HomeMy WebLinkAbout1993-07-06; City Council; 12297; SETTLEMENT OF WORKERS COMPENSATION CLAIM OF TODD COTTONi
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A5#* DEPT. .
SETTLEMENT OF WORKERS DEPT
COMPENSATION CLAIM OF TODD COTT'ON CITY
TITLE: CITY
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RESOLUTION NO. 93-192
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 TODD COTTON
WHEREAS, Attorney Charles Loof and HCM Claim Management Corp., the Third
Party Administrator for the City of Carlsbad, has recommended a settlement in the Workers
Compensation case of Todd Cotton; and
WHEREAS, there are sufficient funds available in the Workers Compensation Self-
nsurance 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 $6,475 from the Workers Compensation Self-
Insurance Fund is authorized for the settlement of said case.
That the Council accept the Stipulations with Request for Award, attached
hereto as Exhibit 2.
3.
I
W
t
PBSSED, APPROVED AND ADOPTED at a Regular Meeting of the City
AYES:
NOES: None
ABSENT: None
Council Members Lewis, Stanton, Kulchin, Nygaard, F
_- - ’$ c W
WORKER5 ‘ COM ENSATIQN AF’-ALS mm r‘ u *- -,
STATE OF CAUFORNLA
9. Medlcablegal oxpsn3~3 arc payable by eefondmt SIP folloum None
6. Applicant’s attorney request a fee of S 777.00
7. Llerw ayahis1 corr@nSa\ion are payable a5 fallows: Nolle
Er. utnerstipulattons: A) it is further understood and agreed that the aforesaid 5um shall be deemed to include such interest as is ]
by Labor Code section 3800, if paid within thirty (30) days.
d-/7-$3
DattrJ
TOCW cotton
Applicant
557-55-0176 Carlsbad, CA 92008
Social s~curtty NumDer or Applicant
1889 Laurel Road
e Oceanside, CA 9354 San Dieqo, CA Y2123
4
AmfT2deL?e
.L~~
1290 Carlsbad Village Drive
MUT~YY ut E~~IV~I
3954 Murphy Canyon Road, Sui.
Aodress of rnwrance company
Charles J. Loof Attorney or Autnorrzea Hepresentative tor osrenas
7851 Mission center Court, S
AClCireSs of Attorney or AUthOriZed RepreSentative
,-. ViGtO
Attorney for Amllcant
2646 Madison Street Carrsbad, CA 92008 San Dieqo, CA 92108
Address of Attorney for Applicant
WC WchB FORU 3 (RN 8-90) (Page 2) DEPUtfMENTOF INDUSTRa
DNlSlON OF INDUSIRWL
TOTGl.
EXHlBl W 3 * .- .. * q!!
WORKERS COMPENSATION APPEALS BOARC
STATE OF CALIFORNIA
Applicant OaseNo- SDO 174641 Todd Cotton
Stipulations
with Request
vs. for Award
City of carlsbad, P,s.I.; % H(3M claim Management Company
Defendants
The Parties hereto sttwlate to the issuance of an Award and/or Order. based uWn the fOllOWtnrl faC
walve the reqolcernents Of Labor Code Sectlon 5313
1, TQ dd Cpttan .born 2/8/64
Street (Emm
ewloyed within the Stah sf Cnlifarnirr srq,Maznk .enance. .Bo rk&g II on 4/2/90
by City of Carlsbad, P.s.~. whose compensation Insurance EWlWWO Admin. by HCM Cldims Manacrement sustained Injury arlSlng out of and in the course of employment -. to - Parts ot oow injur
~Ocwfsarn~ (&to of InJwM
2 The fnjury caused temporary disability for the period FUll Compensated
for Which Indemnity is payable at $ through
week, less credit for such payments previously m68.
3. The injury CaU8Od permanent disability Of 3 4 X, for which indemnity in payabls at f
,In tho eum of $ 6, 475. 00
140. 00
, less cred per weak beginning 1/29 192
paymento prevlvualy made.
An informal rating m has not been previously isrrued.
lsrJect we)
4. there EX Em# may bs wed for medicat treatment to cure or relieve from the effects Of cSetec4 one)
DEPWWENTOP IHDl&lTtU
DMSlON W IIDUmIC
OWCWCAB FORM 3 IRN. 9-90) (Page 7)
TOTAL