A Medicare Set-Aside account or MSA is used when you are eligible or it appears you will be eligible for Medicare either as a result of receiving Social Security Disability Income benefits or because you are entitled due to your age. Medicare is not supposed to pay for treatment which you have received as a result of your injury. The amount of the MSA is an estimate of how much your future medical treatment for your work injury will cost. After settlement, you must place the money for the MSA into a separate account to be used only for payment of medical treatment and related expenses arising from your work injury. Your failure to properly use this money and account for it can result in a denial of Medicare benefits for other non-work related medical treatment.
No, there is are no benefits or recovery for pain and suffering in a workers’ compensation claim.
In addition to medical and income benefits, the third type of benefit you are entitled to receive is permanent partial disability or “PPD.” This benefit seeks to recompense an employee who has suffered a permanent in duration, but partial in quality, disability as a result of his injuries. The employee is given a percentage disability rating by his doctor based on certain impairment tables published by the American Medical Association. For instance, if an employee loses a finger, the tables may call for a 3% permanent partial disability rating to the arm as a whole. This percentage is applied to a number of weeks set by statute — in the case of an arm it is 225 weeks – and then multiplied by the weekly income benefit or “comp rate” of the employee, which yields a figure to which the employee is entitled. In theory, PPD does not compensate for the loss of the finger. It compensates the employee for his future inability to earn wages due to the injury. For this reason, an employee who earns $20 an hour will be entitled to recover twice as much for the same loss suffered by another employee who earns $10 an hour.