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Law Educator, Esq.
Law Educator, Esq., Attorney
Category: Personal Injury Law
Satisfied Customers: 118658
Experience:  Licensed Attorney. Over 20 years experience in personal injury and law enforcement.
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There, I am a senior, 67 and on Medicare. In August 2013,

Customer Question

Hi there, I am a senior, 67 and on Medicare. In August 2013, after I had just retired, I was involved in an automobile accident. To briefly describe, I was stopped in traffic at a stop light, and was rear-ended by a driver who did not even notice the light was red. He hit me at about 35 mph. My car was totaled (while I was sitting in it) - if you can imagine that. The other driver was found guilty and I was found to be not at fault. I declined to be transported to the ER at that time because I was able to get out of my car and had no broken bones or bleeding. I had an appointment with my pcp the following day and went to see him. Lots of bruising and swelling of the knees. black and blues etc. But nothing "broken" I followed my doctor's advice of rest, ice and heat on the bruises, but that did not help. When I had not recovered by March (7 mos later) I consulted an attorney. He sent me for MRI's and X-rays which showed I had 2 torn miniscus (from my knees hitting the dashboard) and a fractured tibia plalteau (same cause) . Yes I took pictures of these bruises and injuries. So my attorneys filed suit again Century 21 to recoup the lost of income (Iwas to start a new job in Oct, 2013) and to the injuries. They also sent me to Physical therapy. By this time, I riealized I was accumulating about $10,000 in medical bills from all this. Mr Attorney (won't mention his name) made it very clear to me that I could not go to my usual Medicare doctors because Medicare will not cover charges from an accident and expects the Insurance company to cover this. It is not about 14 months since the lawsuit was filed against 21 st century. They have made an "offer" of $21,000. This would barely cover the cost of the medical bills that have accured, and the attorney's fees. Not to mention, that I have never received the Miniscal surgery (at least) $10,000 for each knee, as well as any other damages. This surgery should have been done long ago. I feel like I am being manipulated by both my Attorney and by Century 21. My question is..... can I go ahead and get the medical care I need thru My Medicare plan and then let them go after century 21 (an my attorney)? What do I do? Your advice would be greatly appreciated.
Submitted: 2 years ago.
Category: Personal Injury Law
Expert:  Tina replied 2 years ago.
Hello and welcome.
My name is ***** ***** my goal is to provide you with excellent service today. I am sorry to hear of your difficult situation. Before I can give you an accurate answer to your question, please provide the following additional information:
Where in California is the suit pending?
I look forward to assisting you as soon as I have received this information. Thank you.
Customer: replied 2 years ago.
I live in San Marcos, my Attorney is Liljigren Law Group in Escondido.
Customer: replied 2 years ago.
Just to clarify, My attorneys sent a "demand' letter to century 21, the case has not gone to court, it that's what you are asking by suit pending.
Expert:  Tina replied 2 years ago.
Hello again and thank you for sharing this additional information.
If you are not happy with this offer, then you should typically inform your attorney that you wish to reject it and continue to move forward to trial. Insurers often do give a low ball offer in an effort to limit their liability, so it is not too surprising that they have done this.
I would typically recommend getting the medical care you need by your providers and it's not clear why your attorney would recommend doctors who do not accept Medicare--perhaps an effort to inflate your damages? This does not make a lot of sense to me, so I would consider looking for a different attorney to review your case and possibly provide better representation.
Your attorney will typically take a portion of your recovery for their attorney's fees as well, so the current offer would not even cover your actual costs. Here is a link to another firm's website I am familiar with in San Diego which discusses how fees are paid. You might wish to contact them or another firm about reviewing your case:
I hope this helps clarify the situation for you. My goal is to provide you with excellent service – if you feel you have received anything less, please reply back as I am happy to address follow-up questions. Kindly rate my service when I have answered your questions so I will be compensated for my time assisting you. Thank you!
Customer: replied 2 years ago.
Tina, the reason I clicked on "Medicare attorney" is because I need an attorney who is familiar with Medicare Law in California. You are a personal injury attorney, just like my present attorney. I am familiar with what you have already said. I need to know if I can go to my regular Medicare Doctors or not. Can you confirm this or are you just guessing?I have already "rejected" this low ball offer, and now the attorneys and Insurance company seem to be having a "staring down" contest.
Expert:  Tina replied 2 years ago.
There is no reason you cannot get the care you need that I know of, having worked on personal injury cases. I don't, however, have the benefit of your attorney's reasoning for that. He has much more information than I do, so that is why I suggested having another attorney review your case--in the event there is some valid reason to direct you to the providers he has instead of your regular Medicare providers.
Customer: replied 2 years ago.
Are you an attorney in California? By that I mean, do you actually life in California and practice law here?
Expert:  Tina replied 2 years ago.
yes to both
Customer: replied 2 years ago.
Tina, what I am seeking is advice on Medicare Law relating to this situation. You keep saying "your guess is" or you think, and that worries me. Who can I speak with who knows Medicare Law regarding this?
Expert:  Tina replied 2 years ago.
I haven't once said I'm guessing. In fact, I'm answering your questions based on the limited information I have from you and my training and experience. You want absolutes and I cannot give them to you with the limited information I have unfortunately.
I would be happy to opt out and allow another attorney to follow-up with you.
Good luck and take care!
Customer: replied 2 years ago.
Thanks, ***** ***** be a good idea!
Expert:  Law Educator, Esq. replied 2 years ago.
Thank you for your question. I am a different contributor and look forward to working with you to provide you the information you are seeking for educational purposes only.
I am a personal injury attorney, but also have to deal with insurance and subrogation rights.
You are not talking about anything really new or complex here to lawyers (I know to non-lawyers this is very confusing). Your lawyer telling you to not let medicare pay is out of selfishness, because he knows that anything medicare pays for your care (oh, and they WILL pay for your care) you will have to reimburse to medicare out of your accident settlement (this is known as medicare's right to subrogation to recover what they paid out when someone else is at fault for your injury and pays you for the injury).
Thus, you need to go get your treatment. File it with medicare with the understanding that when this suit is finally settled (it is not even close to being ready to be settled yet unless your attorney is only looking for a quick buck and trying to get out of doing work for it) medicare will have to be negotiated with for reimbursement (generally they will agree to reduce what they paid by 25%-33% if you fight and get the insurance settlement for the medical care as you did so on their behalf). Furthermore, based on the total amount for your final settlement, if it is too low to cover what you owe medicare, they will further reduce what they want in subrogation.
I said above, you are not anywhere near being ready to settle or to even entertain settlement offers. A case of this nature is not ripe for settlement (unless the insurer is offering you the policy maximum and there is nothing more you can get from the insurer) until you have reached maximum medical improvement and to try to settle before that is not proper. If your attorney is trying to settle without you getting all of your proper treatment and putting it through your own health insurance then they are doing you a disservice and you may want to consider finding a new personal injury lawyer and walking away from this one as they are not looking after your best interests if you are in need of care.
Until you get all of the care you need and reach your maximum medical improvement you should not even be considering or thinking about settlement.
You also only have 2 years from the date of the accident to file a suit to stop the statute of limitations from running, so you need to make sure that gets done, because you are not close to being ready to settle with you still needing treatment and care. So make sure he did indeed file the suit.