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HomeMy WebLinkAbout1991-08-06; City Council; 11278; SETTLEMENT OF WORKERS COMPENSATION CLAIM OF LARRY WHATLEYw =. C3 E 2 .. Z 0 F= 0 4 s z 3 0 0 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 1 2 3 4 5 6 7 a 9 10 11 12 13 14 15 16 17 18 19 0 0 - 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: 1. 2. That the above recitations are true and correct. That the expenditure of $5,775 from the Workers Compensation Self- Insurance Fund is authorized for the settlement of said case. That the Council accept the Stipulations with Request for Award, attache hereto as Exhibit 2. 3. i 1 2 3 4 5 6 7 8 9 10 XI. 12 13 14 15 16 17 18 19 e 0 * PNSED, APPROVED AND ADOPTED at a Regular Meeting of the Ci Council of the City of Carlsbad on the vote, to wit: 6th day of August . 1991, by the following AYES: NOES: None ABSENT: Council Member Nygaard Council Members Lewis, Kulchin, Larson and Stanton ATTEST: ALETHAL.RAU I 20 21 22 23 24 25 26 27 28 Exhi a * WORKERS' COMPENSATION APPEALS BOA # g - kt; STATE OF CALIFORNIA 21$ 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