Do medical or chiropractor liens get taken out of my settlement in Wisconsin?

Short answer: Possibly. In Wisconsin, medical providers, chiropractors, insurers (including Medicaid/Medicare), and others may have valid claims, subrogation rights, or lien/assignment arrangements that can reduce the money you actually receive from a personal-injury settlement. Exactly how much gets deducted depends on who has a legal claim, what you signed, what your attorney’s fee agreement says, and whether you can negotiate or challenge those claims.

Detailed answer — how this works in Wisconsin

This section explains the main ways medical and chiropractic charges can affect your settlement and the practical steps that determine who gets paid and how much you receive.

1. Two common paths for a provider to get paid

• Contractual assignment or lien signed by you: If you signed an agreement (sometimes called a lien, assignment of proceeds, or healthcare provider agreement) allowing a chiropractor or medical provider to be paid from any recovery you get, that provider can demand being paid out of your settlement. Whether the provider’s claim is enforceable depends on the wording and state law.
• Subrogation/reimbursement by an insurer or government payer: Health insurers, Medicare, and Wisconsin Medical Assistance (Medicaid) often have a legal right to be repaid for benefits they paid if you later recover money from a third party. Federal law gives Medicare strong recovery rights, and Medicaid has state-level recovery rules. These payers can seek repayment from your settlement proceeds.

2. Who gets paid first — typical order of distribution

There is no single automatic order that applies in every case. Typical sequence in practice:

1. Litigation costs and case expenses sometimes get deducted first, depending on your retainer agreement.
2. Your attorney’s contingency fee (often a negotiated percentage) — whether this fee is calculated on the gross settlement or after liens are paid depends on your retainer agreement.
3. Valid liens, assignments, Medicaid/Medicare reimbursement, and provider claims are paid from the remaining proceeds (or from the gross amount if the fee is calculated differently).

Important: whether the contingency fee is calculated on the “gross” recovery (before lien payments) or the “net” recovery (after lien payments) is determined by the attorney-client fee agreement. Read and ask about that term before you sign.

3. Medicare, Medicaid (Medical Assistance), and other insurers

Medicare and Wisconsin Medical Assistance have statutory rights to repayment for benefits they paid. That means if Medicare or Medicaid paid for your medical care related to the accident, those programs can seek reimbursement from your settlement. Federal law (for Medicare) and state law/processes (for Medicaid) set special procedures and often strict deadlines for reporting a settlement and protecting your eligibility.

Always tell your attorney if Medicare or Medicaid paid any bills. Your lawyer should take steps to protect you from penalties and to determine the correct repayment amount and schedule.

4. Negotiation, reduction, and proof of charges

Medical providers and chiropractors frequently accept less than their full billed amount in order to secure payment. Common negotiation tools include:

• Requesting an itemized bill and proof of services.
• Asking for a lien statement or release dated and signed by the provider explaining the amount due.
• Negotiating a percentage or fixed amount to be paid in exchange for a full release of the lien/claim.
• Using provider agreements and insurance write-offs to lower the asserted balance.

5. What your retainer (fee) agreement should address

Before you sign with an attorney, confirm these points in the written fee agreement:

• Is the attorney’s fee calculated on the gross settlement amount or on what remains after liens and expenses are paid?
• Who is responsible for negotiating and paying medical liens — you or the attorney?
• Who advances case costs and how will they be repaid?
• Will the attorney require you to sign any assignment or lien releases in their favor?

6. Example (hypothetical) — how numbers can change depending on the agreement

Hypothetical facts: $50,000 settlement, attorney fee 33% (one-third), costs $2,000, chiropractor lien $5,000.

Two different retainer approaches give different take-homes:

• Fee on gross recovery: Attorney fee = 33% of $50,000 = $16,500. Subtract attorney fee and costs ($2,000) → $31,500. Pay chiropractor lien $5,000 → client receives $26,500.
• Fee on net after liens: Subtract lien first: $50,000 − $5,000 = $45,000. Attorney fee = 33% of $45,000 = $14,850. Subtract attorney fee and costs ($2,000) → client receives $28,150.

As you can see, the order of deductions can materially affect the money you receive.

7. Practical steps you should take now

1. Tell any prospective attorney about all medical bills, providers, and any insurance (including Medicare/Medicaid) that paid for your care.
2. Ask whether the attorney’s fee is calculated on gross or net recovery and get that in writing.
3. Ask your attorney to obtain written lien statements from each provider and to try to negotiate reductions.
4. If Medicaid/Medicare was involved, make sure your attorney follows the required reporting procedures — failing to report can cause large repayment claims or penalties.
5. Before signing any lien or assignment with a provider, ask your lawyer to review it.

Helpful links and where to look for Wisconsin rules

Use these official resources to learn more or to help your lawyer locate precise law and administrative rules:

• Wisconsin State Legislature — statutes: https://docs.legis.wisconsin.gov/statutes/ (search for terms such as “lien,” “assignment,” “subrogation,” and specific program names)
• Wisconsin Department of Health Services (Medicaid/Medical Assistance) for state recovery rules and contacts: https://www.dhs.wisconsin.gov/medicaid/index.htm
• Medicare secondary payer and recovery rules (federal): https://www.cms.gov/

Helpful hints — quick checklist

• Do not sign medical provider liens without understanding what they mean for your settlement.
• Tell your lawyer about any government payer (Medicare/Medicaid) immediately.
• Get lien statements in writing and ask for itemized bills and proof of payment/charges.
• Negotiate liens — providers often accept less than the billed amount.
• Confirm in writing whether your attorney’s fee is taken from the gross or net recovery.
• Keep copies of all bills, communications, and releases related to medical care and liens.

Final notes and disclaimer

This article explains general principles and common practices under Wisconsin law but does not cover every possible situation. It is not legal advice. Laws and rules change, and outcomes depend on the exact facts, signed documents, and statutes or federal rules that may apply (for example, Medicare/Medicaid reimbursement rules). Consult a licensed Wisconsin attorney who handles personal injury and lien/subrogation issues for advice tailored to your case.