Cases

Settlement entered into between employer/carrier and claimant providing for an MSA to be administered by the claimant. A specific amount was to be utilized for seed money to fund the MSA with periodic annual payments as additional funding. According to the agreement, sums allocated for the MSA were final, not subject to change or dependent on the approval of the Center for Medicare and Medicare Services (CMS). If CMS required more money to fund the MSA for future medical expenses, the claimant would be responsible for paying or funding this sum. CMS in fact determined that less money was needed to fund the MSA. The employer/carrier filed a motion to require the claimant to reimburse an alleged overpayment of seed money. JCC granted the motion and claimant appealed.

 

JCC is authorized to determine whether a valid binding settlement agreement has been reached and if so, to establish its terms. In addition, the JCC has jurisdiction to determine whether a party complied with the terms of the settlement agreement. Interpretation of settlement agreements are governed by contract law. The standard of review with respect to a JCC’s interpretation of a written settlement agreement is de novo.

 

On appeal, court determined that, in interpreting the settlement terms, the employer/carrier was not entitled to reimbursement for any alleged overpayment. Claimant was solely responsible for administering the MSA and satisfying any requirements of CMS in approving the final MSA terms. The settlement sums designated in the agreement were final, not subject to reallocation and not subject to CMS approval.