Court Mandates MSA Incorporation into Workers’ Compensation Settlement

An injured worker settled his workers’ compensation claim out of court.  The settlement terms included a provision that a Medicare Set-Aside (“MSA”) be submitted to the Center for Medicare Services (“CMS”) to determine the MSA allocation.  CMS approved the set-aside amount described in the MSA, and the employer filed a motion that the MSA be incorporated into the settlement.  The injured worker objected, arguing that the MSA was incorrect, despite the injured worker’s failure to provide to the employer and CMS necessary information to determine the adequacy of the MSA.  The workers’ compensation judge ordered that the MSA be incorporated into the settlement, and the injured worker appealed.

The injured worker alleged that the workers’ compensation judge erred in incorporating the MSA analysis into the settlement.  He argued that the MSA should not have been admitted on the grounds of hearsay, competency and relevance.  The appellate court held that it was reasonable for the workers’ compensation judge to conclude that the MSA would be the only evidence submitted to complete the analysis of the injured worker’s future medical needs.  Additional information was requested numerous times from the injured worker, delaying the settlement for two years, and the appellate court found no reason why the Office of Workers’ Compensation should have to wait more than two years for additional information.

The appellate court affirmed the workers’ compensation judge’s finding that the MSA analysis, approved by CMS, should be incorporated into the settlement agreement.

Louisiana Commerce & Trade Ass’n, SIF v. Williams