HomeMy WebLinkAbout1991-06-25; City Council; Resolution 91-1896
lr
1
2
3
4
5
RESOLUTION NO. 9 1 - 18 9
A RESOLUTION OF THE CITY COUNCIL OF THE
CITY OF CARLSBAD, CALIFORNIA,
AUTHORIZING THE EXPENDITURE OF FUNDS
FOR SETTLEMENT OF THE WORKER’S
COMPENSATION CLAIMS OF PETER SALVATO
1
6
7
8
9
10
11
12
13
14
15
16
17
18
19
0 e
WHEREAS, Mr. Charles Loof, Defense Counsel for the City of Carlsbad in this matter,
.ias recommended a settlement in the Worker’s Compensation case of Peter Salvato; and
WHEREAS, there are sufficient funds available in the Worker’s Compensation Self-
‘ksurance Fund to pay the settlement,
NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of
Clarlsbad, California, as follows:
1.
2.
That the above recitations are true and correct.
That the expenditure of $6,755 from the Worker’s Compensation Self-
Insurance Fund is authorized for the settlement of said case.
That the Council accept the Stipulations with Request for Award, attached 3.
hereto as Exhibit 2.
1
20
21
22
23
24
25
26
27
28
I/
*
1
2
3
4
5
6
7
a
9
10
21
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
za
e e
PASSED, APPROVED AND ADOPTED at a Regular Meeting of the City
Council of the City of Carlsbad on the
vote, to wit:
25th day of June . 1991, by the following
AYES: Council Members Lewis, Kulchin, Larson and Stanton
None NOES:
ABSENT: Council Member Nygaard
*
ATTEST:
'1 1zh7 L2diZAL k 7R, ALEEL4 L,. RAUTENKANZ, City Clerk
I
I,
w 0 Exhibit 2 . RKERS’ COMPENSATION APPEALS BOARD
STATE OF CALIFORNIA 1). SDO 143653; 2) SDO
Applicant Case No. 5) . SDO ; 6). SDO
\ 3). SDO 143652; 4) SDO Peter Salvato
Stipulations
with Request
vs. for Award
City of Carlsbad, P.S.I.;
%Bierly & Associates
Defendants
The parties hereto stipulate to the issuance of an Award and/or Order, based upon the following facts, a
waive the requirements of Labor Code Section 5313:
9 wl
employed within the State of California aaaintenance Worker IIonVarious I See AttacY
by City of Carlsbad whose compensation insurance carrier \
S-elf-lnsured/ sustained inj arising out of and in the course of employment L0w Back
1. Peter Salvato ,born May 28, 1937
(Employ= 1
(Occupation ) ( Date of Injury )
( Employer )
Adminiszered by Bierly & Y ssociates (Parts of body injured)
2. The injury caused temporary disability for the period Fully ‘Ompensated Various
through - for which indemnity is payable at $ Rates 1
week, less credit for such payments previously made.
3. The injury caused permanent disability of 14-1/ 3, for which indemnity is payable at $ 140.00
6,755.00 , less credit for SI , in the sum of $ July 24, 1990 per week beginning
payments previously made. .
An informal rating- has not been previously issued.
(SeIectone)
4. There 32 - may be need for medical treatment to Cure or relieve from the effects of said inju
( Select one )
DEPARTMENT OF INDUSTRIAL RCLATI
DIVISION OF INDUSTRIAL ACCIDC
DIA WCAB FORM 3 (mcv s.7~1 (Page 1) PA GZ3 IS c
c
WORKERSFOMPENSATION APPEA~ BOARD
STATE OF CALIFORNIA
5. Medical-legal expenses are payable by defendant as follows:
Lawrence A. Jenkins, N.D., $1,250.00
6. Applicant’s attorney request a fee of $810.00 PL 5
7. Liens against compensation are payable as follows:
None
8. Other stipulations:
A) It is further understood and agreed that the aforesaid sum
shall be deemed to include such interest as is provided by
Labor Code Section 5800.
z/, /99 / Dated
Applicant Peter Salvato
549-50-6601 1200 Elm Avenue, Carlsbid, CA 9
Social Security Number of Applicant
1172 Stratford Drive 3954 Murphy Canyon Road, Suite D
Encinitas, CA 92024 San Dieqo, CA 92123
Address of Applicant
Address of Employer
Address of Insurance Compa
- Charles J. Loof
7851 Mission Ce Attorney for Applicant Victor T. Balaker Attorney or Authorized R 2646 Madison Street Carlsbad, CA 92008 San Dieqo, CA 92108
Address of Attorney for Applicant Address of Attorney or Authorized Representative
DLPARTMCNT OF INDUSTRIAL RCLATIO? -. - ..,- L - Fa- - - ,- -.
W 0
ADDENDUM
Re: Peter Salvato
1). SDO 143653
Date of Injury: 4/2/85, Back
2). SDO 143654 Date of Injury: 5/7/86, Back
3). SDO 143652 Date of Injury: 11/23/87, Back
Date of Injury: 4/1/89, Back
Date of Injury: 6/23/89, Back
Date of Injury: 1/22/90, Back
4). SDO 143655
5). SDO
6). SDO
0
CLS
W 0
i WORKERS’ COMPENSATION APPEALS BOARD
STATE OF CALIFORNIA
AWARD
aga AWARD IS MADE in favor of ---EeLeL.Sa.v.to __________ ~-
Bierlv & Associates -- --- -_
(A} Temporary disability indemnity in accordance with paragraph 2 above,
(B) Permanent disability indemnity in accordance with paragraph 3 above,
Less the sum of $--wwN-- payable to applicant’s attorney as the reasonable value of servi
rendered.
Less liens in accordance with Paragraph 7 above,
(C) Further medical treatment in accordance with Paragraph 4 above,
( D ) Reimbursement for medical-legal expenses in accordance with Paragraph 5 above,
(E)
Workers’ Compensatwn judge
WORKERS’ COMPENSATION APPEALS BOARD Dated.
Copy served on all persons listed on
Official Address Record.
Date: - --____
Bv : (Slguahl~)
DEPARTMENT OF IWOU8TRIAL RLLATlOI
OIA WCAB FORM 3 (REV 5.n) ID*”- ?\