Document 0gbKbMX3zwLMyGYBDR1Vqe83d

January 31, 197<f REDACTED Setna Casualty and Surety Company 601 James Street Syracuse, New York Attention: John Mulcahey Claims Department REDACTED RE: WCB Case No. 67900455 Dear Mr. Mulcahev: I trust you will recall our previous telephone conversation of January 9, 1979 in reference to the above named individual who was formerly employed as a part-time bookkeeper at our store #05441 in Syracuse, New York. At -chat time, I advised you that family doctor had diagnosed "chemical luekemia" and related it to exposure to paint and other chemicals at our store, doctor made this diagnosis without ever examining his patients work place. As we discussed in our telephone conversation, claim appears to be somewhat speculative based on the medical infor mation currently at hand. Per your advice, we did not complete Form C-2, "Employer's Report of Injury" for this claim. Instead, our Store Manager, advised that we are not acknowledging this claim and that she would have to seek assistance from the State of New York Workmen's Compensation Board. Apparently, did just that, as we recently received the enclosed forms from the Board. We have completed Form C-79 pertaining to our Workers' Compensation coverage in the State of New York. This form was recently returned to the Workmen's Compensation Board. However, we have not yet returned the completed C-2 application to the Board. Per a carbon copy of this letter to we are requesting that he complete as much in formation as possible on the C-2 application and forward two copies to your office for your review prior to the filing of this form with the State of New York. Please advise us if you should have any questions or require any additional information in regard to this matter. We trust you will give this claim the appropriate handling. Very truly yours, N40542 THE SHERWIN-WILLIAMS COMPANY 0007-SWP-0055017S CONFIDENTIAI REDACTED