Will medical or chiropractor liens be deducted from my settlement?

Short answer: Possibly. In Oregon, medical providers (including chiropractors), hospitals, and public programs can assert liens, subrogation, or reimbursement claims against proceeds from a personal injury settlement or judgment. Those claims often reduce the money you actually receive unless you and your attorney negotiate, resolve, or otherwise satisfy the lien claim before distribution.

Detailed answer — how liens and reimbursement claims work in Oregon

What is a medical or chiropractor lien?

A medical/provider lien is a legal claim a health-care provider can place on recovery from a third party that is responsible for the injury (for example, the at-fault driver or insurer). The lien gives the provider a right to be paid out of any settlement or judgment that compensates you for the injury that required medical treatment.

Where the law lives

Oregon’s statutes that govern liens and related claims are found in the Oregon Revised Statutes (see ORS Chapter 87 for lien law generally). You can review the chapter here: ORS Chapter 87 — Liens. Note that other statutes and federal rules (for example, Medicare rules) can affect how and whether a lien is paid.

Who can assert a claim against your settlement?

• Private medical providers and chiropractors who treated you and who either recorded a lien or assert an unpaid bill.
• Hospitals and larger health systems that have lien or collection practices.
• Private health insurers that paid your care and have subrogation or reimbursement rights under a policy or ERISA.
• Government programs such as Medicare or Medicaid (Oregon Health Plan). Federal and state programs have mandatory recovery rules and sometimes statutory liens or subrogation rights.

When are lien amounts deducted?

Typically liens or reimbursement demands are satisfied out of the settlement proceeds before the claimant receives net money. Settlement funds flow in a set order: first liens and legal obligations that have priority, then attorney fees and costs (depending on your fee agreement), and finally your share. If a medical provider has a valid, perfected lien, the settlement administrator or court may require that lien be paid from the settlement funds.

How much will they actually deduct?

The billed amount is often higher than the amount ultimately paid. In practice:

• Private providers may accept a reduced payment if an attorney negotiates.
• Insurers (including ERISA plans) often seek reimbursement according to plan terms; federal law (ERISA) and plan rules can affect reductions.
• Medicare and Medicaid have statutory recovery processes. Medicare regularly requires repayment for items/services it paid that are related to the injury; you must report settlements and resolve Medicare’s conditional payment demands before final distribution. See Medicare recovery information: CMS — Recovery.

Can a chiropractor place a lien?

Yes. Chiropractors who provided treatment for injuries can assert a lien or claim unpaid bills against your recovery. The chiropractor must follow applicable Oregon law and any procedural requirements for perfecting a lien. Whether the chiropractor’s claim will be fully paid depends on negotiation, insurance subrogation, and priority of other claims.

What if there isn’t enough money in the settlement to pay everyone?

If total liens and claims exceed the settlement amount, parties will negotiate priorities. Some claims may be partially paid or discharged by agreement. If you are left owing a provider after settlement, that bill may become your personal responsibility unless the provider agrees to a reduction or a payment plan.

Steps to protect your settlement and limit deductions

1. Tell your personal-injury attorney about every provider and every insurer that paid for your care. Attorneys know how to identify and address liens and subrogation claims.
2. Request written lien statements and itemized bills from providers and any health plan that may seek reimbursement. Do not sign away rights without seeing these statements.
3. Require that the defendant’s insurer not disperse funds until all lien issues are resolved (often via an escrow agreement or court-approved distribution).
4. Negotiate reductions. Many providers accept a lower payoff, particularly when the provider knows your attorney will challenge the lien’s size or priority.
5. Comply with Medicare and Medicaid reporting rules and resolve conditional payment or recovery demands early. Failure to address Medicare’s conditional payments can create liens or penalties.
6. Consider filing a motion or asking a court to approve a compromise of disputed liens if parties cannot agree.

Hypothetical example (to illustrate)

Suppose you settle a car-crash case for $50,000. You have $8,000 in chiropractor bills and $12,000 in ER bills. Your attorney negotiates with the chiropractor and gets the bill reduced to $4,000. The ER agrees to accept $9,000. Your health insurer demands $6,000 in reimbursement under plan subrogation rules, but your attorney negotiates the insurer down to $3,000. After paying negotiated medical liens ($4,000 + $9,000 + $3,000 = $16,000) and attorney fees and costs (for example 33% contingency plus costs), your net payout will be significantly less than the gross $50,000. If Medicare were involved and had paid care, Medicare would expect to be repaid and typically must be notified and its conditional payments resolved before you receive funds.

What you should do now

• Contact a licensed Oregon personal injury attorney early. Attorneys routinely handle lien resolution and can protect your interests.
• Gather all medical bills, treatment records, and any correspondence from insurers or government health programs.
• Do not accept a settlement check until lien issues are resolved or the funds are properly escrowed.

Helpful Hints

• Always ask for an itemized lien statement in writing from any provider seeking payment from your settlement.
• Ask providers whether they will accept a reduced lump-sum payoff. Many will if you or your attorney requests it.
• Notify Medicare and Medicaid early if those programs paid for your care. They have established procedures and may issue conditional payment demands you must resolve.
• Keep settlement funds in escrow if there are unresolved lien disputes. Escrow protects you from being personally liable if a lien later arises.
• Know that a lien or subrogation claim is different from your own medical debt. A valid lien can attach to settlement proceeds even if you think your insurer should pay.
• If a private insurer asserts subrogation under an ERISA plan, plan terms and federal law can affect the timing and amount of recovery—get legal advice promptly.

Disclaimer: This article explains general principles and is intended for educational purposes only. It is not legal advice. Laws change and every case turns on its facts. Consult a licensed Oregon attorney to get advice tailored to your situation.