Most people understanding that you can seek compensation if another person causes you harm. However, did you know you could end up facing additional litigation to defend your damages award because you sought necessary medical treatment after you got hurt?

Depending on the case, multiple considerations factor into a court’s determination of damages. As such, more than one party may be liable.

At the same time, when Medicaid pays for medical care, they have the legal right to recover their expenses through a process called subrogation. Simply put, Medicaid can file a lien against settlement funds you receive from negligent parties.

Personal injury settlement close to $2 million

That’s what happened in a recent Florida case.  In November 2016, Nigel Carter was shot and injured by a stranger while visiting friends at their Florida apartment. Due to the resulting gunshot wounds, Mr. Carter suffered a traumatic brain injury (TBI). He also:

  • Lost his ability to walk independently
  • Faces a reduced life expectancy
  • Requires around-the-clock care

A personal injury claim was brought against the company that owned and operated the apartment complex where the shooting took place, resulting in a $1.9 million settlement in favor of Mr. Carter. Notably, the $1.9 million settlement amount did not come near his comprehensive damages, which amounted to nearly $22 million in past and future expenses.

Lien reduction

Once the $1.9 million settlement was reached, Florida’s Medicaid oversight agency asserted a statutory lien in excess of $240,000 against Mr. Carter’s financial recovery. Mr. Carter filed a petition to challenge the amount of third-party benefits payable to the agency pursuant to Fla. Stat. § 409.910(17)(b).

The State of Florida Division of Administrative Hearings proceeded to determine that Mr. Carter’s original settlement amount of $1.9 million actually represented 8.6% of the stipulated value of his personal injury claim.

Ultimately, after the administrative law judge reached a decision consistent with Arkansas Dep’t of Health and Human Services v. Ahlborn, 126 S.Ct. 1752 (2006). The court concluded that $23,028.02, rather than $240,587.85, amounted to a fair and reasonable determination of the past medical expenses actually recovered by Mr. Carter that were payable to Florida’s Medicaid oversight agency.

Attorney David Abney limits the dollar amount of healthcare subrogation recovery

The representing attorney for the injured man in this case, David Abney, maximizes damages for accident victims throughout the United States. Mr. Abney seeks expedient, favorable resolution in healthcare subrogation claims against people who suffer from catastrophic injuries.

The lien reduction in this case, from $240,000 down to $23,000, was a particularly impressive victory for Mr. Abney’s client since this was a Florida case dealing with Florida Medicaid, which is notoriously difficult.

Although personal injury claims can result in compensation, you could potentially face claims on the funds you recover. If so, working with someone who dedicates their practice to this niche area of the law can help you come to a reasonable agreement while protecting your best interests.