HomeMy WebLinkAbout1992-03-24; City Council; Resolution 92-72II 0 w
1 RESOLUTION NO. 9 2 - 7 2
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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
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matter, has recommended a settlement of the Workers Compensation claim of Georgia 7
WHEREAS, Mr. Charles Loof, Defense Counsel for the City of Carlsbad in the
Lynn Brown; and 8
9 WHEREAS, there are sufficient funds available in the Workers Compensation Self- '' 11 Insurance Fund to pay the settlement,
=I. ll YOW, THEREFORE, BE IT RESOLVED by the City Council of the City of
l2 /I Carlsbad, California, as follows:
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1. That the above recitations are true and correct.
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2. That the expenditure of $5,000 from the Workers Compensation Self-
Insurance Fund is authorized for the settlement of said claim.
3. That the Council accept the Compromise and Release, attached hereto as
Exhibit 2.
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PASSED, APPROVED AND ADOPTED at a Regular Meeting of the City
Council of the City of Carlsbad on the 24th day of March 1992, by the following
vote, to wit:
AYES: Council Members Lewis, Kulchin, Larson, Stanton and Ny
NOES: None
ABSENT None
ATIEST:
a"@=L Bp. R-
ALETHA L. RAUTENKRANZ, City Clerk 1
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COMPROMISE AND RELEASE 0 ~P*RTklLMT#lnOUmULRLUnOm
STATE OF cullr#(wIA w m sa wmucnows ow
cmPrLnt6a FO~M WORKERS' COMP€WSnON *PpuU BOIRO RMRW W WE 2 BEFORE DMYON Qc lNOUITRULICCIMNlS CASE NO. 91 SD
SOCIAL SECURITY NO. 523-50-5
8557 Lemon Ave., # 23
1200 Carlsbad Village Drive
3954 Murphy Can on?%%d, Suite I San Dieqo, CA 9 4 123
GEORGIA LYNN BROWN La Mesa, CA 91941
CitT of CarlsbgdLi~&rmls&ibly Sel -Insured wlsbad. CA 92008
EUPLOYEE *wREsI
MORES
1. The Injured employee claims that while employed as a Senior Manaqement Analyst
(OCCUPATION ATTIUE OF INJURY)
on, 8/3 9/90 - 8/19/91 at Carlsbad. .California , by tt
(s)he sustained injury arislng out of and in the course of employment to nsvche !c;AymnoF aOOY~YERE ,NJUREDl
2. The parties hereby agree to settle any and all claims on account of said injury by the payment of the sum of $ 5 f Oo0 O0
In addition to any sums heretofore paid by the employer or the insurer to the employee, less amounts set forth In Paragraph Nc
3. upon approval of thls compromise agreement by the Workers' CompensaZion Appeals Board or a workers' compensation judge i
In accordance with the provlsions hereof, said employee releases and forever discharges said employer and insurance ca claims and causes of action, whether now known or ascertained, or vhlch may hereafter arise or develop as a result Of
Including any and ail liability of Said employer and said insurance carrier and each of them to the dependents, heirs,
representatives. administrators or assigns of said employee.
- (DATE OF INJURY) (CITY) (STAT€)
4. Unless otherwlse expressly provided herein, approval of thls agreement RELEASES ANY AND ALL CLAIMS OF APPLICANT'S DEF
DEATH 6ENEFITS RELATING TO INJURY OR INJURIES COVERED BY THIS COMPROMISE AGREEMENT. The parties have con'
release of these benefits in arrlvlng at the sum In Paragraph No. 2
5. Unless otherwlse expressly ordered by a workers' compensation judge. approval of this agreement DOES NOT RELEASE ANY
CANT MAY NOW OR HEREAFTER HAVE FOR REHABlLlTATlON OR BENEFITS IN CONNECTION WITH REHABILITATION.
6. The parties represent that the following facts are true: (If facts are disputed, state what each party contends under P:
DATE OF BIRTH ACTUAL EARNINGS ATTIUE OF INJURY LA3 DAY OFF WORK DUE TO THIS Ih
Disputed
PAYMENTS MADE BY EMPLOYER OR INSURANCE CARRIER
TEUPOFSRY DISABILIM INDEMNITY WEEKLY RATE PERIODS COMRED
None
PERUANENT DISABILITY INDEMNITY TOTAL MEDICAL AND HosPmL BILLS None None
BENEFITS CLAIMED ay INJURED EMPLOYEE
Fully compensated in this settlement Some
BEGINNING AN0 ENOING DATES OF ALL PERIODS OFF DUE TO THIS INJURY MEDICAL AN0 HOSPITAL BILLS PAID BY EMPLOYEE
TOTAL UNPAIO YEDICAL AND HOSPITAL EXPENSE ESTIMATED FUTURE UEDICAL MENS
BE PAID BY: Applicant. TO BE PAID BY: APPl iCant
THE FOLLOWING AMOUNTS ARE TO BE DEDUCTED FROM THE SETTLEMENT AMOUNT:
$1,300.00 PAYABLETO Professional Psych. $ PAYABLE TO
$1,190 e 00 PAYABLETO First Western Med. s PAYABLE TO
Servrces
GrOup/Allen Jay, M. D.
t PAYABLE TO s PAYABLE TO
WvpJQ A "CE OF $ 2,510.00 , less approved attorney fee (See Paragraph NO. 9). payable to applicant. (1
be other than in a lump sum. or there is additional information. specify on separate page(s). 1 '. ; _.. ,
DUW FOClY IS (RN. 1983) (P&X 1)
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7. Liens nbt mentioned in Paragraph No. 60 be disposed of as fOllOw8: Pl- " -. ,
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8. Fo: the purpose of determining the lien ciaimb) filed for benefits paid pursuant to the Unt?mplOYInent InSUfanCe Code or I
turnlshed by lien claimants defined In Labor Code Sec. 4903.1, the parties ptopase reduction of the lien clatds) In acco
formulae attached. Not applicable.
9. Applicant's (employee's) attorney requests a fee of S L 6'0 4 GO . Amount of attorney fee previously pald. jf any, S-
10. Reason for Compromtse. special provisions regarding rehabilitation and death benefit claims, and additional information:
Please see page 2-A and 2-3.
11. ~t is agreed by all partres hereto that the filing of this document is the filing of an application on behalf of the employee wcm may in Its discretion set the matter for hearing as a regular appltcation. reserving to the parties the right to put if
the facts admitted herein, and that if hearing IS held with this document used as an application the defendants shall ha1
them all defenses that were available as of the date of filing of this document. and that the WCA8 may thereafter either
Compromise Agreement and Release or disapprove the same and issue Findings and Award after hearing has been held i
regularly submltted for decision.
Wltness Me signature hereof this /2 fi day of
SED BY WO DISINTERESTED
STATE OF CALIFORNIA 2
Countyof ,qan uao - >
onm day of AD., 19 , before me,
a ~otary public in and for the said county and State, residing Uerein, d2yccxnmissioned and SLUnrn, PersonalrV appeared-
kna~ntometobetheperson- -name
subscribedto~m'~~lnstrumentand~knavledgedtome.that_hs_ emcuted~same-
H mss MREoF, /haw muto set my hand and affw my ofrkial sal the day and year in this Certificate first abmw
mitEen d
DlAwcasFoRUlS[RN.l?83)(PIOE2l NOtUy~kM)W~aacwntrMdstdtrorwctorn.
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Continuation of Paragraph 7 Re: GEORGIA LYNN BROWN
First Western Medical Group withdraws liens of Dr. Papaleo and Dr. Sobel for psychiatric evaluation and testing; Professional Psychological Services and First Western Medical Group/Dr. Ja) agree to accept $1,300.00 and $1,190.00 respectively in ful:
satisfaction of liens filed for psychiatric and internal medica:
services.
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APPLICANT: GEORGIA LYNN BROWN COMPROMISE AND FELIDS1
CASE NO. : 91 SD
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=A) This settlement includes any and all claims for medica: temporary disability, vocational rehabilitation temporar:
disability and reimbursements through th Order Approving Compromise and Release. hq Initi ', s th'
- XX B) It is further understood and agreed that the aforesaic sum includes interest as provided by law for a period 0,
twenty-five (25) days from the date of service by thc Workers' Compensation Appeals Board Approving Compromise and.Release. RAthe Initial Orde:
&* - xx C) DEATH BENEFIT CLAIM WAIVER: The applicant has been advised and fully understands tha. this Compromise and Release Agreement releases any ant
all claims of any dependents to potential death benefit, relating to the injury or injuries cov ed by thii Compromise and Release Agreement.
KD) A reasonable and substantial dispute exists between thl
parties as to: Nature and extent of the applicant' disability, both temporary and permanent; need for past present, and future medical treatment; reimbursement fo self-procured expenses: etc. Rather than risk th uncertainties of litigation, the parties wish to settl this claim, and all its prese and potential issues, vi a lump sum certain. ,&@
=E) A serious and reasonable issue exists as to injur
arising out of the employme t and r occurring in th course of the employment. @
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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 Thoma Finding that applicant has settled all potenti right to vocational rehabilitation benefits. + Initi s
DATE: a({ L[q z APPLICANT :
DATE: q/z/sp APP'S A
DATE: a({ L[q z APPLICANT :
DATE: q/z/sp APP'S A
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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
JTHOMAS VS. SPORTS CHALET, 42 CCC 625)
A serious and good faith issue exists regarding injury AOE/COE an1 parts of the body which, if decided against the applicant, coull defeat all of the applicant's rights to benefits under the Lab0 Code, including those of Labor Code Section 139.5 for vocationa
rehabilitation. The parties therefore request that the trier o fact carefully review the evidence and make a finding in accordanc with Thomas vs. Sports Chalet, 42 CCC 625.
The parties ' acknowledge that applicant will be barred fro: receiving any benefits if the AOE/COE issue is resolved i:
defendant's favor.
In support of request of defendant Is request for a Thomas v. SDort Chalet rehabilitation waiver, defendant would offer the testimon of Christopher Salomone, Patricia Cratty, and Kathy Graham. Eac:
of these witnesses would refute the testimony of applican
regarding her allegations of stress on the job. Defendant als relies upon applicant's deposition testimony and medical record regarding her pre-existing medical conditions.
Defendant had scheduled an internal medicine evaluation wit Douglas Davidson, M.D. and a psychiatric evaluation with Jame Morris, M. D., but applicant chose not to attend either of thos
evaluations in favor of withdrawing and settling her claim. Th applicant is presently employed by a local city in a manageria position on a full-time basis.
The parties recognize that a request for a Thomas Finding i appropriate when there are legitimate doubts concerning th
employer's liability and the worker might receive nothing if th case is pursued through trial. It is also realized that it is no the intention of the Board to prohibit settlements by requiring determination in every case of entitlement to benefits. The Boar is asked only to determine, through a review of the records,
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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 justify the release requested.
Applicant, in this matter, is represented by competent anc experienced counsel who does support the request for a Thomas
Finding. It is therefore respectfully requested by the defendant
that the Compromise and Release, as submitted, be approvec
including the cequested Thomas Finding.
J/I~(~x
DATE - - APPLICA~ 0- 7GiGH T S ATTORNEY
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