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Customer WC Jurisdictional Resource (Rev 11-06)

Customer WC Jurisdictional Resource (Rev 11-06) 2025

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The document outlines the procedures and requirements for filing Workers Compensation claims in Vermont, emphasizing timely reporting of injuries by both employees and employers. It details necessary forms, such as Vermont Form 1 for injury reporting and Vermont Form 5 for employee claims, along with the implications of late reporting. The document also addresses the impact of intoxication on coverage, the necessity of wage statements, and obligations regarding job offers for claimants receiving Temporary Total Disability benefits.

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What is the language threshold for CMS?

Furthermore, the rule reinforces the mandate of fulfilling translation requirements where a language is spoken by at least 5% of the population that a plan services.

What is the threshold for CMS review?

If you choose to submit a WCMSA for review, CMS requires that you comply with its established policies and procedures. CMS will only review WCMSA proposals that meet the following criteria: The claimant is a Medicare beneficiary and the total settlement amount is greater than $25,000.00; or.

How is Medicare set-aside calculated?

The professional hired to perform the allocation determines how much of the injury victims future medical care is covered by Medicare and then multiplies that by the remaining life expectancy to determine the amount of future injury-related care.

What is CMS threshold?

CMS will maintain the $750 threshold for no-fault insurance and workers compensation settlements, where the no-fault insurer or workers compensation entity does not otherwise have ongoing responsibly for medicals.

What is CMS record retention requirement?

CMS requires that providers submitting cost reports retain all patient records for at least five years after the closure of the cost report. And if youre a Medicare managed care program provider, CMS requires that you retain the patient records for 10 years. How should medical records be retained?

What triggers a Medicare set aside?

The necessity of a Medicare Set-Aside (MSA) arises when ensuring that Medicares interests are protected in workers compensation settlements resolving medicals.

Customer WC Jurisdictional Resource (Rev 11-06) 2025

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