Effective Date: November 1, 2021

No Previous Policy

General Requirements

Sometimes an individual may receive payments under a personal injury settlement or from a third party such as an insurance company. The payment, or payments, counts as income in the month received. Certain expenses are usually deducted from the total settlement amount before the individual receives payment. To determine how these payments count, see 440-4.

1. If the settlement is being received because the person was injured and the individual has been receiving CHIP, report the settlement to the Office of Recovery Services as soon as you become aware that the individual may be receiving a settlement. ORS may place a lien against the settlement to recoup expenses that have been paid on behalf of the individual. If you do not learn of the settlement until after the payment has been made, immediately report this to ORS.

2. For CHIP, the following expenses can be deducted from the total settlement before counting the settlement as income. Other expenses may be deductible. Request a copy of the court documents, or settlement agreement to determine the amounts that can be deducted. Contact the BEP Program Specialist if you need help deciding what can be deducted.

· Legal fees and attorney expenses incidental to getting the settlement.

· Court fees associated with the lawsuit or settlement.

· Medical expenses not already covered by insurance or Medicaid that will be paid directly to the provider under the settlement agreement.

· A lien against the settlement for expenses CHIP has already paid on behalf of the individual.

3. Generally, the court or settlement agreement will show the exact amounts to be paid out for the above expenses, and the remaining amount that will be paid to the individual. If the court or settlement agreement specifically indicates that other payments will be paid out before any payments are made to the individual, we may be able to deduct those expenses, too. An example may include payments to someone who has provided personal care and assistance to the injured individual. However, if you are not sure whether some expenses should be allowed as a deduction before counting the remainder as income, contact a BEP Program Specialist.

4. When a worker learns that an individual will be receiving a settlement, make sure ORS knows about the settlement. ORS may be able to place a lien against the settlement for CHIP expenses paid on behalf of the individual.