HomeMy WebLinkAbout1992-09-01; City Council; Resolution 92-268d
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RESOLUTION NO. 9 2 - 2 6 8
A RESOLUTION OF THE CITY COUNCIL OF THE
CITY OF CARLSBAD, CALIFORNIA,
AUTHORIZING THE EXPENDITURE OF FUNDS
FOR SETTLEMENT OF 1XE WORKERS
COMPENSATION CLAIM OF JOSEPH PIMENTAL
WHEREAS, HCM Claim Management Corp., the Third Party Administrator
for the City of Carlsbad, has recommended a settlement in the Workers Compensation case
of Joseph Pimental; and
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WHEREAS, there are sufficient funds available in the Workers 9
:LO Compensation Self-Insurance Fund to pay the settlement,
:L1 NOW, THEREFORE, BE IT RESOLVED by the City Council of the City
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Self-Insurance Fund is authorized for the settlement of said case. :15
2. That the expenditure of $10,920 from the Workers Compensation :14
1. That the above recitations are true and correct. :13
of Carlsbad, California, as follows:
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3. That the Council accept the Stipulations with Request for Award,
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 1st day of %Dtember_ 1992, by the following
vote, to wit:
AYES: Council Members Lewis, Larson, Stanton, Nygaard
NOES: None
ABSENT Council Member Kulchin
ATEST
ALETHA L. RAU
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I e w tXHIBIT 2
WORKERS' COMPENSATION APPEALS BOARD
STATE OF CALIFORNIA
Applicant Case NO. Unassigned i Joseph Pimental
SS# 554-06-1926 Stipulations
with Request
VS. I for Award
City of Carlsbad
Defendcrnfs
__~~~~ ~~
The parties hereto stipulate to the issuance of an Award and/or Order, based upon the following facts, and
waive the requirements of Labor Code Section 5313:
1. Joseph Pimental , born 3/15/55 , while
(Employw) Park Maintenance
employed within the State of California as Worker I1 on 4/30/91 >
City of Carlsbad whose compensation insurance carrier was
HCM Claim ( Employer ) Management sustained injury arising out of and in the course of employment Riqht Knee .
(Occupation) (Date of Injuw)
by
( PDIU of body injud)
2. The injury caused temporary disability for the period X2 2 1 9 1 fully
through 9/3/91 for which indemnity is payable at $ compensate$er
week, less credit for such payments previously made.
3. The injury caused permanent disability of A%, for which indemnity is payable at $ 21 5 140 , 00
per week beginning 9/4/91 , in the sum of $ 10,920000 ,lesscreditforsuch
payments previously made.
An informal rating ~SX has not been previously issued.
(Sekd one)
4. fiere is gmKX&Xg&need for medical treatment to cure or relieve from the effects of said injury.
Upon demand, limited to injury herein mentioned, defendant has
five days to authorize or show good cause for denial, Failure to
(Select one ) .
do so shall give applicant tacid authority to secure whatever treatment is necessary to cure or relieve the DIvl,,MI~or.,WDo.~l~LACFIDCH~ effects of injury. .., .., I .
DUARTULNT OF INDU8TRIAL RELATION8
DUA WCAB FORM 3 (REV. 1-75) (Page 1 )
"1". L; ,-, .".,?.-, - ic. .,,< a L " .. .C\ ..
85 93315
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WORKE~ COMPENSATION APP~LS BOARD
STATE OF CALIFORNIA
5. Medical-legal expenses are payable by defendant as follows: All paid . No liens of record
$
6. Applicant's attorney request a fee of 8 [3 / 0 c/o,
7. Liens against compensation are payable as follows: None
8. Other stipulations: None
$424 ." 2-7, /44+ iYbL,Ja\ YfQ -* 1 3 Datd 1
#qkt v Jos&h Pimental
bkvu%/@
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554-06-1926
Social Security Number of Applicant 1694 Harbor Drive
Vista, CA 92083 z=y;y/"- __..-
plicant Thomas Gniatkowski 2646 ison Street
Carlsbad, CA 92008
Address of Attorney for Applicant
1200 Carlsbad Village Drive
Carlsbad, CA 92008
Address of Employer
3954 Murphy Canyon Rd., #D-205
San Dieqo, CA 97123
Address of Insurance Company
Curd Attorney or Authorized Representative for Defendant
3954 Murphy Canyon Rd., #D-205
Address of im-mey or Auther@d-Representative 1.
uo. CA 97131
DIA WCAB FORM 3 (UEV. 5-75) I Pace 2)
DEPARTMENT OF INDUST@~iREUTIONS
DIVISION OF INDUSTRIAL ACCIDENTS