Conn. high court to hear immigrant benefits case
Ethics
The Connecticut Supreme Court will be hearing arguments in a case where state lawmakers voted to end medical benefits for some impoverished legal immigrants. The justices are set to hear the case Tuesday.
A Hartford Superior Court judge ruled in December 2009 that a state law approved earlier that year violated the constitutional rights of legal immigrants by denying them medical benefits. The state appealed.
Lawmakers approved the legislation to save $9 million from a program serving about 4,800 immigrants who are elderly, disabled or are parents of needy children.
A 1996 federal law barred legal immigrants from receiving Medicaid until they had lived in the country five years. Connecticut had provided medical benefits to legal immigrants who'd been in country less than five years before last year's vote.
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Workers’ Compensation Subrogation of Administrative Fees and Costs
When a worker covered by workers’ compensation makes a claim against a third party, the workers’ compensation insurance retains the right to subrogate against any recovery from that third party for all benefits paid to or on behalf of a claimant injured at work. When subrogating for more than basic medical and indemnity benefits, the Texas workers’ compensation subrogation statute provides that “the net amount recovered by a claimant in a third‑party action shall be used to reimburse the carrier for benefits, including medical benefits that have been paid for the compensable injury.” TX Labor Code § 417.002.
In fact, all 50 states provide for similar subrogation. However, none of them precisely outlines which payments or costs paid by a compensation carrier constitute “compensation” and can be recovered. The result is industry-wide confusion and an ongoing debate and argument with claimants’ attorneys over what can and can’t be included in a carrier’s lien for recovery purposes.
In addition to medical expenses, death benefits, funeral costs and/or indemnity benefits for lost wages and loss of earning capacity resulting from a compensable injury, workers’ compensation insurance carriers also expend considerable dollars for case management costs, medical bill audit fees, rehabilitation benefits, nurse case worker fees, and other similar fees. They also incur other expenses in conjunction with the handling and adjusting of workers’ compensation claims. Workers’ compensation carriers typically assert, of course, that, they are entitled to reimbursement for such expenditures when it recovers its workers’ compensation lien. Injured workers and their attorneys disagree.