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County Attorney's Report 10. 4.

BCC Regular Meeting

Action

Meeting Date:	11/05/2020
Issue: Approval of Proposed Settlement of Medical Benefits in Workers' Compensation Claim Brought by Walter Johnson
From:	CHARLES PEPPLER
Department:	County Attorney's Office
CAO Approval:

RECOMMENDATION:

Recommendation Concerning Approval of Proposed Settlement of Medical Benefits in Workers' Compensation Claim Brought by Walter Johnson.

That the Board approve a proposed settlement in the sum of $85,000.00 for past and future medical benefits, payable to former employee Walter Johnson. If approved, all settlement funds would be reimbursed by the excess carrier.

BACKGROUND:

Walter Johnson is a 70-year-old male who has sustained injuries as a result of an accident in the course and scope of his employment as an equipment operator for Escambia County. On June 25, 1982, Mr. Johnson sustained injuries primarily to his lower back and right shoulder while operating a County truck. Also arising from his employment, he developed hearing loss and hypertension. All of these medical conditions were causally linked to his employment as a heavy equipment operator and have been accepted as compensable.

Since the accident, Mr. Johnson has undergone extensive treatment for his injuries and medical conditions. He has incurred more than $113,000.00 in medical benefits since the commencement of his claim. In 2005, it was determined that he could no longer work in any capacity. Since then, he has been paid permanent total disability benefits and associated supplemental benefits. However, at this point in time, neither Mr. Johnson, nor the excess carrier is interested in settling his future entitlement to indemnity benefits.

Because of his ongoing health conditions that necessitate extensive medical care, he will almost certainly continue to require authorized medical treatment for the rest of his life. Mr. Johnson is a Medicare beneficiary and any settlement of medical benefits in excess of $25,000.00 has required approval by the Centers for Medicare and Medicaid Services (CMS). The carrier has obtained approval by the CMS of a Medicare set-aside arrangement in the sum of $49,887.00. However, the MSA proposal does not include anticipated expenditures regarding Mr. Johnson's hearing aids or other medical equipment. As he continues to age, medical costs for these conditions will increase.

Pursuant to Section 440.20(11), Fla. Stat., the parties recently negotiated a provisional settlement agreement releasing the County and PGCS (the third-party administrator) from future liability for medical benefits in exchange for a lump sum payment of $85,000.00. As the self-insured retention has been exhausted, the excess insurance carrier will be responsible for reimbursing the County these settlement funds. The excess carrier has already approved the proposed settlement amount. Brian T. Hanley, insurance-retained counsel representing the County in this Workers' Compensation claim, recommends approval of the proposed settlement.

BUDGETARY IMPACT:

N/A

LEGAL CONSIDERATIONS/SIGN-OFF:

Mr. Hanley will prepare the settlement documents.

PERSONNEL:

N/A

POLICY/REQUIREMENT FOR BOARD ACTION:

N/A

IMPLEMENTATION/COORDINATION:

N/A

Attachments
No file(s) attached.