Opinion

Simmons v. Secretary of Health and Human Services

Court
United States Court of Federal Claims
Filed
Jun 24, 2019
Status
Published
On the bench
Laura D. Millman
Cited by
0 cases
Authority
More cited than 8.0%

The opinion

In the United States Court of Federal Claims

OFFICE OF SPECIAL MASTERS

No. 11-216V

Filed: May 28, 2019

To be Published

*************************************

JEFFREY DAVID SIMMONS, *

*

Petitioner, * Tdap vaccine; anaphylactoid

* response; immune problems;

* Addison’s-like disease; damages

v. * decision

*

SECRETARY OF HEALTH *

AND HUMAN SERVICES, *

*

Respondent. *

*

*************************************

Clifford J. Shoemaker, Vienna, VA, for petitioner.

Lynn C. Schlie, Washington, DC, for respondent.

MILLMAN, Special Master

DECISION ON DAMAGES1

On April 7, 2011, petitioner filed a petition under the National Childhood Vaccine Injury

Act, 42 U.S.C. § 300aa-10-34 (2012), alleging that the tetanus toxoid-diphtheria-acellular

pertussis (“Tdap”) vaccine he received on April 11, 2008 caused him anaphylaxis, immune

dysregulation, and autoimmune disease leading to Addison’s disease. Pet. at ¶ 107. Petitioner

was 38 years old when he received Tdap vaccine. He is now 49 years old.

On October 30, 2015, the undersigned ruled that petitioner is entitled to compensation,

holding “. . . it is reasonable to connect petitioner’s entire immunologic reaction to his adverse

response [to the Tdap vaccine]. . . . [P]etitioners do not have the burden of proving a specific

biological mechanism.” Simmons v. Sec’y of HHS, No. 11-216V, 2015 WL 6778563, at *8

(Fed. Cl. Spec. Mstr. Oct. 30, 2015). Since then, the parties have been engaged in resolution of

damages. Both parties have filed life care plans but have failed to settle damages.

1

In accordance with Vaccine Rule 18(b), petitioner has 14 days to identify and move to redact medical or

other information, the disclosure of which would constitute an unwarranted invasion of privacy. If, upon

review, the undersigned agrees that the identified material fits within this definition, the undersigned will

redact such material from public access. This means the remainder of the decision will be available

to anyone with access to the Internet.

One barrier to settlement was the calculation of petitioner’s lost wages. On July 19,

2016, petitioner’s economist Dr. Robert W. Cook submitted his first expert report stating

petitioner’s net lost income is $4,950,921.00. Doc 113-2.

On May 23, 2017, respondent filed his first expert report from his economist Dr. Patrick

F. Kennedy stating petitioner has $1,017,816.00 in loss of earnings and benefits. Doc 143-1.

During a status conference held on June 5, 2017, the undersigned gave petitioner until June 30,

2017 to file Dr. Cook’s responsive report.

On September 20, 2017, petitioner filed the first affidavit of Mr. Jeff Barrom, a Senior

Vice President with Hub International Northwest, LLC (“HUB International”). Doc 148-2.

On October 30, 2017, after three motions for an extension of time, petitioner filed Dr.

Cook’s supplemental (second) expert report based on information provided in Mr. Barrom’s first

affidavit, concluding petitioner has $3,978,303.00 in net lost income. Doc 150-2.

During a status conference held on November 17, 2017, the undersigned discussed the

parties’ expert reports (Docs 113-2, 143-1, and 150-2) and Mr. Barrom’s affidavit (Doc 148-2).

On November 20, 2017, the undersigned issued an order addressing several issues in the parties’

economic expert reports, requiring Mr. Barrom to answer respondent’s additional questions and

each party to file their supplemental economist reports. Doc 151. In the same Order, the

undersigned required the parties’ experts, in their supplemental expert reports, to use: (1) the

same date, January 1, 2018,2 as the demarcation between petitioner’s past and future damages,

subject to future changes; (2) the same lengths of life expectancy (March 8, 2049) and work life

expectancy (May 28, 2033); (3) $42,070.00 as the base W-2 income in 2009 to calculate

petitioner’s incomes from 2010 to at least March 31, 2014; and (4) Employment and Earnings for

Insurance Agencies and Brokerages (“EEIAB”) as the source for projections of petitioner’s wage

growth since the data are specific to the insurance industry. Id. at 2-3.

On January 25, 2018, petitioner filed Mr. Barrom’s second affidavit, in which Mr.

Barrom said he cannot provide copies of the material upon which he relied because the material

is “confidential and proprietary.” Doc 153-2, at 1.

On April 10, 2018, petitioner filed Dr. Cook’s supplemental (third) expert report

providing petitioner’s lost wages as “no less than $2,619,329.00 and no more than

$3,698,921.00.” Doc 159-2, at 9. On April 16, 2018, respondent filed Dr. Kennedy’s

supplemental (second) expert report in response to the undersigned’s Order of November 20,

2017 and to Mr. Barrom’s second affidavit. Doc 160-1.

In an email on April 27, 2018 to the undersigned’s law clerk, respondent stated if

petitioner intended to continue to rely on Mr. Barrom’s affidavits, he should produce the material

2

The undersigned in the March 14, 2019 ruling made the demarcation between past and future damages March 14,

2019 and not January 1, 2018.

2

upon which Mr. Barrom relied in his statements supporting petitioner’s loss of earnings. On

April 27, 2018, petitioner filed a status report asserting that the record on lost wages was

complete and Mr. Barrom would not be able to provide copies of documentation upon which he

relied in his affidavits due to confidentiality and proprietary issues. Doc 161, at 1.

On April 30, 2018, the undersigned issued an order requiring respondent to file a Motion

for Discovery of the material upon which Mr. Barrom relied in his affidavits. On May 21, 2018,

respondent filed a Motion for Production of Documents Regarding Petitioner’s Lost Wages

Claim (“Motion for Production”).

On May 22, 2018, petitioner filed a Notice of Clarification and Partial Response to

Motion to Produce Documents stating that because petitioner is not in possession of the

documents and has no ownership of the documents, respondent should be seeking Third Party

Discovery as neither Mr. Barrom nor HUB International is a party in this case. Doc 165, at 1.

On June 5, 2018, respondent filed a response to Petitioner’s Notice of Clarification and

Response to Motion to Produce Documents stating that it is petitioner’s burden to prove

petitioner’s damages and “a special master cannot award over $1 million in additional lost wages

based on a third party’s interpretation of undisclosed evidence that neither party nor the Court

has seen.” Doc 167, at 2.

On the same day, the undersigned ordered each party to select by June 19, 2018 one of

three options: (1) the undersigned will hold a hearing on economic loss with Dr. Cook, Dr.

Kennedy, and Mr. Barrom as witnesses; (2) petitioner shall serve a subpoena duces tecum on

HUB International to produce the documents upon which Mr. Barrom relied in his affidavits; or

(3) the undersigned will decide the issue of lost wages on motion for a Ruling on the Record.

On June 19, 2018, after respondent filed a status report choosing option (2), petitioner

filed a status report requesting 30 days to provide the updated life care plan costs and a Motion

for Ruling on the Record incorporating all elements of compensation. The undersigned granted

petitioner’s informal motion and ordered petitioner to file a Motion for Ruling on the Record

incorporating all elements of compensation by July 18, 2018. The undersigned denied

respondent’s Motion for Production as moot.

On July 17, 2018, petitioner filed an updated summary chart of all past unreimbursable

medical expenses (Docs 173-2 and -3) and petitioner’s updated life care plan (Doc 173-4) with

an analysis of cost differences between his plan (Docs 128-2 and 173-4) and respondent’s plan

(Doc 136-6). On July 18, 2018, petitioner filed his Medicaid Lien update and a press release

regarding Mr. Barrom.

On July 18, 2018, petitioner filed a Motion for [a] Ruling on Damages Award

(“motion”).

On August 29, 2018, the case was referred to another special master for a mandatory

3

settlement conference.3 By email contact with the undersigned’s law clerk and the mediator’s

law clerk, the parties on two occasions expressed a wish not to participate in mediation but to

have the undersigned rule on the record.

On October 26, 2018, respondent filed a response to petitioner’s motion (“response”).

On November 2, 2018, petitioner filed a reply to respondent’s response to petitioner’s

motion (“reply”).

On November 20, 2018, petitioner filed Exhibit 91 consisting of a final Medicaid lien

amount of $465.36. On the same date, petitioner filed a status report stating that there were no

outstanding items left for petitioner to file and the case was ripe for the undersigned’s decision

on damages. Later, on March 27, 2019, petitioner filed a status report stating that Centenne-

Washington-Coordinated Care had retained Equian to process its lien of $465.36 and the

payment of such lien should be made payable to: Equian LLC, P.O. Box 32140, Louisville, KY

40232-2140.

On December 11, 2018, the undersigned issued a Ruling on Damages (which the

undersigned withdrew on March 13, 2019 because of a dispute between the parties over whether

petitioner’s premium payments for health insurance were recoverable under the Vaccine Act).

On the same day, the undersigned removed this case from mediation.

On December 17, 2018, petitioner filed a Motion for Reconsideration, requesting the

undersigned include the updated past cost of life insurance premiums ($6,765.21) as part of the

total of updated past expenses in the damages award. Although on December 18, 2018, the

undersigned denied petitioner’s Motion for Reconsideration, on December 19, 2018, the

undersigned withdrew the denial of petitioner’s Motion for Reconsideration and issued an Order

granting the Motion for Reconsideration.

Five weeks elapsed because of a partial federal government shutdown.

On March 5, 2019, respondent filed a Response to Ruling on Damages Award, requesting

the undersigned give respondent the opportunity to reply to petitioner’s Motion for

Reconsideration and withdrawing the December 11, 2018 Ruling on Damages to reissue the

Ruling on Damages with a complete listing of specific parameters. The undersigned held a

telephonic status conference with the parties on March 13, 2019 to clarify these requests.

On March 13, 2019, the undersigned issued an Order withdrawing the December 19,

2018 Order granting petitioner’s Motion for Reconsideration and withdrawing the undersigned’s

December 11, 2018 Ruling on Damages which included $25,499.50 in past unreimbursable

medical expenses (which award was the subject of petitioner’s Motion for Reconsideration).

3

The Office of Special Masters had implemented a mandatory settlement program for certain non-autism

cases filed in 2012 or beforehand.

4

On March 14, 2019, the undersigned issued a Ruling on Damages Award in a response to

the parties’ wishes.

This more specific Ruling on Damages did not include any past unreimbursable medical

expenses because the undersigned was waiting until April 15, 2019 for respondent to respond to

petitioner’s Motion for Reconsideration whether to include the $6,765.21 cost for health

insurance premiums to the amount of $25,499.50 which would then bring the total award for past

unreimbursable medical expenses to $32,264.71. The undersigned set a deadline of two days

until April 17, 2019 for petitioner to file a reply.

In addition, the undersigned set a deadline of April 15, 2019 for respondent to file a

report by April 15, 2019, updating the figures for wage loss and other items from respondent’s

prior filings, including net present value and growth rates for appropriate items. The

demarcation date for past and future damages was the date of this Ruling, March 14, 2019.

After petitioner filed a reply to respondent’s response to petitioner’s Motion for

Reconsideration, the undersigned would issue a Damages Decision including the updated figures

reflecting net present value and growth rate, and the amount of past unreimbursable medical

expenses.

On March 20, 2019, petitioner filed a Status Report Regarding Damages. Petitioner

wants the undersigned to award the deductible/Max OOP in order to obtain all the medications

petitioner says he requires. S.R. at 3-4. Petitioner also wanted companion care that petitioner

argues he needs. Id. at 4. Petitioner wants $13,608.40/year for companion care; $680.00/year

for snow removal; $9,790/year for lawn care; and $3,575/year for handyman repair for a total of

$24,653.40. Id. Respondent recommends $4,082.52/year for companion care; $480/year

through 2040 for snow removal; $4,850/year through 2040 for lawn care; and $750/year now

through 2040 for handyman repair work for a total of $10,162.52/year. Id. at 4-5.

On April 15, 2019, respondent filed a Response to Petitioner’s Motion to Reconsider Past

Out of Pocket Expenses. Respondent states that petitioner’s insurance premiums are not

compensable under 42 U.S.C. § 15(a)(1)(B)(i)-(iii), and petitioner has not proven entitlement to

compensation of his employer’s share of his health insurance premiums under § 300aa-

15(a)(3)(A). S.R. 1, 3. Moreover, respondent notes petitioner did not provide evidence of a

fringe benefit loss of what Argus Insurance, Inc., his former employer, contributed to his

premiums while he worked there. Id. at 6. Respondent points out petitioner could have made

this claim under a lost wages analysis. Id. However, respondent states since petitioner did not

provide the requisite evidence, the undersigned cannot award the $6,765.21 for past health

insurance premiums. Id. at 7.

On April 15, 2019, respondent filed Exhibit W, an updated loss of earnings calculation in

accordance with the undersigned’s March 14, 2019 Ruling on Damages Award. The total

potential economic loss is $1,079, 981.00 (including $406,642.00 for past loss of earnings

and benefits and $673,339.00 for future loss of earnings and benefits). Ex. W, at 1.

5

On April 15, 2019, respondent filed a Motion for Extension of Time for two weeks to file

updated future care costs. The undersigned granted the motion.

On April 16, 2019, petitioner filed a Reply to Respondent’s Response to the Motion for

Reconsideration of Insurance Premiums, saying special masters routinely award past insurance

premiums when the petitioner’s prior insurance came from his or her employer and petitioner

was unable to work due to a vaccine injury. Reply, at 2.

On April 16, 2019, petitioner filed Exhibit 92, a compilation of petitioner’s insurance

premiums from Feb. 9, 2010 to Dec. 1, 2014, for a total of $6,096.79. Ex. 92, at 1-2.

On April 24, 2019, respondent filed his Surreply to Petitioner’s Motion to Reconsider

Past Out of Pocket Expenses. Respondent notes that the cases petitioner referenced as

supporting petitioner’s view do not support his view. Surreply, at 1-2. Respondent repeats his

assertion that petitioner’s claim for insurance premiums is not accompanied with proof such as

receipts, transaction confirmations, or credit card statements in support of his claimed payments

or that his former employer Argus paid for or contributed to his health insurance premiums. Id.

at 2.

On April 29, 2019, respondent filed a Second Motion for Extension of Time to file

updated future medical costs and proposed growth rates. The undersigned granted the motion.

On May 9, 2019, respondent filed his Status Report Regarding Future Care Items. This

damages decision relies upon respondent’s most recent status report and agrees with respondent

that petitioner is not entitled to maximum out-of-pocket medical costs (“max OOP”) since the

types of treatments and medications do not appear to be reasonably necessary and respondent has

provided for those drugs that the health insurer will not cover (hydrocortisone, aldosterone, and

Excedrine) in the status report. The undersigned also agrees that petitioner has not filed credible

proof of unreimbursed past medical premiums. On April 16, 2019, petitioner filed Exhibit 92,

consisting of “Past Expenses (Insurance Premiums”). Exhibit 92 consists of two pages of

premiums paid from February 9, 2010 to December 1, 2014 followed by two pages of e-mails

from petitioner to an insurance agent. The sum total of the two pages of premiums is $6,096.79.

Petitioner has not explained if this sum is in addition to or in lieu of the $6,765.21 petitioner

previously claimed was his out of pocket expense for health insurance premiums. This jumble

of figures and absence of interpretation make awarding petitioner the cost of past health

insurance premiums not awardable. Therefore, the undersigned DENIES petitioner’s Motion

for Reconsideration.

On May 13, 2019, the undersigned issued a Decision on Damages.

On May 22, 2019, the parties filed a Joint Motion to Withdraw May 13, 2019 Decision

on Damages and Enter Decision with Amended “Award of Compensation” Section to add an

amount for loss of ownership income and the amounts for petitioner’s blood draws and mileage

6

to doctors, as well as eliminating a duplication of an award for the same Medicaid lien. The

Joint Motion also has an Appendix for the undersigned to append to the undersigned’s new

damages decision. The undersigned granted the Joint Motion to Withdraw May 13, 2019

decision on the same day.

On May 23, 2019, the undersigned issued a Decision on Damages.

On May 24, 2019, the parties filed a Joint Motion to Withdraw May 23, 2019 Decision

on Damages and Enter Amended Decision Including Previously Awarded Past Unreimbursable

Medical Expenses. The undersigned granted the Joint Motion to Withdraw the May 23, 2019

the same day.

Below, is the undersigned’s reasoning for awarding wage loss based on respondent’s

economic expert’s reasoning, discussing the parties’ positions on wage loss. The undersigned

then incorporates the wage loss award and the other elements of damages, including the minor

amount for a Medicaid lien and unreimbursable expenses.

MOTION AND FILINGS REGARDING WAGE LOSS

On July 18, 2018, petitioner filed his Motion for [a] Ruling on Damages Award.

Petitioner updated his calculation of economic loss to $4,480,530.62, consisting of wage loss of

$3,698,921.00, life care plan costs of $753,837.00, unreimbursable medical expenses of

$25,499.50, and Medicaid Lien of $2,173.12, and asserted that he is entitled to the full

$250,000.00 in pain & suffering. Doc 176.

On October 26, 2018, respondent filed his response rejecting the amount of each damage

component requested in petitioner’s motion arguing: (1) because petitioner relies upon Mr.

Barrom’s affidavits in the absence of corroborating evidence needed to support his valuation of

lost wages, respondent requested the undersigned award lost earnings in accordance with

respondent’s economist Dr. Kennedy’s analysis and projections, which is $1,019,102.00 (Doc

160-2, at 1); (2) because a petitioner cannot recover damages for a non-identified autoimmune

disease (referring to the Vaccine Act without a citation and citing Broekelschen v. Sec’y of HHS,

618 F.3d 1339 (Fed. Cir. 2010)) and Dr. Weiss4 is the only expert respondent says is qualified to

opine on petitioner’s proper treatment in this case, petitioner’s past unreimbursable medical

expenses and life care plan costs should be reduced to include adrenal insufficiency, petitioner’s

only “defined and recognized injury”; (3) the undersigned should not compensate petitioner

Medicaid Lien since he has not provided an itemized list of the services paid for by Medicaid on

his behalf; and (4) petitioner is not entitled to the maximum award of $250,000.00 for actual pain

and suffering, but respondent defers to the undersigned’s discretion. Doc 184, at 5-15.

4

On November 13, 2016, one year and two weeks after the undersigned issued a Ruling on Entitlement in

favor of petitioner, respondent filed an expert report of Dr. Roy E. Weiss, an endocrinologist, as Exhibit

M. Dr. Weiss states there is no evidence in this case that petitioner has Addison’s disease. Id. at 1. Dr.

Weiss then criticizes the costs for medications, blood tests, care givers, and transportation petitioner’s life

care planner included in the life care plan.

7

On November 2, 2018, petitioner filed his reply to respondent’s response. Petitioner

argues: (1) petitioner has produced substantial underlying documentation of his lost wages

demand with three economist reports from his expert Dr. Cook and two affidavits from a fact

witness Mr. Barrom who has provided answers to all of respondent’s and the undersigned’s

questions; (2) respondent’s reliance on Broekelschen is misplaced and the undersigned made it

clear in her ruling on entitlement that petitioner does not have full-blown Addison’s disease;

therefore, petitioner is entitled to compensation for his past unreimbursable medical expenses

and life care plan costs in full; (3) petitioner is entitled to the full $250,000.00 in pain and

suffering since his suffering has already exceeded the statutory cap based on his wife’s

testimony; and (4) petitioner will provide the final Medicaid Lien as soon as possible. Doc 186,

at 1-6.

DISCUSSION

I. Lost Wages

For calculating petitioner’s lost earnings award, petitioner’s expert Dr. Cook projects the

following five categories of income into the future:

(a) Petitioner’s expected base salary as an employee of Argus Insurance Inc. (“Argus”);

(b) Petitioner’s expected K-1 income as part owner of Argus;

(c) Petitioner’s W-2 income as the result of the transfer of retiring agent accounts;

(d) Employer contributions to petitioner’s 401(k) account; and

(e) The sale value at retirement of petitioner’s ownership interest in Argus.

Doc 159, at 3.

On the other hand, respondent’s expert Dr. Kennedy believes that the only component

that should be included in the calculation is petitioner’s W-2 base salary and commissions (“W-2

income”). In his first expert report, Dr. Kennedy analyzes petitioner’s K-1 income for

illustrative purposes only. Doc 143-1, at 5. Because petitioner’s affidavit and a 2009 K-1 were

the only support at that time for petitioner’s loss of annual K-1 income from January 1, 2009 to

April 1, 2014 when Argus was sold to HUB International, Dr. Kennedy argues that he “cannot

opine that it is more likely than not that the 2009 K-1 income would have continued at the same

level in all future years.” Id. at 4.

On September 20, 2017 and January 24, 2018, petitioner filed Mr. Barrom’s two

affidavits, both of which support petitioner’s K-1 income calculation. However, Dr. Kennedy

maintains in his second expert report that no supporting documentation has been produced that

could be used to verify that petitioner’s statements and calculations for his loss of K-1 income

are accurate. Doc 160-1, at 3. For the same reason, Dr. Kennedy disagrees with including

petitioner’s retiring producer W-2 income in the calculation of petitioner’s past and future loss of

earnings. Id. at 5.

8

In addition, the parties disagree on the present value methodology. While Dr. Cook uses

a two-step discounting approach, Dr. Kennedy uses a one-step net discount rate (“NDR”)

approach.

Thus, the main disagreements between the parties are: (1) whether Mr. Barrom’s

affidavits in the absence of part or all corroborating evidence are sufficient to support petitioner’s

valuation of the disputed components of his lost earnings, which include W-2 income, ownership

income,5 and retiring producer W-2 income; and (2) the method in the calculation of the present

value of petitioner’s future wage loss.

A. W-2 Income

In his first expert report, Dr. Cook takes petitioner’s base W-2 income in 2009 as

$42,000.00 and projects it into the future with the wage growth rates based on Board of Trustees

– Federal Old-Age and Survivors Insurance and Disability Insurance Trust Funds (“OASDI”).

Doc 113-2, at 11. The sum of petitioner’s W-2 income was $1,450,731.00.

In his first expert report, Dr. Kennedy uses the base W-2 income in 2009 as $42,070.00

and projects it into the future with the wage growth rates based on EEIAB, which the

undersigned ruled as the preferable basis in her Order of November 20, 2017. Doc 143-1, at 3.

The sum of petitioner’s W-2 income was $1,017,816.

In his second expert report, Dr. Cook raises the base W-2 income starting in 2010 from

$43,100.00 to $112,500.00, relying solely on Mr. Barrom’s answer to Question 6 in his first

affidavit, resulting in an increase in the sum of petitioner’s W-2 income from $1,450,731.00 in

Dr. Cook’s first report to $3,086,441.00. Doc 150-2, at 2-3. The undersigned identified this

issue in her Order of November 20, 2017:

Question 6 in Mr. Barrom’s affidavit, dated September 20, 2017, reads “Jeff’s

HUB/Argus Income 2014-today? Rather, from what income would Jeff’s

share have been calculated? If prefer to simply state what Jeff’s income would

have been today.” According to Mr. Barrom’s Answer 6, the annual income

of an insurance agent on the same track as petitioner was would be, if all

production goals were met, between $100,000.00 and $125,000.00. The

undersigned finds this answer is too vague for the parties’ experts to use as a

base annual salary from April 1, 2014, the time of sale of Argus to HUB.

While “2014-today (September 20, 2017)” is an over 3-year period of time,

Mr. Barrom did not specify in his answer what was the time period he

intended. Furthermore, no information explains why the base W-2 salary

before the sale of Argus ($42,070.00) and after (between $100,000.00 and

$125,000.00) would be so different if, as Mr. Barrom stated in his Answer 2,

5

Petitioner’s loss of ownership income includes both loss of K-1 income from January 1, 2010 to April 1,

2014 and the loss on the sale of Argus ownership interest in 2014. Doc 143-1, at 5.

9

“the model of compensation for agents [at HUB] is similar to what was in

place at Argus at the time of the sale.” Dr. Cook should not have in his

second report increased petitioner’s W-2 salary to $112,500 from 2010, over

three years before the sale of Argus.

Doc 151, at 2. The undersigned instructed Dr. Cook to change his calculation of annual income

to reflect these corrections. Id.

In his third expert report, Dr. Cook relies solely on Mr. Barrom’s answer to Question 4 in

his second affidavit to run petitioner’s W-2 income from 2010 to 2017 and then based on the

2017 W-2 income projection to calculate petitioner’s future wages from 2018 to 2033. While

Mr. Barrom stated in his first affidavit that “it is difficult to speculate exact incomes” and

provided the estimated annual earnings range for 2017 of $100,000.00 - $125,000.00 (Doc 148-

2, at 2), he provides in his second affidavit a spreadsheet showing an estimated 2010

compensation of $62,070.00 growing to an estimated $121,024.00 by 2017 without providing

any database or supporting documentation (Doc 153-2, at 2-3). Dr. Cook adopts Mr. Barrom’s

projections without providing any further explanation or analysis. The undersigned finds that

Mr. Barrom’s projections of petitioner’s W-2 income from 2010 to 2017 and Dr. Cook’s

adoption of Mr. Barrom’s projections in his third expert report are speculative and inconsistent

with petitioner’s historical earnings and the industry data.

In his second expert report, Dr. Kennedy states that “while the information provided by

Mr. Barrom appears to support some of [p]etitioner’s damages calculations, no supporting

documentation has been produced that could be used to verify that his statements and

calculations are accurate.” Doc 160-1, at 3. Because petitioner is claiming a level of wages

and wage growth that are materially higher than statistical earnings data for insurance agents in

general and are inconsistent with petitioner’s historical wage growth prior to vaccination, Dr.

Kennedy argues that it is important to understand how Mr. Barrom arrived at his projections and

what documentation or information upon he relied in making his projections. Id. at 4.

In her Order of June 5, 2018, the undersigned provided petitioner with an option of

serving a subpoena duces tecum on HUB International to produce the documents upon which

Mr. Barrom relied in his affidavits; however, petitioner chose to file a motion for ruling on the

record. The undersigned agrees with Dr. Kennedy that it is important for a damages expert to

verify the information that forms the basis of a loss calculation, especially when petitioner’s

claimed net losses of nearly $4 million are based on projected wages that are much higher than

his prior years’ earnings as well as the statistical earnings data for insurance agents as collected.

The undersigned finds that the underlying material upon which Mr. Barrom based his projections

is necessary for the undersigned to reach a fair and well-informed decision concerning

petitioner’s W-2 income. Therefore, in the absence of petitioner’s filing this material, the

undersigned rules in favor of respondent on the calculation of petitioner’s W-2 income.

B. Ownership Income

10

Effective January 1, 2009, petitioner purchased a 4.99% ownership interest in Argus and

executed a promissory note for the $550,310.48 purchase price payable to Argus. Petitioner

received $118,366.00 in business income via K-1 (“K-1 income” or “business income”) from

Argus in 2009. On April 1, 2014, HUB International acquired Argus and all holders of

promissory notes were required to pay them off with the proceeds from the sale to HUB

International. Doc 148-2, at 2. The sale price of Argus to HUB International is confidential.

Id. In his first affidavit, Mr. Barrom provided the exact amount of gross distributions from

petitioner’s 4.99% ownership shares for 2010 through 2014 in the absence of any supporting

documents. Id. at 1. In his second affidavit, Mr. Barrom stated that petitioner would have

received the full approximate gross distribution for 2014 regardless of the sale of Argus in April

2014. Doc 153-2, at 2.

In his second expert report, Dr. Cook agrees with Dr. Kennedy that the calculation for

petitioner’s K-1 income should not increase annually for the duration of petitioner’s work life

expectancy since January 1, 2010. Instead it should terminate on April 1, 2014 when HUB

International acquired Argus. Doc 150-2, at 3. In both his second and third expert reports, Dr.

Cook adopts the exact amount of gross distributions that Mr. Barrom provided, resulting in

$499,344.00 of petitioner’s lost K-1 income before tax for 2010 through 2014.

In his first expert report, for illustrative purposes only, Dr. Kennedy analyzes petitioner’s

lost business income from January 1, 2010 to April 2014, using petitioner’s annual K-1 income

of $118,366.00 for 2009 and adjusting the annual compensation at the wage growth rates based

on EEIAB. Doc 143-1, at 5. Petitioner’s potential lost K-1 income after tax is $432,123.00.

Doc 143-5, at 3. Dr. Kennedy then projects petitioner’s promissory note payments6 as an

offset to his potential damages and adds petitioner’s loss on sale of Argus ownership interest in

2014,7 resulting in a total of $338,859.00 as petitioner’s potential economic loss of his

ownership income after tax. In both his expert reports, Dr. Kennedy believes that a single K-1

for 2009 is not sufficient to determine petitioner’s loss of business income for 2010 through

April 2014. Doc 143-1, at 5 and Doc 160-1, at 1. Therefore, Dr. Kennedy does not include

petitioner’s potential economic loss of his ownership income in his calculation of petitioner’s

lost earnings award.

Because petitioner owned a 4.99% ownership interest in Argus, received a distribution in

6

Petitioner took out a $550,310.48 loan to acquire Argus shares, effective January 1, 2009, with monthly

payments of $4,946.35 or $59,356.00 annually. Doc 143-5, at 3. Dr. Kennedy estimates that

petitioner’s payments ended upon the sale of Argus to HUB International in April 2014. Id.

7

Because the sale price of Argus to HUB International is confidential, Dr. Kennedy projected petitioner’s

loss on sale of Argus ownership interest in 2014 by applying a capitalization rate to net income as a

common valuation tool. “2009 K-1 income was $118,366.00. Restated to 2014 dollars, annual K-1

income is $138,777.00. K-1 Income / Capitalization Rate = Ownership Value ($138,777.00 / 24% =

$578,238.00).” Doc 143-1, at 5 n.4. From the $578,238.00 of Argus share value, Dr. Kennedy

deducted the remaining principal balance on the note payable for a net pre-tax amount of $165,143.00.

Id. at 5. In his second expert report, Dr. Cook agrees with Dr. Kennedy’s methodology. Doc 150-2, at

4.

11

2009, and provided his 2009 K-1, the undersigned finds an award for petitioner’s loss of

ownership income reasonable in this case. However, because Mr. Barrom will not provide any

documentation to support his projections of petitioner’s business income for 2010 through 2014,

the calculation for petitioner’s loss of business income should be based on petitioner’s K-1

income of $118,366.00 for 2009 and the wage growth rates according to EEIAB. In other

words, the undersigned agrees with Dr. Kennedy’s calculation of petitioner’s potential lost

ownership income. Doc 143-5, at 1-4. Therefore, the undersigned rules that petitioner is

entitled to $338,859.00 as his loss of ownership income.

C. Retiring Producer W-2 Income

Unlike petitioner’s K-1 income, his claimed retiring producer income was not included in

petitioner’s 2009 tax documents. Petitioner claims that he was going to be compensated for

retiring producer income in 2010. Doc 131-2, at 2. In his first affidavit, Mr. Barrom stated that

“I no longer have records for such things but [petitioner] is honest and the retiring or transition

plan he submitted indicated payments in 2010, so yes he would have been paid the applicable

renewal commission that Argus used at that time, which would have been 25% had he met the

previous year new business goal and if not it would have been 20%.” Doc 148-2, at 3. Mr.

Barrom later confirmed that had petitioner been employed at Argus in 2010, he would have

received commission income for the retiring producer accounts that he had been working on in

2008 and 2009 and the retiring producer income would have been reported in his 2010 W-2.

Doc 153-2, at 3. According to Mr. Barrom’s affidavits, it takes one to three years for the

transitioning agent to receive income from retiring agent accounts. However, petitioner’s

evidence explaining how the commission on retiring producer accounts would be paid to the

retiring partner (“RP”) and the transitioning partner (“TP”) says otherwise:

Beginning with policies which have an effective date of 1/1/2009 and later,

RP will receive .20 points of the producer portion of the agency commission

with the TP receiving the remainder of the producer portion of the

commission.

Doc 113-3, at 7. This document shows that petitioner would have received income from the

retiring producer accounts in 2009.

While Mr. Barrom indicated in his first affidavit, Answer 9, that he no longer has records

to support additional transfers after 2010, he provided in his second affidavit exact amounts of

retiring producer income petitioner would have been paid for 2010 through 2014 without any

supporting evidence. Doc 153-2, at 4. In his third expert report, Dr. Cook adopts Mr.

Barrom’s projections without independently evaluating the underlying evidence and assumes that

this level of income would have continued through petitioner’s remaining work life expectancy.

Doc 159-2, at 12-13. As Dr. Kennedy points out in his second expert report, it is important to

see how much the retiring producer accounts that were to be assigned to petitioner actually

generated in commissions and how those accounts may have changed over time. Doc 160-1, at

5. The undersigned agrees with Dr. Kennedy’s opinion. There was no evidence that retiring

12

producer income was ever paid to petitioner in the manner described in the Argus policy

provided in petitioner’s evidence (Doc 113-3). Since the undersigned cannot award damages

based on speculation, she finds that petitioner is not entitled to the compensation for retiring

producer income.

D. Present Value Methodology

The parties disagree on the method of calculating the present value of petitioner’s future

wage loss. While Dr. Cook uses a two-step discounting approach, Dr. Kennedy uses a one-step

net discount rate (“NDR”) approach. The two-step discounting approach comprises two parts:

(1) future wages are grown annually at the appropriate rate for wage growth and (2) future values

are discounted to present day dollars at the appropriate projected interest rate. The NDR

approach incorporates both future wage growth and future interest rates into a single, one-step

calculation. Thus, if the same assumptions are used regarding interest rates and wage inflation,

the results under both approaches should be consistent.

Dr. Cook’s present value approach depends on the current yields on U.S. Treasury Notes

and Bonds, which are dynamic. Doc 159-2, at 6. Dr. Kennedy’s analysis implies a 3.50

percent annual wage growth and a 4.00 percent annual discount growth, which gives him a 0.50

percent fixed annual NDR. Doc 160-1 at 2. Dr. Cook argues that Dr. Kennedy’s reliance on a

fixed NDR is inappropriate since the interest rates available to petitioner are the same rates

available to all petitioners but the wage growth rate for all petitioners varies. Doc 159-2, at 7.

However, because the wage growth and interest rates are more difficult to project as

individual data series, Dr. Kennedy believes that “the net relationship between the two series is

more stable and can be more reliably projected over longer periods of time.” Doc 160-1, at 1-2.

The NDR approach also includes projected wage inflation. Id. at 2. Dr. Kennedy provides an

example in his second expert report to show that the NDR approach is more beneficial to

petitioner than the two-step discounting approach, if both approaches assume that the appropriate

wage inflation is 3.50 percent per year and the appropriate interest rate is 4.00 percent. Id. at 2-

3.

Thus, the disagreement between the parties is not which present value method is better

academically but what rates should be chosen in this case. The undersigned agrees with

respondent that Dr. Cook’s use of current dynamic interest rates alone as the discount rate is not

accurate for a projection of a future loss of earnings over a long period of years. The

undersigned finds it is reasonable for Dr. Kennedy not to rely too heavily on the recent historical

or current interest rates since it would result in an understated net discount rate and it is

appropriate to examine statistics over a longer period in calculating the NDR because a longer

period includes the series of expansions and recessions that the economy has experienced. Doc

143-1, at 9. The undersigned also thinks it is important to take consumer price inflation into

account over a long period of time as Dr. Kennedy does in his analysis. Id. at 8. Therefore, the

undersigned rules in favor of respondent on the issue of present value methodology.

13

II. Life Care Plans

On September 28, 2016, petitioner filed his original life care plan from his life care

planner Ms. Lynn Trautwein. Doc 128. Subsequently, respondent filed a report from Dr. Roy

Weiss rejecting all care items in petitioner’s life care plan indicated for Addison’s disease since

respondent asserts through Dr. Weiss’s post-entitlement ruling report that petitioner did not have

Addison’s disease. Doc 136-1, at 2-3. Respondent’s life care planner Ms. Linda Curtis relied

upon Dr. Weiss’ report to deny a substantial part of petitioner’s life care plan. Doc 183-1.

Petitioner argues in his motion that Dr. Weiss’ report was unnecessary as the undersigned

and the parties were well aware of the nature of petitioner’s diagnoses. Doc 176, at 6. In his

response, respondent claims that Dr. Weiss, as a board-certified endocrinologist, is the only

expert qualified to opine on the proper treatment of petitioner, and petitioner’s life care plan

should be based on the diagnosis of adrenal insufficiency, petitioner’s only defined and

recognized injury in this case. Doc 184, at 13.

The undersigned finds respondent’s argument against petitioner’s entitlement to

compensation for his entire immunologic reaction is contrary to law. The undersigned made it

clear in her ruling on entitlement that petitioner does not have full-blown Addison’s disease,

which is why petitioner’s treating doctor, Dr. Richard Wilkinson, diagnosed him with adrenal

insufficiency. Simmons v. Sec’y of HHS, No. 11-216V, 2015 WL 6778563, at *8 (Fed. Cl.

Spec. Mstr. Oct. 30, 2015). Respondent’s expert Dr. Levinson believed petitioner had an

adverse reaction to Tdap, but he did not know the mechanism involved and labeled petitioner’s

adverse reaction a hypersensitivity reaction, which the undersigned accepted in her ruling on

entitlement. Id. at *7-8. The undersigned held that a blurring of the distinctions among the

categories of adverse reaction does not preclude a finding of entitlement to damages. Id. at *8.

Therefore, the undersigned finds petitioner is entitled to compensation for his entire

immunologic reaction which Tdap vaccine caused.

III. Medicaid Lien

The undersigned awards $252.77 for reimbursement of a Washington State Healthcare

Authority lien, which amount is set forth in the attached Appendix A. The undersigned award

$465.36 for reimbursement of a Centene-Washington-Coordinated Care (“Centene-CC”) lien,

which amount is set forth in the attached Appendix A.

IV. Pain and Suffering

In his motion, petitioner argues that his past pain and suffering has clearly exceeded the

statutory cap since his Tdap vaccination and he continues to experience daily pain and emotional

distress. Doc 176, at 4-5. As a result, he asserts that he is entitled to the full $250,000.00 in

pain and suffering under the Vaccine Act. Id. at 5.

14

Based on the evidence provided in the case, the undersigned finds an award for “pain and

suffering” to be appropriate. In determining how much to award in pain and suffering for

petitioner, the undersigned notes that any amount for future pain and suffering must be adjusted

to its “net present value.” Youngblood v. Sec’y of HHS, 32 F.3d 552 (Fed. Cir. 1994). The

undersigned finds it appropriate to use a NDR of 0.50 percent per year in calculating the net present

value of the future award. The award for future pain and suffering will be calculated based upon

$75,000.00 divided over a 31-year period, utilizing a NDR of 0.50 percent per year. Therefore, the

undersigned awards petitioner $100,000.00 for past pain and suffering and $64,255.95 as net

present value of $75,000.00 for future pain and suffering.

AWARD OF COMPENSATION

The undersigned finds reasonable and necessary under 42 U.S.C. § 300aa-15(a) the

following damages, and awards compensation for projected life care expenses, wage loss, loss of

ownership income, pain and suffering, and the reimbursement of Medicaid liens as set forth

below and reflected in the attached chart, and incorporated herein, Appendix A: Items of

Compensation for Jeffrey David Simmons:

1. Health Care Premiums – For Kaiser Permanente VistaPlus Silver Plan. Beginning

on the date of judgment, an annual amount of $8,076.00 to be paid up to the

anniversary of the date of judgment in year 2034, increasing at the rate of five percent

(5%), compounded annually from the date of judgment.

2. Medicare Part B Deductible – To cover vaccine-related medical costs once

petitioner is eligible for Medicare. Beginning on the anniversary of the date of

judgment in year 2034, an annual amount of $185.00 to be paid for the remainder of

petitioner’s life, increasing at the rate of five percent (5%), compounded annually

from the date of judgment.

3. Medicare Part D Plan – Through Cigna-Health Spring RX. Beginning on the

anniversary of the date of judgment in year 2034, an annual amount of $1,046.20 to be

paid for the remainder of petitioner’s life, increasing at the rate of five percent (5%),

compounded annually from the date of judgment.

4. Doctors’ Visits – Twice yearly visits to Dr. Wilkinson. Beginning on the date of

judgment, an annual amount of $330.00 to be paid up to the anniversary of the date of

judgment in year 2034, increasing at the rate of five percent (5%), compounded

annually from the date of judgment.

5. Doctors’ Visits – Twice yearly visits to Dr. Emmons for primary care. Beginning

on the date of judgment, an annual amount of $270.00 to be paid up to the anniversary

of the date of judgment in year 2034. Thereafter, beginning on the anniversary of the

date of judgment in year 2034, an annual amount of $54.00 to be paid for the

remainder of petitioner’s life, all amounts increasing at the rate of five percent (5%),

compounded annually from the date of judgment.

6. Doctors’ Visits – An annual visit to an immunologist at Bastyr University Medical

Center. Beginning on the date of judgment, an annual amount of $320.00 to be paid

up to the anniversary of the date of judgment in year 2034. Thereafter, beginning on

the anniversary of the date of judgment in year 2034, an annual amount of $64.00 to

15

be paid for the remainder of petitioner’s life, all amounts increasing at the rate of five

percent (5%), compounded annually from the date of judgment.

7. Doctors’ Visits – An annual visit to an endocrinologist at Bastyr University Medical

Center. Beginning on the date of judgment, an annual amount of $320.00 to be paid

up to the anniversary of the date of judgment in year 2034, an annual amount of

$64.00 to be paid for the remainder of petitioner’s life, all amounts increasing at the

rate of five percent (5%), compounded annually from the date of judgment.

8. Blood Draws – Twice yearly blood draws. Beginning on the date of judgment, an

annual amount of $360.00 to be paid up to the anniversary of the date of judgment in

year 2034, increasing at the rate of five percent (5%), compounded annually from the

date of judgment.

9. Mileage to Doctors’ Visits – Beginning on the date of judgment, an annual amount of

$150.00 to be paid for the remainder of petitioner’s life, increasing at the rate of four

percent (4%), compounded annually from the date of judgment.

10. Drugs – Hydrocortisone. Beginning on the date of judgment, an annual amount of

$252.48 to be paid up to the anniversary of the date of judgment in year 2034,

increasing at the rate of five percent (5%), compounded annually from the date of

judgment.

11. Drugs – Aldosterone. Beginning on the date of judgment, an annual amount of

$582.00 to be paid up to the anniversary of the date of judgment in year 2034,

increasing at the rate of five percent (5%), compounded annually from the date of

judgment.

12. Drugs (OTC) – Excedrin. Beginning on the date of judgment, an annual amount of

$38.91 to be paid for the remainder of petitioner’s life, increasing at the rate of four

percent (4%), compounded annually from the date of judgment.

13. Handheld Shower – Beginning on the date of judgment, an annual amount of $25.00

for an initial purchase. Thereafter, beginning on the first anniversary of the date of

judgment, an annual amount of $5.00 to be paid for the remainder of petitioner’s life,

increasing at the rate of four percent (4%), compounded annually from the date of

judgment.

14. Shower Chair – Beginning on the date of judgment, an annual amount of $41.99 for

an initial purchase. Thereafter, beginning on the first anniversary of the date of

judgment, an annual amount of $4.20 to be paid for the remainder of petitioner’s life,

increasing at the rate of four percent (4%), compounded annually from the date of

judgment.

15. Companion Care – To assist with light housekeeping and errands at the cost of

$28.95 per hour for three hours per week. Beginning on the date of judgment, an

annual amount of $4,516.20 to be paid for the remainder of petitioner’s life,

increasing at the rate of four percent (4%), compounded annually from the date of

judgment.

16. Snow Removal – At a cost of $100.00 per visit. Beginning on the date of judgment,

an annual amount of $600.00 to be paid up to the anniversary of the date of judgment

in year 2041, increasing at the rate of four percent (4%), compounded annually from

the date of judgment.

16

17. Lawn Care – At a cost of $285.00 per week (for mowing five months per year).

Beginning on the date of judgment, an annual amount of $5,700.00 to be paid up to

the anniversary of the date of judgment in year 2041, increasing at the rate of four

percent (4%), compounded annually from the date of judgment.

18. Handyman – At a cost of $85.00 per hour. Beginning on the date of judgment, an

annual amount of $850.00 to be paid up to the anniversary of the date of judgment in

year 2041, increasing at the rate of four percent (4%), compounded annually from the

date of judgment.

19. Wage Loss - $1,079,981.00 consisting of Past Wage Loss of Earnings and Benefits of

$406,642.00 and Future Loss of Earnings and Benefits of $673,339.00, which amount

is set forth in the attached Appendix A.

20. Loss of Ownership Income - $338,859.00, which amount is set forth in the attached

Appendix A.

21. Pain and Suffering - $164,255.95, consisting of $100,000.00 for past pain and

suffering and $64,255.95 as net present value of $75,000.00 for future pain and

suffering, which amount is set forth in the attached Appendix A.

22. Medicaid Lien - $252.77 for reimbursement of a Washington State Healthcare

Authority lien, which amount is set forth in the attached Appendix A.

23. Medicaid Lien - $465.36 for reimbursement of a Centene-Washington-Coordinated

Care (“Centene-CC”) lien, which amount is set forth in the attached Appendix A.

24. Past Unreimbursable Expenses - $25,599.50 for reimbursement for past

unreimbursable expenses, which amount is set forth in the attached Appendix A.

Form of Compensation Award

The undersigned finds reasonable and necessary under 42 U.S.C. § 300aa-15(a) the

following damages for projected life care expenses, wage loss, loss of ownership income, pain

and suffering, and Medicaid liens, as set forth in the attached Appendix A. The compensation

shall be made through a combination of lump sum payments and future annuity payments as set

forth below:

1. A lump sum payment in the amount of $1,631,128.03, which amount represents

compensation for first year life care expenses ($22,432.58), lost wages ($1,079,981.00),

lost ownership income ($338,859.00), pain and suffering ($164,255.95), and past

unreimbursable expenses ($25,599.50) shall be payable to petitioner, Jeffrey David

Simmons, as soon as practicable after entry of judgment, as provided for in Appendix A.

2. A lump sum payment of $252.77, representing compensation for satisfaction of the State

of Washington Medicaid lien, payable jointly to petitioner and the Washington State

Healthcare Authority, and mailed to:

Washington State

Health Care Authority

COB/Casualty Unit

P.O. Box 45561

Olympia, Washington 98504-5561

17

ID# 201379985WA

Petitioner agrees to endorse this payment to the Washington State Healthcare Authority.

3. A lump sum payment of $465.36, representing compensation for satisfaction of the

“Centene-CC” lien, payable jointly to petitioner and Equian LLC, and mailed to:

Equian LLC

P.O. Box 32140

Louisville, KY 40232-2140

Equian File No.: 973640-179618

Attn: Meagan Sloan

Petitioner agrees to endorse this payment to the Equian LLC.

4. An amount sufficient to purchase an annuity contract,8 subject to the conditions described

below, that will provide payments for the life care items set forth above in the Award on

Compensation and illustrated in Appendix A: Items of Compensation for Jeffrey David

Simmons, attached hereto, paid to the life insurance company9 from which the annuity

will be purchased.10 Compensation for Year Two (beginning on the first anniversary of

the date of judgment) and all subsequent years shall be provided through respondent’s

purchase of an annuity, which annuity shall make payments directly to petitioner, Jeffrey

David Simmons, only so long as Jeffrey David Simmons is alive at the time a particular

payment is due.11

Growth Rate

As set forth and in Appendix A, attached hereto, the growth rates to be applied for items

of compensation payable through the annuity shall be four percent (4%) for non-medical life care

items and five percent (5%) for medical items, compounded annually from the date of judgment.

CONCLUSION

The undersigned finds that petitioner is entitled to an award of the above damages.

8

In respondent’s discretion, respondent may purchase one or more annuity contracts from one or more life

insurance companies.

9

The Life Insurance Company must have a minimum of $250,000,000 capital and surplus, exclusive of any

mandatory security valuation reserve. The Life Insurance Company must have one of the following ratings from

two of the following rating organizations: (a) A.M. Best Company: A++, A+, A+g, A+p, A+r, or A+s; (b)

Moody’s Investor Service Claims Paying Ratings: Aa3, Aa2, Aa1, or Aaa;(c) Standard and Poor’s Corporation

Insurer Claims-Paying Ability Rating: AA-, AA, AA+, or AAA; (d) Fitch Credit Rating Company Claims Paying

Ability Rating: AA-, AA, AA+, or AAA.

10

Petitioner authorizes the disclosure of certain documents filed by the petitioner in this case consistent with the

Privacy Act and the routine uses described in the National Vaccine Injury Compensation Program System of

Records, No. 09-15-0056.

11

At the Secretary’s sole discretion, the periodic payments may be provided to petitioner in monthly, quarterly,

annual or other installments. The “annual amounts” set forth in Appendix A described only the total yearly sum to

be paid to petitioner and do not require that the payment be made in one annual installment.

18

In the absence of a motion for review filed pursuant to RCFC Appendix B, the clerk of the

court is directed to enter judgment herewith.12

IT IS SO ORDERED.

Dated: May 28, 2019 /s/ Laura D. Millman

Laura D. Millman

Special Master

12

Pursuant to Vaccine Rule 11(a), entry of judgment can be expedited by each party, either separately or jointly,

filing a notice renouncing the right to seek review.

19

Appendix A: Items of Compensation for Jeffrey David Simmons Page 1 of 1

Lump Sum

Compensation Compensation Compensation Compensation

ITEMS OF COMPENSATION G.R. * M Year 1 Years 2-15 Years 16-22 Years 23-Life

2019 2020-2033 2034-2040 2041-Life

Insurance Premium 5% M 8,076.00 8,076.00

Medicare Part B Deductible 5% 185.00 185.00

Medicare Part D 5% M 1,046.20 1,046.20

Primary Care Dr. Wilkinson 5% 330.00 330.00

Primary Care Dr. Emmons 5% * 270.00 270.00 54.00 54.00

Immunology 5% * 320.00 320.00 64.00 64.00

Endocrinology 5% * 320.00 320.00 64.00 64.00

Blood Work 5% * 360.00 360.00

Mileage: Endocrinologist,

Immunologist, Dr. Wilkinson 4% 150.00 150.00 150.00 150.00

Hydrocortisone 5% * 252.48 252.48

Aldosterone 5% * 582.00 582.00

Excedrin 4% 38.91 38.91 38.91 38.91

Handheld Shower 4% 25.00 5.00 5.00 5.00

Shower Chair 4% 41.99 4.20 4.20 4.20

Companion Care 4% M 4,516.20 4,516.20 4,516.20 4,516.20

Snow Removal 4% M 600.00 600.00 600.00

Lawn Care 4% M 5,700.00 5,700.00 5,700.00

Handyman 4% M 850.00 850.00 850.00

Lost Wages 1,079,981.00

Lost Ownership Income 338,859.00

Pain and Suffering 164,255.95

Medicaid Lien: WA Healthcare

Authority 252.77

Medicaid Lien: Centene-CC

(Equian) 465.36

Past Unreimbursable Expenses 25,599.50

Annual Totals 1,631,846.16 22,374.79 13,277.51 6,127.51

Note: Compensation Year 1 consists of the 12 month period following the date of judgment.

Compensation Year 2 consists of the 12 month period commencing on the first anniversary of the date of judgment.

As soon as practicable after entry of judgment, respondent shall make the following payment to petitioner for Yr 1 life care

expenses ($22,432.58), lost wages ($1,079,981.00,), lost ownership income ($338,859.00), pain and suffering ($164,255.95)

and past unreimbursable expenses ($25,599.50): $1,631,128.03.

As soon as practicable after entry of judgment, respondent shall make the following payment jointly to

petitioner and Washington State Healthcare Authority, as reimbursement of the State's Medicaid lien: $252.77.

As soon as practicable after entry of judgment, respondent shall make the following payment jointly to

petitioner and Equian LLC, as reimbursement of the Centene-CC Medicaid lien: $465.36.

Annual amounts payable through an annuity for future Compensation Years follow the anniversary of the date of judgment.

Annual amounts shall increase at the rates indicated above in column G.R., compounded annually from the date of judgment.

Items denoted with an asterisk (*) covered by health insurance and/or Medicare.

Items denoted with an "M" payable in twelve monthly installments totaling the annual amount indicated.

This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.

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