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Courses/Law/Personal Injury Law

Ghosts of Coverage Past: Benefit Issues in PI Actions

Safeguard your client’s future and your firm’s reputation by mastering lien resolution, benefit preservation, and strategic settlement planning.

Created byNYS Academy of Trial Lawyers
BeginnerUpdated Feb 12, 2026
Ghosts of Coverage Past: Benefit Issues in PI Actions

What You'll Learn

check_circleIdentify ethical duties regarding lien resolution.
check_circleHandle Medicare and Medicaid recovery demands.
check_circleNavigate self-funded ERISA reimbursement liens.
check_circleImplement structured settlements for tax efficiency.
check_circleSafeguard client eligibility for SSI and Medicaid.
check_circleUse Special Needs Trusts to preserve settlement funds.

About This Course

Join us for this CLE examining the full timeline of medical benefit issues in personal injury actions. We will explore the lingering impact of past medical liens, assess current damages in litigation, and navigate the complexities of future medical benefits and planning. Gain practical strategies to manage these issues across the life of a case.

The program dissects the complex timeline of a case, starting with the immediate information required during client intake to prevent surprises later. The presenters detail the distinct differences between Social Security Disability, SSI, Medicare, and Medicaid, explaining how asset limits and income caps impact settlement options. Special attention is paid to the liabilities that can haunt settlements long after the fact, such as surprise Medicare demands, strict ERISA self-funded plan reimbursement rights, and the evolving landscape of housing authority rules under HOTMA.

Beyond identifying risks, this course provides concrete solutions for asset preservation. Attorneys will learn how to effectively utilize structured settlements, Special Needs Trusts (SNT), and ABLE accounts to maintain a client's quality of life without sacrificing essential government support. Through the analysis of real-world hypotheticals, the discussion illustrates practical applications for clients of varying ages and disability levels, ensuring that the settlement creates a true safety net rather than a compliance nightmare.

Key learning outcomes and topics include:

  • Identifying the critical differences between subrogation and reimbursement rights in ERISA and private health plans.
  • Understanding ethical duties regarding competence, diligence, and the notification of third parties holding an interest in settlement funds.
  • Strategies for managing Medicare conditional payments and avoiding double damages.
  • The specific roles of Special Needs Trusts, Pooled Trusts, and Settlement Trusts in preserving SSI and Medicaid eligibility.
  • Best practices for reviewing Power of Attorney and Guardianship documents prior to settlement.
  • The financial and tax advantages of structured settlements for plaintiffs across different demographics.

Your Instructors

NYS Academy of Trial Lawyers
NYS Academy of Trial Lawyers
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The NYS Academy of Trial Lawyers is the largest statewide trial bar in the US with 5,700+ lawyer and judge members. We are committed to protecting, preserving and enhancing the civil justice system. Our highly acclaimed CLE programming features extraordinary presenters covering the most timely and important topics.

Paul  Isaac, Esq., ChSNC
Paul Isaac, Esq., ChSNC

Founder and Managing Partner of Paramount Settlement Planning, LLC and Precision Resolution, LLC

Paul Isaac, Esq. is the founder and managing partner of Paramount Settlement Planning, LLC, and Precision Resolution, LLC. He is a past president of the New York Trial Lawyers Association Western Region Affiliate Group and a Chartered Special Needs Consultant® (ChSNC®). A trial attorney and strategic life planner, Mr. Isaac’s years of experience allow him to anticipate a plaintiff’s long-term financial needs. Mr. Isaac has helped several clients obtain large settlements and favorable verdicts. In addition to assisting plaintiffs with settlement strategies for various personal injury lawsuits, Mr. Isaac is experienced in navigating the complexities of cases where Medicaid and future Medicare benefits must be preserved. Mr. Isaac received his undergraduate and law degrees from Duquesne University and is admitted to practice law in New York and Pennsylvania.

Joan Robert
Joan Robert

Attorney at ROBERT LEGAL GROUP

Touro College School of Law, (valedictorian of the part time division). Past Chair of the New York State Bar Association Elder Law Section and author of several NYSBA Publications including: Guidelines for Guardians, a chapter on Supplemental Needs Trusts in Guardianship Practice in New York, and a chapter’s on Government Liens and Planning Options in Personal Injury Practice in New York. She’s presented at numerous Guardianship training programs approved by the Office of Court Administration. Past Chair of the Nassau County Bar Association Elder Law Committee, served as the Dean of the Nassau Academy of Law and as a member of the Board of Directors of the Nassau County Bar Association. She served as President of the New York Chapter of the National Academy of Elder Law Attorneys (NAELA) and received their Theresa Foundation Award for outstanding service and advocacy for those with disabilities. She received a Lifetime Achievement Award from the New York State Bar Association Elder Law & Special Needs Section. She has been named a Super Lawyer in Elder Law for the New York Metropolitan Area since 2013 and is Certified as an Elder Law Attorney.

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Frequently Asked Questions

We are a registered provider with 327+ associations and regulatory bodies worldwide. We operate across 29 global markets including Canada, the US, Australia, and the UK. Every course page clearly displays its specific accreditations. Upon completion, you receive a professional certificate that can be validated online. Our certificates include all necessary accreditation details, credit hours, and completion dates, and are formatted specifically to meet the submission requirements of most global regulatory bodies.