to produce, including the authors of said documents and the circumstances surrounding their creation.

22. All employment policies and practices of the Defendant.