State Workers Compensation claims are becoming more complex.  In the past, if the insurance company, the employer, the injured worker and their lawyer agreed to a compromise settlement, a Maryland workers compensation judge could approve the settlement and payments would then be made.  Now the Maryland Workers’ Compensation Commission (WCC) is proposing to make permanent a regulation requiring federal approval of medical set-asides before the state will sign off settlements.  This additional step has been in effect as an emergency rule since Jan. 4, 2010 according to a report in WorkCompCentral in which multi-state comp lawyer Doug Landau of the Herndon law firm ABRAMS LANDAU, Ltd. was interviewed this week.

The proposed regulation will require the Center for Medicare and Medicaid Services (CMS) to approve all claims that meet the agency’s threshold for review.  Settlements that do not meet the CMS review threshold are required to include a statement confirming that the interests of CMS have been considered and to identify the amount of the proposed settlement that is apportioned for future medical expenses.  CMS requires approval on settlements where the claimant is 65 or older, is a Medicare recipient or has a reasonable expectation of becoming eligible for Medicaid within 30 months and the anticipated total settlement for future medical expenses and disability exceeds $250,000.  The WorkCompCentral article relates. “One of the lessons learned by Doug Landau, an injured workers’ attorney located in Herndon, Virginia, is that CMS approval is a long process.  It takes at least 90 days to get a response, he said.  Landau thinks regulations like the one proposed in Maryland will start popping up throughout the country.”