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HomeMy WebLinkAbout1992-09-01; City Council; 11863; SETTLEMENT OF WORKERS' COMPENSATION CLAIMS OF MICHAEL S. VAN HOOSER.. z 0 F 0 a s 2 3 0 0 LI& UP CARLSBAD - AGENB BILL / - DEP AB# ’I’ ’’ 3 TITLE: SETTLEMENT OF WORKERS’ MTG. 9/1/92_ COMPENSATION CLAIMS OF MICHAEL S. CITY DEPT. RM VAN HOOSER CITY RECOMMENDED ACTION: Adopt Resolution No. q2-267 approving the Compromise and Release which authorizes thc payment of $28,000 to Michael S. Van Hooser. ITEM EXPLANATION The claimant is a former Senior Police Officer in the Carlsbad Police Department. He was employed by the City for a period of 12 years prior to his retirement in 1989. In 1990 the State Workers’ Compensation Appeals Board issued a Findings and Award and Order, awarding Mr. Van Hooser various benefits for injuries. Mr. Van Hooser also receivc a disability retirement from the Public Employees Retirement System (PERS) that same yea However, disputes regarding the claimant’s eligibility for additional disability benefits pursuai to Labor Code Section 4850, and the extent of the City’s liability for vocational rehabilitatio remained. The terms and conditions of the proposed settlement are set forth in the Compromise and Release (Exhibit 2). The terms and conditions were agreed upon by the attorney representi the claimant and the attorney representing the City, and have been approved by HCM Clain Management, the City’s Third Party Administrator. The settlement is intended to include a1 claims that the claimant may have as a result of his employment with the City, pertaining to the injuries set forth in the Findings and Award, with the exception of future medical care provided for in the Findings and Award. FISCAL IMPACT The cost of the settlement is $28,000 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. Resolution No. %4 -269 2. Compromise & Release 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 0 e RESOLUTION NO. 9 2 - 2 6 9 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF CARLSBAD, CALIFORNIA, AUTHORIZING THE EXPENDITURE OF FWNDS FOR SETTLEMENT OF THE WORKERS COMPENSATION CLAIMS OF MICHAEL S. VAN HOOSER WHEREAS, Mr. John W. Mullen, Defense Counsel for the City of Carlsbad in thi matter, has recommended a settlement of the Workers Compensation claims of Michael S Van Hooser; and WHEREAS, there are sufficient funds available in the Workers Compensation Sel 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 $28,OOO 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, I , 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 0 0 $PASSED, APPROVED AND ADOPTED at a Regular Meeting of the Citj Council of the City of Carlsbad on the 1st vote, to wit: day of SEPTEMBER1992, by the following AYES: Council Members Lewis, Larson, Stanton, Nygaard NOES: None ABSENT: Council Member Kulchin /’ gk[- /-~ I, ;m tLAUDE A. LEWIS, Mayor ATTEST: I rnniDii L 88 SI 1302! a9 SI 7335 a- SAFE OC CAULORNIL. 0 JEP*RTMLNT 3s HOU~IAL RCUnONj WOR%Cn)I C3MPIZNsAnON APWFAU ~ARO COMPROMISE AND RELEASE awERSE OP -&GB 2 awona 3lvl?lION Or 'NOUSTRIAL AC=:OWTS CASE NO. PLEASE Stf INSRUCTIONS 3N COWWNG CORM 1 SOClAL SECURITY NO.>= MICHAEL VAN HOOSER P-0. BODC 900602, San Diw, CA 9 CITY OF CARLSBAD, permissibly Self-insured 1200 Wmd Village Dr., -1s HERTZ CLAIMS MANAGEMENT [HGYI 3954 M.x@~y won Rd.? Ste, D-2 -Et - OL -- - - ( Pauce Officer - I-TUI 4ooms4 CDI.~.CT *4 Q a-m - 1. The inpred mp- claims hut while employed as ~csw~nor Ar nua w ruun on PT&SELkEJ~AnnWXJM " c. at C-ad 9: California ($)he mm~d inpry omoq ocrt of and in he course of amp- to --a [ PLEASE SEE ADD€ 2. The pamu hq agree to Knte anyand all dorms on ~ecount ofbd inpry by*. pent of he sum of S23 000. < IMl8 Q rvIzn 1- I+ /vu bU.m fSTAm WaT Dm W -4. - to any ulms haramfore pad by the..mployer or the insurer to rhr hmployw less amounts set forrh m Paragraph No. 6. -. 3. Upon appd of this compmmirr agreement by the Worken' Corn- * Appeds Bo4d or a worked cornpendon iq accordance with the provisions hereof, md amployoe mieasas ond forwar dirqes soid .mpkyw ad insuranea corri.( COUM of omon. whether now known or -mad, or w+Gdt may hd onso or d.vdop as a result of sad injury, i ri&iii of said employer and mid imuranco comer and eocl~ of them to rh. dependem. hem, executors, rep- OW~ of said cmployea. - .. .. .. _. . . .. . dC - -- ~ - -- ----. - 4. Unfess otherwise expressty pmwded herein, oppmvai of hk ag- REWSES ANY AND All CLAIMS OF APQllCAM DEATH BENEFITS RELATING TO INJURY OR INJURES COVERED ay THIS COMPROMISE AGREMENT. ~hr pamar rehose of these bedits in arrivmg atthe sum in Parug+ No. 2. 5. Unks othmm exxprarty ordered by a W~M' compatsufh kdp, approval of this ogm=tnent DOES NOT RELEASE CAM MAY NOW OR HEREARER HAVE K)R REHABIlKAnON OR Bp(EATs IN CONNECTION WITH REHABILITATION. 6. The pahe represent hut he following facts are me: (If fock are dispvrsd, stub whcrr eod~ party contends under Poqmpl Mm 0 rrr* rcN.L I_ AT 1y a - WTMTP-DUmm 0910 4/54 maximum in disnute PAYMENTS MADE BY EMPL[IMR OR INSURANCE CARRER -ADvpwurr rnmt n rL - Pursuant to tr8revious Pindings anyfward issued in this case, pap with the excention of a remainins dispute on amlic eligibility for "4850 Time". mu - rro -u w ---I10011111 us and Award. BplWfs aAIMED BY INJURED EMPLOYE€ rL0c.L UO *oUU .W CUO mT -TU - M C(oI0 0.- w ry - aa M m nrt. - Additional TTD/4850 Time claimed. No additional claims arc To Be Paid Br Please see #lo. ToBePaidBr Please see 1 -mrr+lu.-- in dl none presented roT4 mu0 - rv4 -0suTu DDOI).. THE FOLLOWING AMOUNTS ARE TO BE DEDUCTED FROM THE S"TLWEN1 AMOUNT: J PAYABLE TO f PAYABLE TO PAYABLE TO - '- r- S PAYA6G TO f \,* .. .- I PAYABLE TO f PAYABLE TO y- 28 t Oo0 o O0 . less approved cmomey fee (See Poragroph No. 9). poyabie LEAVING A BALANCE OF 3 orher than In a iump sum. or here IS oddihonal informohon. specrfy on *parme paq+s).) oeIpf c 0 Q' 0 e 7. tiem not mentioned in Parogmpb No. 6 am to be disposed of os foilowst PTXASE SEE ADDENDUM 8. For rho purpose of determining tho lion clatm(s) filed for bmefik paid punuant to he Unempioyment Insurance Code 01 on of *e Iko cIatm(s) in accordancs wtth 9. Appkont'r (employee's) oircmay raquesn a fee of f ..' . Amount of onornay fee prmously paid, ti any, 10. Reason for Cornpmmise. rpeaai pronu'ons regarding rehabtiitonon and death benefit cfaimr. and oddrional infomaon: z3&3 $/ 7 2 by rkn datmann defined in labor Code Sac. 4903.1, the pomes prop- PLEASE SEE ADDENDUM 1 1. It is agreed by all parlies herato thai the filing of this document b the firm of 4 appiicatian on behalf of the empiaye mmy in its dii-on sat the matter for hearing as a regular appiiih, rcJcninq to the parties the right to put in iuue ur herein, and that if hearing is heid & this document used as on oppruarion the defendants shall have available to thew avadabie 01 of the dm of filing of this document, and that the WCA8 may thareofrcr either apprave said Compromise 4 ings and Award after hearing has been heid and the rnattw regularty submitted fo ~9Aat - ,>%U&2Z0 -- Michael Van Hoose Scott A. O'M ara, Applicani John W, Mullen, Uezendant: 7 M - -I) -'M - u A- wm- -s OR -rrornryw- 1 STATE OF C4LIFOEWU County of On thu day of AD., 19 -,before me, a 'Votary Publtc tn and for the sard County and Stare, resding theretn, duly commrsstoned and sworn, personally ar . - -- c - known to me to be the person, chose name subscribed to the wrthtn Instrument. and acknowledged to me that Ae, executed the same. IX WTTNESS WHEREOF. I hace hereunto set my hand and affixed my offinal seal the day and year zn thrs ( untten .L c e 0 ADDENDDM TO COMPROMISE & RELEASE Re: Michael Van Hooser v. City of Carlsbad WCAB NO.: 88 SDO 130249, 130250, 130251; 89 SDO 133865, 133866, 133867 .............................................................. 1. Dates and Parts of Body Injured: CASE NO. DATE OF INJURY PARTS OF BODY a) 88 SDO 130249 09/19/77 back b) 88 SDO 130250 10/08/78 back c) 88 SDO 130251 07/11/87-07/11/88 hearing, internal d) 89 SDO 133865 08/17/83 right wrist e) 89 SDO 133866 07/07/87 ribs, back, neck f) 89 SDO 133867 09/23/81 right knee 7. Liens: [gastritis; colitis] The employer has made an effort to pay/adjust all medi bills pursuant to the previously issued Findings and Award. Appeals Board will retain jurisdiction of those liens that h been incorporated within the Findings and Award and the emplo will be solely responsible for those liens referenced in Findings and Award with the Appeals Board to retain jurisdict on the same; applicant to be held harmless. 10. Reason for Compromise: It is noted that the underlying "normal issues" have b resolved pursuant to the Findings and Award that previou issued in the above-cited matter. The Findings and Award been paid, however, there remains additional disputes w respect to the applicant's eligibility for payment of additio disability benefits pursuant to Labor Code Section 48 Additionally, there are disputes with respect to some of collateral expenses that the applicant may have sustained dur the course of his vocational rehabilitation effo Additionally, this settlement is intended to include essentia and all claim that the applicant may have as a result of employment with the City of Carlsbad, pertaining to the injury injuries set forth in the Findings and Award or pleadings La , with the exception of rovr'sions for future medical care that have been provided to $4~in~~~~ Award that previously issu More specifically, all claims $or injury to all body pa - .- e a Addendum Continued ... Re: Michael Van Hooser v. City of Carlsbad Page 2 mentioned in the pleadings or medical record are to be reso: within the terms of this settlement, however, the applicant retaining his eligibility for future medical care as other?( provided in the Findings and Award issued by Judge Dietterle. As it pertains to Labor Code Section 139.5, the part agree and stipulate that the applicant has been successft retrained and that the employer's obligation for retraining essentially been satisfied. The parties anticipate rehabilitation "plan" to be submitted to the Rehabilitat Bureau and in anticipation of that effort the part concurrently agree that with the payment of the monies otherwise set forth within this settlement agreement , applicant will have been compensated in full for all benel available to him under Labor Section 139.5 as a result of injury or injuries suffered herein. interest or penalties on otherwise accrued benefits up thrc and including thirty (30) days after the order issues appro7 this settlement agreement. This settlement is intended include any claim applicant's dependents may have for potent death benefits stemming from the injury or injuries mentic herein which the applicant has sustained as a consequence of entire tenure of his employment with the City of Carlsk Approval of this settlement agreement, therefore, resolves claim applicant's dependents may have for potential dc benefits. With respect to the liens of record, as otherwise addre: in the Findings and Award, the employer has "adjustedn the 1 of these bills but should there be any outstanding liens or b: for which the employer has been obligated to make payment adjustment, as provided in the Findinqs and Award only, Appeals Board shall retain jurisdiction an these bills and 1: accordingly. WCAB No.: 88 SDO 130249, 130250, 130251; 89 SDO 133865, 133866, 133867 -------------------------------------------------------------. This settlement is intended to include any claim DATED : *Ji//L&- Michael Van Hooser, Applicz DATED : .e f , -tt A. O'Mara Attorney for Applicant John W. Mullen Attorney for Defendant DATED : 6.