QUESTION:

My mom received a check for a personal injury settlement. How will that affect her SSI and medical benefits along with her living under section 8? I am also living with them as my father’s caretaker.

ANSWER:

A binding settlement is reached upon timely and proper acceptance of the proposed terms. At that point, the offer, together with original proof of acceptance, may be submitted with a written judgment for the court’s signature and entry of judgment. Where a settlement, judgment or award fails to specify the portion representing past medical expense damages (or where a settlement allocation appears suspect or otherwise unreliable), the court should be “guided” by “relevant statutory and case law” in determining the appropriate amount of the State’s lien. [Welf. & Inst.C. § 14124.76(a); see Lopez v. Daimler Chrysler Corp. (2009)– not an abuse of discretion to make allocation based on injured party’s evidence where Department failed to explain or present evidence to support its allocation [Lima v. Vouis (2009)]. If the beneficiary’s injuries have pretty much run their economic course by the time the recovery is obtained, a lien amount in the proportion that medical expenses bear to the total amount of the claim, and not the recovery may be considered appropriate. [Bolanos v. Super. Ct. (State Dept. of Health Care Services) (2008). California law gives a health care provider who accepts Medi–Cal payment for services rendered the right to file a lien for the full cost of its services against the entire amount of any judgment, award or settlement obtained by the patient/beneficiary against a third party responsible for the beneficiary’s injury.  The provider’s “substitute billing” lien is subject to the State’s prior recovery  and may be enforced only if the provider fully reimburses the State for any Medi–Cal payments it received [Welf. & Inst.C. § 14124.791].  It would be best to seek personal assistance from a lawyer in order to guide you with your personal injury claim.

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