Lien Resolution

Why liens decide your net recovery

The number a case settles for and the money you take home are rarely the same. Anyone who paid for your treatment, a hospital, a health insurer, Medicare, Medicaid, or L&I, may have a right to be reimbursed from the recovery, and if those claims aren't managed they can eat most of a settlement. Every lien has its own rules, and many can be reduced or defeated. We treat lien resolution as part of winning the case, not an afterthought, because the net is what matters to you.

Hospital and medical-provider liens

Washington's medical lien statute, RCW 60.44, lets a hospital, an ambulance service, and licensed physicians, surgeons, nurses, and practitioners claim a lien against your injury claim, and any recovery from the person who caused it or their insurer, for the value of the care they provided. To hold that lien, the provider has to record a verified notice with the county auditor, and the statute doesn't apply to Washington workers' compensation claims. All of these provider liens together can't exceed 25 percent of the settlement, verdict, or judgment from one accident. We check whether each lien was properly recorded, whether every charge is tied to the injury, and whether the total stays under that cap.

Health-insurance and ERISA liens

Your health insurer often wants reimbursement too, and the rules turn on what kind of plan it is. For an insured plan, Washington's made-whole rule from Thiringer v. American Motors Insurance Co., 91 Wn.2d 215 (1978), can bar reimbursement until you are fully compensated. A self-funded ERISA plan is different: under US Airways v. McCutchen, 569 U.S. 88 (2013), the written plan terms control, and equitable rules such as the common-fund doctrine fill in only where the plan is silent. But under Montanile v. Board of Trustees, 577 U.S. 136 (2016), an ERISA plan's claim can be enforced only against an identifiable settlement fund, or property traceable to it, which creates real room to negotiate.

Medicare and Medicaid

Government payers have their own rules. Under the Medicare Secondary Payer Act, 42 U.S.C. 1395y(b)(2), Medicare must be repaid from your recovery for the conditional payments it made for your injury care, and when a settlement covers future care, Medicare's interest in that care has to be considered too. Ignoring Medicare's claim can stall a settlement. Medicaid, which Washington runs as Apple Health, can recover as well, but only within limits. Arkansas Department of Health and Human Services v. Ahlborn, 547 U.S. 268 (2006), confines the state's recovery to the medical-expense portion of a settlement, and Gallardo v. Marstiller, 596 U.S. 420 (2022), held that portion includes money for future medical care, not only past bills. We work those allocations to keep the government's share to what the law actually allows.

Negotiating the liens down before disbursement

A lien's first number is rarely its last. Depending on the lien, we reduce it for the attorney fees and costs that created the recovery, for comparative fault, for made-whole shortfalls, and for hardship, and we document the basis so the reduction holds. When an auto insurer wants its PIP benefits repaid, for example, Mahler v. Szucs, 135 Wn.2d 398 (1998), requires it to pay its pro rata share of those fees and costs. All of it happens before the settlement is disbursed, because once the money is paid out the leverage is gone. Our aim is the largest possible share of the recovery in your hands, not the lienholders'.