Many of our clients worry about who may place a lien on their case. When you’re facing medical bills and a long recovery from an injury, you need to know whether your costs are going to be covered by a settlement offer or a judgment.

We’ve previously discussed that Medicaid and Medicare have the right to recover their costs by placing a lien on a personal injury case. By contrast, we’ve also noted that under Connecticut law, a private insurance company that covers medical expenses generally has no right to lien a case to recoup those costs. But this is not the end of the discussion.

SAGA Cash Assistance Liens

If you are over the age of 18 and you have received benefits “under the state supplement program, medical assistance program, aid to families with dependent children program, temporary family assistance program or state-administered general assistance program,” then the state may place a lien on your personal injury case. Conn. Gen. Stat. Sec. 17b-94. The amount of the lien can be the full amount of the benefits received or fifty percent of the recovery after certain litigation costs are subtracted, whichever is less.

Prison Liens On CT Personal Injury Cases

Some folks think when they have done their time that they have paid their debt to society, only to learn that society will then send them another bill.

If you have been incarcerated within the past twenty years, the state may lien your case to recoup its costs. Conn. Gen. Stat. Sec. 18-85b. This lien would take priority over any lien for state assistance, and it would be equal to the full cost of incarceration or fifty percent of the recovery after certain litigation costs are subtracted, whichever is less. These liens are commonly called incarceration liens.

If you’re concerned about a lien on your personal injury case, it’s important to speak with an attorney so that you fully understand your rights. On this blog we speak in general terms, but every case is unique and that’s where trusted counsel can help.

One of the best things you can do is to let your attorney know if you were incarcerated or have received cash assistance. Different rules apply in wrongful death cases.

Call us if you have any questions contact Hartford Personal Injury Lawyer Ryan McKeen.

The post Cash Assistance And Prison Liens On CT Personal Injury Cases appeared first on CT Personal Injury Lawyer.

If you’ve been hurt in a car accident and you’re a recipient of Medicaid, the last thing you want to hear is that Medicaid may lien some of your recovery. You may be a single parent, raising young children and struggling to make ends meet. We understand. We have many clients in your position. It’s hard to make ends meet in Connecticut.

Many people in CT receive assistance in the form of Husky Insurance.

However, you should know that state and federal law give Medicaid the right to recover related medical costs.

We’ve previously discussed the extent to which Medicare may place a lien on a personal injury case.

Not surprisingly, Medicaid has rights to reimbursement, too.

What is Medicaid?

Medicaid was created in 1965. It is a joint program between the state and federal governments to provide assistance to those who struggle to pay medical expenses. Each state administers its program for its citizens.

Every Connecticut recipient of Medicaid has agreed to allow Medicaid to recover medical costs caused by third parties. Conn. Gen. Stat. Sec. 17b-265.

In fact, if you’re a Medicaid recipient, the state has the automatic right to directly pursue the person responsible for your injuries–this is called subrogation. In Connecticut, when a person has subrogation rights, that person also has the right to place a lien on a recovery.

If there is any good news, it is that Medicaid is only entitled to lien the portion of a recovery related to medical costs. Sometimes Medicaid does not even put liens on CT personal injury cases. And often times when they do, we negotiate a reduction.

An experienced Connecticut personal injury attorney can help you properly navigate these sometimes complicated waters.

This is Part II of our series on liens on CT personal injury cases. Click here to read Part I.

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When someone gets injured their world gets turned upside down. Suddenly the hospital is asking you to sign papers. Lots of papers. Financial responsibility papers. And that’s just the hospital.

There are calls from insurance companies. And people you have never heard of threatening that if you don’t pay they’ll send you to collections.

You didn’t sign up for any of this. Your life turned on a dime when someone decided looking at their phone was more important than keeping their eyes on the road.

The good news is that many CT injury firms like ours – operate on contingency fee agreements. Meaning there’s no money up front. We only get paid when we recover money for you. This keeps the doors of the courthouse open to the injured.

You think about getting a lawyer. But where to turn? The internet is spammed with people wanting to help you. And how do you pay for a lawyer? What are fee agreements in CT personal injury cases?

Here is what you need to know:

Fee Agreements In CT Personal Injury Cases Must Be In Writing And Signed

A lawyer in CT cannot receive a fee in a personal injury case if the agreement is not in writing and signed by the client. You should never feel pressured to sign a fee agreement with an attorney. You have the right to read it over and asked questions.

The Statutory Fee Agreement

The language below is taken right out of our firm’s standard statutory fee agreement (though we call them client agreements).  This agreement is set by Connecticut General Statute 52-251c.

Agreement . This is an agreement between the attorney and the client. The client hires the attorney to represent the client with respect to (a)_______  that occurred on _______________.

Expenses . The client will pay for all expenses. The client will reimburse the attorney for all expenses advanced by the attorney. “Expenses” include court fees, investigation expenses, expert fees and all other necessary costs. The expenses are in addition to the legal fees.

Legal Fees  The “gross recovery” includes all money that is collected (recovered) from others arising from the matter(s) described in Section III. The legal fees shall be based upon the gross recovery of any award, verdict or settlement arising from the matter(s) as follows:

Thirty Three (33%) percent of the gross recovery. It is also understood that the following fees are in effect for all sums recovered, by settlement or verdict, in excess of $300,000.00:

Twenty five (25%) percent of any award or settlement in excess of Three Hundred Thousand ($300,000.00) up to Six Hundred Thousand ($600,000.00) Dollars;

Twenty (20%) percent of the next Three Hundred Thousand ($300,000.00) Dollars;

Fifteen (15%) percent of the next Three Hundred Thousand ($300,000.00) dollars; and

Ten (10%) percent of any amount which exceeds One Million Two Hundred Thousand ($1,200,000.00) Dollars.

The Statutory Waiver Agreement

In complicated cases, an attorney may ask for a “Statutory Waiver Agreement”. The statutory waiver agreement waives the limitations set forth by the statutory agreement and will entitle the attorney or law firm up the a fee of 33% of gross amount recovered.

When Does A Statutory Waiver Agreement Apply?

The statute makes it clear that it should only apply to complex claims:

Notwithstanding the provisions of subsection (b) of this section, a claimant may waive the percentage limitations of said subsection if the claim or civil action is so substantially complex, unique or different from other wrongful death, personal injury or property damage claims or civil actions as to warrant a deviation from such percentage limitations. Factors that may indicate that a claim or civil action is substantially complex, unique or different from other wrongful death, personal injury or property damage claims or civil actions include, but are not limited to, if the claim or civil action (1) involves complex factual medical or legal issues, (2) involves serious permanent personal injury or death, (3) is likely to require extensive investigation and discovery proceedings, including multiple depositions, or (4) requires independent expert witness testimony. For the purposes of this subsection, “independent expert witness testimony” means testimony, whether at trial or in a deposition, from an expert who has not participated in the care of the claimant and has not participated in any official investigation of the incident involved.

What Are The Requirements For A Statutory Waiver Agreement?

There are very specific steps that an attorney must do to obtain a statutory waiver agreement from a client. The are spelled out by statute:

(d) Prior to a claimant entering into a contingency fee agreement that provides for a fee that exceeds the percentage limitations of subsection (b) of this section, the attorney shall (1) explain the percentage limitations of subsection (b) of this section to the claimant and the reasons the attorney is unable to abide by those limitations; (2) advise the claimant of the claimant’s right to seek representation by another attorney willing to abide by the percentage limitations of subsection (b) of this section; and (3) allow the claimant a sufficient period of time to review the proposed contingency fee agreement and, if the claimant wishes, seek representation by another attorney prior to entering into such agreement.

(e) No waiver of the percentage limitations of subsection (b) of this section shall be valid unless the contingency fee agreement (1) is in writing, (2) sets forth in full the fee schedule of subsection (b) of this section, (3) contains a conspicuous statement, printed in boldface type at least twelve points in size, in substantially the following form: “I UNDERSTAND THAT THE FEE SCHEDULE SET FORTH IN SECTION 52-251c OF THE CONNECTICUT GENERAL STATUTES LIMITS THE AMOUNT OF ATTORNEY’S FEES PAYABLE BY A CLAIMANT AND THAT THE STATUTE WAS INTENDED TO INCREASE THE PORTION OF THE JUDGMENT OR SETTLEMENT THAT WAS ACTUALLY RECEIVED BY A CLAIMANT. NOTWITHSTANDING THAT THE LEGISLATIVE INTENT IN ENACTING THAT FEE SCHEDULE WAS TO CONFER A BENEFIT ON A CLAIMANT LIKE MYSELF, I KNOWINGLY AND VOLUNTARILY WAIVE THAT FEE SCHEDULE IN THIS CLAIM OR CIVIL ACTION.”, and (4) is signed and acknowledged by the claimant before a notary public or other person authorized to take acknowledgments.

What Are The Differences?

Basically in a big case a statutory waiver agreement will result in a larger fee to the lawyer or law firm. This may be necessary for a firm to economically justify the expense and risk of the litigation.

For the client, an attorney cannot seek costs if no recovery is made in a statutory waiver case. The attorney is responsible in the event of no recovery not the client. Without the statutory waiver it is the client who is responsible for costs in the event of no recovery. Here are common costs in CT personal injury cases. 

Different firms have different policies on this. It is our belief that the language is required to seek costs from the client, however it is our decision whether or not to pursue a client. We don’t pursue our clients for costs in the event of no recovery.

If you have any questions please call  us (860) 471-8333.

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After you set up a meeting with an attorney for the first time, you will probably have a lot of questions. Like “do I have a case?” or “how long will my case take?”

One question we’re asked all the time is, “What documents should I bring to our first meeting?” This post will cover the basics. Don’t worry if you don’t have all of these things. We can have you sign authorizations and get them for you.  Every personal injury case is different. And every case can require different documents. These 8 things are generally good documents to provide to your attorney as soon as possible if you have them.

Driver’s License:

This is for simple identification purposes. A driver’s license tells us the correct spelling of your name, your current address, and your date of birth–all of which are necessary for us to have on file.

Health Insurance Card:

We work with injured people, so we deal with insurance companies a lot. It is necessary for us to have your health insurance information in order to have a full understanding of your coverage and recovery.

Medicare ID:

We are required to report claims to Medicare, so if Medicare is covering the medical costs for your injury, we’ll need to know this. We will only need this if you are on Medicare.

Auto Insurance Policy:

If you’ve been in a car accident, we’ll need to have your auto insurance policy information on file. Why? We may have to pursue an underinsured motorist claim, or you may have other benefits that we can help you to obtain. You may have medpay benefits.

A Recent Tax Return:

If you’re missing work because of an injury, a recent tax return tells us who your employer is and what your earnings are. These lost wages are important as we negotiate a settlement or prepare for trial. If your case gets put into suit and there is a lost wage claim the defense attorney will be entitled to 3 years of tax returns.

Accident Photos:

If you have ’em, we need ’em. Accident photos are critical documents as we negotiate a settlement or prepare for litigation. More immediately, they help us to understand what happened to you.

Police Report or Accident Summary:

If you were just in a car accident and the police were called to the scene, the reporting officer probably gave you a slip of paper. This is an accident summary. We use this document to order a police report and to identify the person or persons who struck your vehicle. The accident summary will contain their insurance policy information, which we will use to send a letter of representation to their insurance company.

Medical Documents:

If you happen to have bills or medical records, please bring them. If not, don’t sweat it. We ask all of our clients to sign a release so that we can order their complete medical records pertaining to their injury.

That about covers it. These are the 8 things to give to your CT personal injury attorney. If we need anything extra from our clients, we discuss it at our meeting. But bringing these documents gives us what we need to hit the ground running. These are the documents in personal injury cases that will help your lawyer prosecute your case.

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So you’ve been in a car accident and you’ve mentioned to a friend that you’re talking to an attorney. Your friend says, “Why bother? Isn’t any money you recover going to be eaten up by liens?” And suddenly you’re not sure.

When you are over 65 and on Medicare – every penny matters. You live on a fixed income. And sometimes have to choose between buying food or paying for prescription medications.

Being in a car accident wasn’t something you planned for. And it is made a tough financial situation near impossible.

What is a medicare lien, exactly? Who may have a lien on your case? What is a lien in a personal injury case?

A lien is an amount of money that must be paid to someone else after you receive a settlement or a judgment. For example, if you receive $10,000 from a settlement but there is a $2,000 lien on your file, then you are entitled to receive $8,000. Basically, it’s a bill that must be paid.

What liens are not allowed in a personal injury case in Connecticut?

Generally speaking, if an insurance company has paid for your medical costs, they are not entitled to recover those costs from you or the person who caused your injury. So if you’ve been in a car accident and have required surgery, and your insurance company covered that surgery to the tune of $100,000, Connecticut does not allow your insurance company to put a $100,000 lien on your file. Conn. Gen. Stat. Sec. 52-225c.

Of course there are some big exceptions to this rule, so keep reading. Including self-funded ERISA plans and medicaid.

Who is allowed to place a lien on a personal injury case in Connecticut?

In a word, Medicare.

If you are receiving Medicare benefits for your injury, then Medicare has a right to place a lien on any amount you recover. In fact, your attorney is required to notify Medicare that you are seeking recovery from the person who caused your injuries so that Medicare can evaluate your case for repayment. 42 U.S.C. §1395y(b).

You may be thinking: why tell Medicare in the first place? Well, because the United States can sue for double the amount up to six years later if they don’t get their money in the first place, and no one wants that. 28 U.S.C. 2415(a). The good news is that sometimes your attorney can negotiate with Medicare to significantly reduce the lien.

So, are all Medicare plans allowed to lien a personal injury file?

No. That would be too simple.

If the insurance covering your treatment is a Medicare supplemental health plan–otherwise known as Medi-Gap insurance–then there is no right no recovery. Why? Because supplemental Medicare plans are not really Medicare plans, but private health insurance that is used to compliment Medicare coverage. Remember that in Connecticut, the general rule is that private insurance providers may not recover their costs. Conn. Gen. Stat. Sec. 52-225c.

What about Medicare Advantage plans? Can they place a lien on my file?

We don’t know. This is a question that Connecticut courts haven’t fully addressed. There are good arguments against paying such a lien, but there is also unfavorable case law from other states.

In short, Medicare Advantage plans are private insurance plans that are approved by Medicare. Federal law (42 U.S.C. §1395mm(e)(4)) authorizes these private insurers to recover costs from their insured, and many have placed this right to recovery in their contracts. But are these contractual provisions valid under Connecticut law, considering that we don’t allow private insurers to recover their costs?

We just don’t know. It’s not clear whether the federal law is intended to trump state law. This is a question that your attorney will need to evaluate because if your Medicare Advantage contract does not include the language to permit recovery, case closed. They cannot lien your file. But if the contract does include that language, then your attorney must consider how to proceed.

Of course, as with Medicare, it is sometimes possible for your attorney to negotiate and significantly reduce a Medicare Advantage lien. We don’t take Medicare Advantage Liens at face value. Many of them are bogus liens.

If you have been injured and you’re concerned about liens that may be placed on your file, please call me at 860-471-8333.

You may also like:

Who Pays My Medical Bills After A Car Accident?

3 Questions To Ask A CT Car Accident Attorney

Expenses In CT Personal Injury Cases

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