Medicare_Carriers_Manual / 2370 / 2370.1_Definitions

Why This Topic Matters

Understanding these terms helps readers interpret Medicare workers' compensation guidance consistently and identify how different parties and settlement structures are referenced in claims-related policy.

Article Sections

1. Workers' Compensation Law or Plan

   Defines the general concept of a workers' compensation system and describes broad categories of workers who may or may not be covered. The section also notes that occupational diseases are included in state programs.

2. Workers' Compensation Agency

   Explains which governmental entities administer workers' compensation laws at the federal or state level. The section references the kinds of organizations included in this category.

3. Workers' Compensation Carrier

   Defines the entities considered workers' compensation carriers under federal or state administration. The section addresses insurers, state funds, and self-insured employers at a broad level.

4. Lump Sum Commutation Settlement

   Describes a lump-sum settlement concept related to future medical expenses and disability benefits. The focus is on settlement structure rather than coding or payment policy.

5. Lump Sum Compromise Settlement

   Describes a compromised settlement arrangement and its general relationship to total compensation. The section remains limited to the definition of the settlement type.

6. HCFA's Claim

   Defines the Medicare claim amount referenced in the manual and relates it to amounts paid by Medicare and procurement costs. The section is specific to Medicare terminology used in workers' compensation contexts.