Agenda

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County Attorney's Report 12. 2.

BCC Regular Meeting

Action

Meeting Date:	09/05/2019
Issue: Approval of Proposed Settlement of Workers' Compensation Claims Brought by Brenda Simmons
From:	CHARLES PEPPLER
Department:	County Attorney's Office
CAO Approval:

RECOMMENDATION:

Recommendation Concerning Approval of Proposed Settlement of Workers' Compensation Claims Brought by Brenda Simmons.

That the Board approve a proposed settlement in the sum of $405,000.00 in exchange for complete resolution of all claims for Workers' Compensation benefits as well as the execution of a general release. The excess carrier, Zenith Insurance Company, would be responsible for payment in full of the settlement.

BACKGROUND:

Ms. Simmons is a 68-year-old Workers' Compensation claimant who was employed for twenty-five years by Escambia County as a detention deputy (during this period of time, Ms. Simmons was either employed by the County or the Sheriff depending on which entity had control over the jail). During the course of her employment, she was involved in several compensable accidents. Her most significant compensable accident occurred on May 10, 2003 in which she sustained multiple injuries, including a severe injury to her low back.

Over the lengthy history of this claim, Ms. Simmons has undergone extensive medical treatment relating to her low back. Between 2004 and 2017, Ms. Simmons has been treated primarily with a pain management specialist. This doctor prescribed a series of facet injections and assigned light-duty restrictions. However, Ms. Simmons suffered a severe exacerbation of her symptoms following one of the injection procedures and she was referred to an orthopedic surgeon and spine specialist. This doctor recommended an L4-L5 laminectomy and fusion procedure. Ms. Simmons has postponed any decision on proceeding with surgery pending the approval of the proposed settlement.

Ms. Simmons has not been able to return to any meaningful occupation. Based upon the restrictions and limitations on her activities imposed by her treating physicians, Ms. Simmons is a viable candidate for being found to be permanently and totally disabled. If Ms. Simmons prevails on her pending PTD claim, the total exposure could exceed one million dollars. It should be noted that Ms. Simmons has incurred well over $300,000.00 in past medical expenses and that the recommended laminectomy could exceed $50,000.00. As Ms. Simmons is a Medicare beneficiary, approval by CMS has been obtained for a proposed Medicare set-aside allocation of $101,794.00 over her life expectancy.

A provisional settlement has been negotiated in which she would release the County and its excess insurer, Zenith, from future liability for Workers' Compensation benefits in exchange for the lump sum payment of $400,000.00 plus a $5,000.00 advance payment. The proposed settlement would fully and finally resolve all claims for medical benefits, indemnity benefits, attorney's fees and costs and would include a general release of any employment-related claims that she could potentially assert. Brian Hanley, the attorney retained by PGCS, the servicing agent for Zenith Insurance Company, has recommended that the Board approve the proposed settlement agreement.

BUDGETARY IMPACT:

The excess carrier would fully fund this settlement.

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.