HomeMy WebLinkAbout1990-04-24; City Council; Resolution 90-117.&.
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RESOLUTION NO. 90-1 17
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF CARLSBAD, CALIFORNIA, AUTHORIZING THE EXPENDITURE OF FUNDS FOR THE SETTLEMENT OF THE WORKER‘S COMPENSATION CLAIM OF WALTER W ILKEL
5 WHEREAS, Mr. John Mull en, Defense Counsel for the City of Carlsbac
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Compensation Self-Insurance Fund to pay the settlement , 9
WHEREAS, there are sufficient funds available in the Worker’s 8
case of Walter Wil kel ; and 7
in this matter, has recommended a settlement in the Worker’s Compensatior
’LO NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of
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1. That the above recitations are true and correct. 12
Carlsbad, California, as follows:
for the Compromise and Release, attached hereto as Exhibit A. 17
3. That the Council accept the proposed terms and conditions 16
case. 15
Compensation Self-Insurance Fund is authorized for the settlement of saia 14
2. That the expenditure of $32,500 from the Worker’s 13
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PASSED, APPROVED AND ADOPTED at a Regular Meeting of the City
Council of the City of Carlsbad on the 24th day of April , 1990,
by the following vote, to wit:
AYES: Council Members Lewis, Kulchin, Pettine, Mamaux and Larson
NOES: None
ABSENT: None
ATTEST :
ALETHA L. RAUTENKRANZ, City C1 erk/
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PLEASE SEE INSTRUCTIONS ON
REVERSE OF PAGE 2 BEFORE
COMPLETING FORM
DEPARTMENT OF INDUSTRIAL RELATIONS vu Y" I 0 DlVlSlON OF INDUSTRIAL ACCIDENTS @ CASE NO. 88 SDO 1
WORKERS COMPENSATION APPEALS BOARD
EXHIBIT A SOCIAL SECURITY NO. 3 6 8 - 3 2 -'
WALTER WILKEL 1803 Palisades Drive, Carlsbad 9200;
CITY OF CARLSBAD 1200 Elm Avenue, Carlsbad, CA 92008
BIERLY & ASSOCIATES 7750 Dagget St., Ste. 206, San Diegc
APVUCANT (EUPLOYEQ ADDRESS
CORRECT NAME OF EYPLOYER ADDRESS
CORRECT NAME OF INSURANCE CARRIER ADDRESS
1. The injured employee claims that while employed as a park maintenance worker r 111 9/7 /aa WXJJPAVON AT nut OF \~~n.r\
on 9/87 - 88 at Carlsbad CA ,t
(s)he sustained injury arising out of and in the course of employment to back and psych
(DATE OF WTl ICltn (STATE)
ISTATE WAT PAmS OF EODY WERE INJUREDI
2. The parties hereby agree to settle any and all claims on account of said injury by the payment of he sum of $ 32,500.00
to any sums heretofore paid by the employer or the insurer to the employee, less amounts set forth in Paragraph No. 6.
3. Upon approval of this compromise agreement by the Workers' Cornpenscrtion Appeals Board or a workers' compensation judge I
accordance with the provisions hereof, said employee releases and forever discharges said employer and insurance carrier from
causes of action, whether now known or ascertained, or which may hereafter arise or develop as a resuh of said injury, includi
liability of said employer and said insurance carrier and each of them to the dependents, heirs, executors, representatives, ac
assigns of said employee.
4. Unless otherwise expressly provided herein, approval of this agreement RELEASES.ANY AND ALL CLAIMS OF APPLICANT'S DEI
DEATH BENEFITS RELATING TO INJURY OR INJURIES COVERED BY THIS COMPROMISE AGREEMENT. The parties have I
release of these benefits in arriving ut the sum in Paragraph No. 2.
5. Unless otherwise expressly ordered by a workers' compensation judge, approval of this agreement DOES NOT RELEASE ANY
CANT MAY NOW OR HEREAFTER HbVE FOR REHABlllTATlON OR BENEFITS IN CONNECTION WITH REHABILITATION.
6. The parties represent that fhe following facts are true: (If facts are disputed, state what each party contends under Paragraph No.
DATE OF OIRTU ACTUAL EARNINGS AT nu€ OF IWURY 7/5/33 UST DAY OFF WORU CUE TO THIS INJUUR Maximum In dispute
PAYMENTS MADE BY EMPLOYER OR INSURANCE CARRIER
TEMPORARY DISABIUTI INDEMNm WEEKLY RATE PERODS COVERED
See No. 10 below.
None $2,697.54
CERMANENr DISABILITY BNDEMNrn TOTU MEDICAL AND YOSPTTAL BILLS
BENEFITS CLAIMED BY INJURED EMPLOYEE
S€GINNtffi AND ENDING DATES OF ALL PERIOOS OFF WE TO THIS IWURY YEMCAL AND HOSPfTAL BILLS PA10 BY EMPLOYEE In dispute. None.
TOTAL UMPAlD UEMCU AND HOSPITAL U?ENSE ESTIMATED FlSNRE UEMCAi ErPENSE Unknown T~ & paid B~: See No. 1 0 below. To &Paid By: Solely by appli
THE FOLLOWING AMOUNTS ARE TO BE DEDUCTED FROM THE SETTLEMENT AMOUNT:
s NONE PAYABLE TO s PAYABLE TO
s PAYABLE TO 5 PAYABLE TO
f PAYABLE TO s PAYABLE TO
LEAVING A BALANCE OF $ 32 ' 50 o O0 , less approved otrorney fee (See Paragraph No. 9), payable to applicant. (If'payr
o&er than in a lump sum, or there is additional information, specify on separate page(s).)
DIA WCAB FORM 15 (REV. 1983) (PAGE 1) I"-..", 'CY>
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7. Liens not mentioned in Paragraph No. 6 a be disposed of as follows: -. - 0
See No. 10 Below.
8. For the purpose of determining the lien claim(s) filed for benefits paid pursuant to the Unemployment Insurance Code or for b
by lien claimants defined in labor Code Sec. 4903.1, the parties propose reduction of he lien claim(s) in accordance with formu
9. Applicant's (employee's) attorney requests a fee of $ . Amount of attorney fee previously paid, if any, $ -
10. Reason for Compromise, special provisions regarding rehabilitation and death benefit claims, and additional information:
(SEE ADDENDUM ATTACHED HERETO).
11. It is agreed by all parties hereto that the filing of this document is the filing of an application on behalf of the employee, and 1
may in its discretion set the matter for hearing as a regular application, reserving .to the parties the right to put in issue any of he
herein, and that if hearing is held with this document used as an application the defendants shall have available to them all deft
available as of the date of filing of his document, and hat the WCAB may hereafter either approve said Compromise Agreeme
or disapprove the same and issue Findings and Award after hearing has been held and the matter regularly submitted for decisio
WITNESS the signature hereof this hY of ,19-,at
rnmE5.s *PPUCIM ~DIPLOYER WALTER WlLKEL
WnNESS THOMAS E. GNIATKOWSKI, Atty. for appl.
THE APPUC.AN7-S (EUPLOIEBS) SIGNANRE YUST OE ATESTED OY TWO DISINTERESTW PERSONS OR ACXHOW =FORE A NOTARI PMUC. RICHF;RD G. REVEL , Attorney for defend
STATE OF CALIFORNIA
County of 1
On this day of A.D., 19 -, before me,
a Notary Public in and for the said Cuunty and State, residing therein, duly commissioned and sworn, personally appeared -
known to me to be the person- whose name
subscribed to the within Instrument, and acknbwledged to me that _he- executed the same.
IN WTLVESS WHEREOF, I have hereunto set my hand and affixed my official seal the day and year in this Certijicai written.
DIA WCAB FORM 15 (REV. 1983) (PAGE 3
Notary PuMic in and for said County and Stole of Calijmia
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ADDENXJM rc COZ~IPRO~SE AED RELESE
Walter Wilkel v. City sf Carlsbad ,WCAB CASE NO: 89 SDO 130732; 730733
Paragraph 7.. s
LIENS: The parties spscifically request that the applicant, >:x. Walter Wilkel, be held harmless as to the lienslbillings of Dr. - W.T, Maynes, Dr. Stephen V. Sobcl, and Dr. KamrIerxian, as well as the lien of the Employment Development Eepartmerit, These liens
will be negotiated outside of this Compromise and Release agreencnt by &€endant, City of Carlsbad,
The lien (as enclosed} of the First kjeskeerr, Medical Croup as relatss ts medical/legal expenses w5ll be ?&.id by defendants according to the fee schedule,
“”- ”“- ””- ””I ””” ””-
Paragraph IO. ..
PAGE 2A
IO. REASON FOR COMPROMISE: There is a trae and serictls dispute
as to the issue of injury AOE/CUE a6 4s the psychiatric portims of this claim as well as to the mture, extent, and duration of
the orthopaedic portion of this claim. This dispute extsnds to
the lave1 of residual disability, apportimmont to 2re-Pxisting
and non-industrial psobl.ems, the duration of temporary disability and self-procured medical treatrnerrt.
By the terms and conditions of this settlement agreement, it
is specifically understood that the ~pplicant is forevc,r releasing any and all claims that he may have against the city of Carlsbad occurring during the tenure of his eny;laymer,t wikk “chat entity as it relates to applkant’s orthopasfiic conplzints
involving and stemming from his back 2s well 83 cny 323 all emotional probPcms and their asscciatl-d ramificzt-icm zllegedly occurring either as a result of a specific inciderit or injl~ry or
as related to a continuing trauma kheory of iEjury, It is further underst.oad taat those residual raaifications ECCIZI the
applicant’s emotional and orthcpaedic complaints, as ztherwise
incorporated within the present medical record, are to be released within the terms of this ssttlenent agr.serner,t.
It is anderstood that, cmctlrrent with esecutiAg this
settlement, bslt - not as a condition of this settlement, Plr. Nslter
Wilkel will be submitting a written resignation to the City of Carlsbad indicating his resignztion froxr, active enployrnent.
This settlement is intended tc izclude any ciaim fer
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' interest or penalties or otherwise accr-ded benefits occurring up through and including thirty (30) days following the issuance of an Order approving this Compromise and Release agreement.
The parties, by this sertlerwnt agrement, specifically intend to settle any. and all claims applicant's dependent's nay
have for potmtial death benefits which nay be related to or
allegedly stemming from the injury or icjuries covered by this Comprmise and Relea6e agreemmt. The parties specifically call this fact tu the attention of the Worksrs' Compensztion Appeals Board Judge and request that :?e so coxnsnt in the Cfrder Approving Cornpronise and Release agreement,
Temporary Disability Irrdemity; There i$ a dispute as bekwee;Li the partiee concerning potential temporary disability benefits
owed to Mr. Wilkel. Applicant allegEs various broken periods of temporary disability owizg beginning on 9/7/88 and coritinuicg through the date of this Compromise and Release agreenect. During that stated period, it appears that Nr* Wiikel returned to work and then was placed on ts~porary disability beriefits by a physician on at least two or three cacasions, There also appears
to be segments of this tima. period whicn the applicant was paid
his full salary by the City of Carlsbad. Mr. Wilkel was also
paid temporary disability from 9/20/B7 through 9/23/87, All other periods remain in dispute. The parties have come to an
agreement that the amount 6f $1 ,GOO.OO of the agreed to
settlement amount is established as a fair and equitable settlement of any and all disputed Seriods on the issue of
temporary disability benefits.
Applicant nst3
Attorney for Apgiicar,t Date
e a
APPLICANT'S DECLARATION REGARDING VOCATIONAL REHABILITATION BENEFITS, LABOR CODE SECTION 139.5
Re: Walter Wilkel v. City of Carlsbad
WCAB CASE NO: 88 SDO 130732; 88 SDO 130733
1. Employees who have had industrial injuries may b
entitled to receive vocational rehabilitation benefits if the
are likely to be precluded from returning to their employment an
would benefit from the provision of vocational rehabilitatio services.
2. This benefit, known as vocational rehabilitation
varies with the employee's needs and abilities. This may includ an evaluation to identify the type of vocational rehabilitatio services which can help the employee to return to suitabl employment. These services may involve changing the demands o the employee's usual job; assisting the employee to obtain ne employment compatible with his or her abilities, or training th employee for a new occupation.
3. When the employee is a qualified injured worker, a1
vocational rehabilitation costs are paid by the employer or it insurer. The employee continues to receive temporary disabilit
indemnity payments during the period of entitlement to vocationa
rehabilitation services.
4. The employee has the right to choose whether he or sh
will accept the provision of vocational rehabilitation services Regardless of the employee's choice, other workers' compensatio: benefits will not be affected.
5. If the employee declines rehabilitation benefits now
he 01 she may be able to request future consideration of thest benefits within statutory time limits. The request must be i, writing and submitted to the Rehabilitation Bureau within on^
year Of either a finding Of permanent disability or approval of i
cornpromise and release by the Workers' Compensation Appealr Board; Or within 5 years from the date of injury, Rehabi1itation Bureau will determine entitlement to services.
Thc
6. In the event that I elect to participate in vocationa:
rehabilitation at some future date and am found to be a qualifiec
injured worker, I EXPRESSLY WAIVE ANY POTENTIAL CLAIM FOI ORDINARY COMPENSATION BENEFITS AND MEDICAL TREATMENT FOR AN!
INJURIES THAT MAY BE SUSTAINED WHILE PARTICIPATING IN VOCATIONAI REHABILITATION in compliance with the Rodgers v. WCAB (1975) anc Weatherspoon v. St. Ferdinand's School (1986) cases.
7. If I sustain an injury while rendering service tc
another under a vocational rehabilitation plan which creates ar
employment relationship, the employer in said relationship is not
released by this agre- ement.
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8. I, WALTER WILKEL, also understand that any and a1 potential claims for retroactive rehabilitation vocationa
temporary disability benefits as well as any and all othe
rehabilitation benefits have been settled by way of thj
compromise and release agreement submitted to and approved by thl
Workers' Compensation Appeals Board in this matter. Thi'
declination of rehabilitation benefits shall continue to be i
effect until I have complied with Paragraph 5 of this document.
9. I have read and understand this notice and I choose tc
decline the provision of vocational rehabilitation benefits.
EMPLOYEE'S SIGNATURE
EMPLOYEE REPRESENTATIVE SIGNATURE
DATE :