Dissatisfied CMS customer

Medicare Set-Aside Blog on May 17, 2012 | Posted by


Although the “Ask” in “Ask Jen” implies that a question of a non-rhetorical nature should normally be posed, this statement of fact deserves unedited publication for its cogent analysis and literary flourish.

My Life Plan was formulated by Messrs. Gould and Lamb in September, 2011, and submitted to CMS for MSA review. On November 21, 2011, I received from CMS their acknowledgement of the Case along with a request to wait 45-days before contact. So now I am in my sixth month and was told today that it is quite probable that my Case has not yet even been “looked at.” Why? “We have a backlog…we are just looking at cases we received in September 2011.” There are several words I could use to describe this disgraceful situation, each day I see Medicare litigating cases to retrieve money from those who have used Medicare to get treatment. Proposed Bills that protect Medicare and not its’ recipients. Enormous amounts of money and resources are being used that should go towards staffing The Centers for Medicare and Medicaid Services Regional Office (aka The Circumlocution Office), an establishment that appears to have no accountability to anyone they serve. Today, all the “supervisors” were “in a meeting.” I have not spoken with one person with any intellect who can (or will) describe the “Review” process in the many months I have been status calling.

In the meantime who suffers? Not the insurance company who refuse to settle without MSA CMS approval; certainly not the corporation whose premises were so unsafe that they ended my [long and prosperous] career 12 years ago; NO, not at all, it is I who suffer because CMS cannot do a simple job of reviewing a document with attachments. I am a Medicare beneficiary, but it wouldn’t take a genius to see that I have never used Medicare, so add up the numbers provided and process the MSA. This is a blatant, incompetent bureaucracy and with a “NINE MONTH” backlog, they ought to be ashamed of themselves.

And so the money-spinning top whirs and whirs around: Life Plans, Work Comp Judges, Applicant and Defense attorneys, CMS, MSA Administrators, etc., etc., and who is at the bottom being spun into the ground? The Injured Worker, who plays dumb-bunny through the entire process as weakness and chronic pain take over and one day they get a call or a bold-headed CMS communication and as they slowly lift up their head, they alone hear: Oh, is it my turn now?

Who cares?


Comment: Admit it. You had to look up the word “circumlocution” too.


Ryan