HomeMy WebLinkAbout1991-11-12; City Council; 11418; SETTLEMENT OF WORKERS COMPENSATION CLAIMS OF RICHARD K. SMITHZ
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CIT OF CARLSBAD - AGENDQBILL a
DEPT.‘
RICHARD K SMITH CITY n
AB#= T2 SETTLEMENT OF WORKERS MTG. 11 112191 COMPENSATION CLAIMS OF CITY P
DEPT. RM
RECOMMENDED ACTION:
Approval of Resolution No. g/ * 3Sgapproving the Compromise and Release which authorize:
the payment of $17,000 to Richard K Smith as settlement in full of his various workers
compensation claims.
ITEM EXPLANATION
The claimant is a former Captain of the Carlsbad Fire Department. He was employed by the
City for a period of 23 years prior to his retirement in 1987.
In 1986, the Applicant filed several Applications for Adjudication with the Workers
Compensation Appeals Board (WCAB). Those applications were for disabilities which
allegedly resulted from the numerous injuries which the Applicant sustained during the tours(
of his employment.
Although the Applicant received an industrial disability retirement from the Public Employee
Retirement System (PERS), he is also entitled to benefits, including compensation, under
California’s Workers Compensation System.
Attorneys representing the Applicant and the City have reviewed the medical evidence and
agreed that disabilities exist which would preclude the Applicant’s return to his chosen
profession. Additionally, they have agreed that at least some portion of those disabilities wei
the direct result of injuries which were sustained during the course of his employment.
The terms and conditions of the proposed settlement are set forth in the Compromise and
Release. They were agreed upon by attorneys representing the respective parties and have
been approved by HCM Claim Management, the City’s Third Party Administrator for these
matters.
It is staffs recommendation that the Compromise and Release be approved.
FISCAL IMPACT
The cost of the settlement is $17,000. However, the Applicant has waived his right to futun
medical treatment. The only other financial exposure which the City may have relates to thc
Applicant’s right to request rehabilitation. Due to his age and other factors, it is not
anticipated that that benefit will be utilized. There are sufficient funds available in the
Workers Compensation Self-Insurance Fund to cover the cost of this settlement.
EXHIBITS
1. Resolution No. (7-6
2. Compromise and Release
6.
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RESOLUTION NO. 9 1 - 3 5 8
A RESOLUTION OF THE CITY COUNCIL OF THE
CITY OF CARLSBAD, CALIFORNIA,
AUTHORIZING THE EXPENDITURE OF WNDS
FOR SETTLEMENT OF THE WORKERS
COMPENSATION CLAIMS OF RICHARD K. SMITH
WHEREAS, Ms. Susan England, Defense Counsel for the City of Carlsbad in this
matter, has recommended a settlement of the Workers Compensation claims of Richard K
Smith; and
WHEREAS, there are sufficient funds available in the Workers Compensation Sell
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 $17,000 from the Workers Compensation Self-
Insurance Fund is authorized for the settlement of said claims.
That the Council accept the Compromise and Release, attached hereto as
Exhibit 2.
3.
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PASSED, APPROVED AND ADOPTED at a Regular Meeting of the Ci
Council of the City of Carlsbad on the
vote, to wit:
5th day of Novemberl991, by the following
AYES:
NOES: None
ABSENT: Council Member Kulchin
Council Members Lewis, Larson, Stanton and Nygaard
ATEST:
.. le &a ALETHAL.aU
I
OEPARl MEYT OF INDUSTRIAL RELA I IUNS CdM-PROMISE AND RELEASE
6 SM IUULJ, I 3mm
376-26-C
0 at38 /I$ DlVlSlON OF I~OUSTRIAL ACCIDENTS
WORKERS COMPENSATION APPEALS BOARD
SOCIAL SECURITY NO.
e PLEASE SEE sNSTRUCTlONS ON QEVERSE OF PAGE 2 BEFORE COMPLETING FORM
I'
995 Knowles Avenue
3ICHARD K. SMITH Carlsbad, CA 92008
1200 Carlsbad Village Drive
Admi n i ste red by.PfCt NAY€ OF EY*LOvEn 3954 Murphy Canyon Road, Suite
HCM CLAIM MANAGEMENT CORPORATION San Diego, CA 92123
ACCLIC IN I IPuCLOTEE)
CITY OF CARLSBAD, Self-InSured Carlsbad, CA 92008-1989
CORRECT NAUC OF INSURANCE CAnRlEn 4DDRLSJ
Fi ref i ghter
at Car 1 sbad California
IDATE oc INNRW 7/ f 185 - 7/ 1 /86 -back, heart, ski n, ISTATI~
1. The i 'ure employee cl i IOCCUPAWN *T TIYL OF iwmnvi 57!26784, 71 f?Y€%f wh7i7q3P)8g: Os a
o#/7/05, 11 /7/85, 1/4/87,
(s)he sustained injury arising out of and in the course of employment to ears (hearing loss), hypertens
(STATE WWAT PARTS Of WDV WE-€ INJUIEDI
17,000.00 2. The parties hereby agree to settle any and all claims on account of said injury by the payment of the sum of f
to any sums heretofore paid by the employer or the insurer to the employee, less amounts set forth in Paragraph NO. 6.
3. Upon opprovol of this compromise agreement by the Worken' Compensation Appeals bard or a workers' compensation iudg
occordance with the provisions hereof, said employee releases and forever discharges said employer and insurance carrier frc
causes of action, whefher now known or ascertained, or which may hereafter arise or develop as a result of said injury, inck
liability of said employer and said insurance carrier and each of them to the dependents, heirs, executors, representatives,
assigns of said empioyet.
4. Unless otherwise expressly provided herein, approval of this agreement RELEASES ANY AND ALL CLAIMS OF APPLICANT'S
DEATH BENEFITS RELATING TO INJURY OR FURIES COVERED BY THIS COMPROMISE AGREEMENT. The parties ha
release of these benefits in arriving at the sum in Paragraph No. 2.
5. Unless otherwise expressly ordered by a workers' compensation judge, approval of this agreement OOES NOT RELEASE P
CANT MAY NOW OR HEREAFTER HAVE FOR REHABlLlTAflON OR BENEFITS IN CONNECTION WITH REHABILITATION.
6. The parties represent hot the following fads are true: (If facts are disputed, state what each pa* contends under Paragraph
LAST DAY OFF WORN OW TO 7M13 DATE OF WIT* ACTUAL EARNINUS AT TIME oc INJURT 10/21/29 Maxi mum Not Appl icable
~ll applicable periods compensated by full salary per L.C. Section
$2,940.00 $1 2,190.10
AS above - no further claim None Known
PAYMENTS MADE BY EMPLOYER OR INSURANCE CARRIER CIEIIODS CaVER€D WEEKLY RAT* rEuwamv DISAOIUTI INDEMNIT*
CEIYANCNT DISANUTI IxDEMNIT* TOTAL UEDlCU AND YOSCnAL BILLS
BENEFITS CLAIMED BY INJURED EMPLOYEE
I~EGIP~NING AND EkOlffi DATES 01: ALL eRl0DS 0- DUI TO Ty(S IWURV YEMCAL AND YOSLKAL BILLS PAID BY EMPLOYEE
-
TOTAL uNpbtc wmcu AND MSPnAL EXPINW None KnO wn; IT any, ES1YATED MURE MEDICAL EXPSNSE M 1
To ~e Paid B). Solely by Applicant
THE K)LLOWING AMOUNTS ARE TO BE DEDUCTED FROM THE SETTLEMENT AMOUNT:
To Be Paid By.sO 1 e 1 Y by APl
s PAYABLE TO 2,940.00 CREDITTo Defendants for P.O.A.
s PAYABLE TG s
s
PAYABLE TO
5 PAYABLE TO J PAYABLE TO
, less approved otiorney fee (See Poragrgph No O), payable to opplicar 14,060.00 CEAVlNG A BAUNCE OF S
oher than in a lump sum, or there is additional information, specify on separate poge(s).)
' 3)iA WCAB CORM I5 (REV 15831 (PAGE I1
7. <. Liens nor mentioned in Porograph No. 6 or. @be disposed of as follows: 0
SEE ATTACHED PAGE 1-A
8. For the purpose of determining the lien claimb) filed for benefits paid pursuant to the Unemployment Insurance Code or for
by tin claimants defined in Labor Code Sec. 4903.1, the parties propose reduction of the lien cloim(s) in accordance with forrr
. Amount of attorney fee previously paid, if any, f - 09 9. Applicant's (employee's) ottorney requestl a fee Of 4 20 4
10. Reason for Compromise, special provisions regarding rehabilitation and death benefit claims, and additional informati&:
SEE ATTACHED PAGE 1-A
11. H is agreed by all parties hereto ?hat the filing of this document is the filing of on opplicotion on behalf of the employee,
m- in its discretion set the matter for hearing as o regular application, reserving to the parties the right to put in issue any <
herein, and that if hearing is held with this document used as an application the difendanfs shall have available to them a
~ailobie as of the dote of filing of this document, and that the WCAB moy thereafter either approve said Compromise Ag
or disapprove the same ond issue Findings and Award after hearing has been held ond the matter regularly submitted for d
Wlmm the signature hereof this f 7 day of SP,? 5
mTI.Lu - SCOTT A. O'MAI
SCOTT A. O'MARA
ATTORNEY FOR APPLICANT
ENGLAND, HOOIK 81 TROVILLION
Twt -wfS IEYCCOYES'S) -A- WIT .E ATrUTLE) W Two DI1IWIEICSTCD CERlxml OR ACKNOI*LEDCED EWE A WTUY -.
STATE OF CALIFORNIA
e 1 By SUSAN L. ENGLAND
ATTORNEY FOR DE OANT hntyoj LC& 3l.&%&
On this 17~ day of .L. AD., 19 -, q I beforeme, TdP- ,-ZPHfn
a Notary Public in and for the said County and State, residing therein, duly commissioned and sworn, personally app
v bQ .v&
known io me to be the person- whose name-@-? 5 subsc~ri~~o-t~e,~z~h~~, [ngt yyt:,
IN *T,VESS. Sr'HEREOF. ['have. ;I;i.rcun& set my hand and affixed my official seal the day and year in this C
owl43-d to me that -he- executed rhc same. . L. .: -.. .-..-
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COMPROMISE AND RELEASE
RE: RICHARD K. SMITH v. CITY OF CARLSBAD
CASE NOS. 86 SO0 105529, 105530; 86 SDO 105538-41; 87 SO0 11
7. Liens not mentioned in ParasraDh No. 6 . . .
Defendant has paid or will pay medical-legal liens as followc
Steven Emmet, M.D., $645.00, $900.00, $280.00, $375.00,
$115.00, $295.00, and $770.00;
Geoffrey Smith, M.D., $770.00;
Scott Adler, M.D., $910.00, $60.00, $285.00, and $740.00;
S. 0. Neurodiagnostic, $910.00;
James Grisolia, M.D., $880.00;
Smith-Hanna Medical Group, $365.00;
Richard Cundiff, M.D., $706.00.
----------_--------_____________________----~-~----------~~~ __---------------------------------~--------------~--~------
IO. Reason for ComDromise:
There is a serious and substantial issue as to whether or no
Appt icant’s hypertensive condition arose out of and occurred i
course of his employment. It is the contention of the Defe, that the Applicant is not affected with heart trouble ar
support of that contention relies upon the opinion6
Douglas Davidson, M.D., who set forth in his report that there no objective factors for diagnosis of heart disease. As tc other allegations of injury, there is a dispute as to the na
extent and duration of permanent disability, if any. There dispute as to the apportionment to be applied to this Applic, disability because of his preexisting condition. There
dispute as to the kind, need, frequency and quality of f medical treatment that may be required, if any. It is the i of the parties that this agreement absolves Defendant of 1 iability for claimed retroactive temporary disability throug
date this agreement is approved by the Board.
Pursuant to the case of Carter v. County of Los Anseles. e
51 C.C.C. 255, the Defendant employer herein is released fro
liability for workers’ compensation benefits which may arise any subsequent injury or re-injury during any phase of rehabi 1 itation process. This waiver includes any addit
permanent disabi 1 ity or further medical treatment, mileage or
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incidental benefits. It is understood that this waiver does not any way af,fect Awl icant’s right to receive vocationc
rehabilitation benefits which are or may be due to the injuri
alleged in Paragraph 1 of the Compromise and Release Agreement.
Applicant hereby makes this Waiver expressly, knowingly and wi
full knowledge of the potential rights he may have, if any, in t
absence of this waiver and release. Nothing contained here
abrogates the right of Defendant to raise QIW as an issue in a
subsequent rehabilitation proceeding.
Legal counsel for the respective parties have reviewed the medic reports submitted in this case, the opinions and conclusions of t
doctors as set forth in those reports and the subjective complair of the Applicant as set forth in those reports.
After assessing the information, the parties feel that the figt
indicated in Line 2 is a fair and equitable settlement of this GI
and have decided to resolve these questions in dispute and any all other questions relative to this injury which may exist now
may arise in the future and avoid the hazards and delays
litigation.
The parties do intend to include in this Compromise and Release of the provisions of Paragraph 4 of this agreement.
It is further agreed that if the Order Approving Compromise Release is paid within twenty-five (25) days of its date
issuance, interest thereon shall be waived.
Law Off ices of
SCOTT A. O’MARA
BY
ney for Appl‘
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OFfICIAL RECORDS snti DIKO couw BECOB~DER~S OFFICE h\\Nlif EUBtiS, COUNTY RECORDER RF : 3.01) FEES: llf: 1.00 nr : 1.00
(SPACf &VC THIS LlNdfl RtCOnOIR.5 USf)