Medicaid wants part of your injury case — can it take that?

Attorney Answer

Generally, yes — New York gives the agency that paid for your care a lien on your injury claim. But the statute itself caps that lien, and the figure your lawyer was given is worth understanding in detail before anything is signed.

Where the lien comes from. Social Services Law § 104-b(1) provides:

If a recipient of public assistance and care shall have a right of action, suit, claim, counterclaim or demand against another on account of any personal injuries suffered by such recipient, then the public welfare official for the public welfare district providing such assistance and care shall have a lien for such amount as may be fixed by the public welfare official not exceeding, however, the total amount of such assistance and care furnished by such public welfare official on and after the date when such injuries were incurred.

Read the last clause closely, because it is the cap: the lien cannot exceed what was furnished on and after the date your injuries were incurred. Care from before the fall is outside it.

Why Medicaid's general no-lien rule does not stop it. New York usually bars liens against a Medicaid recipient's property during their lifetime. But the same section then preserves recovery from an injury claim — Social Services Law § 369(2)(c):

Nothing contained in this subdivision shall be construed to alter or affect the right of a social services official to recover the cost of medical assistance provided to an injured person in accordance with the provisions of section one hundred four-b of this chapter.

So the general rule and this lien sit side by side, and it is the lien that governs a personal-injury recovery.

What remains genuinely open is the amount, and that is a conversation with your lawyer, not a fixed fact. Whether the $15,000 reflects only care for this injury since the date of the fall, whether the lien can reach the whole recovery or only part of it, and whether it can be reduced are all questions with real answers — some of them governed by federal law as well as New York's. Your lawyer is the right person to answer them, and they are the right questions to ask.

What you can do

1. Ask your lawyer for the itemized statement behind the $15,000, so you can see what care it covers and from what date.

2. Ask whether every item is care for the ankle injury, furnished on or after the date of the fall.

3. Ask which part of the recovery the lien is being taken from, and why.

4. Ask whether the lien can be reduced, and how it fits alongside the legal fee and costs.

5. Do not sign a release or a settlement statement until those questions have been answered to your satisfaction.

⏱ Time limits apply. Your lawsuit is already filed, so the ordinary three-year period for a personal-injury action under CPLR 214(5) is not the pressing clock now. What is time-sensitive is the settlement itself: a lien under Social Services Law § 104-b is ordinarily dealt with before money is paid out, so raise these questions with your lawyer before you sign anything.

A New York attorney can look at the specifics quickly, and most offer a short first conversation at no cost. A few minutes on your actual facts is worth more than any general guidance, this page included.