HomeMy WebLinkAbout1993-10-26; City Council; Resolution 93-2957 I! 0 0
1 RESOLUTION NO. 97 - 795
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A RESOLUTION OF THE CITY COUNCIL OF THE
CITY OF CARLSBAD, CALIFORNIA,
AUTHORIZING THE EXPENDITURE OF FUNDS
FOR SETTLEMENT OF THE WORKERS
COMPENSATION CLAIMS OF RUDOLF METZGER
5 11 WHEREAS, Attorney Mark A. Block and HCM Claim Management Corp, the
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Third Party Administrator for the City of Carlsbad, has recommended a settlement in the
Workers Compensation case of Rudolf Metzger; and
WHEREAS, there are sufficient funds available in the Workers Compensation St:
Insurance Fund to pay the settlement,
NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of
l2 I/ Carlsbad, California, as follows:
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1. That the above recitations are true and correct.
2. That the expenditure of $7,595 from the Workers Compensation Self-
15 11 Insurance Fund is authorized for the settlement of said case.
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3. That the Council accept the Stipulations with Request for Award, attache
here to as Exhibit 2.
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1 PASSED, APPROVED AND ADOPTED at a Regular Meeting of the Cit]
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vote, to wit: 3
Council of the City of Carlsbad on the 26th day of OCTOBER 1993, by the following
4 AYES: Council Members Lewis, Stanton, Kulchin, Nygaard, Fi
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NOES: None
1 1 ABSENT None
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ATTEST
13;1 14 II ALETHA uL- L. RAUTENKRANZ, City erk
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.e 0 0 EXHIBIT 2
WORKERS' COMPENSATION APPEALS Bod&
STATE OF CALIFORNIA
qoplicant Case No. 91 SDO
Rudolf Metzger 91 SDO i Stipulations
with Request
vs. for Award
City of Carlsbad, P.S.I.;
HCM Claim Management Corp., I Defendants /
The parties hereto stipulate to the issuance of an Award andfor Order, based upon the following f2
waive the requirements of Labor Code Section 5313:
1. Rudolf Metzser ,born 5/10/45
[Employml 1. 9/13/90
employed within the State of California as Fire Enaineer on 2. 11/6/90
by city of Carlsbad, P.S.1. *%&'a&L
HCM Claim
Mat. CorD. sustained injury arising out of and in the course of employment 1. T,eft &
~OccUpatlOnl [Date ot Injury1
(Employer1
Shoulder; 2. Left Shoulder and Left Knee (Pans of body in$
2. The injury caused temporary disability for the period N/A
through N / A for which indemnity is payable at SN/A
week, less credit for such paymentspreviously made. Applicant has been paid disabili,
' Labor Code S4850 and has been adequately compensated for all 10s.
3. The injury caused permanent disability of 16 X, for which indemnity is payable at $ 140 0'
per week beginning forthwith , in the sum of $ 7,595.00 , less Cre
payments previously made.
An informal rating has has not been previously issued.
(select One1
4. There ~x #]QWK may be need for medical treatment to cure or relieve from the effects 01
(Saea one1
DWC WCAB FORU 3 [REV. 9-Sa) (Page 1)
DEPARTMENTOF INDUfn
DMSION OF INDUm
. e e
WORKEd’ COMPENSATION WPEALS BOAF
STATE OF CALIFORNIA
5. Medlcql-legal expenses are Pa able py defendant as follows: Defendants will pay or a the lien of Dr. MarLarlan.
6. Appllcant’s attorney request a fee of S SIP
7. Liens against compensation are payable as follow:
R Other stipulations: A. It is further understood and agreed that the aforesaid su
deemed to include such interests as is provided by Labor Code
5800. B. The applicant has no permanent disability or need for fur
medical care associated with the injury of-9/13/90 to the lef
C. Parties stipulate that the opinion of Dr. Markarian regar restrictions was modified by the deposition of the doctor con
5/4/93. Work restrictions relating to the applicant‘s left u
extremity is prophylactic in nature and consisting of an avoi
repetitive or frequent use of the left upper extremity above
level and no repetitive or frequent heavy use and pushing and of the left upper extremity.
x- 077- 73fl Dated
Rudolf Metzger -
Applicant
283-38-7928 Carlsbad, CA 92008
Social Security Number of Applicant Address of Employer
4647 Pannonia Road 3954 Murphy Canyon Road, Su
Carlsbad, CA 92008
Address of plitant
Scot Gd;,.. A. O‘Mar s? EP $h- SM Mark A. Block, Esq.
Attorney for Applicant Attorney or Authorized Representative for Defen
2333 Third Avenue 7851 Mission Center Court, San Diego, CA 92101-1514 San Dieqo, CA 92108
Address of Attorney for Applicant Address of Attorney or Authorlzed Representativ
1200 Carlsbad Village Drive
DWC WCAB FORU 3 (REV. 9-90) (Page 2) DEPARTMENT OF INDUSTRI
DMSION OF INDUSlUII