HomeMy WebLinkAbout1991-11-05; City Council; 11421; SETTLEMENT OF WORKERS COMPENSATION CLAIM OF PHIL PAGEk
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DEPT. I
CITY A
CITY M
CIThOF CARLSBAD - AGEND~ILL I' + - -
AB#- TITLE: SE'ITLEMENT OF WORKERS
MTG. 11/5/91 COMPENSATION CLAIM OF PHIL PAGE
DEPT. RM
RECOMMENDED ACTION:
Approval of Resolution No. 4 I -3 6 Lpproving the Stipulations with Request for Award which
authorizes the payment of $19,425, at the rate of $140 per week, to Phil Page as settlement of
his workers compensation claim.
ITEM EXPLANATION
This matter arose on July 27, 1989, when the claimant, a Street Maintenance Worker 111,
suffered a work related injury and sustained extensive damage to his knee. He has been
under medical care since the date of the injury.
The claimant's condition has stabilized and he is now permanent and stationary. He has
extensive limitations and is permanently precluded from repetitive bending, stooping, climbing
and heavy lifting.
Although he has returned to work, he has filed an Application for an Industrial Disability
Retirement with the Public Employees Retirement System (PERS).
His medical reports were submitted to the State Division of Workers Compensation, Office o
Benefit Determination, for evaluation. The permanent disability rating which they provided,
as well as the need for 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 upon the terms and conditions contained in that agreement.
It is staff's recommendation that the Stipulations with Request for Award be approved.
FISCAL IMPACT
The cost of the settlement is $19,425, excluding future medical treatment. If such treatment
required, the City will be obligated to pay for those expenses. There is no method for
predicting what those costs might 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. q I -36 B
Stipulations with Request for Award
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RESOLUTION NO. 9 1 - 3 6 1
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 PHIL PAGE
WHEREAS, HCM Claim Management Corp., the Third Party Administrator for
City of Carlsbad, has recommended a settlement of the Workers Compensation claim of
Phil Page; and
WHEREAS, there are sufficient funds available in the Workers Compensation S
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 $19,425 from the Workers Compensation Self-
Insurance Fund is authorized for the settlement of said claim.
That the Council accept the Stipulations with Request for Award, attach
hereto as Exhibit 2.
3.
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PASSED, APPROVED AND ADOPTED at a Regular Meeting of the Ci
Council of the City of Carlsbad on the
vote, to wit:
5th day of November . 1991, by the following
AYES: Council Members Lewis, Larson, Stanton and Nygaard
NOES: None
ABSENT Council Member Kulchin
ATTEST
llQGtL 2- 6?- ALETHA L. RAUTENKRANZ, City Cle k
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0 0 EXHIBIT 2
4
t
s WORKERS’ COMPENSATION APPEALS BOARD
STATE OF CALIFORNIA
Applicant Case No- Unassigned Phil Page
Stipulations
vs. for Award
- with Request
City of Carlsbad
Defendants
The parties hereto stipulate to the isstrance of an Award and/or Order, based upon the following f
waive the requirements of Labor Code Section 5313:
X. Phil Paqe -, born 06-17-51
W5lities/mintenane ( Emph- )
0 7-27-89 employed within the State of California as Worker I1 ___on
( Ormption ) ( Date of Injury)
-- whose compensation insurance ci
HCM Claim Mqmt* sustained injury arising out of and in the course of employment -- to Left
City of Carlsbad
( Employer) by
(Part3 of body
2. The injury caused temporary disability for the period ____ 04-30-90
through ~ 05-29-90 --- for which indemnity is payable at $. 224 0
week, iess credit for such palmenrs previously made.
14( 3 3 % 5, for which indemnity is payable at $--
, in the sum of $ 19 1 425 -00, less cred
3. The injury caused permanent disability of
per week beginning - 06-02-90
payments previously made.
An informal rating has hmt been previously issued.
(sew one)
4. There is trmkxnozpche need for medical treatment to rure or relieve from the effects of s
( Selert ooc 1
Upon demand, limited to injury herein mentioned, defendant has 5 to authorize or show good cause for denial. Failure to do so sha applicant tacid authority to secure whatever treatment DCfARlYLNT is nec OF I fit% cure or relieve the effects of injury. DIVISION or I
SE
c 0 e WORKERS' COMPENSATION APPEALS BOARD
STATE OF CALIFORNIA
5. \ledical-lcgal expenses are payable by defendaiit 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:
--
1200 Carlsbad Village Dr. 570-88-6805 Carlsbad, Ca 92008
Social Security Number of Applicant Address of Employer 4225 Lonnie 3954 Murphy Canyon Rd. #D- Oceanside, Ca 92056 San Diego, Ca 92123
Address of Applicant Address of Insurance Company
None Karen Church
N/A - San Diego, Ca 92123
Attorney for Applicant Attorney or Authorized Representative for r-
3954 Murphy Canyon Rd. #D-
Address of Attorney or Authorized RepresE Address of Attorney for Applicant
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