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Ortega v. Cantu Services, Inc.

Court of Appeals of Louisiana, Third Circuit

May 2, 2018

MARY ORTEGA
v.
CANTU SERVICES, INC., ET AL.

          APPEAL FROM THE OFFICE OF WORKERS' COMPENSATION - # 2 PARISH OF RAPIDES, NO. 14-04296 JAMES L. BRADDOCK, WORKERS' COMPENSATION JUDGE.

          George Arthur Flournoy Flournoy, Doggett & Losavio P. O. COUNSEL FOR CLAIMANT/APPELLANT: Mary Ortega.

          Gregory John Laborde, Daigle Rayburn, LLC, COUNSEL FOR DEFENDANTS/APPELLEES: Liberty Mutual Insurance Company Cantu Services, Inc.

          Court composed of Marc T. Amy, Van H. Kyzar, and Candyce G. Perret, Judges.

          CANDYCE G. PERRET JUDGE.

         Mary Ortega appeals the judgment of the Office of Workers' Compensation denying her Motion to Enforce Settlement and for penalties and attorney fees after concluding the settlement was conditioned on CMS approval of a Medicare Set-Aside Agreement.

         FACTS AND PROCEDURAL HISTORY

         This workers' compensation case arises out of a work injury that Claimant-Appellant, Mary Ortega ("Ms. Ortega"), sustained while she was employed by Cantu Services, Inc. ("Cantu"). Ms. Ortega filed a Disputed Claim for Compensation on June 27, 2014. The parties reached a settlement agreement in 2016, which was judicially approved and recited in open court on September 1, 2016. The agreement was explained on the record by counsel for Cantu and its insurer, Liberty Mutual Insurance Company, as follows:

Mr. Laborde: Your Honor, we've agreed to compromise all claims asserted by Ms. Ortega in each docket number for the total sum of $120, 000.
We will file with CMS [Centers for Medicare and Medicaid Services] approval for a Medicare set-aside agreement [MSA] in the amount of $56, 049. The balance that would then be paid in benefits is $63, 951.
Now, the proviso is if CMS does not approve the requested amount, but alters it in any way, we will fund the MSA as directed by CMS and then adjust the amount to be paid in benefits accordingly, so that the total of the settlement still amounts to $120, 000. And we will continue to pay benefits until we get the CMS approval and the funds tendered to claimant.
Mr. Flournoy [counsel for Ms. Ortega]: . . . .
Yeah, that's right.
Judge Braddock: And you understand the nature of this ...

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