Answer:
I am not an attorney, however from personal experience being in a very bad crash. Once my case was settled, I was informed I had to pay back $40K in medical costs after the attorney got his 33% off the top. He negotiated, but I still paid back $30K.
On a workman's comp, my ex had to pay out $10K in medicals, plus the 20% from the top to the attorney.
I found all this to be underhanded in Wisconsin because neither of us were informed about this liability from our attorneys until directly after we signed the settlement.