---
kind: "section"
citation: "42 C.F.R. § 411.43"
title: "42"
number: "411.43"
heading: "Beneficiary's responsibility with respect to workers' compensation."
url: "https://uscodex.org/cfr/42/411.43"
---

# §411.43. Beneficiary's responsibility with respect to workers' compensation.

- (a) The beneficiary is responsible for taking whatever action is necessary to obtain any payment that can reasonably be expected under workers' compensation.
- (b) Except as specified in [§ 411.45(a)](/cfr/42/411.45.md?p=a), Medicare does not pay until the beneficiary has exhausted his or her remedies under workers' compensation.
- (c) Except as specified in [§ 411.45(b)](/cfr/42/411.45.md?p=b), Medicare does not pay for services that would have been covered under workers' compensation if the beneficiary had filed a proper claim.
- (d) However, if a claim is denied for reasons other than not being a proper claim, Medicare pays for the services if they are covered under Medicare.

## Notes

### Authority

Authority: 42 U.S.C. 1302, 1395w-101 through 1395w-152, 1395hh, and 1395nn.

### Source

Source: 54 FR 41734, Oct. 11, 1989, unless otherwise noted.