This Decision is not final until expiration of the fourteen day rehearing period.
On Appeal from the Office of Workers' Compensation, In and for the Parish of Livingston, State of Louisiana. No. 11-01881. Honorable Gwendolyn F. Thompson, Judge Presiding.
Joe Arthur Sims, Hammond, Louisiana, Counsel for Plaintiff/Appellee, Wendell McCarroll.
K. Renee C. Willis, Baton Rouge, Louisiana, Counsel for Defendants/Appellants, Livingston Parish Council and Louisiana Workers' Compensation Corp.
BEFORE: PETTIGREW, McDONALD, AND McCLENDON, JJ.
[2013 2120 La.App. 1 Cir. 2]
An employer and its insurer appeal a judgment of the Office of Workers' Compensation (OWC), vacating the approval of a settlement between them and an employee. For the following reasons, we affirm.
FACTUAL AND PROCEDURAL HISTORY
It is not disputed that Wendell McCarroll was injured in a work-related accident on December 22, 2003, while employed with the Livingston Parish Council (Council). The Council's workers' compensation insurer, Louisiana Workers' Compensation Corporation (LWCC), began paying medical and indemnity benefits soon thereafter. Mr. McCarroll treated with various doctors, including Dr. Lori Summers, who recommended cervical fusion surgery in July 2008. Mr. McCarroll initially declined the surgery, and, in November 2008, LWCC began negotiating a settlement with Mr. McCarroll's attorney.
In early January 2009, the parties agreed to the terms of a settlement, including a Medicare Set Aside (MSA). The MSA projected future medical treatment and prescription drug treatment in the amount of $98,684.00. That amount was broken down into an estimate of $44,129.00 for future medical payments and $54,555.00 in future prescription costs. Of the $44,129.00 amount, $21,793.00 was allocated for Mr. McCarroll's recommended surgery. The MSA was to be funded through an annuity with seed money in the amount of $32,045.00 and an annual payment of $4,759.91 for a maximum of fourteen
years. There was also an agreement for an indemnity payment in the amount of $110,000.00. The MSA was submitted to the Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) for review and approval.
Thereafter, Mr. McCarroll decided to proceed with the cervical fusion surgery, and LWCC was contacted by the hospital for approval of the surgery. Because of the pending ...