Many of those involved in the MSA industry (including CMS officials) point to “LMSAs” being approved by Federal District Courts. These cases are circulated on listservs and message boards as reminders that LMSAs may be necessary in certain cases. These cases all carry one extra piece of information worth noting: the underlying injuries were the result of on-the-job events. The four most-circulated examples of “LMSA” cases are:
- Schexnayder v. Scottsdale Ins. Co., US Dist. Ct., W.D. LA (2011). This liability case settled for $2,100,000.00 and an MSA was prepared. Not only did CMS decline to review the MSA, but Health and Human Services declined to participate in the district court hearing regarding an MSA. The court eventually approved an MSA as adequately protecting Medicare’s interests. But the injury occurred in an automobile accident while Schexnayder was in the course and scope of his job. This was not an LMSA. It was a WCMSA.
- Smith v. Marine Terminals of Arkansas, US Dist. Ct., E.D. Ark (2011). This liability case settled for $1,000.000.00 and an MSA was prepared; however, this liability case was actually a negligence claim under the Longshore Act (a/k/a/ Longshore and Harbor Workers Compensation Act). This was not an LMSA. It was a WCMSA.
- Big R Towing v. Benoit, US Dist. Ct. W.D. LA (2011). This liability case settled for $150,000.00 and an MSA was prepared; however, this liability case was actually a claim under the Jones Act (a/k/a/ Merchant Marine Act). It is the seaman’s version of Workers’ Compensation. A $52,000.00 MSA was prepared even though the need for a future surgery was disputed. Nonetheless, it is not an LMSA; it is a WCMSA.
- Guidry v. Chevron USA, Inc., US Dist. Ct. W.D. LA (2011). This liability case was the result of both a Longshore and a Workers’ Compensation case. On top of that, Guidry’s Medicare status was clear as a Social Security Disability application was pending and he was therefore within 30 months of Medicare. An MSA was created; however, it is not an LMSA. It is a WCMSA.
The result of the above is clear: the cases cited are inapplicable to LMSAs as they all involved an on-the-job injury and a reimbursement law comparable to Workers’ Compensation. Is this good news? Or does it just make LMSAs even murkier? For starters, it adds to the one thing we can say for certain: LMSAs are uncertain.
Please contact us for any lien resolution support or assistance. We do offer opinion letters as to whether an LMSA is necessary on any case. In addition to Medicare lien resolution, we can assist you with Medicaid lien resolution, ERISA subrogation, private insurance companies’ liens, and more.Ryan J. Weiner Co-Founder Lien Resolution Services www.lienresolutionusa.com https://lienblog.wordpress.com email@example.com