HomeMy WebLinkAbout1991-08-06; City Council; 11278; SETTLEMENT OF WORKERS COMPENSATION CLAIM OF LARRY WHATLEYw =. C3 E 2
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CIThOF - CARLSBAD - AGEND~LL 1 \
DEPT. I AB# I" a' 8
CITY A MTG. 8/6/91
DEPT. RM WHATLEY CITY M
RECOMMENDED ACTION:
TITLE: SETTLEMENT OF WORKERS
COMPENSATION CLAIM OF LARRY
Approval of Resolution No. 9 1-2y 5 approving the Stipulations with Request for Award which
authorizes the payment of $5,775, at the rate of $140 per week, to Larry Whatley as
settlement of his workers compensation claim.
ITEM EXPLANATION
This matter arose on August 30, 1990 when the claimant, a Park Maintenance Worker 11,
suffered a work related injury when he strained his neck and shoulders while unloading bags
of cement from a flatbed truck. He sustained a middle upper back and cervical strain. He
has been receiving medical treatment since the date of the injury.
The claimant's condition has stabilized and he is now permanent and stationary. He is
continuing to work in his usual and customary occupation as a Park Maintenance Worker 11.
However, he has permanent disabilities which cause recurring headaches and pain in the
upper back.
His medical reports were submitted to the State Division of Workers Compensation, Office of
Benefit Determination, for evaluation.
The permanent disability rating which they provided, as well as the need for possible future
medical treatment, have been incorporated into the settlement agreement which has been
submitted for consideration.
The claimant and HCM Claim Management Corp., the City's Third Party Administrator, have
agreed on the terms and conditions contained in that agreement.
It is Staffs recommendation that the Stipulations with Request for Award be approved.
FISCAL IMPACT
The cost of the settlement is $5,775, excluding possible future medical treatment. If such
treatment is required, the City will be obligated to pay those expenses. There is no method
for predicting what those costs may be. There are sufficient funds available in the Workers
Cornpensation Self-Insurance Fund to cover the cost of this settlement.
EXHIBITS
1. Resolution No. 91 -2q5
2. Stipulations with Request for Award
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- RESOLUTION NO. 9 1 - 2 4 5
A RESOLUTION OF THE CITY COUNCIL OF THE
CITY OF CARLSBAD, CALIFORNIA,
AUTHORIZING THE EXPENDITURE OF FUNDS
FOR SETTLEMENT OF THE WORKERS
COMPENSATION CLAIM OF LARRY WHATLEY
WHEREAS, HCM Claim Management Corp., the Third Party Administrator for t
City of Carlsbad, has recommended a settlement in the Workers Compensation case of
Larry Whatley; and
WHEREAS, there are sufficient funds available in the Workers Compensation Se
Insurance Fund to pay the settlement,
NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of
Carlsbad, California, as follows:
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That the above recitations are true and correct.
That the expenditure of $5,775 from the Workers Compensation Self-
Insurance Fund is authorized for the settlement of said case.
That the Council accept the Stipulations with Request for Award, attache
hereto as Exhibit 2.
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* PNSED, APPROVED AND ADOPTED at a Regular Meeting of the Ci
Council of the City of Carlsbad on the
vote, to wit:
6th day of August . 1991, by the following
AYES:
NOES: None
ABSENT: Council Member Nygaard
Council Members Lewis, Kulchin, Larson and Stanton
ATTEST:
ALETHAL.RAU
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WORKERS' COMPENSATION APPEALS BOA # g - kt;
STATE OF CALIFORNIA
21$ Case No. UnasSisned
Larry Whatley
Stipulations
with Request
VS. for Award
City of Carlsbad
The parties hereto stipulate to the issuance of an Award and/or Order, based upon the followu
waive the requirements of Labor Code Section 5313:
0 5-01-48
9 bml Larry Whatley 1. (Empbrr)
08-30-90 employed within the State of California as
by
Park Maintenance =IC no,
-- - whose compensation insurana
HCM C1aim Managemen$ustained injury arising out of and in the course of employmentcG.
( Occupation ) (Date of Injur
City of Carlsbad
( Employer )
(Pam of b
2. The injury caused temporary disability for the period ___ Broken periods -
fully -__ for which indemnity is payable at $.- through -
week, less credit for such payments previously made.
3. The injury caused permanent disability of 12.742, for which indemnity is payable at $- 3
per week beginning 10-05-90 , in the sum of $ 5 I 775.00, less cn
payments previously made.
An informal rating has (Selea )IdsmK OLK ) been previously issued. RECEIVE
$Ul u 4. There Is &xo&xmapkmeed for medical treatment to cure or reIieve from the e ects of
Lpon demand, limited to injuy herein mentioned. Defendant has 5 &yS to or show good cause for denial, Failure to do so shall give applicant taC
authority to secure whatever treatment is necessary to cure or relieve tl
(Select one )
of injury. DCtAITYENT OF INDUS1
OIVlllON OF INOUSl
I a e
WORKERS’ COMPENSATION APPEALS BOARD
STATE OF CALIFORNIA -
5. MedicsI-legal expenses are payable by defendant as follows: None
6. Applicant’s attorney request a fee of $ N/A
7. Liens against compensation are payable as follows: None
8. Other stipulations:
T-/- 9/
1200 Carlsbad Village Dr 526-74-8226 Carlsbad, Ca 92008
Social Security Number of Applicant Address of Employer UEIM
JUL 0 2
1637 Lopez Street 3954 Murphy Canyo Oceanside, Ca 92054 San Dieqo, Ca 92
Address of Insurance Company Address of Applicant
- None Karen Church
Attorney for Applicant Attorney or Authorized Representative for D
3954 Murphy Canyon Rd. #D-
Address of Attorney or Authorized Represen
N/A San Diego, Ca 92123
Address of Attorney for Applicant