Checklist for Special Needs Settlement Planning
- Determine if plaintiff is receiving government benefits or has needs that can be addressed by government benefits.
- Determine if a special needs trust is appropriate to assist in qualifying for government benefits.
- Determine if there are enforceable liens to be addressed prior to settlement and, if so, are the lien amounts correct and can the amounts be compromised:
- Medicare
- Procurement costs;
- Medical expenses related to injury only;
- Compromise.
- Medicaid
- Application of Ahlborn;
- Medical expenses related to injury only;
- Compromise.
- ERISA
- Does the governing plan provide a right to recovery?
- Does the governing plan identify a specific fund?
- Medicare
- In a worker’s compensation case, are future medical expenses included in the settlement? If so, should there be a Medicare Set Aside and in what amount?
- In a third party liability caser, are future medical expenses included in the settlement? If so, should there be a Medicare Set Aside and in what amount?
- Will there be a lump sum settlement, structured settlement, or combination? If so, is a special needs trust appropriate? If so, make sure that payments are directed to the special needs trust. Who will serve as trustee?
- Determine whether court approval of settlement and special needs trust is necessary (as in the case of mentally incapacitated individuals and minors).
- Is a guardian or conservator appropriate?