HomeMy WebLinkAbout1991-08-20; City Council; 11295; SETTLEMENT OF WORKERS COMPENSATION CLAIM OF JAMES CONTINO. *.
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GlrWF CARLSBAD - AGENDWILL I
AB# 'I; 295 TITLE: SETTLEMENT OF WORKERS DEP
MTG. 8/20/91 COMPENSATION CLAIM OF JAMES CONTINO CITY
CITY DEPT. RM
RECOMMENDED ACTION:
Approval of Resolution No. 9 1.2 63 approving the Stipulations with Request for Award whicl
authorizes the payment of $8,715, at the rate of $140 per week, to James Contino as
settlement of his workers compensation claim.
ITEM EXPLANATION
This matter arose on October 29, 1990, when the claimant, a Street Maintenance Worker 11,
suffered a work related injury when he began to experience severe pain in his right lower
back and right leg. The symptoms had been increasing over a period of several weeks. 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 Street Maintenance Worker 11.
However, he is required to wear a back brace while working. He has a herniated disc in his
lower back. He suffers from permanent disabilities which cause recurring pain in his lower
back, especially during heavy activity, and which limit his ability to flex, extend and bend.
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 Staff's recommendation that the Stipulations with Request for Award be approved.
FISCALIMPACT
The cost of the settlement is $8,715 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
Compensation Self-Insurance Fund to cover the cost of this settlement.
EXHIBITS
1.
2.
Resolution No. 9 I -ab 3
Stipulations with Request for Award
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RESOLUTION NO. 9 1 - 2 6 3
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 JAMES CONTINO
WHEREAS, HCM Claim Management Corp., the Third Party Administrator for the
City of Carlsbad, has recommended a settlement in the Workers Compensation case of
James Contino; and
WHEREAS, there are sufficient funds available in the Workers Compensation Self-
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 $8,715 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, attached
hereto as Exhibit 2.
3.
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PASSED, APPROVED AND ADOPTED at a Regular Meeting of the Citj
Council of the City of Carlsbad on the
vote, to wit:
20th day of August . 1991, by the following
AYES:
NOES: None
ABSENT None
Council Members Lewis, Kulchin, Larson, Stanton and 1
ATEST:
LLLL2L-P 6LL ALETIU L. RAUTENKRANZ, City Cler
I
e e Exhibit 2
WORKERS' COMPENSATION APPEALS BOARD
STATE OF CALIFORNIA
\ Applicant Case No. Unassigned
James Contino Stipulations
with Request
vs. for Award
City of Carlsbad
Defendants
The parties hereto stipulate to the issuance of an Award and/or Order, based upon the following fa(
waive the requirements of Labor Code Section 5313:
1. James Contino ,born 09-25-55
(Employee 1
10-25-90
( Date of Injuy ) employed within the State of California as Street MaintenanCe Wkr I%n ( Omspation )
City of Carlsbad -- whose compensation insurance car
sustained injury arising out of and in the course of employment tow!!
( Empbyer ) by
HCM Claim Mgmt-
(Pam of body in
10-29-90
at -___ for which indemnity is payable at $--
2. The injury caused temporary disability for the period -- fully
through - 0 1-21-9 1
week, less credit for such payments prevjously made.
140. l8 s, for which indemnity is payable at $-
, less credit
3. The injury caused permanent disability of
per week beginning - 01-25-91 , in the sum of $8 8 715 OO
payments previously made. e?'
$&$
1''
An informal rating has hxmt been previously issued.
(Sekct ooe )
4. There*XkCmk may be need for medical treatment to cure or relieve from the effects of sai
( Selert ooc )
Upon demand, limited to injury herein mentioned, defendant has 5 authorize or show good cause for denial. Failure to do so shall g
tacid authority to secure whatever treatment is necessary DCPARTY NT to OF INDUSTRIAL cure the effects of injury. DIVISION OF IWDUSTRIAL
& WORKERS' ? OMPENSATION APPEA b BOARD
STATE OF CALIFORNIA
5. hfedical-legal expenses are payable by defendant as follows: N~~~
6. Applicant's attorney request a fee of $ N/A
7. Liens against compensation are payable as follows: None
8. Other stipulations: None
/".s' Zh* 1941 A& J hA0
1200 Carlsbad Village Dr.
3954 Murphy Canyon Rd. #@
:; 562-98-8432 -2;: >h
Social Security Number of Applicant
Address -Carlsbad; of Employer Ca 920081-i- 3
IS5 Madison St. Oceanside, Ca 92;56 San Dieso, Ca 92123
NIA Karen Church
N/A San Diego, Ca 92123
Address of Applicant Address of Insurance Company
Attorney for Applicant Attorney or Authorized Representative for De! 3954 Murphy Canyon Rd. #D-
Address of Attorney or Authorized Representa Address of Attorney for Applicant