HomeMy WebLinkAbout1987-09-08; City Council; Resolution 92331
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RESOLUTION NO. 9233
A RESOLUTION OF THE CITY COUNCiL OF THE CITY OF CARLSBAD, CALIFORNIA, AUTHORIZING THE EXPENDITURE OF FUNDS FOR SETTLEMENT OF THE WORKER'S COMPENSATION CLAIM
OF JEROME N. PlETl
WHEREAS, by recommendation, Mr. Robert A. Kegel, Defense Counsel
for the City of Carlsbad in this matter, has approved a settlement in the
Worker's Compensation case of Jerome N. Pieti; and
WHEREAS, there are sufficient funds available in the Worker's
Compensation Reserve Account to pay the settlement,
NOW, THEREFORE, BE IT RESOLVED by the City Council of the
City of Carlsbad, California, as follows:
1. That the above recitations are true and correct.
2. That the expenditure of $15,176 from the Worker's Compensation
Reserve Account is authorized for the settlement of said case.
3. That the Council accept the Stipulation with Request for Award,
attached hereto as Exhibit A.
PASSED, APPROVED AND ADOPTED at a regular meeting of the City
Council of the City of Carlsbad, California, held on the 8th day of
September , 1987, by the following vote to wit:
AYES: Council Members Lewis, Kulchin, Pettine, Mamaux and Larson
NOES: None
ATTEST:
Exhibit A
I -. WORKERS' COMPENSATION APPEALS BOARD .. *
STATE OF CALIFORNIA
JEROME PIETI
\'S .
CITY OF CARLSBAD
A LEGALLY UNISNURED EMPLOYER
CaseNo. 86 SDO 120952 Applicant
Stipulations
with Request
for Award
I
The parties hereto stipulate to the issuance of an Award and/or Order, based upon the following facts, and
waive the requirements of Labor Code Section 5313:
, wide 2/28/26 --, born _________- JEROME PIETI 1. -
(Emplovee)
manager (personnel) 1972-7/1/87 -___- on -----, empIoyed within the State of Califomia as -
(Occupation ( Date of Injury) City of.Carlsbad, a legally uninsured
employer XdjsicE,,loG)-~CdTexgre by __ - X~Wm~~~Bxx~~~x~#rXdt.3SX
- sustained injury arising out of and in the course of employment xar?ijw (Parts of body injured ) r
no compensable lost time 2. The injury caused temporary disability for the period --____-
Per through - -____- for which indemnity is payable at $
week, less credit for such payments previously made.
3. The injury caused prrmancnt t1isat)ility of 261!2;! for which indemnity is payable at $ l4O O0
per week beginning _?/4/8Z----, in the sum of $14,245.00 less credit for such
payments previously made.
An informal ratingSK has not been previously issued.
( Select one )
4. >p-]b&X x.3( x31;Mm-ua x3G)CrxdmK fi&%I%&% Xd X&X %I X3Q&Xx Ec&lrx YlbX Xr&Xt)S X3.x X&$ XI&G$X .iSelrc,t one)' The issue of applicants entitlement to future medical care is
submitted for decision by the WCAB judge.
AGRICULTURE AND SERVICES AGENCY
DEPARTMENT OF INDUSTRIAL RELATIONS
OlYIStON OF INDUSTRIAL ACCIDENTS
DIA WCAB FORM 3 tREv. 5-73) @A OS?
I.... , . ..
o/ 0j WORKERS COMPENSATION APPEAL^ BOARD
STATE OF CALIFORNIA
5. Mecfic;iI-legal expenses are payable by defendant as follows:
Dr. Cundiff $781.00
Dr. North $150.00
6. Applicant's attorney request a fee of $ 1 ,700. 00
7. Liens against compensation are payable as follows:
Reasonable attorney's fees. Line claim of Colen & Lee in the sum of $150.00.
8. Other stipul a t' ions:
The parties hereto agree that the applicant is not disabled from
performing his regular duties as a personnel manager by the
disability set forth herein and is not a qualified injured worker
within the meaning of Labor Code Section 139.5.
The parties agree that no interest is payable if Award is paid
within twenty days of the approval of the Award.
It is hereby agreed by the defendant employer that the attorney's fee awarded in the above-entitled matter may be commuted off the far
end of the Award.
u 371-24-9304
~ Social Security Number of Applicant 2642 Abedul Carlsbad, CA 92008
Address of Applicant
Attorney for Applicant
1200 Elm Avenue
Carlsbad, CA 92101
Address of Employer 1930 S. Brea Canyon Road, #lo0
Diamond Bar, CA 91765
Address of Insurance Company
At niey uthorized Representative for Defendant
SOtb-ROgRT A. XEGEL ----- San Diego, CA 92101 - -- %.O. Box 1499, Santa - Ana, CA 92702
Address of Attonicy for Applicant Address of Attonicy or Aiitliorizrcl Rcpwscnt;itive
DIA WCAB FORM 3 (REV. S-71) . (Page 2)
AGRICULTURE AN0 SERVICES AGENCY
DEPARTMENT OF INDUSTRIAL RELATIONS
DIVISION Or INDUSTRIAL ACCIDENTS