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In recent weeks Zero Dollar Allocation MSAs came into question. Initially it was thought that on any claim, even fully denied claims, where approval of a zero dollar MSA was sought, documentation would have to be provided to the Centers for Medicare and Medicaid Services (CMS) to support the zero dollar MSA. This would include submitting 1) Final settlement documents or a statement that none exist, 2) All court rulings including but not limited to rulings on compensability or 3) if no court ruling exists on compensability, treatment records showing no further treatment is needed for the work injury or a statement from the doctor concerning future treatment.
However, additional information surfaced later that indicated the above stricter guidelines would not apply to settlements of completely denied or disputed claims.
As for zero dollar allocation MSAs on accepted claims, it is our understanding that the above guidelines will likely be put in place. In these cases to secure CMS approval, you will need to get a court order that indicates the claim is not compensable or treatment records showing no further treatment for the work injury will be required.
With all that said, we will wait to see if CMS issues any new guidelines via policy memo.
ABOUT THE AUTHOR
This article was written by Joshua G. Holden, Esq., a member of Fish, Nelson & Holden, LLC, a law firm dedicated to representing employers, self-insured employers and insurance carriers in worker’s compensation and related liability matters. Mr. Holden is AV rated by Martindale-Hubbell, which is the highest rating an attorney can receive. Holden and his firm are members of the National Worker’s Compensation Defense Network (NWCDN). The NWCDN is a national network of reputable law firms organized to provide employers and insurers access to the highest quality of representation in workers’ compensation and related employer liability fields. If you have any questions about this submission or Alabama workers’ compensation in general, please contact Mr. Holden by emailing him at jholden@fishnelson.com or calling him directly at 205-332-1428.