Articles Posted in Litigation Strategies

Almost two years ago now, Medicaid/Medicare liens became even more difficult to deal with as the law pushed to the lawyers and insurance companies the obligation of confirmation and resolution of Medicare/Medicaid liens. I’m sure betting an insurance company has yet to receive a fine for not verifying a lien before paying a personal injury settlement. But nobody wants to be the first.medicare lien law

Medicare, Medicaid and State Children’s Health Insurance Program Extension Act of 2007 created so many headaches people starting fighting back. In Haro v. Sebelius, an Arizona case in U.S. District Court, Medicare beneficiaries (and, interestingly, a personal injury lawyer in his own capacity) challenged – as a class – two things: (1) Can Medicare/Medicaid (hereinafter “Medicare because I’m sick of the slash) “require prepayment of a reimbursement claim before the correct amount is administratively determined where the beneficiary either appeals or seeks a waiver of the MSP reimbursement claim?, and (2) Are personal injury lawyers financially responsible for reimbursement if they do not hold or immediately turn over to Medicare their clients’ personal injury settlement awards.

Personal injury lawyers are completely in a pickle on these liens. Our clients want their money; we want to get them the money they are entitled to get. The question is whether personal injury attorneys are precluded from giving the clients their settlement money until after Medicare’s claim has been satisfied, and, let’s be honest, whether Medicare can recover the reimbursement claim directly from the attorney if the client cannot pay the reimbursement claim after the settlement money has been turned over to the client.

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The Lawyers Logbook has an article on truck accident claims by John F. Romano that I really liked. I read a lot of articles by lawyers on handling personal injury cases. Honestly, you have to kiss a lot of frogs to find something interesting or useful. Usually, what you get is a lot of trite advice providing information that you already knew. (If this blog is doing that, tell me and I’ll stop writing immediately.)

John’s article has an “I can feel you have been in the trenches” vibe with really insightful commentary. His favorite from the article was his theory that you have to be on guard of what he calls “the man behind the curtain” strategy.settlement tactics

If you have handled large cases, you know exactly what it is. “Hey, Ron, what are we doing here? Let’s get this case settled. Give me a real demand and let’s get this thing behind us.”

John’s angle on this is that it causes you to drop your guard and assume the case will settle early. I don’t think many good personal injury lawyers drop their guard in this situation and, if they do, they have the make-up speed to get the case back on track. The best plaintiffs’ advocates load before firing – your case should be ready to go when you file the lawsuit, anyway. So, maybe you take a few late drops but it all should work out the way it would have before the bait and switch.

But I think some of the best personal injury lawyers get tripped up by this tactic differently. The lawyer goes back to the client and says, “If we could get X, that would be a great value for this case. Would you be willing to accept X? The client agrees to X. So the lawyer demands X + 50%. The defendant does nothing with the offer and the case proceeds. The lawyer realizes the whole thing was a ruse and gets back to the business of getting the case ready for trial.

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independent medical examination doctors

For some IME doctors, every x-ray is negative

Insurance companies have “go to” doctors for “independent” medical exams. These doctors operate by either (1) the sincere conviction that virtually no one is as hurt as they say they are or, (2) by financial motivation.

My money is typically and cynically on the latter. There are some true believers, but I suspect most of the true believers retrofit their zealotry to match their economic interests. These are doctors who insurance companies name as their experts before they ever speak to them.

It is uncanny.  Even in the very worst, most obvious case, they find something — anything — to earn their keep.  I was just looking up an IME today where the kid’s knee was just torn up from the floor up.  He needs a knee replacement.  A tragedy for a young kid.  So the expert gives us that.  But then says that the one knee will last him a lifetime.  EVERY OTHER EXPERT says it will last 10 years.

It makes sense: they don’t have to because they know exactly what the expert will say. We rarely need to depose them because I could write their testimony out for them. The insurance company knows what they will say, I know what they will say, the judge knows what they will say. Like Avon Barksdale said, “The game is the game.”

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medicare liensI’ve never filed a motion to enforce a settlement and I don’t think anyone in my firm has. I think as far as I’ve come is threatening to file a motion, but it never comes to that.

That streak may not survive as insurance companies continue to overreact to their risk of Medicare or Medicare coming back to haunt them after a settlement. Sure, there are theoretical potential penalties if Medicare and/or Medicaid liens are not dealt with out of the settlement funds. I don’t have a problem with insurance companies trying to reduce their small risk. But some insurance adjusters handling claims in Maryland are cementing their reputation of being unreasonable by taking extreme positions on what post-settlement hoops plaintiffs’ lawyers must jump through to get a check.

Torts Talk, a defense lawyer oriented blog I just stumbled upon, talks about how a Pennsylvania judge dealt with this issue. Plaintiff’s attorney filed a Motion to Enforce a Settlement when the insurance company refused to issue a settlement check after a car accident settlement until the Plaintiff produced documentation confirming the status of any Medicare/Medicaid lien.

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I read somewhere recently that making Top Ten lists really attracts readers. Regrettably, I don’t know ten things about fighting medical liens that I think you don’t know. But I know a few.information on liens

I’ve been working harder and harder, trying to better understand the ins and outs of subrogation liens that arise in personal injury cases. With some of the larger cases, we farm out lien work to firms that focus only on resolving lien issues. But there are so many basic things I think personal injury lawyers need to appreciate about lien issues. Anyway, here is my Top Five list:

1. The mere fact that it is an ERISA lien does not automatically mean that the lien cannot be reduced for attorneys’ fees. Subrogation and reimbursement rights for ERISA insurance plans only exist if the language of the plan says they do. You have to actually read the plan to know.

Jake Brigance gave one of the greatest closing arguments ever in A Time to Kill. This remains true even though Matthew McConaughey has tried to cheapen my memories by making so many “not so very good” chick flicks.

In the actual world, closing arguments rarely sway a jury like Jake Brigance’s did. How rarely? According to David Ball’s recent book, only about 1 in 12 jurors change their mind during a closing argument. This is actually a good thing. It underscores that most juries decide based on how they process the evidence, not which party has the best lawyer orator.david ball damages

Yet almost every personal injury lawyer goes into a closing trying to convert jurors unlikely to be swayed. So what should a lawyer be doing in closing? Instead of trying to win an argument, the number one job of a lawyer in closing is to arm jurors are with him/her already. Continue reading

Yesterday, I wrote that we would buy David Ball’s 3rd edition of “Damages.” Little did I know we had already ordered the book. I will write about things in this book that grab me, in no particular order at this point.

Ball writes: “Among the hollowest of advocacy moments can be when counsel says, in the opening, that his client has lost one of her great pleasures – say, gardening.scales

This got my attention quick. I don’t think I have done this. I know I have. Right down to the example: gardening.

Ball’s point is that just throwing out boilerplate suffering like loss of “gardening” without human context, can appear hypocritical and will “turn even the friendliest of jurors into enemies.” Find out exactly what they are talking about when they say they “miss gardening” and you have to make sure you understand – really understand – what the client was doing and why losing it is a real absence in their lives. Continue reading

David Ball’s book, appropriately titled “Damages”, is now out.

You have already bought the first two editions of a book that is just ridiculously priced, $105 for a paperback. Insane. Ball has never had a jury trial and is not even a lawyer. But buy it anyway. We will and would even if it was 10 times the price.david ball damages

You don’t have to accept every premise in the book. I don’t. But Ball’s view on how to maximize the value of a personal injury case has evolved a great deal in recent years, and it is worth keeping up with him. Some of the best personal injury lawyers still rely on their gut when deciding how to approach trials. But even if you are a “go with your gut” personal injury lawyer, having a bit of science and psychology behind you is beneficial thing.

The Legal Intelligencer has a blog with a smart title any trial lawyer would love: “Beware of the Smiling Juror.” In their heads, lawyers agree with the premise of the article which is: trying to read jurors is a complete waste of energy. But at trial, our hearts overrule our heads and we interpret more useless clues than we ever did on the dating circuit.reading jurors

Regarding the smiling juror, the author writes:

Of course, we also have the ever-mysterious “smiling juror.” Many of us may have encountered that person who looks right at us when we give our presentations with a grin on her face. That person can make us feel good because a smile is typically a friendly gesture by someone who likes us and agrees with us … unless it is not. That beaming smile, as we all know, can also be a sign that this particular juror is happy to have the opportunity to stick it to us the first chance she gets.

Continuing with the heart/head metaphor, a plaintiffs’ personal injury trial lawyer’s head knows that the case is ultimately about whether the jurors believe the client is entitled to compensation? Does it help if the jury likes the client or the lawyer? Sure. Jurors are just like us. But, ultimately, in many more cases than not, the jury comes to a fair resolution based on what they believe the evidence to be.

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It seems like Lawyer 101 advice: if you are making an agreement with the opposing lawyer, get it in writing.

Few lawyers do it. There are two reasons for this. The first is laziness. If this is your problem, this blog post will not help.agreement defense lawyer

But I think another reason people sometimes do not send letters memorializing agreements is that they feel like it is almost a breach of the trust between counsel. We all know some defense lawyers who would shoot their own mother in the head for the slightest of advantages. It is easy to send a confirmation letter to that lawyer. (You should not even be talking to that guy on the phone.) But what about when you like and trust the other guy? You feel a little like a jerk sending out an “I’m writing to summarize our agreement today” letter, don’t you?

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