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Claimant knowingly and voluntarily accepts responsibility for this risk and waives any and all <br />claims of any nature and/or damages against the Employer should Medicare take such action <br />including but not limited to a Private Cause of Action against the Employer under the Medicare <br />Secondary Payer Act (MSP) pursuant to 42 USC § 1395y(b)(3)(A). If the Claimant decides to <br />seek treatment for the accepted medical conditions outlined in this agreement without going <br />through the Self -insured Employer and/or the Department, and Medicare finds it covered and <br />provided for treatment that should have been paid for by funds associated with the worker's <br />industrial insurance claim(s), the Claimant agrees to accept responsibility for all costs and penalties <br />for that treatment assessed by the Center for Medicare & Medicaid Services, Medicare Secondary <br />Payer Recovery Contractors) collection agencies, or any other governmental entity's claims, <br />actions, judgments or settlements. <br />16. Assignability <br />The Claimant will not and has not already agreed to sell, mortgage, encumber or otherwise assign <br />any part of the payment. The payment will be made to the Claimant except in the event of the <br />Claimant's death In the event of the Claimant's death prior to the payment, payment will be rnade <br />in accordance with Section 17-Claimant's Beneficiaries. <br />17. Claimant's Beneficiaries <br />In the event of the Claimant's death prior to payment, the payment will be made in accordance <br />with Section 6-• Lump Sum Payment to such person or entity as designated in writing on a form <br />acceptable to the Department. If no such designation has been made, or the person is not living <br />at the time, such payment will be made to the Claimant's estate. <br />18. Attorney Fees <br />Each party shall pay all attorneys' fees and costs arising from the actions of its own counsel in <br />connection with the administration and litigation of the Claims and this agreement up to the date <br />this agreement becomes final. This provision is not intended to affect any rights the Claimant <br />.may have under RCW 51.52.130 to obtain attorney fees in any future superior court appeal <br />regarding the Claims. <br />Pursuant to RCW 51 52.120, the Claimant's attorney services are limited to 15% of the payment <br />made under Section 6-- Lump Sum Payment as compensation for work done in connection with <br />this agreement. <br />19. Filing for Approval <br />The parties acknowledge that this agreement must be approved by the Board, and that the <br />Employer will be responsible for filing for such approval pursuant to Board rules. The Employer <br />will file for approval no later than ten (10) days after receiving signed copies from all parties and <br />will send notification to all other parties upon filing. <br />20. Revocation <br />Any party may revoke this agreement by providing written notice to the other parties and to the <br />Pagel 12 <br />