HomeMy WebLinkAbout1992-10-20; City Council; Resolution 92-313\ II 0 0
d
1
2
3
4
5
6
RESOLUTION NO. 92-313
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 ROY PEIRSON
WHEREAS, HCM Claim Management Corp., the Third Party Administrator
7
of Roy Peirson; and 8
for the City of Carlsbad, has recommended a settlement in the Workers Compensation case
9 WHEREAS, there are sufficient funds available in the Workers
10
11
12
13
14
15
16
17
l8 I
19 I
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. That the above recitations are true and correct.
2. That the expenditure of $5,215 from the Workers Compensation
Self-Insurance Fund is authorized for the settlement of said case.
3. That the Council accept the Stipulations with Request for Award,
attached hereto as Exhibit 2.
20
21
22
23
24
25
26 /I
27
28
0 e
a
1 PASSED, APPROVED AND ADOPTED at a Regular Meeting of the City
2
vote, to wit: 3
Council of the City of Carlsbad on the 20th day of OCTOBER 1992, by the following
4
5
6
7
8
9
10
AYES: Council Members Lewis, Kulchin, Larson, Stanton, Nygaarl
NOES: None
ABSENT: None
11
12
'. ATTEST:
13
ALETHA L. MUTE 14
:
15
16
17
18
19 I
20
21
22
23 11
24
25
26
27
28
0 txH'w z <$ i ,"j L ''\-AD WORKERS' COMPENSATION APPEALS i
STATE OF CALIFORNIA
Applicant Roy S. Peirson
.vs. I CaseNo. SDO 157386
Stipulations
with Request
for Award I City of Carlsbad, P.S. I.
Defendants
The parties hereto stipulate to the issuance of an Award and/or Order, based upon the following fact5
waive the requirements of Labor Code Section 5313:
1. ROY S. Peirson ,born 9/26/53
(EmPWW)
employed within the State of California as Police Off iCer on 12/18/90
by city of Carlsbad whose compensation insurance ci
P.S.I. % HCM Claih
(occupabonl (oats of Injury)
EWWd
Management COrp. sustained injury arising out of and in the course of employment r,eft knee
(Parts of body injured:
2 The injury caused temporary disability for the period Fully compensated
Labor Code
through for which indemnity is payable at $ 4 8 5 0
week. less credit for such payments previously made.
3. The injury caused permanent disability of 11-3 /4 %, for which indemnity is payable at $ 140 .oo
per week beginning July 18 I 1991 .inthesumof$ 5,215.00 , less credit
payments previously made.
An informal rating Dfsp has not been previously issued.
(Select ?ne) As*
.4. There EX #mot be need for medical treatment to cure or relieve from the effects of sa
(Select one) r
DWC WCAB FORM 3 (REV. 9-90]
RECFlvFn 1M.w EI(T OF INDU5IRW. R
MSION OF INDUSTRUL A
(Page 1) s~p 17 SIQ 90
3
1 1-1 1 w
' 'W v - wmw+ Cowmwwl~N ,WEAM 'BOARD
, .d STATE Of CWFORNU
I.
..
s. W~ICJJI-J~~~J expensee are payable by detendant rs.rollovre
Mission Hills Medical Group has been paid by Defendant,
6. Apgocant's attorney fewest a fee of S 626
7. Llens against convensatlon.afe payable 83 101)oWs:
Norre
8. Other stipulations:
A) It is further understood and agreed that the aforesaid'sum shall be deemed to include such interest as is provided by Labor Code Section'5800.
B)' Based upon the total medical record and the testimony given by Roy S. Peirson, the parties have agreed that the level of disability (11.75%) is based, in full, upon the worker'^ subjective complaints, as opposed to any physical restrictions or work preclusions, ,.
3( Oatea ' Gl.Sh7;
2.- AppIiC8nt s.
555-72-4142 Soctal Security Number 01 ApPlklnt
1157 La Tortug8
Vista, CA 92083
Addf e <F%qb
Attorney for Appticant
2330 Third Avenue San Diego, CA 92101-1514
Address of Attorney for Apolicrnt
1200 Carlsbad Village Drive Carlsbad, CA 92008 ~oere9a1 of Emptoyer
3954 Murphy Canyon Road, Suite D2C San Diego, CA 92123 AdQ1eSS ormuranee comgany
Charles J. 'Loof, Esq, Attorney or AutnorizeQ mwemntative for &fendant
7851 Mission Center Court, Suite : &an Oiego, a. 92308 -7
reso or Attorney w mtnortzeu rtepasesntatrv&
~ ~~~ ~ tWc WcA9 f OAU'3 (e@/. %$o> I
~~ ~ ~~ -~ ~. ~~~ ~
(Page 2) w*r*mrcI W IMDUIIIIIAL RKUllOIl
OWOM OF WUStWAL ACClOLlm