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FILE NAME Bechtel BECH DATE 1968 DOC BECH101 DOCUMENT DESCRIPTION Tyler John - Worker's Comp Claim mY, 4 3 tt, INTER VA COMMUNICATION OFFICE To F. L. Gardner Lancaster . - re From W. A. Maggio Los Angeles Subject Order Approving Compromise and Case No. 67 LB 36087Compensation Appeals Workmen's Compensation John Tyler 1 Release Board rs an 1/1/22 1/1/22 information Attached for _ your { is the October 24 1968 award in this case , Bj f attachment oS Saye 7 1 : a a, 3-10-81 c.F. FORM 1501 Printed in U.S.A. ; \a i e : j , 1 ; * . > -4 t ae . + 4 ' "he rr on we a OM, * "a "7 a i ope mary : . ae 1 .Pr co. ; . . Lome roy Pe, yo, enn Hee oa . DEPARTMENT . , OF INDUSTRIAL RELATIONS DIVISIOONF INDUSTRIAL ACCIDENTS BOARD WORKMEN'S COMPENSATION APPEALS STATE OF CALIFORNIA WA fe : 7 * . +) JOIN TYLER Deceased DOROTHY TYLIR and DOROTHY TYLER * ao Guardian ad Litem and Trustee t; - for CLAUDIA KAY TYLER and TERRILEEE TYLER Applicant CASE = 67 LB 36007 . - - Order Approving + Compromise and Release " me Defendants an . oy e oo oot tge - eyed ae . . . . The herein ea that parties to the entitled acrion have filed a Compromise and Release on ' : October 24 1963 settling this case for $ 20.000.00 Dok % , in addition to all sums which may have been paid previously and requestingit be approved. vase 3 and this Board having considered the entire record including said Compromise and Release now finds that it should be approved and : is ff now IS ORDERED chat said and is approved we IT Compromise Release 1 * # i. Award is made in favor of ; oat _ . / ste cu tf, oo) | " DOROTHY TYLER and DOROTHY TYLER DS Guardian ad Litom and Trustos for o CLAUDIA KAY TYLER and TERRIR LER TYLER Mere mes as . . . . an) . aa ae sy AETHA CASUALTY & SURETYCOMPANY ws ARGONAUT INSURANCE 1PANY PIMAN'S FUND INSURANCE COMPANY a 20 PACIFIC EMPLOYERS INSURANCE COMPANY ||: +*, AMERICAN MOTORISTS INSURANCE COMPANY| FIBREBOARD CORPORATICHCORPORATICH AND PLAIT 6 1. AUEMER AND ASBESTOSWORKS aaey THE F TRAVELERS INSURANCE COMPANY $e oy : STATE COMPENSATION INSURANCE FUNDtle . INDUSTRIAL INDENITY COMPANY . or GEIERAL ACCIDENT GROUP Payable as followes BY AETNA CASUALTY A SUMETY COMPANY / DOROTHY TYLER and DOI.OY TYLER n Guardian ad Litem and Trustee for coe soot applicants CLAUDIA KAY TYLLR and TERRIE : LEE TYLER 5,328.00 . ROSE KLEIN & MARIAS As attorney cob 2,000.00 , rer! } ee . BY FIREMAN'S COMPANY sBY PLOYERS " BY BY INSURANCE COMPANY COMPANY PACIFIC PLOYERS INSURANCE COMPANY .. MOTORISTS AMERICANMOTORISTS INSURANCE COMPANY oo es AND FIEREBOARD CORPORATION AND PLANT RUDDER AND _7 | vat ws ASBESTOS WORK3 ...POP eneeHSEHORSCESOEHEHBREHSOHIEGHOBGAHE ces: vt ) THE TRAVELERS INSURANCE COMPANY oeacecsavoccescscees - wtr BY INSURANCE . STATESTATE COMPENSATION FUND see eene soccvesere COMPENSATION eectseuseed ACCIDENT GENERAL GROUP ... TO DOROTHY TYLER and DOROTHY TYLER as ~ Guardian ad 1.item and Trustee for : CLAUDIA KAY TYLER and TERRIE . - LEE TYLER applicants ::.-+1. 2,672.00 ra F J hy ee sled ite: PTs 400.00 2,864.00 ve 1,466.00 Le . ; 960.00 3,820.00 720.00 684.00 .902.00 . . 20,000.00 20,000.00 i Dated * SEAL Dated at Long Beach California Served by mail on persons shown addrees on the official record fo, RAYMOND COMPENSATION a re pee el to ae " 4 /ft (mw On Po Ingham By / tbs a, eet OT aa +' i feat an oe aoe wt My a 7 iv fue . \ of ae JI- bee Me eas fy Qe a , .a 7 what . F wer an 4 ae t . oy 2 4 4 " . ye a, a a . (MO ' ar. . 8. tu, wt . oo . . EMPLOYER & ADDRESS Mundet Corp Corp.; Fiberglas Engineering & Supply Company now o Jivision of Owens Corning Fiberglas Corporation 5933 Telegraph Rond . Los Angeles California Const Insulation Company 2684 Lacey Street Los Angeles California Thorpe Insulation 2741 So. Yates Ave. Los Angeles California J. T. Thorpe Inc 948 E. Second Los Angeles California Marine Engineering & Supply Co.Marine 941 East Second St. Los Angeles California Insulations Inc. 532 So. Monterey Pass Rd Monterey Park California Thorpe Insulation ae Fiberboard Corporation voy & Plant Rubber & st. : Asbestos 1789 Montgomery Street San Francisco California . * i: h. ,.,. Armstrong Contracting & Supply 4340 District Boulevard Los Angeles California John Monsville Sales Corp. Leonis Street Vernon California ce Accurate Insulation Co. St f 4: 900 South Cypress as . La Habra California 2 siz Lee R. Ekins Company gr. 4933 Valley Boulevard 5. Los Angeles California Inc. . rot, ot it+" pee ye. Plant Asbestos Compony 1300 64th Street Emeryville California Bechtel Corporation 220 Bush Street San Francisco California mot ee ' J. T. Thorpe Inc 948 East Second Los Angeles California- ot oN Philip Carey Mfg Co. 532 So. Monterey Pass Rd Monterey Park California CARRIER & ADDRESS SURETY COMPANY AFTNA CASUALTY &SURETY 5 2404 Wilshire Boulevard | it i" COMPANY . Los Angeles California at a tty Argonaut Insurance 443 Shatto Place Company Los Angeles California Fireman's 3223 West Fund Insurance 6th Street Company Los Angeles California , Pacific Pacific Employers Insurance Company 4050 Wilshire Boulevard *. Los Angeles California i " Insured a te; Travelers Insurance Company 3600 Wilshire Boulevard . ae Los Angeles California Sak oF State Compensation Insurance Fund ' 600 South Lafayette Park Placewon ee Los Angeles California \ * Industrial Indemnity Company 505 South Virgil Avenue Los Angeles California Insurance American Motorista Company 3545 Wilshire Boulevard Los Angeles California od a! Assurance General Accident & Life 3535 West Sixth Street Angeles ; Los California 90005 of en a aN Dee Mr. Mike Tornesen Claims Representative 2404 Wilshire Boulevard ; Los Angeles California 90054 Dear Siri a mo, . a 4 Ros Claim No. T M 33 CC 215709 M Employer - Armstrong Contracting and Claimant - John Tyler A - 3/21/66 Supply Corporation Ho have copy of your letter of September 18 addressed to the Los Angelos Office of Armstrong Contracting and Supply ro the above On May , 1967 we sent to your office information regarding the earnings of Mr. Tyler Two copies of our letter of May , 1967 and bo all attached information are nolosed You will note a different Aetna olain number was assigned at that time t- _ The only additional information we carnings for the year 1966 and two also enclosed have now is a breakdown of his copies of this data shoot are ee ue ; nr Very truly yours 7 Enclosures MabeEl. Barnet Insurance Department . 7 Sh, a oy with onos - gS . Co ' s ae wo eda ifs . . Joo! vey 4 Seer, eae entA a- ; - - ~ : ated . a Oe ones ee imme e new me Pay Serena ~-| . bop yt mipotrtetotriner pep | | - - . oe oef Poot JOHN Laloswodtt TYLER i= i 3-17-66-415-66 Laloswod , California | . T0u wo earned previousplyreviouslypreviously - @j i information EarnedinformationAlso 1966 i 3/21/66 i Mi 234 Paget : 3/21/66 4/10/66 fre | to Laidoff have 4/10/66 to . izy | es qd. 9se3edid6 Fr chek 0 - san 2 he aemployee employee 7 sabrreeakidown mel [i an Rat !Pee nis a ho that laces sentiB. dsi. :: : eatateshave check _ e ocoy 3-20.66 eo;neo ee - 2 = | 3-20.66 (54 svez [ever 3-27-663-27-66 did PEP SY SF Li S68 9360 0% 23400 . |''][ti] i 23400 py 2340 iestiae) Coysq4y,-17-66 ^' J J9/L2/9/<'/97/0b/r 60 2029 rex % 04os cAvy ponsyu fo 9/82/gor. | 99/ tacg 12/ < wt NOs Og -1 mo fee be a ae Mal 2 anpE | | {. Tht ey 4 : | TE ! lee "9-998dr" O99-:-47-74 ti + Sa HIF nn coins ~~ _ , C BSI an if : - a/ on a roe \ - .* os a PEST TT SroveGsco pp) .-1 beet ie pexyrs o Asy et ee Zetlen 4doq a S.S./ 50-9452 - u -|. wh 2 Fae LakewoTYdLER 500-09-4525 Tear ter esmusryAcording ASBETCIS employeCalifornia RIcaNS Division Acording California employe formerlyAGaGyoy employe ASBESTCSIS T received ASBESTCSIS CLAIM AGGo employee ASBESTCSIS at Apeals Compensation listing John from Tyler Workmen's CALORIA listed Cork amounts Armstrong Divsion worked Corkthe amounts listed reminration periods received remineration Compensation Appeals that substantiate please this those facts Retntion However please subtaniate subtaniate Retntion However what what , have us you Armstrong or & he you worked | tell us he 151 151 152 givewould periodsperiods mumber and could | by we klyweklypay & breakdown breakdown of mosthelpful . earning| s earningsi y | { | eb Job af} Insurance Insurance pe Insurance t 4/25/67 ae % eS ic ae ee ee ae ae ees [LT ee es ee Divsion 4/25/674 Industrial Contracting Curent Tyrasnd | Recordsyrs Acidents Accidents Corpatin ot bit Current Industrial determine first determine TylerTyler 156 when 2 was except except first days RECORDS uption uption qs days 1956 the : Ee ; i i A. tell these years the reason leaving his COMPANY tell years nok Lad dee ARMSTONG EarnedEarned Insured ep Insured 1,158 Ac ident 1,158 fe Earned1,158 chStandara } 2,183.80 GATS oq 77 toy 9fan 1,604.25 ae 4,50 -- Syuc 34) eafotcre 1,604.25 Travelors yomserup toskex Ds 1,339.75 Travelors 4} |: 1fob ;|] FREOA bit] Travelors Rs qofterond ogy OUT, 12/352 Rseos 308.85 228noH SESpTODY Te - Ease961.35 Pmgdto p--1 peeZeqzenfi 12/31/6112/31/61 MLAT pre t193 yy py} jo eof rosy 2 : exuek 2 | 3scll [te[ek: Sy. 2,40.58 il. lsteang- 67 H_filj Peseuy 3/31/56 2962,240.58 bsay SOY fae 6q a - H - ;a if 9/30/60 800 [of 12/31/61 12/31/61 ia.ed ef 3/31/62 3/31/62 6/30/62 UE | y en | yo i|_ 5qt 17 2,059.2 | Sif f 094] Hr a ity il] it if ey 735.69 a: i coz 2,240.58 6/30/50 pe 572 Salotc=e eter, p4 160+ Aetna 572 BLO)SHELLDesLL CLs. Aetna 9/30/56 2 572 12/3160 EPIST 12/31/60 cyy 187.70 187.70 CONTRAIG Tresfsd B03 ARMSTRONG 9/3065 1,59.73 eroneous 160 ARMSTRONG CONTRACTING roneouseroneous listed Steresod listed roll= mn pJreopag| | j 1,60492 1,60492 1,60492 vont ETnoway9% ST 6cE eg TE 20 Stuy THIS LISTING LISTING SHELLD jo SyOF poe 1 1 AC S 1/1/58 formed formed ee quarter 6/30/62 /30 frank- 160+ down i: down 2S 96/1 (shee ek Se st cc o/ sz CONTRACTINeG soeo" es/osclyete formed quarter POTsay: 42/0</61S/1</21 /oE/ F=1H sauy ceqr 160 he / < EtYeatsestuz82555 . .. rad afc - FR 2-4 BA: ln \ ry " : ae a Ian Ian Ian Ian Ian Farcicio ai 5 #262 025 tates -500- -500- uf 5-12-60-6-13-61 9-11-61-11-15-4A 9-11-61-11-15-4A 9-1-61-1-15-4A 9-11-61-11-15-4A Ye work { work work eae 4 7 WAZ. 7Sy ne Dod agete!he = S-tp-60.3! AEE Fe ffp bd a 5 ee Lee obhtiprsWe ARGS 6 vee En / om |. T Los oy we NY SN UNAS, ui es oe of t Hi j= we Way ~ N yt Way yay 17760 te to i [ l: Ye. : Credwebs sla we a. odi tt { at | 3.3385 - [tte canes ee S 3.3385 3.3385 % ee Gs ita! i i Tae aoe re. sree . ove . 7-5-6-47 7-5-6-47 7-5-6-477-5-6-47 7-5-6-47 10800 . ees 39 we fem fe . > I ! _ 7760 1/51973 } - {l MarTTTMar Mar {i fp tits ft | iudns. 2 { Trio ee 38 iF 14 ah: . INTER --Thanks LG OFFICE COMMUNICE Ta F.L. Gardner Lancaster ; October 16 1968 From W.A. Maggio Los Angeles Subject Request For Information Aetna Life & Casualty Claim Number T M 33 CC 215709 MR John Tyler Attached is Aetna'a September 18 1968 letter requesting information in . regard to Mr. Tyler's earnings while in our employ Such information is requested for the insurance claim that Tyler has processed We have reviewed Los Angeles branch files as far back as they are presently at this location and find that any earnings Tyler had prior to 1966 are not here We have attached all of the records pertaining to dates termination and would hope that you can have the proper Lancaster research the necessary information for Aetna of hiring and department in We have informed the local Aetna office that this matter is being referred to the home office and you may feel free to answer them directly from . Lancaster M.C. Sweet Los Angeles ne oe , . , , ^' . , relat CASUALTY 2. m4 ey Alts +4 : RROO Casualty & Surety Division 2404 Wilshire Boulevard Los Angeles California 90054 382 5401 September 18 1968 1487 Armstrong Contracting & 4340 District Boulevard Los Angeles California Supply Gentlemen ; CLAIM NUMBER EMPLOYER CLAIMANT ACCIDENT T M 33 CC 215709 MR ARMSTRONG CONTRACTING & SUPPLY JOHN TYLER 3/21/66 Mr. Tyler has filed an Application with Compensation Appeals Board applying for Compensation benefits the Workman's Workman's _ He alleges that during his employment for you he tained a pulmonary disorder due to his exposure asbestos sus- - to ' au mo To assist us we would like you to provide information regarding Mr. Tyler's employment On your Company letter- following head stationery would you please provide the | information 1. Dates of employment during worked for you and whether he porary or permanent employee which Mr. was hired Tyler as tem- 2. Type of work Mr. Tyler was hired to do and a detailed description of his duties Please pay . exposed special attention to whether Mr. Tyler was to asbestos fumes or not Tyler'sTyler's 3. We will need a earnings while in week your by week employ resume of Mr. Please use the wage statements that are enclosed for your convenience The above information will enable us to properly defend your - firm and determine what benefits if any are due Mr. Tyler information Your prompt response in providing us with this will be greatly appreciated . Yours very truly ee Mike Tennesen Claims Representative Bont ae - ne Insurance 1B The Workman's Compensation Claims , MT | e Company The Atra Atra Casualty and Surety Company ME StanfordStanford Fire Insurance Clamps cosumocn, wo? To -- -- --...-- Address - Address Address 7 * . len John 4333 Deanwood . : : EMPLOYEE Lakewood RECORD CARD 5. No. 500-89-4525 Date 6-28-65 Date 500-89-4525 | Telephone Number RECORD OF EMPLOYMENT Hirod Hirod Terminated Terminated Reason Terminated Data 15-27-671-13-651 15-27-671-13-651 15-27-671-13-651 A Address Date : OCCUPATION AW Mechante - HOURLY | EFFECTIVE EXPIRATION EXPIRATION RATE DATE DATE 1.25 6-28-6 6-28-6 }s 5.55 8.1.651 APPROVED RT4 CC.U 4 CLASS CLASS 2 DATE 16-28 - 3 . UNION AFFILIAT Form 4715 8/63 / DEDUCTIONS TYPE Pension AMOUNT | Vacation Local Tax Bond Name Address TTyylleerr Address Addross I John I Dashwood EMPLOYEE RECORD CARD 500-09-1525 S.3 No. 500-09-1525 S.3 Lekewood DaDtaete Date Date 3-23-277-66-663-27-66 __ Date _. Date Telephone Number Number i RECORD OF EMPLOYMENT Reason Hired Terminated Terminat : 3-21-66 4.17-11 4.17-11 LtAig Address OCCUPATION AMM | HOURLY RATE EFFECTIVE EXPIRATION APPROYED DATE DATE BY 5.55 13-16-66 4 CLASS CLASS 2 _| 3-29-16 - ee ee UNION UNION AFFILIATION DEDUCTIONS TYPE AHOUNT Pensinn Vacation 5 ee Local Tax Blond ores bd "| . a : . at" Pe ete tl ah ene!y 4 epee cy ' tt, . Ms ac . ' i woe ay as ee, woo 1, One 2 = . -? amet eyl TYLER JOHN I. . ee Caly woos Wa hwood, 4 _- Tee 4 , . . * sO Auth Auth Auth ; 5.55 et b 5.55 w 4 4. . . om, A oe ae . aos * 500-09-4. 525 ale . Ps , i; ot " ne teint Minid + Minid 12 2-15-42 2-15-42 2-11-61 fe . , 12-15-61 ve 12-15-61 12-15-61 : an cb woos , be , . ; ' in .aa 4 . , oct a an * 3-16-16 4-15-66 4-15-66 LO soos ~ . i ) i i. . aoe . opt oe 4, : ot rn aye . . . , . sha : Tyler John ~ 6333 Dashwood . * Lakewood Calif - - co 500-09-455200-509-4525 _ tee e , et . : . wt wets vie a cote . " wy, . and . , 1 hooky wat ran tt te, as ts t won . : ow ee Hn oe ' : , vat ra Rate . Hired 5725 117565205 , : 6-28-65 4 1 . . we Wall _ 2 AWM = LONW : 8-13-05 8-13-05 ' ste ue . a . oe . ' te rvs woo A . . ae . | a : . : on e ont . s 4 nn by :. 1 : . an 2 on oat fer tet roe, * wy : ! 4 me Se t. : ry : os 2 . : tree iy acy. Oe asaee, Tt ; a wy atc bee rreghone oboe ay eo : r . . on to ome . ve : \ : re te ry . y wore 2%, : a rs * ayer e . Me . atut re . ; * ' JohnJohn TylerTyler te . : r ; en / 7 : / ^' . i f SC Se : 7 f / ee 6/28/65 Off no 6/28/65 to 8/13/65LaLiadid no recorde 3 ' t Thoes Exp 3-21-66 -3-27-666 -3-27-66 23.400 Exp | Rehired - wey cy 3-28-663-28-6 3-28-66 - 4-3-66 4-3-66 234.00 5.00 , SUI 2.34 2.34 ohn Land 4-4-66 4-4-66 4-10-66 234.00 234.0 4-11-66 4-11-66 234.00 Off 234.0 4-17-44 4-17-44 L 5.00 = 234 5.00 2.34 2.34 vont eee ' - 008 he tg) ee et tee oe oe ' . - - : FICA *Vae FWT | 39:38 39:38 12.001 39.38 39.38 120010 39.37 39.37 12:0012:00 1. 8 39.38 200/ . . . e * = -- oe mone fe ~~ wen . or -- - at te ; wee ' - 3 tne j s _ ' wee em ow: {- sn a ee e - ee Gen j ; woe b | - _ pew etmte te eee worm wee fio ee . ' - : a ' ! ~ . . -{ ame aks , . : i ' fi . ' . | oT ane : om ee poo 1. commen - th e - { : ree: : - a a . - . ee + " - : Sees aye 1 , , * . t- ae U ery weer eg oo m . " x H we fi ae | " dow o cee ge ie ue as ] _ | fsSe : 4 74; Ha is . an ! wt . ae r mh a a. 1 . ' ' Py . a ee ae ' . One ede, er . } 1 neyi: naet . , ALG a> fs 1 a ee 1; Syd g ery a rs 1 + NAKE OF COMPANY 43 etn 3 Associated Insulation Contractors ofthe Western States _ TERMINATIONNOTICE REASON FOR TERMINAeTne IdONpe Ae Es oe5DISCHARGE + Force Reductionin . +! ge ew. Explain Other * ( iq . ^' - % Other ExclaDirninking, - ORIGINAL White ~To Employee aay "! DUPLICATE Yellow - To Lacal Union- TRIPLICATE Dua - To Fi na we COFFANCOFFAe N i woe COFFAN rmarAaeanTAlien ae e, Pree Merce ely . : , ae ae oof a . 6 - . Pa , INTER MOHMOHMOH OFFICE COMMUNICATION Gardner To F.L. Gardner Lancester, . From Subject M.C. Sweet Los Angeles . John Tyler Angeles Case No. 68 LB 36087 ee eee r Conis Jaber Conis . Conis Oe oe penne i . hoa oN . . br : August 19 1968 . rs s, . Attached is copy of a Notice of Hearing and Application For Adjudication of Claim from the Workmen's Compensation Appeals Board for the subject former : employee ss CS ! fas FORM 1501 Printed In U.S.A. , om -- \ . we, 7 a . yk, . . 7 ro co . o : te a = a! - , i" is s. ee . wy 2 %! , " DEPARTMENT OF INDUSTRIAL RELATIONS DIVISION OF INDUSTRIAL ACCIDENTS WORKMEN'S COMPENSATION APPEALS STATE OF CALIFORNIA BOARD , . . DOROTHY TYLERIII( JOHN TYLER JOHN I TYLER SON DECEASED ) ( WIDOW ; nt ae SEE ATTACHED LIST os . Co. . co Case No. 68 LB 36087 NOTICE Of Hearing ApAppplliicacnat nt ) ONE FULL DAY : Defendant , N ih 4 "4 Appeals You are hereby notified that an application for compensation has been filed with the Workmen's Compensation Board of the State of Californis You are further notified that mid application has been set for hearing at 230 EASM FOURTH STREET ROOM 302 LONG BEACH CALIFORNIA 90812 au OCTOBER 3 1968 AT 9:00 A.M. lag that Compensation mid and at said time and place the Workmen's in Appeals Board will proceed to hear and dispose of the application in the manner prescribed by law , WORKMEN'S COMPENSATION APPEALS BOARD oo Dy JOHN L. SMUETT , oa Referee Dated at LONG BEACH CALIFORNIA . - oy and other prod NOTE The parties are capersed in submit all disputedissues far decision at this hearing All warnewer evidence medical reparts payrolls be Reqs for mysi avalehir the bearing CONTINUANCES WILL BE GRANTED ONLY UPON A CLEAR MIDWING OF GOOD CAUSE " contignances contignances are to be made within 5 days chur date of this notice . NOTE TO INNUKID IMPLOYL85 IMPLOYL85 Your attendance at this bracing may nm bu fanctuary hak your susuramis compaE . 3 Ay : ' _ ; ' ' SERVED MAIL ON PERSONS SHOWN THE ON OFFICIAL ADDRESS RECORD _ Date 8/15/83 By = dikam : aan . a ; we . ve re % mt . o. . JOE , sa oo 3 ve .t . . os wo . WCAG FROM DIA 10 6:47 IFONNEASY PORN VAS - 1. on . - , . . . wo t ? a " foc oa . fl ae . hs d . MUNDS CORPORATION AETNA CASUALTY & SURETY CO E. S. MCKITTRICK COMP ANY J. 7. THORPE INCORPORATED SELF INSURED ROYAL INDEMNITY INDEMNITY COMPANY AMERICAN NOTORISTS INSURANCE COMPANY PACIFIC EMPLOYERS INSURANCE COMPANY MOBIL OIL CORPORATION SELF INSURED -_ . MARINE ENGINEERING & SUPPLY PACIFIC EMPLOYERS INSURANCE COMPANY COMPANY PLANT RUEDER & ASBESTOS WORKS SELF INSURED . FIBREBOARD CORPORATION SELF INSURED HUGH A ELCDON PLANT ASBESTOS COMPANY INDUSTRIAL INDEMNITY COMPANY MULDOON COMPANY INC SELF INSURED INSULATIONS INCORPORATED . PACIFIC EMPLOYERS INSURANCE CO THERMAL THERMAL ENGINEERING INCORPORATED HOFFMAN & SON INDUSTRIAL INDEMNITY COMPANY EHRET INCORPORATINCOERPORDATED INSURANCE COMPANY OF NORTH AMERICA THE PHILLIP CAREY MFG COMPANY GENERAL ACCIDENT FIRE & LIFE ASSURANCE CORP . y oo SUBSEQUENT INJURIES FUND BECHTEL CORPORATION INDUSTRIAL INDEMNITY COMPANY THORPE INSULATION COMPANY SELF INSURED FIREMANS FUND INSURANCE COMPANY PACIFIC EMPLOYERS INSURANCE COMPANY ARMSTRONG CONTRACTING & SUPPLY COMPANY TRAVELERS INSURANCE COMPANY AETNA CASUALTY & SURETY COMPANY FIBERGLASS ENGINEERING & SUPPLY COMPANY A DIV OF OWENS CORNING FIBERGLASS CORP AETNA CASUALTY & SURETY COMPANY RELIANCE INSURANCE COMPANY JOHN MAMSVILLE.SALES MAMSVILLE.SALES CORPORATION TRAVELERS INSURANCE COMPANY COAST INSULATING PRODUCTS PACIFIC EMPLOYERS INSURANCE SELF INSURED GUARANTEE INSURANCE COMPANY ARGONAUT INSURANCE COMPANY COMPANY LIE R. EKINS COMPANY STATE COMPENSATION INSURANCE FUND ACCURATE INCULATION COMPANY SELF INSURED STATE COMPENSATION INSURANCE INC FUND . oe > Department of Industrial Relations LT Sat . - GOOD CAUSE APPEARING The application herein is taken oil calendar - 12 BESTT 1474 ' Division of Industrial Accidenu Workmen's Compensation Appeals State of California FOR APPLICATION ADJUDICATION OF Death Case CLAIM Please filo signed original and six copies and print or type names and addresses . . oy Board CASE NOES oy ; AG ae ae v Li Kr 30087 ' LE 30087 30087 30087 30087 t MEN NSH AO TIT AFPLICANTA * . ot 5333 Dashwood APPLICARE'S ADDED rs Lakewood California . vat M. Ray TYLER et JOHN I TYLER DUKEST 49ECRATED CUPLOVER'S CUPLOVER'S NAME SAJ SOCIAL SECURITE e 500-00-4525 rhe s, " na . VL 221 22c2,6 22c2,6 22c2,6 ... ...... ...... ... MPLATEC~fi ., ' (dacvarea bacreasar * .4 2 ue a ww rf a SEE ATTACHED SUPE ot COMPLAITO'S BELPRIPENSES OF COMPLAITO'S COMPLAITO'S chiudonoj chiudonoj sheita on STATE OF BELPRIPENSES f FERNILGIDAT URIGEONS3 BELPRIPENSES ! ( S JEGUJREGURAAMES MJEGEURASMES CARRIEN ANTI ly , : - . : ; : 4 IT IS CLAIMED THAT 1. Deceased employee born 19.11 19.11 19.11 to an 1/9/1967 Arbata Arbata de injurtj Asbestos 2/25/1975 DATE OP Bantuj while employed is a Worker By OCCUPATION AT TIME OF tase) Various at Various 511 Calif GYAT by the employer sustainedinjury arising out of and in the course of employment to Pulmonary Disorder ESTATE WHAT PARTS OF BOY WERE IN esee 2. The injury occurred as follows , 3. Actual earnings at time injury were Prostou asm bee stos PLAY PLAY EPLOTESOING EPLOTESOING EPLOTESOING EPLOTESOING AT TIME OF INJURE AND HOW IT AS BECER resulting in death on June 1960 DATE MO MO Marizu i GIVE WACOLYN BONTHLY SALARY DE ONLY DATE and RDASLS OF S RO PER WE ai - se ey oe , injury disability 1/10/57 6/19/086/19/08 4. The caused as follows | ^ P^ CIFLYAST DAY OFF WOKE QUE 10 FH18 ImJu"stau St^^>kninagnd EKOLAH YATER OF ALL PERIMES PERIMES art sue to Paid 1028293 3. Compensation was paid **** . TTA 39 5 * ITOTAL PRIDE 52.50 TOLLY BATE Juno of 1960 LATE OF LAST FATHENTI 6. Medical treatment was received ... 7401 511900 ...1 ... 511900 511900 - RATE OF LAST TOGATMENT All treatment was furnished by the employeorr insurance a : company -- -- T cna other treatment was provided or paid for by M cig i . ve Doctors not provided or paid for by employer or insurance company who treased or examined for this injury are t | 4: ae WK . . a) . ; oof , .. Soe . hoe : oa Oe Pi ade - ZOVATE NAMES ADO ADOREDIch ADOREDIch or such nociona nociona ang DAVER OS MOSs~ taka MOSs~ taka T^WHICH QUEN BOLTORE BOLTORE SOMITTED IRANGIRI: 7. Defendants have paid burial expense centr .. (nee TOTAL PAID 1. The employee left surviving him the following dependents i . ro ay! NAME DATE OF NORTH if under 21 RELATIONSHIP TO THE EMPLOYE~ . . ADDRESS ' Ge . : > j . Derekhy Ty Re ae Cyaan Tea Dashwood Lakewood Wife 6333 15 Daughter Daughter " 11 1 . 12 Deverren: WHEREFORE applicant requests a hearing and an award of Death benetic Burial expense til. Compensation accrued : ane and unpaid Unpaid Medical bill Other_ Specify and all other appropriate benefits provided by law . toe vag ^' Hearing requested at Santa Ana June 1969 NuNmumbberer ofof witnesses a witnesses trial Pretrial wanwantedtedwanted Dated as a anus Sa_S nta a Santanta California Santa M A.bye ian Estimated time of trial 900 1 Full Day pti 7 <4 ; i & MANIAS Fost WgfmaSIGNATURES Set now ; Set later on written request 4 - L \ ~ v rt Howard A. CLAPLICANT'S CLAPPLICANT'S ATTON an Cobler Me ; ; 412 Broadway Suite Sant Ana | NorCatlihfornia of ) California ADELE ADELE bub A l le t 52701 52701 | vs t Telephone 541-4129 EMPLOYEREMPLOYER & ADDRESS CARRIER & ADDRESS EARNINGS Hundet Cork Corporation Walton Walton 6116Walton Maywood , Avenue Avenue CaliforniCaalifornia California fiberglas Engineering Supply Company How a sion of Owens Corning & ' divi- Fiber- glas Corporation 5903 Telegraph Telegraph Road Los Angeles California Aetna Casualty & Surety 2404 Wilshire Coulevard Los Angeles California Company 90054 Aetna Casualty & Surety Company Coast Insulation Company 2684 Lasey Streat Los Angeles California Argonaut Insurance Company 90005 443 Chatto Place Los Angeles California $ 19,976.60 16,669.02 . 2,032.20 Thorpe Insulation Company 2741 South Yates Avenue Los Angeles California Fizoman's Fun Insurance 3223 West Sixth Street Los Angeles California Companies . 4,246.75 T. Thorpe Inc. 3. Angeles 98. Zast Zast Second Street Los Angeles Angeles Angeles California Pacific Employers Insurance 4050 Wilshire Doulevard Los Angeles California Company 700.00 Engineering MarineMarine ' Marine Engineering Engineering Enginering & 941 ESauspt plySecCoomnpdanySComptanyreet Los Angeles California Pacific Employers Insurance Company 5,186.07 Thorpe Insulation Company 2741 South Yates Avenue Los Angeles California Insulations Inc. 532 South Monterey Pass Road Unterey Park California Pacific Employers Insurance Company Pacific Employers Insurance Company 2,067.38 =\ 6,366.30' Fibreboard Corporation 1709 Montgomery Street San Francisco California Insured 3,352.00 . a ay ot: Asbestos Plant Rubber & 1300 - Goth Street Emeryville California Works Insured Armstrong Contracting a Supply Company 4340 District Boulevard Los Angeles California Travelers Insurance Company 3600 Wilshire Coulevard Los Angeles California 1,466.00 mee spe i : wo John Mansville Sales Corporation Leonis Boulevard Vernon California Mil Oil Corporation- 612 South Flower Stroot Los Angeles California Com- Accurato Insulation " pany Inc. . 900 South CypressCalifornia e La Habra California - Travelers Insurance Company 7 re 2,058.50 Insured Poo. 100.00 o ts o ; State Compensation Insurance Fund 600 South Lafayette Park Placo | Los Angeles California| ; ; . . 3,739.20 ee dwt? , a : i oN af a ge roa, Ae Note eee * , rae , e . ' . . .. . . CONTINUED FROM ATTACHMENT 61 A 1 z. : CRA owt b oo Employer & Address Plant Asbestos Company 1300 64th Street Eucryville California Carrier & Address | Earnings +: tt e . Industrial Indemnity Company * 505 South Virgil Avenue - an Los Angeles California 90005 $ 3,366.00 , . 220 Bush Stroz San Francisco California Industrial Indemnity Company Thermal Engineering Roffman & South 10th Richmond California Inc. Street \ Industrial Indemnity Indemnity Company J. T. Thorpe Inc. 943 Cast Second Street Los Angeles California , oe 3. T. Thorpe Inc. an i . American Motorists 3545 Wilshire Boulevard Los Angeles California 90005 _ Royal Globe Insurance Company 210 West Seventh Street Los Angeles California ale 2.50 ys * wan or 1,237.00 , we ++ . 7,327.00 i. 7,327.00 Co The Philip Carey Mfg > . Compeny 632 South Monterey Pass Road Monterey Park California _ General Accident Fire a Life Assurance Corporation Limited 3535 West Sixth Street Los Angeles California 90005 2,250.00 .. . A .- . : 4 . . - ob e - s . 4 . "th A t . ' pb ' f n y . ; Pore Laahd Ww : . DT q: Lady ly rt . wets ore) ee ou i ee ig of . - . ae vale: a a . . . % . erat : a! . " ? we x . wth a - . , ' dope . Je . : . . wax : . te tee a e8 . a) 6 A : we ti at, ef oboe 5 a? te . + ? cy ry a s ren JUNIJ . JUNIJ JUNIJ INTER : COMMUNICATION OFFICE COMMUNICATION To L. Gardner Lancaster February 13 1968 " From W. A. Maggio Los Angeles Subject Workmen's Compensation Appeals Board Notice of Time and Place of Hearing \ JohT n yler No. 67 LB 36087 Attached for your information is the ; subject appeals board notice 1 2/16/68 Bj 2/16/68 attachment | ; : . . | ; . Cobertoria as Cobertoria \ cl .a ! ! . Wann Wann Wann , \ t FORM 1501 Printeidn U.S.A. . 5 . . Ba . + ; : a . A2 : . 4 ve ae) poooeat \ - , ; re ey . tw ee ... yy ' > , rte ~ fe . er ia 4 \ f el, . ve a _ . we . Boe oy g seri an NY Pa . . eo ofete iv DEPARTMENT OF INDUSTRIAL RELATIONS DIVISION OF INDUSTRIAL ACCIDENTS WORKMEN'S COMPENSATION APPEALS STATE OF CALIFORNIA BOARD BY a . JOHN TYLER Case 67 LB 36087 oy . . ve SEE ATTACHED SHEET " Applicant f Notice of Time and Place of Further Hearing , NORMAL ONLY ONE FULL 1 DAY . Defendant cee 1 NOTICE TO ALL PARTIES _ . You are hereby notified that further hearing will be held in the entitled action at 230 EAST FOURTH STREET ROOM 302 LONG BEACH CALIFORNIA 90812 e APRIL 15 1968 at 9:00 A.M. thos, 3 ls es . WORKMEN'S COMPENSATION APPEALS BOARD i By JOHN L. STRUETT fs Referee a . Ve te *4 1 NOTE CONTINUANCES AND FURTHER HEARINGS ARE NOT FAVORED : - ' igh . . , Vege, SERVED BY MAIL ON PERSONS SHOWN ON THE OFFICIAL ADDRESS RECORD os vt so an ae . i ra a 1 MUNDST CONK CORP 2 E.S. McKITTRICK CO 3 J.T. THORPE INC A SELF INSURED cc ROYAL INDEMNITY CO AMERICAN MOTORISTS INS CO MOBILE OIL CORP SELP INSURED | 5. MARINE ENGINEERING & SUPPLY CO 6. PLANT RUBBER& ASBESTOS WORKS SELF INSURED 19 INGULATTO INC PACIFIC EMPLOYERS INS CO 20 ' 21 . 22 thermal engineering inc INDUSTRIAL HOPEMAN & CO INDUSTRIAL ININDDEEMNMITYNITY CO BALDWIN INS CO OF NO AMERICAN THE PHILIP CAREY MFG CO GENERAL ACCIDENT FIRE & LIFE |. ASSURANCE CORP' a 7 PIEREBOARD CORP SELF INSURED 8. HUGH A. ELSDON 9 _ BECHTEL CORP INDUSTRIAL INDEMNITY CO 10 THORPE INSULATION CO SELF INSURED : FIREMAN'S FUND INS CO 11 ARMSTRONG CONTRACTING & TRAVELERS INS CO AETNA CASUALTY & SURETY SUPPLY CO CO 12 FIBERGLASS ENGINEERING & SUPPLY CO now a DIV OF OWENS CORNING FIBERGLASS AETNA CASUALTY & SURETY CO . RELIANCE INS CO CORP 13 JOHN MANSVILLE SALES CORP TRAVELERS INS CO . ard +. 14. COAST INSULATING PRODUCTS a PACIFIC EMPLOYERS INS CO b) SELF INSURED ) GUARANTEE INS CO G) ARGONAUT INS CO 15. 16. 17 LEE R. EKINS CO STATE COMPENSATION INS FUND ACCURATE INSULATION CO INC 8} SELF INSURED b) STATE COMPENSATION INS FUND PLANT ASBESTOS CO INDUSTRIAL INDEMNITY CO 18. MULDOON CO INC SELF INSURED . oo I 2 3 4 B 6 7 8 Pls Retu to worm j arty Founding to JEZ' ve ti e on OF BEFORE THE NOTESNOTES CAT STATION APPEALS COAND CAT STATE OF CALIFORNIA THIN CASE NO 67 LD 36087 JOHN TYLER 1 . Applicant ) YO > PHILIP THECOMPANY COMPANY CARENMANUTI.CHUTTING MANUTI.CHUTTING GENERAL ACCITINTA FERD AID LIFE ASSURANCE COTIORATION LED of ) )} al ' Defendants 5 i . 4 FINDINGS AND AWARD . AND . oO ORDER DENNING PETINICH TO COINUING : . ; re ty ; 4 20 11 12 13 14 15 18 17 18 19 20 21 22 23 222 j 25 4 28 Rose Klein & Mariasby Howard A. Gebler attorneys for applicant Accident Brill Hunt DoBuys & Furby by Richard L. Moomau attorneys for Cameral Fire and Life Assurance Corp. Ltd. Robert Klempner attorney for State Compensation Insurance Fund J. D. Henderson representative Alorican Motorista on Company Insurance - Ives on & iible by John Francis attorneys for Comphy American Mutual Insane Comphy Clopton & Penny by Hoby attorneys for Pacific Hoby Hoby Employers C7 Insurance by (| and Insurence Com fe) Weingand Kondig & are liance Insurance Company no America : by Robert C. Wreigner attorneys for M By : Sumpty Company and > in# Argonaut Insur u Herly Herlihy Herlihy aia Helson by Jack Sisk for The Travele in poet the Company attorneys Company Allen Peteres & in by Dowling attorneys for ao Industrial Indemnity Company and Industrial Indemnity Exchange representative Mr. Kazi representative representative for Fireman's Fund Insurance Company < Samuelsen c Whitehead by Donald Gonzales Bolson Company attorneys for CuaranteCsuarantes InsurtecInsurtec Company Brobeck Phleger dc: icon by - Sciaroni Jr. Rinaldo attorneys for an alber& Asbestos lonka insured formerly and Fiberboard Corporation formerly Fiberboard Paper : insured Products Corporation Corporation James W. Hockatten by Charles R. Ibold Jr. attorneys . Corporation for Royal Indemnity Company Sims Hamilton attorney for Mobil 011 solf- incurred - . ; 27 An Application having been filed herein all parties having = 22 . 29 30 appeared and the Honorable RAYHOND { as follows matterhaving been regularly cubmitted tha easth orders LEAVER Refores now finds awards and my ay . . ee . . , . e cuts ne is! : Bepartment s . of fatwiifial Aristines : Dinner of ladyvient Storabl Wwomen's Kamainituts Kamainituts ^ ngeGesto Wat Wwomen'sh Wwomen's rane > wo ' ! oe had a Serra en yay Sen i cae : fe " . vig 8 aa + ory . 3. a. Se 1 Dy 3 kk OW 6 days 7 ef g 10 10 11 1212 1313 1414 15 16 16 1717 1818 1919 NNN20 NNN21 NNN 2322 2424 2626 2626 27 27 2828 4 ( FINDINGS OF FACT , . 1. John Tyler born February 26 1918 sustained a compensable injury ttoo his lunga arising out of and occurring in the course e of his employment as an asbestos worker in California from 1943.. through January 9 1967 and while specifically so employed from Januar1y 1967 through Jan 9 1967 by Philip Carey Manufacturing Company which was then insured by General Accident Life Asturance Corporation Ltd. Firo and 2. Applicant has elected to proceed against Philip Carey Manufacturing Company under Labor Code section 5500.5 3 Applicant's carnings were maximum at the time of injury 4. The injury COPY COPY disability from January 10 1957 through March COPY COPY COPY COPY condition became permanent and stationary entitling during said period 5 Applicant is COPY COPY was caused by the COCPYOPYCOPY at 52.50 a week or COPY COPY COPY of said applicant to . disability 240 weeks 6 Applicant is COPY COPY COPY COPY with such lifatima | medical treatment as may reasonably be necessary to cure or relieve the effects of the injury 7. Applicant is entitled to medical costs of 362.00 payable as follows 192.00 to Dr. Morton Kritzer 100.00 to Dr. Herbort Shubin 20.00 to Dr. Charlos Weinstein and 50.00 to applicant for his partialpayment to Dr. Kritzer 8. Subject to correction for clorical error applicant is allowed additional medical costs of 50.00 for reports from Dr. Baker and Dr. Palavca payable to Roso Klein and Marias , 9. Applicant is entitled to reimbursement for the reasonable valuo of procurod medical treatment in 1966 and 1967 related Destment rules 4 of Common ctices Wren's Wren's tadusteral risi tadusteral ctices As LE 6087 State of Cafori -7 + DIA WEAR Ton_53 h 4-66 ... -2- 5 me tos . . : . . on te . i. : 1 as provided by law together with lifetime madical treatmont 2 pursuant to Finding No. C together with medical costs as 3 cot forth in Findings No. 7 & C together with reimbursement for 4 procured medical treatment as set forth in Findinga lo 9 's) 10 and 12 les lien claim of the Department of Employment at the " 8 rate of 70.00 a week for the period January 17 1967 through 7 | March 3 1967 in the amount of 460.00 los 119.25 payable g to Rose Elein & Marian for costs less 1,500.00 payable to 9 Rope Klein & Marina applicant's attorneys as lien for their " 10 ff 200 Me DL. : 11 i ORDER 12 GOOD CAUSE APPEARIHC OPY OPY 13 IT IS HEREBY ORDERED that OPY Pon OPY Commutation be 14 | and it is hereby denied OPY Se 16 18 19 20 21 22 . Dated at Long Beach California ~ s . ; OCT 6 1967- 1967- Served by mail on By / Ingham all parties listed on the es . official , address record fee 23 it 24 26 : 26 27 16 28 4 29 30 | 57 13 36037 -4- ve - " ; Bipescon af asttoey Aeaetente C + men's C destae Bare target Beate arabe sf ere "4! 1A ah < - nh J. E. Zailer - Lancaster August 23 1967 .A Maggio - Branch Manager foe John Tyler - Workmen's Compensation Appeals Board - Notice of Hearing Compensation Board Attached for your information is a Workmen's of Hearing for John Tyler on October 3 1967 Appeals Notica fen M. C. Sweat L.A. : Tyler . Asbestos Asbestos . : Asbestos Asbestos Asbestos s _ ; . . 4 . - ~ e . Veaghy . 7 ' 1%, . - , . ") isis . [fe 3 . i . wa, oo oo) ee . oo , ue ub wa LA ths . ae 1. pao "s a Voy, ced er fe, if aes Loe t re ey re a: { ay we ' i wo ' DEPARTMENT OF INDUSTRIAL RELATIONS DIVISION OF INDUSTRIAL ACCIDENTS * BOARD WORKMEN'S WORKMEN'S COMPENSATION APPEALS Asbestos Asbestos OF Laat 4. . 00 Asbestos " JOHN TYLER Asbestos Applicant Case No. 67 LB 36087 NOTICE OF HEARING FOURTHS DAY : . SEE ATTACHED SHEET - - # 219 219 Defendant | CF. 3-10-813-10-81 3 PLAINTIFF'S M. s)_ EXHIBIT 7 Syne EXHIBIT : ; 5/27/81 ~ ~ . . You are hereby notified that a "++ Board of the State of California Sua ae filed compensationcompensation has been with the Workmen's Compensation noti^"ed Appeals that said application has been set for hearing at . 1, 230 EAST FOURTH STREET ROOM 302 LONG BEACH CALIFORNIA OCTOBER 3 1967 at 9:00 A.M. oat fos -. Appeals dispose said and that at said time place the Workmen's Compensation applicationin the manner prescribed by law Board will proceed to hear and of the > Tihas, . * WORKMEN'S COMPENSATION Appeals Board '. ': he og tat gl - JOHN L. STRUETT By . Aaferre Dated 151 LONG BEACH CALIFORNIA ' os i expected NOTE The parsion are expected to submit all disputedinwes for decision at this heaving All witherret evidence medical reparts payrolla and other penal must be available at the hearing CONTINUANCES WILL BE GRANTED ONLY UPON A CLEAR SHOWING OF GOOD CAUSE for Requests saqsinuances are to ba made within 3 days of the date of th"flemuce NOTE TO INSURED EMPLOYERS Your attendance as shle heating may not be necessary Ask year insurance company SERVED BY MAIL ON PERSONS SHOWN 17/07 ADDRESS . ON Date REFICIAL ADDRESS By RECORD . . oO . re . ee . +, ' DIA WEAS FORM ..... roe MO es . ; 1.ves HN ^ T ot ; EMPLOYERS A 1.Mundet Cork Comp INSURANCE COS " iy ry 1 os : . 7 | - 2.E. S. McKittrick Co. 3. J. T. Thorpe Inc. av? ~ Mobil 011 Corp. 2 3. Insured Royal Indemnity * American Motorists AmericanMutual Ins Co. 4. Insured ' ao ' ey 5. Marine Engineering & Supply Co. oe X6 Plant Rubber & Asbestos Works X7 Fireboard Corp. 8. Hugh A. Elsdon 9. Bechtel Sy 5 6. Insured 7. Insured B 9. Industrial Indemnity | ee \ ; 10. Thorpe Insulation Co. 10. Insured X Fireman Fund Ins Co. 11. Armstrong Contracting & Supply 11 Travelers Ins Co. Aetna Casualty & SuretyCo Aetna 12. Fiberglass Engineering & Supply Co. Div of Owens Corning Fiberglas Corp. Casualty & Surety Co. Reliance Insurance Co. 13. Johns Manville Sales Corp 14. Coast Insulating Products 15. Lee R. Ekins Co. 16. Accurate Insulation Co. Inc. 17. Plant Asbestos Co. 18. Muldoon Co. Inc. 19. Insulations Inc Travelers ansurance ci, _ 14.XPacific Employers Ins Co. . Insured a co Guarantee Insurance Insurance Co. L'Argonaut L'Argonaut Co. Co. oO . ' 15.XState Compensation Insurance Fund ! 16. Insured State Compensation Ins Pund w 17.XIndustrial Indemnity 18. Insured fy 19. Pacific Employers Ins Co. _ 20. Thermal Engineering Inc. Hoffman & Co. 20. Industrial Indemnity 21. Baldwin Inc. 22. The Philip Carey Mfg Co. 21. Ins Co. of North America General Accident Fire& Life Assurance Corp. limited a corp Paid Gali 1968 . . | . 1 Se mets . cd eons , oe . fe ge tp St . . . .- . . . K'ORKMEN'S COMPENSATION APPEALS BOARD . INDUSTRIAL ACCIDENT COMMISSION , STATE OF CALIFORNIA Ca, me 67 LB 36087 . , | AP veto ain ve i 4 . rt a + . ro oe Ty t4s en ie cn ery listed L, JOHN I. TYLER JR a TYLER : v2. . ApApppliclanticant still defendant Order Dismissing ; f . MUNDET CORP CORP et al Party Defendant =" [' - . . I Defendants : ood o . 5/29/67 Good Cause Appearing Therefor | 5/29/67---- --... | Dept. Cener Petroleum InIdnucsotmreial | ' ; Co. ; IS HEREBY ORDERED THAT The Vong Lumber Co. Coy Standard Asbest Stoorns Roger Corp Industrial Battery Supply i Co. Inc. / John Co. Inc. Vhe Asbestos Furnacos Inc. J. Connor Pres 2 & : Magnesia Matorials Matorials Income & Excise Tax & Insulating Co. Insulators Inc. 2 eering & + Co. Jackson Insu : Cork lation Inc. Fuller Los Angeles Cork Co. Austin Insulations Co. Acme Insulation Co. C5 Reece Insulation Minnesota Mining & Mfg . C5 |. . Armstrong Cork Tacoma Asbestos Co. Plant Asbestos Co. Thermal ' ' Engineering inc : - . Doty . ry oy , be dismiassaspeardty defe in tn he edntaitnletd case ; . . ' ' oe : = wee 3 2S ae ; , : . . . . . ! , A Lower hd ae ~ ~ Referee at mo . ; INDUSTRIAL ACCIDENT COMMISSION WORKMEN'S COMPENSATYT! APPEALS BOARD - LONG BEACH : ' ae oe af s -- ' . Wy ad ou . oo ' , : Pons Nat \ o' ; ae All pers served as listed on the official address shoot by mail V1 . sey Ria ON 6/2/67 413 341-0314 . BABLE ADDRESS ALEXDAND ALEXANDER AGENCY INC INSURANCE WORLD WIDE SINCE 1883 UNION BANK BLDG PITTBOUROH PA 18232 whe gRea a wo , ; : . . Oye i ory moO, 7 . os ' 7} ' June 1 1967 So Wallace B.Hofferth Insurance Manager Armstrong Cork Company Lancaster Pa a) Dear Mr. mo - Hofferth Subject . . ; oY John Tyler vs Fiberglass Engineering and 67 SCuaplpilfyorCnioampWaonrykmeant'sal Compensation Case LB3 Aetna Claim R D 33 CC 156831 MR Hearing | I wish to acknowledge copy of your letter and Notice of 3 and order dismissing party defendant . I have forwarded this to the Standard Accident Ins.co. 4 Very truly yours S.A Huy 1 s ' e eof . Wy a as - ity 7 a? a . a ee) . . ae a woe ao, we oad sgt he A 7 a wou oO a ny . Aa hace , U ts x ' . oh ety . oy . . ' v : - : \.- at SECOND CENTURY - FOURTH GENERATION a bho wy | cpa ae peor yy ; x ! : ' ' o Gos ; t nr a wy ON, hogs " j vote af 4 af ae tae, : n - CO eee ae a Maver ne the a a ae. ce NG \ %, ut . a fhe aa a a aha) any h oe May 31 1967 ' , ATR MAIL i t a Hr Don Shelton Claim Representative The Aetna Casualty and Surety Company - 2404 Wilshire Boulevard Los Angeles California 90054 Dear Mr. Shelton Subject AJnodlmSuplSy uTyplpelryvsvC.so.mpFiabenrgylasse Fibet rgallass Engineering - an California Workmen's Compensation Case 67 LB 36087 er Actna Claim 156831 R D 33 CC MR Party We just received the enclosed Notice of Hearing and Order Defendant ots | Dismissing , Very truly yours e Enclosures Wallace B. Hofferth Insurance Manager ome on : i ae t Ga oy uw le Ae 0 > Mr. B. R. Chriver . Aloxendor Agency Inc. 316 Fourth Avenue Pittsburgh Pennsylvania 15222 Loss Department Alexander & Alexander Inc. 2225 North Charles Street Baltimore Maryland \. bi: Goat rs an . yy" te te ' 14 a? if 4 m my ny Ss cheat nN We er ... ... ... fl - fl " -fl "- 8" s . Ome ess * oye eo. ., 4,6 : wee , en er ey . i ty ome ew . ~ ra ; INTER OFFICE COMMUNICATION . To J.E. Zeller Lancaster from W.A. Maggio Los Angeles Subject = Workmen's Compensation John Tyler Case No. 67 LB 36087 Appeals Board May 26 1967 - . "4 5 . we a i. 5/31/675/31/67 Attached please find the Workmen's Compensation Noticoef Hearing on - the subject former employee CH | oe WAM | | Pee GH t ' . 4 ' FORM 1501 Printed in U.S.A. . ? , wi : . ' ween eens ~e ' tk be en ' , i. chon . .. 4 ts ob ' ry : as 4 :; ot | . 0 Co" DEPARTMENT OF INDUSTRIAL RELATIONS DIVISION OF INDUSTRIAL ACCIDENTS WORKMEN'S COMPENSATION APPEALS BOARD STATE OF CALIFORNIA JOHN TYLER +. H^ RDETCORK CORPORATION et al Cuse No. 67 LB 36007 NOTICE OF Hearing Applicant ONE FULL DAY Defendant JULY 31 1967 at 9100 8.5 ONY FULL DAY You are hereby notified that an application for compensation has been filed with the Workmen's Compensation Appeals Board of the State of California You are further notified that said application has been set for hearing at CALIFORNIA 230 X FOUNTH STREET LONG BEACH jo o oe nsy 3 : r . s Bw ~ Sco ef 4? - te, Ma oa Was S ? S | and that at said time and place the Workmen's Compensation Appeals Board will proceed to hear and dispose of the sid application in the manner prescribed by law roe ee af WORKMEN'S COMPENSATION APPEALS BOARD wt, - teas JOHN L. ANNUURTE ; ANNUURTE to Coe Dated ats ; LONG BEACH CALIFORNIA : ; iH wo d ay experts petrollsand orker NOTE The perim am cxpected to submit sil disputed inver for decision at this hearing All witness evidener medical pros^> must be available at the hairing CONTINUANCES WILL DE GRANTED ONLY UPON A CLEAR SHOWING OF GOOD CAUSE Rusoms for coutlaminem are so be made withia , day~-of the date of this seli~ a sb oy te NOTE TO INSURED EMPLOYERS EMPLOYERS Your Mtendance at this boozing may not be necessary Ash your imacance company ; SERVED BY MAIL ON PERSONS SHOWN ON THE Official addRESS RECORD RECORD * : i . : : : . , . wh tog pgiStdebidnbob : avi eee , - S .. Ta SCEST 4@e.e AcordingAcording ACOSLakewodlisting we received formerly employe Beach periods subtanite CALIFORNIA and received nowthe CaliforniaTYLN 500-09-4525 California California employe and formerly ff from recived the worked Armstrong listed John and asked listed subtaniate below recived substantiate subtaniate facts remunration However have of this | informatioinnformation informationGan tell or Armstrong couldcould earnigs givegive Gan breakdown tell of his u\ a 2 ce aT : CLAIMAppeals Board Compensation Cork thatinrealize ancuntsancunts stated you | us worked for us in workedworkedweekly tell & you1965 breakdown forhiweskly periods could , tell periods CORK AFSTRONG us a for would most xy for for these COMPANY uy the reason ote | | pay leaving | i tr | COMPANY AFSTRONG Famed nokInsuredInsured ending Famed Acident 1,604.25 1,158 Standard } Accident a i -i q. . F StandarAdcident Pash 6/30/60 1,604.25 sty! 1,604.25 ee 1,604.25 uoyestedzo peqaon yseg - en | oe q 9 xoFz or: 1,359.75 8 Travelers F po 1,359.75 eee 13 143.75 ae 143.75 | { lp 6/30/52 bh ao i on 3/31/61 9/30/52sUE=IOR1,359.715,359.75 Travelers pw, iostwes sn. 308.85 308.85 rs 9/30/61 x0F 12/31/61 961.35 ARPT onoyout 12/352 961.35 erngdtor Pz=A 961.35 amy eregh pbb mory Tzewt0y shoprem FroTeaest 3/31/62 286 er 286 TT nik be fva x ~| oy i rof hoa ie a! ; wep Dy qsout o Pengoa r2,240.8 6/30/56 2,240.8 psoxg punaz 9/3056 :PTRBA Ty EAa 12/31/60 eato^'=e eroneus 2,40.8 roxy SL6ce* SUT3ST e1ro8neo7us.70 LISTING SHELD cL*ert 9/30/64 12/31/60 eroneous formed SHELD This posibly | eq: he 2,240.8 | Eto ch Jx.o: eay3 187.70 2THIS 187.70 xo STyy Acas SOGLTHIS ARMSTRONG Acas 1/1/58 1/1/58 3s!I | dl . | i SHELD bt ARMSTRONG CONTRACTING ARMSTRONG CONTRACTING CONTRACTING 6/30/62 9/30/65 '60 payrol payrol of there payroll listed 4th listed for quarter quarter se Ore under payrol 4S/LEet 9/30/65BN futmp pete : ts/2C/6 as/tc/e 2$/C/9 : a 2uoy oy eacyq cony z961losty zo a 4/25/67 a wey 1 3 1 Industrial Division Industrial Supply Current Retntion detrmine RecorfedcsiosCurent determine schedule schedule Tyler Tyler feccios except feccios | Thank worked for ThankARMSTRONG AND SUP LY CONTRACTING phe $ WL Travelers 4. D Dh TF SE ele: fod 2,120.60PySyS j 3 BS/1/ iod 3 | 735.69 n f ed. t ; pentsj ; SOY Astra 1,972.40a e8*ore.1,972.40 1 519.73 a 4. ST aLaysBe 9$/02/98/0 </6mon! . A orl : ie Inler-530-07 Ppt wy 7 Ww NS Inlermoe -530-07 Parinde Parinde {singled singledsingle5-d15-56.7.26-50 fant 3 ee single2d-15-60-1-14-60 -{_ aa 5-15-56.7.26-50 5-15-56.7.26-50 5-15-56.7.26-50 5-15-56.7.26-50 5-15-56.7.26-50 2-15-60-11-14-60 2-15-60-11-14-60 t 7-1-61-1-5-61 LAR 7-1-61-1-15-61 4ey3- -32-62-424-27 -3-2-62-4-24-427 -32-62-424-27 -3264-27 \ rt - 6.25-64-1-4-64 Angel sMEA bei I Angeles 6-28-65-8-13-45 6-28-65-8-13-45 6-28-65-8-13-45 3-17-66-415664 Angeles 3-17-66-415664 yes Angeles { Angeles 3-17-66-4156643-17-66-415664 a) NL a a Nb. \, AN N s N at ~ Se Se es x eeriewb @ ae 4 moh fe Tad , me 3; 8. 3-11-62 oe 3-11-62 ~ 7488 7488 ~ NS As ye 14776 Q Se % . - \ 4.1.62 by 23275 23275 no 4.5.62 4.5.62 4.5.62 4.5.62 4.5.62 4.5.62 4.5.62 4.5.62 4.5.62 { 1-15-62 11-15-62 S ree po, toe erty ' eo: s . 13920 13920 1392013920 _: 422-62 a | 4.7462 4.7462 8120 bitteeS 4.7462 4.744.7466 2 2 tthe 4.7462 ee 4.7462 4.7446.27462 = Mee fag Gy 181604/92 cee ten een 181604/92 7580 181604/92 2: Leaving Leaving eae 208/3 3.2,0 222001 23500 | moooak . 4 : rn v. May 1 1967 Aotna Casualty and Surety Company 240 Hilahiro Boulevard Los Angeles California 90054 Attention Mr. Don Shelton Claim Representative Workmans Compensation Unit . OO : . - GLADIANT John TyleWCr AB GAST NO 67 - ID 36087 Insured Armstrong Cork Armstrong and Supply Corporation Actna R Glaim D 33 0 156631 MR ae Contracting = Le In response to your letter of April 11 to enclose two shoots giving you all the information wo have bom able to obtain from our Payroll Department on the above claim Lixder our intention of Records Dohodulo all information prior to covon years and current is : destroyed " ~ oy re Ho are conding a copy of this lottor and the information cheats to Rolinnco Insurance Commanios Standard Accident and Travolors 0 Insurance Company through our brokers Alexander & Alexandar - so they will be apprised of the available | information '? So .Enclosures Insurance Department noliance Insurance Companies 540 South Kingoloy Drivo Los Angeles Calif 90005 1r J. D. McGaughoy Olain Supervisor - Your filos Enclosuros ; _ an ah , Susponse A wey 7116 7116 | aes dee oo ia ene Travolors 1 1, Insurance Company . / Momnior & Alaxander Inc. |. 2225 11. Charles Ste. roy Daltimore Maryland 21210 Enalonres . . bos a ut fe EE te wove . S the Wy be me ya. o soap % Et eny Ss . . . way! we GOOD CAUSE APPEARING . Department of Industrial Relations Division of Industrial Accidents sismere eG , At cpm ate reg 64 os ahh! ' | 1957 The application herein is taken calendar off . FATS DEPROSE DCAG Workmen's Compensation Appeals . State of California . AFFLICATION FOR ADJUDICATION OF CLAIM Board . oo boos |; 7; sete fs ce vera a Please file signed original and six copies and print or type names and addresses -- ALFERIDED CASE NO 67 LB 36087 Mr.XXXXXXXMr.XXXXXXX JOHN TYLER TARJURED LEMONET Social Security 500-09-452505-09-4525 6333 Dasinwood Lakewood PUREPD URED TOPLESS TOPLESS AUBERTY California APPLICANT IP OTHER OTHER THAN EVE EVE SEE ATTACHED . . va REMOVER CAPPLICANT'S AAJALIST COMPLETED'SCOMPLETD'S separa? SEE ATTACHES LISTS QUAFAKAMPER turlatih S I9TUFARCI CARRIER OD STATE OF QUAFAKAMPER OL PLATONIBLY MUERTURED JADEES OF SUCI CARNIE MANT MANT IT IS CLAIMED THAT - +e 1. The injured employee barn 1941 to 1-9-1967 on a DATE OF INTE 2-26-1918 10ASE OF RISTR various KITT while employed as an Asbestos Worker OCCUPATION at TIME 07 Ba _ Calif +398703 by the employer sustained injury : . ! arising out of and in the course of employment to 2. The injury occurred as follows __._p_ulmonary disease CREATE bmaT PARTS OF Qa yWeir inJUDONA Exposure and inhalation of silicons asbestos SERPLAES WHAT EXPECTED V^ LMINGAT TIME OF Jums AZN MON UNZUMOV WAO SELEWADI SELEWADI 6.35 hr 40hrshrs perek 3. Actual earnings at time ofinjury were . per , CONT WELBLY OD KONTHLY BASARY OR NOW^ LEGA12 n^oNugera of mounT WARAEO PEN WERDY AMDAMATPLY OVATE SALME PER WEEK 69 MONTH OF TIPS aaLD LODGING 60 SINGS ADVANTAGET FLAMLAZ YV^ L^ V^ML^ E MEN N The disability January D67 stilloff TI 4. injury caused - as follows ISPECIFY LAST DAY OFF MORE AVE TO THIS tA JUCT AND READ READ ERING STOR OF ALL OFF PERING ONE TO THE 5. Compensation was paid ... ... ...PQ 6. Medical treatment was received 4 1910 $ TOTAL PAIDS ry MITJAN Qa96 DATE OF LAST FUDENTS 06 All treatment was furnished by the employer or insuranes . eOete MF Lent FoRaenTets company 19881 ate m1 other treatment was provided or paid for by Belf FRAME FRAME FLUGOR DE ARZNET SERVIDING OR ALTINE FEDHA FEDHA Csoki Doctors not provided or paid for by employer or insurance company who treated or examined for thisinjury are Y. A. Hospital Long Reach 31478 R DERAND APLULOSIO DE SUEM COCTO31 in^'NASES DA NOSPITALE T^ BRI BNUEN 9009 ARWITTER INJURES INJURES or 4 7. Unemployment Insurance Unemployment Compensation Disability benefits have been received since the date of injury ie . ITEL ITEL mt 1. Other cases have been filed for industrial injuries by this employee as follows Nane SPECIFY Raff Muqoth AND CITE UMENI SKLEDI disability dis 9. This applicationis filed because of a disagreement regarding lubility for Temporary indemnitPerymanent ability indemnity Reimbursement for medical expensee_xpense_ Medical treatment Compensation at proper rate * Other Specify 47 and applicant require a hearing and award of the same and for all other appropriate benefits provided by law LA U Hearing requested at oe ' Long Beach Acuery Dated at Long Beach Lit California May 1122 1967 1967 a MATE Number of witnesses - trial wanted - __. wos , " time of re Estimated - ahead EIKHIKER 1 FULLDPAYOSELARTA : 7Hn , a . Se net ye ere . 5 soot : . elt , le . waa ero 1 ' eee . BRIAZER && ADDRESS PAKETINGS FOR QUARTER ENDED undet Cork Corp. 6116 Walker Ave. Maywood California 6/30/43 9/30/43 - 12-31-43- 12-31-433-31-44 6-30-44 - 658.90 628.77 1,02.63 769.69 1,002.63 166.50 4-30-43 - 768.00 12-31-53 3-31-54 6-30-54 - 9-30-54 = 2,200.00 1,569.716 ,569.76 1,787.00 1,787.00 243.24 243.24 3-31-55 = 1,734.00 6-30-55 - 795.60 12-31-55 3-31-56 <- 1,358.50 104.00 104.00 9-30-56 12-31-56 9-30-57 - 1,086.36 1.420.140 .420.40 653.20 12-31-57 - 1,618.00 5. 3-31-50 - 1,411.125 ,411.25 + 3-31-59 - 1,616.00 6-30-59 - 2,086.020 ,086.00 9-30-59 - 196.80 mo . . te he ae CARRIER | BUSINESS INSURED is OUT OF . ; . , Cot a al rite a sos : . E. S. McKittrick Company 7839 South Senta Fe 6-30-44 - Huntington Park Calif 73.20 J. T. Thorpe Inc. 948 East Second St. Los Angeles Calif , - 6-30-44 9-30-44 - 505.50 328.75 , . 6-30-48 - 334.13 12-31-50 - 786.25 9-30-53 - 690.00 12-31-56 ~ 321660 3-31-57 6-30-57 + 1,675.00 - 281.40 3-31-58 - 532.80 6-30-58 - 1,095.20 12-31-58 + 426.60 12-31-63 - 2,055.40 3-31-64 - 1,129.168 ,129.68 . . . SELF INSURED OUT OF BUSINESS SELF INSURED 210 Royal Indemnity Co. Weat 7th St. Los Angeles 944480 Calif - 1-1-52 53 Motorists American Motorists Insurance Company 3545 Wilshire Los 431An-g8el9es8 Calif 1-1-56 431-898 1-1-63 American Mutual Ins 8929 Sepulveda Calif Los .. ' 6CMAn4g3e1l-e8s98Calif 1-1-56 4C1-431-898 eet 1-1-64 Mobil Oil Corporation 612 So. Flower Los Angeles Calif. 90054 6-30-44 " 100.00 SELF INSURED ' Marine Engineering & Supply Company 941 East Second St. | Los Angeles Calif \ ; . 9-30-44 = 3-31-46 0 - 6-30-46 9-30-46 = 12-31-46 3-31-47 = 3-31-51 6-30-51 - 342.25 = 378.00 826.00 42.00 966.57 394.50 1,168.25 1,068.50 , SELF INSURED 4 ne Sere . ae yee aC _ OUT OF BUSINESS ' ' oo, Asbestos Plant Rubber & Works 3-31-46 - 475 Brannon Street 3-31-47 - _ ' San Franc Calif 6-30-47 ... 9-30-67 2.00 . wt INSURED 385.00 | 648.00 361.00 Co *. .. . , Drobeck Phleger & Harrison 111 Sutt St. San Francisco Francisco be Pro ey ; ne | Fe Pol ITRO ADDRESS a ALLOATD UL UE TIO 475 Brennon Street | Can Francisco Calif wh . . FARNINGS 9-38-42 = 12-31-47 3-31-40 6-30-40 FOR = oe = QUARTER MIDED 673.00 1,059.00 982.25 482.00 en ah SURED CARRIE SELF et ae | - Brobeck Phleger larrison 111 Sutter St ' San Francisco +. . Bugh AE.asEtledGaogne -. Huntington Park Calif 6-30-48 9 126.00 . INSUD OUT OF BUSINESSBUSINESS Bechtel Corporation 6-30-48 - 220 Euch Street ': San Francisco Califozis 52.50 ; . ; , INSURED prior to 3-1-57 Industrial Indemnity Co. 73: . Thorpe Insulation Co. 2741 So. Yates Ave. Los Angeles Calif . : a . 6-30-48 = 169.00 9-30-48 - 479.13 ' 12-31-5102-31-1520-31-50 bad 3-31-51 = 752.50 198.75 : 160.00 6-30-51 9-30-51 9-30-51 6-30-52 9-30-52 == - 110.00 110.00 - 1.087.50 - 803.30 3-31-53 - 513.30 Los Angeleso : CC100228 it 3-1-57 INSURED =? Fireman's Fund - InsuraE.nce 1C7th ompan Conta Ana Calif Fireman's Fund Fireman's Ins Co. . . 3223 W. 6th .* Los Angeles - + 6-30-57 = 9-30-57 - = 9-30-59 26.80 187.60 442.80 } Armstrong Contracting 9-30-51 = 1.158.00 & Supply Company 12-31-51 - 1,604.25 4340 District Boulevard 3-31-52 = 1,339.75 - Los Angeles California (y oo ALUS Co 9091863 INS 8659228 9321342 TRAN RUB 9321342 a 12-31-50 1460 DRUB 1460 DRUB DRUB * 1461 99--330-05-2 52 12-31-52 3-31-56 9-30-56 12-31-50 3-31-60 6-30-60 - 308.85 308.85 308.85 + 961.35 =, 2,240.88 2,240.88 = 187.70 | - + 952.00 ~ 1,471.50 " 1962 9-30-60 3-31-61 ~ 2,188.80 = 2,120.80 + SWCP 3843 10-1-56 withth continuous cover ' oge WPI20360 . : | 10-1-60 , : Travelers Ins 3600 Company . Wilshire Los2047243 An2 ge0l4 es724 ate3 100 1-1-52 o- v 100 4991518 for RUB 8659227 oy SP 1-1-60 vt Actna Casual&ty| Surety Company 2404 Wilshire , Los Angeles Calif 12-31-61 + 3-31-62 = 6-30-62 = . _ . Fiberglass Engineering & Suply Co. flow A Div of Owens Corning Fiberglas Corporation 5933 Telegraph Rd j Los Angeles Calif oe . . a : bade rr hpootaa' 4 9-30-64 9-30-65 - 1966 9-30-65 - 9-30-52 = 12-31-52 = 3-31-53 9-30-57 6-30-59 - 12-31-62 2 3-31-63 6-30-63 = 9-30-63 + '3-31-64 + 253.60 735.69 869.23 869.23 1,972.40 1,519.73 1,029.60 ! 72.60 . 567.20 . 379.40 89.40 '; 65.60 .309.12 1483 98C 2001 2003 10/1/86 96C 1965 10/1/86 41035R 41035R 54/08 54/08 986 410452 986 Aetna Casualty & Surety Co. 031C . 9-1-50 9-1-50 67 7 3250 PT 020-004191 FT 22,.310284..6234 367.08 1,190.61 . 32 Reliance ; So. Company .540 Kingsley . Los Angeles Calif ,s EXLOVER&ANDREER EL EEnginenringgineering Enginering contcinounedtcio2nntuienuded Page Sales John Kanoville 1.conio Boulevard Corp. , Vernon California PARNINGSPARNINGS DE FORQUARTER 12-31-6142-31-6142-31-64 - -798.80 1,198.80 3-31-65 - 1,198.80 4,306.904,306.90 1965 4,306.90 3-31-53 6-30-53 - 632.20 -1,1 426.30 CARRIER Travelers Insurance Co. 8748249-5145 1010 North Main St. " Fan California 7-1-52 . Coast Insulating Products - 2004 Loccy Street " Los Angeles California 6-306-5-530-55 3-1563-1-563-1563-15633--311605263-1563-31602 aet 381.20 1,651.00 293.12 1,368.48 Lee R. Ekins Company 4933 Valley Boulevard Angeles Los California 12-31-58 a 61.60 Accurate Insulation Co. 900 Co. Cypress St. La Habra California Inc. 12-31-58 6-30-62 12-31-62 221.20 1,721.24 1,721.24 1,796.76 1,796.76 Plaat Achestos Co. 1200 64th Street Emeryville Calif | Hildoon Company Inc. 6557 E. Show Ave. Clovis California Rd Insulations Inc. 532 Co. Monterey Pass Monterey Park Calif _ Thermal Engineering Inc. Hoffman & So. 10th St. Richmond California Baldwin Inc. 4000 Root 26th Street Los Angeles California 9-30-59 12-31-59 3-31-60 6-30-61 9-30-61 3-31-65 6-30-65 12-31-65 1966 12-31-65 12-31-65 1,496.00 1,768.00 102.00 109.46 1,630.80 799.20 2,911.20 ad 690.30 1,965.60 1,237.00 257.40 The Philip Carey Mfg Co. 1966 flonterey So. Rd 1967 flontereyMoPntaerreky CalifPass Rd 1,825.00 3 mene nw ' Pacific Employers .- Insurance Company 4050 Wilshire Blvd. : ' Los Angeles California 55592 9-11-51 9-11-51 : SELF INSURED ; OUT OF BUSIN af Gunrantee Insurance 1671 Wilshire Los Angele 206329 10-1-53 10-1-53 to Argonaut Insurance Co. AAJ Shotto Place 1.on Angeles Calif FC6716 FC6716 5-1-555-1-55 Ins \ Stata Compensation Fund 4210325-58 10-1-58 | SELF INSURED FSutnadte Compensation Ins . 0140046-66 0140 46-6 1-1-612 -1-62' Industrial Indem Co. 7 C08056 | 1-1-59 INSURED |: OUT OF EUSINESS. On e . Employers Pacific 701 24319 4-6-64167 Ins CG ; -, co} Indemnity Industrial Co. 103031 6-1-646-1-64) Insurance Company of North America 621 So. Virgil Ave. * 1-1-65 Los Angeles Calif 403328 1-1-65 1-1-65 Street General Accident Insuran Group 3535 West 6th | Los Angeles Calif | e) ne cS, ine a Ty CASUALTY Casualty& Surety Division 2404 Wilshire Boulevard Los Angeles California 90054 ' 382-5481 382-5481 April 11 1967 SriSforifo 4/25/67 ~ Srifo 4/25/67 & iviWko4ot: Coe | oy Armstrong Cork Company Lancaster Pennsylvania Attention mo , Wallace B. Hofferth Insurance Manager Gebentort io e ; -------- -- 4/24/67 4/24/67 4/24/67 Han Han / a he rd Gentlemen 7M " CORPORATION CLAIM R D 33 CC 156831 MM- INSURED ARMSTRONG CORK CLAIMANT JOHN TYLER > WCAD CASE NO 67 LB 36087 CROSS REFERENCE JOHN TYLER VS FIBRE CLASS ENGINEERING AND SUPPLY ET AL In response to your letter of March 21 1967 we have established the above claim number and have forwarded a legal file to our attorney's office in case it is necessary to make an appearance before the Los Angeles Worlanens Compensation Appeals Board aro presently defending Gibre Glass Mr. Tyler's allegations wo are of on your behalf Since our attorneys Engineering and Supply Company against course being kept advised of all current developments zs InIn your letter of March 21 1967 you mentioned that Mr. Tyler's employment with Armstrong Cork Company and amount of wages earned have not yet been substantiated Since these are the two most important factors in determin- ing the extent of exposure in continuous trauma cases we ask that you begin an immediate investigation of these two points and forward your ro Armstrong findings to our office so that we can be prepared in case Company is joined as a party defendant in this matter Cork i We will keep in touch with you regarding all developments in this case : | Very truly yours LIFE AND COMPANY SStitltionlton Don Shelton Claim Workmens Compensation Unit ar Ot : ; April 14 1967 MAIL . t Mr. J. D. McGaughey .. Claim Supervisor ' . Reliance Insurance Companies . 548 South Kingsley Drive Los Angeles California 90005 Dear Mr. McGaughey Subject John Tyler va Fiberglass Engineering & Supply California W. C. Cace 67LB30087 Your File Suspense 7116 El Al Standard Accident Insurance Company insured Armstrong Cork Company in California * in 1951 under workmen's compensation Policy A2718480. Your company did not my insure us in 1952 as stated in my letter of March 21 this was an error on part and 1952 should have been listed as one of The Travelers years : Armstrong Contracting and Supply Corporation came into existence on January 1 . 1958 and was formed from the former contracting operation of Armstrong Cork obviously - - Company It is a wholly subsidiary of Armstrong Cork Company and * was not an insured of your company ; co ate, This case was originally scheduled for hearing on April 6 but it was removed " condition from the calendar by the Referce who ruled that it was not in trialable We assume that this information in part of your file even though it was not received and forwarded by us until March 29 Doe: Any further correspondence will be sent directly to your attention ". , Very truly yours a oy Bye! oak , DIBB | Wallace B. Hofferth Sots CERTIFIED | Dar INSURANCE 648 YOUTH KINGSLEY DRIVE April 10 LOS ANGELES CALIFORNIA DODOS TELEPHONE 213 388-7971 1967 RELIANCE INSURANCE COMPANY . RELIANCE standaRD LIFE INSURANCE COMPANY PLANET INDURANCE COMPANY Armstrong Cork Company Lancaster Pa 17604 rr . Attention Wallace B. Hofferth Insurance Manager RC Our File : Insured Claimant Claimant : Injury +: Suspense 7116 F&ibSeurpgpllayss Engineering . John Tyler Various , A carbon copy of your letter with attachments has been directed ; to this office by our Pittsburgh office ots We will very shortly have litigatioinn Los Angeles In your letter you indicate coverage by Standard Accident Ac ident Insurance Company for the years 1951 and 1952 could you supply us with policy numbers or copies of the policies \./ for these years You also indicate that either Relianceor Standard Accident Insurance Company covered Armstrong Contracting and Supply Corporation and I would appreciate - your confirming this if possible with policy numbers I can appreciate the difficulties in establishing this coverage and appreciate very much your cooperation Inasmuch as further litigation is anticipated at an early date I would appreciate hearing from you at your earliest convenience , ae for 1951. 718480 Very truly yours RELIANCE INSURANCE COMPANIES COMPANIES JDMC mg McGaughey ot oe, J. D. claim Supervisor OUR 100th YEAR 1 DEPARTMENT OF INDUSTRIAL RELATIONS ie COMPENSATION APPEALS BOARD WORKMEN'S STATE OF CALIFORNIA na f=) y a . ANSWER of MOBIL OIL CORPORATIOCORPNORATION GraberGraber JOHN TYLER CORD RJAOTLEJ Case No. 671836Q87 Date of alleged injury 1/9 to/1/6 9/7 67 wa MOBIL OIL CORPORATION CADDECT HADE OF EMPLOYM 612 S. Insured S ONIUCTNAME OF TREURANGE CAMBIANS 4 CINSURANCE CINSURANCE CANVINTE CANVINTE AUGHLIN^ 926 Formerly SCOTIFICASCOTTIFIECATE NUMBER IF em SE Haake No. 397 allegations of ANSWERING DEFENDANTS deny the the Application as indicated below with such explanations as ex- pressly set forth and admit all other material allegations DENIALS MANE 2 IF ALLEGION IS DeareeD i Employment EXPLAIN BELOW ; ad . Occupation ' Injury 400 SERIAL SERIAL IS BASED ON DATE OR PART OF SODT INJUSED SEPLAID FULLES with Insurance coverage 4/3/674/3/67 liability for self with procured treatinent with Llability for future medical treatment Modical costs CEASE OF FuPiaree wid atte weTIFICe 1B sevess sue CETEMa) , wf . . ' . Earnings Parlods of disability - X____. Permonont disobility . : IT IS FURTHER ALLEGED - F ICELAST DAD WORKED AND GORAEGY DATE OF ESTNEN TO B : : OM APPORTIORMENT APPORTIORMENT 1p CLAMEN dp STATES soe t pork, . t : . tag ' . ae 1 1. Defendents have poid disability Indemnity in the total amount of None _at the rate of 5 work ' beginning through _plus_ . 2. Affirmolive defenses and other maijerk Mobil 011 Carnoration formerly known as Sacony Hobil 011 Company Inc Inc _ succ by e mergs er s to o Gener ral Petroleum Corporation . '" Defendants do not waive the sight to raise additional issues in accordance with the provisions of low and the Rules of a Practice if other issues develop aos Estimated time for triah Additiodneafelndants medical filed All defndants medical reports have been reports will be filed before . Pre tilal wantedi moe i eld | oe. Doted of Los Angeles GAAP 3/30/67 3/30/67 California 7 nt _ MOBIL OIL CORPORATION ' EMPLOYEE ryta EMPLOYEE ON 141ARGE CANDIQN By reg Roller StanleyStanleyFlower St. 90 54-626-571 9054-626-571 FABOZEST amp Lk L.A. 90054-626-57190514-62-571 90054-626-5711 OF m PUKIER ATTORNATI , ' DIA YO EP F .. see A ae , ATR HAIL The Actna Casualty and Surety Company 2104 Wilshire Boulevard aw Los Angeles California 90057 Bentlemen1 Dubject John Tyler vs. Fiberglass Engineering & Supply et al California Workman's Compensation Case No. 67 LB 36007 Lae sy This case which was scheduled for hearing on Auril 6 1967 has been ardared off calendar by the Referce win decided the file was not in a trialable condition ^ copy of the Referee's notice is inclosed 2 Very truly yours DAG Paclosures oF, WallacBe. Bofferth sen Insurance Manager . Hr B. R. Shriver Alexander Agency Inc. 316 Fourth Aventa Pittsburgh Fermsylvania 15222 Loss Department Alexander & Alexander Ina 2225 North Charles Strect Baltimore Maryland 21218 DEPARTMENT OF INDUSTRIAL RELATIONS DIVISION OF IND^ STRIAL ACCIDENTS WORKMEN'S COMPENSATION APPEALS STATE OF CALIFORNIA BOARD : rath . JOHN TYLER YS FIBERGLASSENGINEERING INSULATION INCOSPORATED INCOSPORATED INCOSPORATED AND SUPPLY AETNA CASUALTY & SURETY COMPANY Applicant Defendants Case 67 LB 36087 , . vee Order Joining Party Defendant + . fo boas Good Cause Appearing IT IS ORDERED THAT | SEE ATTACHED LIST Calendar Ordered Calendar 3/23/17 . Calendar be joined as a party defendant herein JOHN L. STRUETT Referee WORKMEN'S COMPENSATION APPEALS BOARD | SERVED ON ALL PARTIES LISTED ON THE OFFICIAL ADDRESS RECORD by mail Datet 3-23-67 By mp . . : FORM REV DIA WEAR FORM 8-64 SFORMERLY : ye . ' . . : . _nesnan oad 00 @ 080 ED ' Howard A. Robert C. March 23 Page 2 Gebler Esq Wreisner Esq 1967 When with will the amended Application is sufficient copies to serve then be set for hearing furnished us in that condition upon all parties the matter and trial on all issues It is noted that the applicant had similar employment in this case as an Asbestos Worker as in the case of OLLIE W. ROGERS vs. FIBERGLASS ENGINEERING et al Case Number 64 LR 26779 It is recommended that applicant's Counsel review that record to expedite information concerning coverage 7 Odpir BORIS RAYNES Referee , kjb CC Aetna Casualty & Surety P.O. Pox 54165 CC 40 employers listed on attached Order of Angeles Los Angeles Joinder ae 90054 ek * RQGE AVIlCaTmOeRd C. KLEIN MARIAG ZUGENE MAD JENNI A. A. SEAMAN MAROLO FANSTEIN FANSTEIN MOVIEND A GROLEN JASON 4. GOTTLING HEAREA , BALTREON - STANFORD L. GELOM^ N MARVIN N. SHAPIRO A JORNOLD BLOCH HARRY ' REDNIC BOLCHAN LD WINE BARRY I BOLCHAN NOEN M. SIMPION - STUART L. DOUQHENTY HOWARD J. Com WALLAGE WOLFS _ : : . LAW OFFICES OF Rose KLEIN KLEIN & 318 WEET OM STRENT MARIASMARIAS SUITE BIT LOS ANGELES CALIFORNIA DOOIS weer rear . REPLY REPLY March 16 1967 ee . | . . VAN BUYS OFFICE . ~ IVAN KUTO ELVO BUITE 118 YAN NUTS CALIFORNIA 1408 TE. LEPHONES ders.48F dedresr.ss.4s84F8Fders.s48F 688 POON OFFICE : . WEST 4TH STRELT BUITE IDS POKORIA CALIFORNIA B1764 TELEPHONE 483-1146 BAMIA ANA OFFICE weet TO TO 100 HO BROADWAY B O19 ahe Reftfi SANTA ANA FORNIA 10 -. TELEPHONE 841-412 , _ _ SAN DIEGO UFFICE 103 A STREET SUITE 404 DAN DIEGO CALIFORNIA CHfl N YKLEPHONE YKLEPHONE 18 FEJL Workmen's Compensation Appeals Board , 230 East Fourth Street Long Beach California Re John Tyler vs Fiberglass Engineering & Supply Case No. 67 LB 36087 AsbeAstsosbies stosis Asbestosis ) ( men Gentlemen 3/21/67 3/21/67 whit - , whit i - The captioned matter is now set for hearing on April 1967. Pursuant to information received from the Department of Health Education and Welfare it is respectfully requested that the employers listed on the attached sheets be joined as parties defendant in the captioned matter Along with a copy of this letter we are serving the newly joined defendants with a copy of the Application previously filed with your Board on January 18 1967 ", a ee oy re j... We have requested information from the California Inspection Rating Bureau as to the carriers for these named defendants but have not yet received this infor- mation As soon as these carriers are ascertainewde a will notify them accordingly . Very truly yours / . _ | Howard Gebler of ROSE KLEIN & MARIAS ! a Employer Name and Address ! Hundet Cork Corp. 65 South 11th St. Brooklyn New York Mundet Cork Corp. 7839 S. Santa Fe Ave. Huntington Park California J. T. Thorpe Inc. 948 E. Second St. Los Angeles California General Petroleum Corp. Income & Excise Tax Dept. 612 S. Flower St. Los Angeles California Marine Engineering & Supply 941 E. Second St. Los Angeles California Co. Marine Engineering & Supply Co. Plant Rubber & Asbestos Works 537 Brannon St. San Francisco California Long The Weed Bell Lumber Co. California Marine Engineering & Supply Co. Plant Rubber & Asbestos Works Period Ended 6/30/43 9/30/43 12/31/43 3/31/44 6/30/44 6/30/44 6/30/44 9/30/44 6/30/44 Amount $ 658.90 ee 628.77 769.69 $ 1,002.63. 166.50 73.50 505.50 328.75 ~ 100.00 9/30/44 3/31/46 6/30/46 9/30/46 12/31/46 3/31/46 9/30/46 3/31/47 3/31/47 6/30/47 9/30/47 342.25 oo 378.00 826.00 42.00 966.57 i 2.00 Employer Name and Addrdea Standard Acbestos Mfg & Ioculoring Co. 410 Ove St. Kansas City Missouri Fibreboard Paper Products 1789 Montgomery Street San Francisco California Grp J. T. Thorpe Inc. Fibreboard Paper Products Corp. 10 Hugh A. Elodon 3262 E. Cage Ave. Huntington Park California Bechtel Corp.. 220 Cush St. Mh San Francisco California Thorpe Inculation Company 2741 S. Yates Ave. Los Angeles California 13. ft 15. Stearns Roger Corporation 600 Dammock St. Denver Colorado Industrial Industrial Purnaces Inc. 944 E. Slauson Ave. Los Angeles California Industrial Insulators Inc. Dax 3388 ; Houston Texas Olottery &Company o John J.Connor 101 Vallejo Denver Colorado Inc. Pres Period Ended 6/30/47 9/30/47 12/31/47 9/30/47 12/31/47 6/30/40 3/31/48 6/30/40 6/30/48 F26 00 Amount 462.00 480.90 12.65 - 829.00 1,059.00 334.13 902.25 482.00 126.00 6/30/48 6/30/48 9/30/48 9/30/48 52.50 r \ ' 169.00 479.13 311.75 9/30/48 12/31/48 9/30/48 18.00 180.60 129.00 ye 25 Employer Name and Address Period Ended Industrial Insulators Inc. 3/31/49 6/30/49 17 19 & Engineering & Supply Co. Inc. P. O. 2531 Houston Texas The Asbestos & Magnesia Materials Co. 119-127 H. Peoria St. Chicago ilinois 3/31/49 6/20/49 12/31/49 6/30/49 9/30/49 12/31/49 .19 Jackson Insolation Inc. 4 Cox 689 Jackeen Ss Michigan Fuller Insulation Co. Cox 36305 \~ 20. Houston Texas 21. Hundet Cork Corp 7101 Tonnelle Ave. North Bergen New Jersey J. T. Therpo Inc. 9/30/49 12/31/49 12/31/49 12/31/49 12/31/50 Thorpe Insulation Company 9/30/50 12/31/50 & Engineering & Supply Co. Inc. 3/31/50 6/30/50 Fullar Austin Insulation Co. Acme Insulation Co. 22. P. O. Box 4001 Texas Corpus Christi Los Angeles taco taco ns 23 W. R. Hargrova _ 365 N. Ave. 22 Los Angeles California 3/31/50 . 3/31/50 6/30/50 9/30/50 Amount $ 131.15 40.85 914.29 199.95 76.00 792.27 748.20 32.40 396.00 659.26 41.56 ts . ; 166.25 . \ | $ 786.25 752.50 9, ) 198.75 \ 549.82 | 216.94 ' | 251.75 3% = ath 93.81 85.50 ; 4 Lp 135.00 Pery Sars i] 325 29 Employer Name and Address Johns Manville Sales 22 E. 40th Sc New York New York Corp. Hundet Cork Corp. Thorpe Insulation Company Hundet Cork Corp. Period Ended 3/31/53 6/30/53 3/31/54 6/30/54 9/30/54 9/30/55 12/31/55 3/31/55 6/30/55 12/31/55 Coast Insulating Products 2004 Lacey St. Los Angeles California J. T. Thorpe Inc. Cork Co. | rsatt Mundet Cork Corp. Coast Insulating Products Rocce Insulation Company 4563 Valley Blvd. Los Angeles California J. I. Thorpe Inc. Thorpe Insulation Company & B Engineering & Supply Co. Inc. Hundet Cork Corp. . 6/30/55 12/31/56 3/31/56 30| 9/30/56 3/31/56 9/30/56 12/31/56 3/31/56 12/31/56 3/31/57 6/30/57 6/30/57 9/30/57 9/30/57 9/30/57 12/31/57 roby il Amount 3 632.20 1,426.30 $ 1,569.76 1,767.00 $ 1,550.25 78.00 1,734.00 795.60 1.358.50 301.20 $ 321.60 286.00 2,240.88 572.00 104.00 | - 1,086.36 2,420.40 1,651.00 160.80 $ 1,675.00 281.40 26.80 187.60 207.87 653.20 Employer Name and Address 32 Ovens Corning P. O. Box 901 Toledo Ohio Fibergina Corp. J. T. Thorpe Inc. Period PeriodEnded 9/30/57 3/31/50 6/30/58 12/31/58 Mundes Cork Corp. Loc R. Ekino Company 4933 Valley Boulevard 100 Angeles California Accurate Insulation Co. 900 South Cypress St. La Habra California Inc. Thorpe Insulation Company Kandet Cork Corp. 3/31/58 12/31/50 12/31/58 9/30/59 3/31/59 6/30/59 9/30/59 Owens Corning Fiberglas Corp. Acbeatos Plant Co. 1300 64th Street 35. California Emeryville CONTRACTING ARMSTRONG ARMSTRONG CONTRACTING J. SUPPLY Armstrong Armstrong Cork Conf et Plant Asbestos Co. 86 Armstrong Contracting & Supply Corporation . 120 N. Liza St. Lancaster Pennsylvania Coast Insulating Products Armstrong Contracting & Supply Corporation 6/30/59 9/30/59 12/31/59 a Poe 12/31/60 a 3/31/60 ean TT, 3/31/60 6/30/60 9/30/60 eee 12/31/61 eg ernn 3/31/61 6/30/61 9/30/61 12/31/61 reine 532.80 1,005.20 . 426.60 1,411.25 61.60 Al; ae . 221.20 442.80 1,616,00 2,006.80 196.80 65.60 1,496.00 |. 1,768.00 187.70 102.00 952.00 J 2,188.80 * 293.12 2,120.80 : 2,059.20 366.40 253.60 419 no^ ^fl^ QABLE ADORERS ALEXOAND . . ALEXANDER AGENCY INC INSURANCE WORLD WIDE SINCE 1053 union BanK OLD - FITTBOLIROH PA 15222 . wo t _ March 22,1967 on Wallace B.Hofferth Insurance Armstrong Cork Company Lancaster Pa Manager Dear Mr. Hofferth Re Supply John Tyler Vs Fiberglass Engineering & California Workmen's Compensation Case No16L7B3 papers in We wish to acknowledge receipt of copy of letter and connection with the above We have forwarded them to the Standard Accident for Insurance Co. attention | Very truly yours ce wist By a BE . , 78 _ PA RRI trArmirnw 2 J Ce CAMINH CAMINH CAMINH CAMINH 4 re " ' HallHall INTER OFFICE COMMUNICATION 9 J.E. Zeller Lancaster . FLG FLG for recorrdsecords Tyler Tyler Tyler info Octobar Asbestonia 1967 records Asbestonia W.A. Maggio Los Angeles | : Workman's Compensation Appeals Board Case No. 67 LB 36087 Asbestonia Asbestonia Attached for your interest is the findings and award on Asbestonia Asbestonia Case ia w . a Asbestonia Asbestonia Asbestonia ; Asbestonia CS ' | Asbestonia Asbestonia seems pprettry etty rough for Carey = sdity sdity mp neene 4. 1501 Printed in U.S.A. e r ~ paid206868 _ : . , a . be 4 . . ae + use me aye 1s wee . as ane Qe feo oF , ' a 1 4 arn * . !