HomeMy WebLinkAbout1992-03-24; City Council; 11604; SETTLEMENT OF WORKERS COMPENSATION CLAIM OF GEORGIA LYNN BROWN-1
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CITY AB#* TITLE: SETI’LEMENT OF WORKERS MTG. 3124192 COMPENSATION CLAIM OF GEORGIA LYNN
DEPT. RM BROWN CITY
RECOMMENDED ACTION:
Approval of Resolution No. 93 - ?& approving the Compromise and release which authorize
the payment of $5,000 to Georgia Lynn Brown as settlement in full of her workers
compensation claim.
ITEM EXPLANATION
Applicant was a Senior Management Analyst employed by the City of Carlsbad through
August, 1991. She is currently employed by another agency in a managerial position. While
employed by the City of Carlsbad, Ms. Brown experienced stress related injuries and illnesse
Although applicant’s condition has stabilized and she has been declared Permanent and
Stationary, she continues to be on medication and is under a doctor’s care for conditions
related to her claim.
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.
HSCAL IMPACT
The cost of the settlement if $5,000. There are sufficient funds available in the Workers
Compensation Self-Insurance Fund to cover the cost of this settlement.
EXHIBITS
1. Resolution No. (?J- ?&
2. Compromise and Release
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RESOLUTION NO. 92 - 7 2
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 GEORGIA LYNN
BROWN
WHEREAS, Mr. Charles Loof, Defense Counsel for the City of Carlsbad in the
matter, has recommended a settlement of the Workers Compensation claim of Georgia
Lynn Brown; 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 $5,000 from the Workers Compensation Self-
Insurance Fund is authorized for the settlement of said claim.
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 Cig
Council of the City of Carlsbad on the 24th day of March
vote, to wit:
1992, by the following
AYES: Council Members Lewis, Kulchin, Larson, Stanton and
NOES: None
ABSENT None
ATTEST
LkGL R. Rw
ALETJ3.A L. RAUTENKRANZ, City Clerk
I
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i dIBIT 2 COMPROMISE AND RELEASE 0 STAm W CIUCOQMU 0
OCC~LICIOC IWDL#TIILU Runow
WORKERS cowcnsmoi ypuu BOARO
DMSIOW W IUOUSTRuLLcCiDEwII CASE NO.,A,
52
&* ¶EE INmUCnONS OW awmz DC WE '+ wrwe COWplcnWO f ObM
SOCW SECURliY NO,
8557 Lemon Ave., # 23
1200 Carlsbad Village Driv
3954 Murphy Can onvhgd, S
GEORGIA LYNN BROWN La Mesa, CA 91941
Sel -Insured sbad. CA 92008
*MwKss Citf of Carlsb$8i?$&tbkibly YPL SE
on WESS
San Dieqo, CA 9 r 123
1 The injured employee claims that while employed as a
on 8/1 9/90 - 8/19/91
(s)he sustained injury arising out of and in the course of employment to asvcha I stress)
Senior Manaqement Analyst
(OCCUPATION AT TINE OF INJURY)
at Carl sbad Ca 1 if ornia (CITY) (STATE1 (DATE OF INJURY]
(STATE WHAT PIRTS OF 800Y WERE INJ
2 The parties hereby agree to settle any and all claims on account of said injury by the payment of the sum of t 5 t 0
In addition to any sums heretofore paid by the employer or the insurer to the employee, less amounts set forth in Pari
3 upon approval of this compromise agreement by the Workers' Compensation Appeals 8oard or a workers' compensatio
in accordance with the provisions hereof, said employee releases and forever discharges said employer and insur clalms and causes of action. whether now known or ascertained, or which may hereafter arise or develop as a I
including any and all liability of said employer and said insurance carrier and each of them to the dependenl
representatives, administrators or assigns of said employee.
4 Unless otherwise expressly provided herein. approval of this agreement RELEASES ANY AND ALL CLAIMS OF APPLlCP
DEATH BENEFITS RELATING TO INJURY OR INJURIES COVERED BY THIS COMPROMISE AGREEMENT. The parties hz
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 DOES NOT RELE
CANT MAY NOW OR HEREAFTER HAVE FOR REHABILITATION OR BENEFITS IN CONNECTION WITH REHABILITATION.
6 The parties represent that the followrng facts are true: (If facts are disputed. state what each party contends 1
MTE OF BIRTH ACTUAL EARNINGS AT TlUE OF INJURY us1 WY OFF mau OUE
40 $1.777.00 mor&Lly D-d
PAYMENTS MADE BY EMPLOYER OR INSURANCE CARRIER
TEMPORARY OISbBILIlY INOEUNITY WEEKLY RAE PERIODS COMRED
None
None
PERUANENT Ois*BiLIlY INOEUNITY TOTAL YEOICUANO HOSPITAL BILLS None
BENEFITS ClAlMED BY INJURED EMPLOYEE
UEDICIL AND HOSPITAL BKLS PAIO BY EUPLO BEGINNING AND ENOING DATES OF ALL PERiOOS OFF DUE TO THIS INJURY Fully compensated in this settlement Some
ESTIMAlED FUTURE UEDICL MENS€ TOTAL UNPAID UEOlCIL AND HOSPlTliL MpElYsE
TO w BY: Applicant
THE FOLLOWING AMOUNTS ARE TO BE DEDUCTED FROM THE SETTLEMENT AMOUNT:
TO BE PAID BY. Applicant
s1,300.00 PAYABLETO Professional Psych. s PAYABLE TO Services
Group/Allen Jay, M.D. ~1,190 . 00 PAYABLE 10 First Western Med . x PAYABLE TO
t PAYABLE TO s PAYABLE TO
UWNQ A BAUNCE OF $ 2 I 5 10 * 0 0
be other than in a lump sum. or there 1s addltional information. specify on separate page($) .I
, less approved attorney fee (See Paragraph No. 9). payable to applica
I - 7. Liens not mentioned In Paragraph NO. 6 B 0 be dlsposed of as toll0 ZL '. -
8. For the purpose of deterIninlng the llen Claim(S1 filed for benefits paid pursuant to the UnemQloyment Insurance
lurnlshed by lien clalmants defined In Labor Code Sec. 4903.1. the partles propose reduction or the lien claim(
formulae attached. Not applicable
9. Appiicant's (employee's) attorney requests a fee of s 6 00 ' 00 . Amount of attorney tee prevtously paid, i
10. Reason for Compromise. Special provisions regarding rehabilitation and death benefit claims, and additional inform Please see page 2-A and 2-8.
11. It is agreed by all parties hereto that the filing of this document is the filing of an application on behalf of the e
WCAB may in its discretion set the matter for hearing as a regular application, reserving to the parties the right
the facts admitted herein. and that if hearing is held with this document used as an application the defendants c
them all defenses that were available as of the date of filing of this d0CUMnt. and that the WCAB may thereaftc
Compromise Agreement and Release or disapprove the same and issue Findings and Award after hearing has bee
regularly submitted for decision.
THE APPLICANTS C D BY TWO DISINTERESTED
, mforeme,
z STATE OF CALIFORNIA
COunWO,~ Dieao
Onm davd AD., 19
a~tary~~Inandlorthes~CountyandState.resrclingtherein,clulycommis~edandswlwn,personaayeppearec
knambmetobetheperson- bdmsename
sulbscribedtommthlnlnstMnentand~~tom.tmr~~~ -msame.
N - WHEREOF, I have -to set my hand and aftbced my dfkla s881 UN3 ay Wp3W h wS Cerbficate lht E
writtsn
NotuyRdLcm amm sals Cou*yamstSre:a 7 '1;UIwm
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Continuation of Paragraph 7 Re: GEORGIA LYNN BROWN
First Western Medical Group withdraws liens of Dr. Papaleo a1 Sobel’ for psychiatric evaluation and testing; Profess Psychological Services and First Western Medical Group/Dr
agree to accept $1,300.00 and $1,190.00 respectively in
satisfaction of liens filed for psychiatric and internal mE services.
Page 2(i)
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APPLICANT: GEORGIA LYNN BROWN COMPROMISE AND REW
CASE NO. : 91 SD
- XX A) This settlement includes any and all claims for medi temporarydisability, vocational rehabilitation tempor
disability and reimbursements through th Order Approving Compromise and Release.
It is further understood and agreed that the afores sum includes interest as provided by law for a perio3 twenty-five (25) days from the date of service by Workers' Compensation Appeals Board Approving Compromise and Release.
DEATH BENEFIT CLAIM WAIVER:
The applicant has been advised and fully understands t this Compromise and Release Agreement releases any
all claims of any dependents to potential death benel relating to the injury or injuries cov ed by I Cornpromise and Release Agreement.
A reasonable and substantial dispute exists between
parties as to: Nature and extent of the applica disability, both temporary and permanent; need for p present, and future medical treatment; reimbursement self-procured expenses: etc. Rather than risk
uncertainties of litigation, the parties wish to se this claim, and all its prese and potential issues, a lump sum certain.
La
ee O1
-&&
- XX B)
Initial
xxc 1
- XX D)
&&
7 XX E) A serious and reasonable issue exists as to ir
r occurring in arising out of the employme t and
course of the employment. &E&?
PAGE 2-A
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COMPROMISE AND RELEASE
RE: GEORGIA LYNN BROWN
Page Two
- XX F) THOMAS VS. SPORTS CHALET FINDING REOUESTED:
Please see attached Addendum regarding request for Tho Finding that applicant has settled all potenti rig to vocational rehabilitation benefits. &&-
DATE: a(l Lis z
DATE: - _cf /z
APPLICANT :
APP'S A
PAGE 2-A(i)
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Continuation of Paragraph 10
RE: GEORGIA LYNN BROWN
STATEMENT OF PARTIES RELATING TO SETTLEMENT OF REHABILITATION BENEFITS
UNDER
LABOR CODE SECTION 139.5 (THOMAS VS. SPORTS CHALET, 42 CCC 625)
A serious and good faith issue exists regarding injury AOE/COE parts of the body which, if decided against the applicant, cc defeat all of the applicant's rights to benefits under the Lz Code, including those of Labor Code Section 139.5 for vocatic rehabilitation. The parties therefore request that the trier
fact carefully review the evidence and make a finding in accord? with Thomas vs. Sports Chalet, 42 CCC 625.
The parties acknowledge that applicant will be barred 1 receiving any benefits if the AOE/COE issue is resolved defendant's favor.
In support of request of defendant's request for a Thomas v. SD Chalet rehabilitation waiver, defendant would offer the testii of Christopher Salomone, Patricia Cratty, and Kathy Graham. I
of these witnesses would refute the testimony of applic regarding her allegations of stress on the job. Defendant 4 relies upon applicant's deposition testimony and medical recc
regarding her pre-existing medical conditions.
Defendant had scheduled an internal medicine evaluation 1 Douglas Davidson, M.D. and a psychiatric evaluatfon with J Morris, M.D., but applicant chose not to attend either of t evaluations in favor of withdrawing and settling her claim,
applicant is presently employed by a local city in a manage
position on a full-time basis.
The parties recognize that a request for a Thomas Findinc appropriate when there are legitimate doubts concerning employer's liability and the worker might receive nothing if case is pursued through trial. It is also realized that it is the intention of the Board to prohibit settlements by requirj determination in every case of entitlement to benefits. The E
is asked only to determine, through a review of the records,
PAGE 2-8
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Statement of Parties Relating to Settlement of Rehabilitation Benefits Re: GEORGIA LYNN BROWN
whether a serious and good faith issue exists such as would just the release requested.
Applicant, in this matter, is represented by competent l experienced counsel who does support the request for a Tho!
Finding. It is therefore respectfully requested by the defend that the Compromise and Release, as submitted, be appro including the requested Thomas Finding.
d I I%( 9 x
DATE
E /flfl T S ATTORNEY
PAGE 2-8 (i)