Workers’ Compensation Frequently Asked Questions (Part 2)

  • What are the review thresholds set by the July 23, 2001 All Associate Regional Administrators (ARA) letter concerning WC Commutation of Future Benefits?
  • When an injured individual’s WC settlement does not meet the current review thresholds, will the Regional Offices (RO) provide the settling parties with “verification” letters confirming that approval of a Medicare set-aside arrangement is unnecessary?
  • An injured individual, who does not have a “reasonable expectation” of Medicare enrollment within 30 months of the settlement date, settles his/her WC case for less than $250,000. Once this individual becomes a Medicare beneficiary, will CMS pay for services that are otherwise reimbursable under Medicare, that are related to the WC injury, even though funds still remain in the individual's settlement?
  • Will CMS treat WC cases that were settled prior to the issuance of the July 23, 2001 ARA letter concerning WC Commutation of Future Benefits in the same manner as those settled after the review threshold guidelines were established?