Cases

Settlement agreement was contingent on approval of a Medicare set aside arrangement (MSA) by the Centers for Medicare and Medicaid Services (CMS). Because no such approval occurred, the court determined that the claimant could void the settlement. JCC erred in enforcing a mediation settlement agreement.

 

CMS approval was not necessary to approve the MSA prior to settlement since the claimant was not a Medicare beneficiary, was not expected to be such a beneficiary within 30 months, and the settlement was for less than $250,000. Because of this, the employer/carrier declined to submit the MSA for approval, informed the claimant’s attorney of this development, and forwarded the final settlement release documents for the claimant’s signature. The claimant refused to sign the settlement documents since there was no CMS approval.

 

In determining the intent of a settlement agreement, appellate review is de novo. A court may look beyond the language of a contract only when the document’s terms are ambiguous. Whether an agreement is ambiguous is a question of law, and review is de novo. Court determined that settlement documents were not ambiguous and since there was no CMS approval, the claimant could void the agreement.