Document 6w9X7bkbKG3d1GNyNJdQ5paBg

FILE NAME: Contract Unit Workers Comp Claims (WCC) DATE: 1963 DOC#: WCC001 DOCUMENT DESCRIPTION: Workers Comp File - Goans, Robert 0 Contains all documents found in the Claimant's file, with one blank page between each separate document. i r \r h ' i ' : '/ ; l , / STATE OF CALIFORNIA IN D U ST R IA L A C C ID E N T COMMISSION A P P U C A TIO N FILE SIGNED ORIGINAL AND SIX COPIES (PLEASE PRINT OR TYPE NAMES AND ADDRESSES) CASE N O .^ ^ R O B E R T 0 . G O A N S __________________________________ APPLICANT-- , ___ 4 2 3 2 - 2 5 t h S t r e e t __________________________ APPLICANT'S ADDRESS S a n F r a n c i s c o , C a l i f o r n i a _____________ vs. LORENTZEN & COMPANY (an d o t h e r s ) _____ KMPLOrCi Social Security N o . __________________ ______________________ 1 1 5 5 - 5 t h S t r e e t ____________________________ KMPLOTIt'S ADDRESS O a k l a n d , C a l i f o r n i a _________________________ A R G O N A U T I N S U R A N C E C O M P A N Y ______________ EMPLOYER'S |NSURAHCI CARRIER 550 San C a l i f o r n i a S t r e e t _____________________ INSURANCE CARRIER'S ADDRESS F r a n c i s c o , C a l i f o r n i a ______________ 1 . ___R o b e r t 0 . G o a n s ______________________ 9 / 2 / 0 0 nsne or m n o m date or ninth t aUcges that while employed on_ A p l J _________ 1 9 6 & _ oatr or ihjurt as - a s b e s t o s w o r k e r & i n s u l a t i o n . . m o v e r * _____________J i a r l o . u S _ p J L a c . g . s ___________ , California, by OCCUPATION ATTIME OF INJURY CITT, TOWN OR PLACE WHERE INJURY OCCURRED ______J iS L E liH ia ______________ ______________ 7 __lie sustained injury arising out o f and in the course o f the em ploym ent, as follows: NAME OF EMPLOYER ______d D . l n ^ _ l n a i a a l i l D i u j (i Q E k _ i l D .n ,, m a n y _ .y . a r _ s ----------------------------------------------------------------------------- resulting in EXPLAINHOWINJURYWAS RTCEIVEB ______p .n e .u r a o n Q .Q h .Q n lG S .1 .5 _______________________________________________________________________________________________ STATE WHAT PARTS OP SODT WERE INJUREDAND SURSCQUENT RESULTS 2 , ____ V a r j - O U S _______________________________________________________ was the employer's insurance carrier on date o f injury. NAME OF INSURANCE COMPARTOR, IF EMPLOYER WAS NOT INSURED. STATE WHETHER SELF*IHSURED OR UNINSURED 3_______ A p c l l 3 j - J S 6 3 _ . f t j a E s a n t __________ :--------------------- ------------------------------------------- -------------------------------------------- reriods orr won* due to the injurt bati injures returned to worn bate lait nebical rvimiKCB 4. Was com pensation paid?___N-P____________ $------------------------------------------ I --------------------------------------------------------------------------------------- TES 0 NO TOTAL RAID WEEKLT RATE DATE ORLAST RATNINT i . Earnings at tim e o f injury $__ M .aX .iffiillll------@ ________________,-----------Tbe basis o f pay was----------------------------------------------- --------- MONTHO* WEEK TATE rATRERIOD0 HOUALTNATE, HOUESAOATANOOATAWEEE 6. W as m edical treatment needed?___Y .? __________ W ho furnished treatment?------------S e l f ------------------------------------------------------------ret on NO IVENAMEor DOCTOA<WHOTREATEDTHE INJURTANOTATEWHORAIDTHEIR ILL ' 7. This application is filed to determine liability for: a. Temporary disability--YSLS b. Permanent disability-- Y g .S c. Medical treatment-- Y fiS -- d. Medical costs---------------------- TE* ONMO TE OR HO TE OR NO TER OR NO e. L itigation expense_________ f. -------------------------------------------------------------- --------------------------------------------------------------------------------------- TER OR NO (TATE ANTOTHER REASON 8. _______________________________________________________________________________________________________________ LIST CASE NUMBERS Or ANT OTKEN ArNLICATIONS TILED W H E REFO RE, it is requested that a time and place be fixed for hearing and that, an award be made granting such relief as may be proper under the W orkmen's Compensation Laws of California. Dated at_____ O a k l a n d __________ , C aliforn ia,____ A u g u s t 8 , 1 9 6 . 3 _______ CITT DATS H earing requested a t _ _ Q a k l a n d ----------- ---------------------------ciTT N umbf er ocf witnesses________________________________________ Estimated time o f a L f l n f i r l i a Y f . j J& Y _________________ / s / R o b e r t 0 . G o a n s ________________________________ _ SM IT H , APPLICANT'S SIGNATURE P A R R ISH , PADUCK & CLANCY 3 1 5 F i n a n c i a l C e n t e r B u i l d i n g ________________ APPLICANT'S ATTORNET O a k la n d 1 2 , C a l i f o r n i a G L e n c o u r t 2 - 2 0 0 0 ____________________________ .__________ ATTORNEY'S ADDRESS AND TELEPHONE NUMBER NOTE-- IVK 1 P L I A i l NAM I OF CITT W H IM M fA IIN ? D C C IR IO . C A M W ILL R l IT FO * C IT T t O U IlT IO OR N C A B C IT CDM VtN IIM T C ITY IF AMR AN It T IM A T l OF T H l T IN ! RtO U IR C O FO R H IA R IN Q 0 A M P LI TIM | CAN 1 A L L O W ID TO C O N P L C T I C A t l WITMOVT A c o m t i n h a m c i . TION N i l OtVKN OF N O T E ----- U N O T N I P R O V I S I O N O F T H W O M M t N ' l C O M F I N A T I O N . I N S U R A N C I A N O N F I L L t O O U T . A N O 1C N I D t T A P P L I C A N T I T M U S T 1 P I L I O WI TH OR M A I L t O TO T H I T I N ! A M O P L A C | O F H I A I I N O . E I T H C R F A R I T H A T >1 R f P R I S I H T I O IN M R I O N , S T SAFITT LAW THI NtARCST A T 10M K T OS , T H I APPLICAN T O P F IC I o r IN C OTM IR A U N T , M ttR OMLT iN e w iTR IA L TATI TH I A CCIO IN T P O C M O L I , I T MU C H IR A L N A T U R I OF T H I CLAIM IN COM M ICSION W ITHOUT O fLA T O u t rcT io ti C 0 N T R 0 V I T , W h in a p p l ic a . N O T IC I W ILL T H C R IA F T IR 01 RM 3 4 <RCV. M l ) EMPLOYERS 1. Western Asbestos P.0. Box 3784 Rincon Annex San Francisco, California 2. Mundet Cork Company 410 Talbert Street San Francisco, California 3. Plant Rubber & Asbestos Works 1300 - 64th Street Oakland, California 4. Plant Asbestos Company 1300 - 64th Street Emeryville 8, California 5. Army Port Contractos 1501 Maritime Street Oakland, California 6. Van Arsdale Harris Lumber Co. 5th and Brannan Streets San Francisco, California 7. Bay Cities Asbestos Co., Ltd. 6th and East 12th Street Oakland, California 8. Harry A. Dutton, Jr., Dutton Asbestos Company 532 Natoma Street San Francisco, California 9. C. F. Braun & Company 1000 South Fremont Avenue Alhambra, California 10. Asbestos Company of California 941 - 16th Street San Francisco 7, California 11. John Mansville Sales Corp. P.0. Box 3784 Rincon Annex San Francisco, California 12. Marine Engineering & Supply Co. 941 East 12th Street Los Angeles, California 13. Armstrong Cork 304 Shaw Road So. San Francisco, California 14.i M. R. Carpenter 907 Front Street Sacramento, California 15. Caw Insulations 36OO - 20th Avenue Sacramento 17, California 16. Fiberglass Engineering & Supply 1200 - 17th Street San Francisco, California 17 Owens Corning Fiberglass Corp. 1200 - 17th Street San Francisco, California PERIODS 1926-1943, 1946-1950, 1955" 1963 and others 1937, 1939, 1940, 1941, 1962 and others 1941-1944 and others 1957, 1959, i960 and others 1941 and 1942 and others 1942 and others 1944-1946 and others 1941, 1954 and others 1938 and others 1944 and 1945 and others 1949 and 1950 and others M > 1938, 1950 1950, 1954, 1955, 1957, and others 1950-1953, 1959, 1962 and others 1950, 1961 and 1962 and others 1953, 1954 and others 1955-1957, 1961, 1962 and others (1) X EMPLOYERS l8. Charles Ayres Company 698 Minnesota Street San Francisco, California 19. Coast Insulation Products 2316 San Fernando Road Los Angeles 65, California 20. Thomas C. Douglas, Jr. Douglas Insulating Company 2233 Ingalls San Francisco, California 21. J.T. Thorpe & Sons 1351 Ocean Avenue . Emeryville, California 22. Armstrong Contracting & Supply c/o Armstrong Cork 304 Shaw Road So. San Francisco, California 2 3 . National Insulation Inc. 503 Polk Street San Francisco, California PERIODS 19 55, 1957-1959 and others 1956 and others 1956 and others 1959., I960, 1957 and others 1958 and others 1962 and others 24. Lorentzen Company 1155 - 5th Street Oakland, California 1955> 1962 and others 25. Jackson Hopkins Company, Inc. P.0. Box 490 Bakersfield, California 1957 and others 2o. Kelly Asbestos Inc. 2030 Grand Avenue Kansas City 8, Mo. 1949 and others 27. Asbestos Products Inc. 710 Raymond Avenue St. Paul 4, Minnesota 1949 and others INSURANCE COMPANIES 0 * State Compensation Insurance Fund, 525 Golden Gate Avenue San Francisco, California Industrial Indemnity, 300 Grand Avenue, Oakland, California Aetna Casualty Insurance Company, 1330 Broadway, Oakland, California Travelers Insurance Company, 1956 Webster Street, Oakland, California American Motorists, Russ Building, San Francisco, California Argonaut Insurance Company, 550 California Street, San Francisco, California Standard Accident, 433 California Street, San Francisco, Calif. American Employers, Russ Building, San Francisco, California Hanna & Brophy, 1540 San Pablo, Oakland, California (2) (PROOF OF SERVICE BY MAIL-1013a, 2015.5 C.C.P.) STATE OF CALIFORNIA) COUNTY OF ALAMEDA ) I am a resident of the United States and a resident of the aforesaid county; I am over the age of eighteen years and not a party to the within above action; my business address is: 315 Financial Center Building, Oakland 12, California On _____ At)G 9____ _______ , 1963, I served the within AMENDED APPLICATION on the various parties in said action, by placing a true copy thereof enclosed in a sealed envelope with postage thereon fully prepaid, in the United States post office mail box at Oakland, California, addressed as follows: Western Asbestos, P.0. Box 3784, Rincon Annex, S.F. Calif. Mundet Cork Company, 410 Talbert Street, S.F., Calif. Plant Rubber & Asbestos Works, 1300 - 64th St., Oakland, Calif. Plant Asbestos Company, 1300 - 64th Street, Emeryville 8, Calif. Army Port Contractors, 1501 Maritime Street, Oakland, Calif. Van Arsdale Harris Lumber, 5th and Brannan Sts., S.F., Calif. Bay Cities Asbestos, 6th and East 12th St., Oakland, Calif. Harry A. Dutton, 532 Natoma St., S.F., Calif. C. F. Braun & Co., 1000 So. Fremont Ave., Alhambra, Calif. Asbestos Co. of Calif., 94l - l6th Street, S.F., Calif. John Mansville Sales, P.0. Box 3784, Rincon Annex, S.F., Calif. Marine Engineering, 9^1 East 12th Street, L.A., Calif. Armstrong Cork, 304 Shaw Road, So. S.F., Calif, M.R. Carpenter, 907 Front Street, Saeto., Calif. Caw Insulations, 36OO - 20th St., Sacto., Calif. Fiberglass Engineering, 1200 - 1 7 th St., S.F., Calif. Owens Corning Fiberglass, 1200 - 1 7 th St., S.F., Calif. Charles Ayes Co., 698 Minnesota St., S.F., Calif. Coast Insulation, 2316 San Fernando Rd., L.A., Calif. Thomas C. Douglas, Jr., 2233 Ingalls, S.F., Calif. J.T. Thorpe, 1351 Ocean Avenue, Emeryville, Calif. Armstrong Contracting, 304 Shaw Road, So. S.F., Calif. National Insulation Inc., 503 Polk St., S.F., Calif. Lorentzen Co., 1155 - 5th Street, Oakland, Calif. Jackson Hopkins Co., P.0. Box 490, Bakersfield, Calif. Kelly Asbestos Inc., 2030 Grand Avenue, Kansas City 8, Mo. Asbestos Products, 710 Raymond Ave., St. Paul 4, Minn. State Compensation Insurance Fund, 525 Golden-Gate, S.F., Calif. Industrial Indemnity, 300 Grand Ave., Oakland, Calif. Aetna Casualty Insurance Company, 1330 Broadway, Oakland, Calif. Travelers Insurance Company, 1956 Webster St., Oakland, Calif. American Motorists, Russ Building, S.F., Calif. Argonaut Insurance Company, 550 California St., S.F. Calif. Standard Accident, 433 California St., S.F., Calif. American Employers, Russ Building, S.F., Calif. Hanna & Brophy, 1540 San Pablo, Oakland, Calif. I certify, under penalty of perjury,* that the foregoing is true and correct. AUG 9 ..4 Executed on__________________ , 1963, at Oakland, California /s/ Sharon McKay *The proof of service by mail form, being signed under penalty of perjury, does not require notarization. -- r* - _________ ____ |5.ci)ri4_ 0 6 o c \n ^ r -4 co tt__ O o-ITA __ __ : J7yi t (Av'Vy------- . :------------ .------ ---- ---Z.------ ----- :---- _ fY\u^cU4 Co r fc: . r-' ---------------,,O oC feL -- - : % l% /Cy ___ U v>4_R ^?t? tcLlcLH d _ . <asJ-- -J ___ Pfi-- fl % 11r~4r 7 Plo*r& >.- J: ,:4:^L u zJ ^ l : __ ___J k n -4/V\..cvnA) ULl*-_____ ' J \ r r w S - \r O f* ^ _ C ^ .e .b _ s ___ . C o t h i ^ _J 1!________ '__ _:___;_.____ 9 ATLANTA BALTIMORE CHICAGO CLARKSBURG LOS ANGELES MIAMI MONTREAL NEWARK NEW ORLEANS NEW YORK PHILADELPHIA PITTSBURGH SAN FRANCISCO ST. LOUIS TORONTO TULSA A lex a n d er & A lex a n d er IN C O R P O R A T E D I NSURANCE AVERAGE ADJUSTERS CONSULTING ACTUARIES 2225 NORTH CHARLES STREET, BALTIMORE, MD. 21218 February 26th, 1964 TELEPHONE TUXEDO 9*4304 CABLE ADDRESS "ALEXBLUE" Insurance Department A rm strong Cork Company L an caster, P ennsylvania G entlem en:- r e : R ob ert Goans D/A November 22nd, F ile B 585651 1957 We h a v e r e c e i v e d a s t a t u s r e p o r t from t h e O ak lan d , C a lif o r n ia O f f ic e o f th e T r a v e le r s I n s u r a n c e Company on t h i s c a se , which read s as fo llo w s: MA h e a r in g was h e ld Jan u ary 29th , 1964; no r e s u lts to d a te . Probable fu rth er hearings to be sch ed u led ." The above i s fo r your in fo rm a tio n and f i l e . S in cerely R A ttach ed are l e t t e r s from S ta te C om pensation Insurance Fund and rep o rt o f H. Corwin H inithev, M .D ., f o r h o th A rm strong C o n tr a c tin g and A rm strong Cork. DJH FORM 1501 Printed In U.S.A. January l4, 1964 FIFTY YEARS OF SE R V IC E STATE COMPENSATION I NSURANCE Industrial Accident Commission Room 300, State Building 1111 Jackson Street Oakland 7, California IN R E P L Y R E F E R TO A04183 Robert 0. Goans Re: Robert 0. Goans vs. Western Asbestos Company (and others) and State Compensation Insurance, et al I.A.C. 63 OAK 11052 Gentlemen: We are enclosing report of H. Corwin Hinshaw, M.D., dated October 14, 19 6 3 . A copy of this report has been mailed to the parties listed below. Very truly yours, Charles M. McMillan Attorney jr Enc cc: Robert 0. Goans, 4232 - 25th Street, San Francisco, California Smith, Parrish, Paduck and Clancy, 3 15 Financial Center Building, Oakland 12, California *'* Lorentzen and Company, 1155 Fifth Street, Oakland, California Warren Manley, c/o National Insulation Company, 503 Polk Street, San Francisco, California Argonaut Insurance Company, 550 California Street, San Francisco, California 3360 GRAND AVENUE, OAKLAND 10. CAU FO RN I , Re: Robert A. Goans A04l83 Page 2 Hanna and Brophy, 1540 San Pablo Avenue, Oakland 12, California J. Patrick Goodwin, 4l Sutter, San Francisco 4, California F. E. Carignan, c/o American Motorists Insurance Company, 4lf Montgomery Street, San Francisco 4, California Western Asbestos, P. 0. Box 3784, Rincon Annex, San Francisco, California Mundet Cork Company, 410 Talbert Street, San Francisco, California Plant Rubber and Asbestos Works, 1300 - 64th Street, Oakland, ' California Plant Asbestos Company, 1300 - 64th Street, Emeryville 8, California Army Port Contractors, 1501 Maritime Street, Oakland, California Van Arsdale Harris Lumber Company, Fifth and Brannan Streets, San Francisco, California Bay Cities Asbestos Company, Ltd., Sixth and East 12th Streets, Oakland, California Harry A. Dutton, Jr., Dutton Asbestos Company, 532 Natoma Street, San Francisco, California C. F. Braun and Company, 1000 South Fremont Avenue, Alhambra, / California Asbestos Company of California, 941 - l6th Street, San Francisco 7# California Johns Mansville Sales Corporation, P. 0. Box 3784, Rincon Annex, San Francisco, California Marine Engineering and Supply Company, 941 East 12th Street, Los Angeles, California /'''Armstrong Cork, 304 Shaw Road, South San Francisco, California /M. R. Carpenter, S 0 J Front Street, Sacramento, California Caw Insulations, 36O - 20th Avenue, Sacramento 17, California Fiberglass Engineering and Supply, 1200 - 1 7 th Street, San Francisco, California Owens Corning Fiberglass Corporation, 1200 - 1 7 th Street, San Francisco, California Charles Ayres Company, 698 Minnesota Street, San Francisco, California Department of Employment, P. 0. Box 3534, San Francisco, California Coast Insulation Products, 2316 San Fernando Road, Los Angeles, California Thomas C. Douglas, Jr., Douglas Insulating Company, 2233 Ingalls, San Francisco, California J. T. Thorpe and Sons, 1351 Ocean Avenue, Emeryville, California Armstrong Contracting and Supply, c/o Armstrong Cork, 304 Shaw Road, South San Francisco, California National Insulation, Inc., 53 Polk Street, San Francisco, California Jackson Hopkins Company, Inc., P. 0. Box 490, Bakersfield, California Kelly Asbestos, Inc., 2030 Grand Avenue, Kansas City 8 . Missouri Asbestos Products, Inc., 710 Raymond Avenue, St. Paul 4, Minnesota Asbestos Products and Fabricators Corporation, 2316 San Fernando Road, Los Angeles, California Re: Robert A. Goans A04183 Page 3 Aetna Casualty and Surety Company, 926 J Building, Room 1308, Sacramento 14, California Employers Mutual Liability Insurance Company of Wisconsin, 114 Sansome Street, San Francisco 4. California Standard Accident Insurance Company, 433 California Street, San Francisco, California Industrial Indemnity Company, 350 Sansome, San Francisco, California United States Fidelity and Guarantee Company, 444 California Street, San Francisco, California Employers Liability Assurance Corporation, Ltd., 1050 Russ Building, San Francisco 4, California Fireman's Fund Insurance Company, 330 -- 19th Street, Oakland 12, California Travelers Insurance Company, 195& Webster Street, Oakland 12, California American Motorists Insurance Company, 417 Montgomery Street, San Francisco 4, California American Employers' Insurance Company, Russ Bldg., San Francisco, Zurich General Accident, 417 Montgomery Street, San Francisco, California' Industrial Indemnity Exchange, 350 Sansome, San Francisco, California Associated Indemnity Corporation, 332 Pine, San Francisco, California California Casualty Indemnity Exchange, 550 Kearny Street, San Francisco 8, California Pacific Employers Insurance Company, 244 Pine Street, San Francisco 4, California Zenith National Insurance Company, 582 Market Street, San Francisco, California Argonaut Insurance Exchange, 550 California Street, San Francisco, California Cal: 1 o TttlFHONC YUKON a-7IO H. Corwin Hinshaw, M. D. Horton C. Hinshaw.J r- M.D. ABO SUTTIR STRICT San Francisco 8, California fr* W * V October 14, 1963 From: H. Corwin. Hinshaw, M.D. To: State Compensation Insurance Fund 525 Golden Gate Avenue San Francisco 1,. California Subject: Robert O. Goans. A04183 REPORT OF SPECIAL MEDICAL. EXAMINATION Purpose of the Examination: To determine Mr, Goans' present physical condition with special reference to his . reported pneumoconiosis attributed to exposure while doing insulation work over a peric of 42 or 44 years. The patient states that he has worked as an insulator since a young man, less than 18 ye of age, during the period of World War I. He says that over these years he has used many different kinds of insulating materials particular asbestos and corrugated paper during early years and during the last four years or so has been concerned mainly with fiberglass insulation. He says that he has worked inaH kinds of construction including ships and public buildings. UsuaHy the work has involved the insulation of pipes and boilers rather than walls. Frequently the work involved insulation of both hot and cold air duct lines. He says that frequently there was dust and sometimes he was required t work in relatively closed poorly ventilated spaces. He considered himself to be'well and had no complaints until recently. He says that abc three or four years ago his union made arrangements to have members take x-rays once a year at the Kaiser Hospital in Oakland, California. He believes that his first x-ray w made about three years aga and that he had never had an x-ray of the chest made before He was told at that time that there was evidence of some dust in his lungs, at first only " on the bottom of the lungs" but in more recent years that this was worsening and that it involved not only "the bottom" but also "the top of the lungs" . When informed that there was progressive disease he went to see a physician in San Francisco, s* Doctor Walter Kolman (3490 - 20th Street). Doctor Kolman confirmed the diagnosis and advised Mr. Goans to discontinue his work and to apply for disability benefits. The patient states that he has been eager to continue working if possible until the usual retirement age of 65 years but, of course, he is not willing to run any risk of serious pulmonary difficulty. He says that it is not possible to escape all exposure to dust in hi! occupation, and that he would not be able to find a job in this industry that does not involv dust exposure* i!CV 6 1963 r'"K I.EGAL Page 2i From: To: Subject: October 14, 1963 H. Corwin Hinshaw, M.D. State Compensation Insurance Fund Robert O. Goans He says that he had had no significant symptoms during previous years and he recites an instance of excessive physical activity about 1936 in connection with a deer hunting expedition he was forced to run for a distance of about one and one-half miles and this was done without serious difficulty. He says that he worked at an altitude of about 6,00 feet in the vicinity of Reno about two or three years ago and he does not recall any difficulty breathing at that altitude. Since learning of his x-ray changes he has noted cough and expectoration, especially during the last year or two, shortness of breath als mostly during the past year or two. He says that if he walks slowly for a moderate distance he would not have any shortness of breath but if he attempted to walk rapidly oi did some other unusual effort that he would become short of breath and stop. He has no chest pain on such occasions. He says that he also has developed a cough in the last tw' years or so. He coughs up some sputum which is never bloody and apparently is never green or yellow pus. He has not done any work at all the last nine months or so. Present Symptoms: He says that his general health and strength would be satisfactory except for his lung difficulty. He does not believe he has lost any weight in the last year although his prese weight is about 10 or 15 pounds below his usual weight. Respiratory Symptoms - He says that he has a mild cough in the morning with expectora of clear sputum. He has never expectorated blood. He has never had asthmatic sympto such as wheezing, no chest pain. He has moderately severe shortness of breath on any unusual activity as described previously. He is not particularly prone to develop respiratory infections. Cardiac Symptoms - He has never had a heart attack. He has no anginal pain, no palpitation, no swelling of the ankles. Gastro-intestinal Symptoms - His appetite is satisfactory, no abdominal pain, no constipation or diarrhea, no difficulty swallowing. Genito-urinary Symptoms - No frequency, no nocturia, no pain, no obstruction to the flc of urine or any other symptom to suggest kidney or bladder disorder. Eyes - He says that he has a cataract in his right eye. The left eye gives satisfactory vision. His hearing is satisfactory. No symptoms related to the nose, sinuses, etc. Neuromuscular, Skeletal, Central Nervous System - No paralysis, no weakness, no bone or joint symptoms, no central nervous system disorders. Personal Habits: He smokes 20 to 30 cigarettes a day and has all of his adult life. He drinks regularly. . says, that he always has a."shot1before breakfast and sometimes drinks as much as a ha a pint a day. He says that he has never become intoxicated and does not go on drinking sprees but drinks these amounts on a regular basis. He has been m arried twice. His first wife bore him one child but he does not know whether that child is still living. He has been m arried to his present wife for 38 years. They haye had-no. children. He says .that. his. wife has suffered from colitis. He does not know about,the health of his mother and father, haying had no communication with them since 1926i ;!-TkeyOwiie3living in the t, o O Page 3: From: . To: Subject: :October 14,. 1963 H. Corwin Hinshaw, M.D. State Compensation Insurance Fund Robert O. Goans State of Missouri. He is not sure how many brothers or sisters he has but thinks there were seven or eight in the family. He has not had any contact with them for many years Past Medical History: In 1950 he had an injury which inoluded a fracture of his left heel and was in Sutter Hospital in Sacramento. He does not know whether he had an x -ray of his chest at that time or not. His physician was Doctor Horn. . He also sprained his .right w rist but this did not require hospitalization. He has never been in a hospital in any other circumstam He has never been in military service. He has not had any serious childhood diseases. He has' never been hospitalized for any other condition. He doesn* t believe he has ever h pleurisy, pneumonia, jaundice, rheumatic fever, malaria, syphilis, other accidents or injuries aside, from those mentioned,.no hay fever, asthma, heart attacks, etc. THE FOREGOING PORTION OF THIS REPORT WAS DICTATED IN THE PATIENTS. PRESENCE ON OCTOBER 11, 1963. . Physical . Examination: General Appearance - The patient's general appearance is satisfactory. He looks like a well man and he seems to be frank and cooperative. . His appearance is consistent with his statement that he is of partial Cherokee Indian extraction and part Anglo Saxon. Blood P ressure - Abnormal, consistently elevated to a level of 180. to 200 systolic and 90 diastolic. Pulse - Normal, 64 and regular. Temperature - Normal, 98.4. Eyes - Pupils are round, regular and equal,, reflexes to light and accommodation normal, . external ocular movements are normal. Oral Caviiy - No significant findings. . Lymph Nodes - None are enlarged or diseased. . Thyroid - Normal. Breasts Normal. Skin Normal, no cyanosis. Chest Wall - Shape is within normal limits. Respiratory excursion satisfactory. No tenderness. Lungs - Percussion note normal, breath sounds withinnormal lim its. No wheezes heard. There were a few basal rales rather coarse and symmetrically distributed on both sides, suggesting pulmonary congestion. Heart - Size indeterminate, rhythm regular, no murmurs or other abnormalities detected. No distention of neck veins in the upright position. Abdomen - No enlargement of liver, spleen or kidneys. No abnormal masses palpated. No unusual tenderness. Electrocardiogram: Auricular Rate 70, Ventricular Rate 70, Rhythm Sinus, T Waves Normal, P-R Interval 0.16, Q-R-S Interval 0.06, S-T Segment Isoelectric, Position Semi-vertical, . Electrical Axis Normal. ----J REMARKS: Normal record. g jggg K w J Page 4; From: To: Subject: October 14, 1963 H. Corwin Hinshaw, M.D. State Compensation. Insurance Fund . Robert O. Goans Urinalysis: (GersonR, Biskind, M.D. - Medical Laboratory) Color Yellow,. Turbidity Clear, Reaction pH 6.0, Spec. Grav. 1.021, Albumin Negative, Sugar Negative, Urobilinogen (normal pos. 1:10) pos. dir.' neg. 1:10, Epithelial Cells rare sq ., RBCAdf 0, WBC/hdf O cc., Casts 0, Bacteria 0, . Crystals 0,. Mucus Threads 0. . Complete Blood Count: Hemoglobin 97%, 15.0 Qm., Erythrocyte Count 4.98 Million, Color Index 0.97, . Leukocyte Count 9,400, Polymorph. Neutr. 59%, Filamented 58%, Nonfilamenied 1%, Eosinophiles 1%, B.asophiles 0%, Lymphocytes 34%, Monocytes 6%. ..... Rare atypical lymphocytes noted; the red blood cells and platelets appear normal. Blood Serology: VDRL - Nonreactive. . Kolmer - Nonreactiye. X-ray Examination of the Chest: Stereoscopic and left lateral projections show a bony thorax within normal limits. T1 heart shadow is questionably enlarged and the aortic shadow is prominent. Both hemidiaphragms are irregular in contour and hazy in outline. Most impressive is thi fine linear densities extending out from both hilar regions into the base of each lung : some less distinct and coarser strands extending into the right apex. There is a bin .of the right cardiophrenic angle but it is unclear whether this is cardiac or pulmonai origin and most likely it is a distortion of the cardiac outline produced by pleural ch; IMPRESSION: The appearance is that of diffuse rather extensive and moderately se^ pulmonary fibrosis such as is seen in cases of asbestosis. . The pleural changes are compatible with this diagnosis. Tests of Pulmonary Function: One second forced expiratory volume - 2.2 liters, two seconds 2.6 liters, three se< 2.9 liters and total 2.9 liters. * Maximal Breathing Capacity - 68 liters per minute. IMPRESSION: The picture is one of moderate restrictive lung disease with nearly ' air flow rate (175 liters per minute on the spirogram). Such restrictive disease is in pulmonary fibrosis, congestive heart failure, etc. The ventilation as measured should be adequate to permit moderate physical activity in so far as"'such an estims can be made by these methods. Discussion and Summary: This patient has definite elevation of his blood pressure, moderately severe pulmc fibrosis (presumably asbestosis) and symptoms of reduction in exertion tolerance only recently. On the basis of our x -ray findings and his history of exposure, it seems probable j;l'7 k IOC j t '` Page 5: From; To: Subject: . October 14, 1963 H. Corwin Hinshaw, M.D. State Compensation Insurance Fund Robert O. Goans Discussion and Summary CONTUSED: bis pulmonary fibrosis bas been present for many years, that it, is of occupational origin and due principally if not entirely to exposure to asbestos fibers. His symptoms are described as baying been of rather recent origin and I suspect that the cardiac stress of his hypertension may have been the recently added factor, which has combined with the pre-existing and probably longstanding pulmonary fibrosis to produce the symptoms. Since Mr. Goans is so near to his normal retirement age, he is eager to remain employed until the age of 65. It is my opinion that it would not be deleterious to his. physical welfare, to continue working provided he can be assigned to tasks that do not involve inhalation of pathogenic dusts or fibers in the air. He should be under continuous medical supervision and if the hypertensive trend contir he should probably receive antihypertensive drugs. In the event that these are marker effective in relieving his symptoms, it would tend to confirm the belief that the cardiai aspect of his disability was an important one. Previous x-ray films have not yet been obtained for comparison with current films. The most reliable method of analyzing his cardiac and hypertensive status would be tc admit him to a hospital for a week or two of appropriate treatment designed to control his hypertension and to relieve any pulmonary congestion produced by this condition. However, the existence of pulmonary fibrosis of occupational origin has been satisfactorily established by present studies,, in'my opinion. ,Very truly yours, HCHDF ,H. Corwin Hinshaw, M.D. RECEIVED ^ NOV 1 1963 1:07 6 legal- January 13* 19&- Mr. John A. B inkley Legal Department Bnplqyers Mutuals o f Wausau Adam Grant B u ild in g San F rancisco, C a lifo rn ia Dear Hr. B inkley: Subject: Robert 0 . Goans YS " Armstrong Cork Company, e t a l F ile AZr-h6k62 3AC F ile 63 OAK 11052 We are sorry th a t we cannot g iv e you the periods o f employment o f Hr. Goans from January 1 , 19& to January 1 , 1952 when you were an insurer o f a portion o f our C alifornia operations. A ll o f the p a y ro ll records p r io r to 1956 except a y ea rly p la n t summary have been destroyed. You vere never the insurer o f our con tractin g op eration s, however, and th is i s th e area fro a which th e pnevraonochoniosis tea sed . You insured our m anufacturing p la n t a t South G ate, Our y ea rly p la n t summary fo r the period in q u estion does n ot l i s t Hr. Goans as having been in our espdcy a t South G ate. We hope th a t t h is inform ation w ill be o f see a ssista n c e to you . Very tr u ly yours, W allace B. B offerth A ssista n t General Manager Insurance Department SLK Mr. A. L. S to k sly , D is tr ic t Manager Armstrong C ontracting and Supply Corp 3Qlf Shaw Road South San F ran cisco, C a lif. Mr. Fred L. Gardner, AC&S, Lancaster for A c r i6 N ....i3 k ^ .^ i^ -.^ W ttitGRMATIOM ^ 4 ^ & jl i - C^Lj C^^d non m t b a ' u ^ & l C ^ r / J i - c f c c j A S 6 S & . ....................... 1 KO IE HkTRN __-- . KL S - . T - \ ^ * ^ I ^ S S B S !^ _ _ _ ,, - - - - .-- ___ /$ < & * * * % ', f f e | 00 /> (^ ^ % * \ ^ O / "\ E m p lo y e r s M u t u a ls o i W a u s a m 4 ^ '* > J/ 4, ~*'i-O Sv n q 4 0 4 A G R A N T B U I L D I N G ' S A N F R A N C I S C O , C A L I F O R N I A 9 4 1 0 4 G A R F I E L D } - e 3 B * ^ Z & g Armstrong Cork Company 304 Shaw Road South San Francisco, C alifornia January 6, 1964 Robert 0. Goans v . Armstrong Cork Company, e t al Our f i l e : A27-46462 IAC f i l e : 63 OAK 11052 Gentlemen: Vie have been joined with a number of other employers in a claim by Robert 0. Goans, Social Security No. 559- 2-0- 6873 whose retu rn address i s 4232 25th S tre et, San Francisco, in a claim fo r the in d u stria l disease of pneumonoconiosis. The alleg atio n in th e application i s th a t th e appli cant has been working fo r the various employers lis te d , doing in su latio n work fo r a number of years. The applicant's employers date from 1926 to date. We are concerned with verifying the above applicant's employment with you during our policy period of January 1, 1944 to January 1, 1952. He claims to have worked fo r the Armstrong Cork Company in 1950, as well as in 1954# 1956 and 1957 and other dates not specified. Woul-d you please indicate the periods worked between our policy period of January 1, 1944 and January 1, 1952? Also, indicate the t o t a l wages earned during t h is period of tim e, and th e applicant' s job t i t l e during th a t time. Also, please in d icate the name of the applicant's foreman or immediate super v iso r. Also, give us a b r ie f description of the type o f work he was perform ing fo r you during h is employment with you within the above indicated dates. This m atter i s now set fo r hearing in Oakland on January 29, 1964, and we would appreciate your prompt response to th is request. Thank you fo r your an ticipated cooperation. 0 j E M P L O Y E R S M U T U A L L I A B I L I T Y I N S U R A N C E C O M P A N Y O F W I S C O N S I N E M P L O Y E R S M U T U A L F I R E I N S U R A N C E C O M P A N Y H O M E O F F I C E - W A U S A U . Wt$< A ttached i s n o tic e o f tim e and p la ce o f fu rth er h ea rin g , and order jo in in g p a rties defendent. You w i l l n o te th a t t h is i s t o h e serv ed on h o th Arm strong Cork and Armstrong C ontracting w ith c o p ies b ein g g iv en to T ra v elers and A etna. Only one copy was r e c e iv e d h e r e , e v id e n tly a c tin g a s r e c e ip t f o r b o th th e Cork Company and A rm strong C o n tr a c tin g . DJH FORM 1501 Printed In U.S.A. BEFORE THE HEuJSTtOAL AC0IDI2T C-0IIIS3I0N OF THE STATE OF CALIFORNIA C L IZ IA 63 Oak 11052 R0E5RT 0. GOALS, Applicant, ) V3 LORElir-ZEU Ss COMPANY (and cthex's'j and ARGONAUT INSURANCE COUPART, et i ) E-afendantD NOTICE OF TH-iE AM) PLACE OF FURTHER HEARING NOTICE TO ALL PANTIES You aro hereby notified that Eartncr hearing rill bo hold hi the abora-entitled action at 3000 State Bailins 1111 Tael:eoa Street Oakland, California January 29# 196 4 9i00 A.K. (ALL 2>AY) (Before Witt} `Dated at Oakland, California NTBUSTRIAL A U C H H I T CCPSMYSSXOK i'0i~A C0I3HFJAi:CSS ALL FURTHER HEARN.i f ARE HOFT FAATXO"IOtRlIHi.l'.o i. H U E AI3 ADDRESS OF PERSONS SERALI;; Bates Daaember 12, SEE ^sFFACTf-TED LIST 1 G \'l1 ' FO I t V l-i n *av o IO ?-* P t' p -1 C-i ri o !& TT 4Ci -i i':7 f *4 > l';ri h f-' f- ; - ,v> *<"' P5 C> ^ ?\) i'i3 I; C5 <'7 0.l3 ,i^Un `vi f ) O (" *J fQA *t./ Ci cy *i1 u p t> rc! n rQ? i n10tr> {<.) V Op% rt*;o VH' i UJ|3 P 'i P O r: v* M r,:Xl TOr* Crfl* f,. I ^ rT' !:> 7 f>lfr-N.j ro p M 1- c- l'd 'j P..f4>,t/\Syr h !- c <f- ti.iK l i,) K* . tK.,s<f",,7 HU t.'!1Ut n ; i i-- n *.vrv k -i Ufo i-^ c.* {- n r I^'ji {-.v -< ;.- CaI r ">` n Ci pj -4 P X ' {., Ci* H* T? H* > v v1! f;.* n <'i-** Cl*' rt t'V r+ i-\ *t' r** -% )*i *-T<I-. ;.4, ( V-* --1 1 <'' *v~ -*. V~/ K.l ^^*-' #* --** *-, , ( ^ ') '. O: : p +( *- O*'-ptx <; C`.`*i'rAi iP) ht! K P fi n l <1 :j tk n r- A V>I f * f. ri U-,*5*^ 1%*P ^t'?s rb-> c r*.r s* o ' o ';*. Cc':, dt.* r> f , b., F4 t. l " r. r j*/.l o 'r.' t- * iJi r3'** i**-'** i '"^.' ro m * Fj, 4 n\ ;-.4 !--:.t *3*T>OrC^ O U .-.Ji, c o Pf''* Ci O ! > C &CT ;r ^ Si .3 f-i r> n iUc'i po ! irVJ" I l W fc>"*' K),",*t ^P.f7* >-l c * NV *,V ; ; : r; rc v; *,v :j o p O c: t - > O r^* n f-*^'.- 7 xi ?ir i> \n r i"H> > H* G r'' 0 r' C ,; n j o o < Q : P 'A H' '.i j--* o m C! U p O C' p es o n r* '.l i r t'.? p" C O ; '% <- , 3 o i N* i ;<( ^, 1* **r*O - j H p"7 c; j > :> nM i-* p' r i rn V,s>-*' Vi *;: v-j P O f,7 n f.*-' cl* ri kJ G ' i-I v7 - ; .Uf^t 't f- .r ft V * ( 7?u *. ~ i ''s ** > '* 'P 3 p vo * o P> '.O C-: o r? O t. / y p. f-; ;_> r-n `>-vi O C.! O O c C> f ; r? s S", f*3i .0vV h i r c 'j b O C K *1 r ' .^r O n i* ` ` f. / i ji-y fi3 (. * J, \ r? j t? 2 O 'b il - J i-) , p . o ro C < * S ,*> r j 1. J "* * r *. 1 t-./ e - i h n r- V> ft S-! o j r \ b . i *r-M i f j f/1 . 1 1 , .* ; 1 0 * i'< i-'* i. t '- y '- i *< r*\ >.(.; M c> |ri> J y t' * rW *:5 x * `f J -> '. 3 *, > M J-N ri ^T -O * ;\\ r* H O ' r ' ** i t r' > ;> I J " "< r i rv' '- o t'*-4 -'i l . J * O J l~* CfO ^ Vs A* : \ 7 J: < ;, c-. ,r o t ; U COfc! i V *", R ^ V k , j O o '1 O ' :! l ' ; t;,' r i * P i 7 5 ^ C -j 4 V > i> - j \ n w - 4 1 Wv o t- h-* r j J li j f i' .- U \ * ; , _v ! \ r > / ** --> 7*-', f .. n C "> , - y, t , w% i rx M .X Cl r. f rt iv *w_f f rFt.*F - i"-> r? j T C *7y O T P P) - 5 O ?i o `* o m 'o HP C" f) c i- rV H k r*3 . \ |'y ^v->T T j W,-tJ, i--A' - Ci 4-^ * *J s J o y ^ C \ / y-J '"*7 U t r :.' i- ' \r; V ; , * K r TO U.1 : ; j *. y-*- ,- e y O * <4 f ,5 f V c; f C1 > *>? V. t'V r.^ y '>V**' i^ i . r.v.. - O V .'i * **- f \ s *rl 4- ' J b,, 'v " J t-/ a '# r- :. C ' P : ii o CJ L * * ; Ci' ') > ) v% > 4-j T O b V. < i* 0\ v n -** f ? ` t P <1- D i ! f i f ; i. f-* ` 5 <**' ' P o vo l-r- rv K ci- c i !T n o P ! C' j.,-* *` cP r: j f` X* *i r*.'S% ... 0 vo .0;* r-x y-y v * .!, O /% i "j '"y ** Sf / C J f'.) M w . ! i `-* *" h o ? V t h " H ' S-'* *. " ^J i. "` cr O 1 O f > ./ t \ , ,7 t' o r-* r n f>kj o < > f ; t r ` i .A r; i.; ' -i ?'-> C* C i ' ! t-* fi `" N -) n n n *-? r i +. r*v '-4* t-? v ? >* n* CO ro t . t V 1 * X.. *- Pi CO / v, O J h-j CO i i Pr- CO i -r.- f '> n O i i r;. w c> M ** *\n - c f '* * T 1-4 V * r\ r. C Pi ii' i ' --1 q n -1 . : g \C !. ry W K t- > *** sJ h t p t-.j C 1 c: P < ' >j < \ h 5 ti- CO K V'' ri fJ 'S G > C ;!>' D P ) * O (.: J i 1 -r , (' i - ^ fJ TO r-) n f3 . CC CO \5 *3 TJ r;* p' *" * -h tj; (% l <\ TO b w ci- m rrx *- / c ' O v-/ h ci* b < : ' ~j k -i ' ; - P* fr !3 a rJ O K ' !) n i * rV* <r*i *0 r7 ' * o P Pr? o ' ^ *J* O O w cf t--, d 'f n e '."i1 {-' J s". U * '* i - p W- r- b ,v>M .' ' i*** '- ] TO P H oc !-; Ci V* n> J O : < P 'J Vk K * b - f r f C i: t '1 b {* CI J y t \, i') ; ^ .V u < c c* *.r* - vt P l'ij U V i j %j k > i - 4- ' *7 O ) C7 r.o O y* r*4 en r~ * r o r - - ! * r/> r.o r j o U* iV t'N ' s n `a V v c!' o T* c?- i - - (-' i~r i J M o ro ' en - r? y *z \ * i ' *<i.> 11.J 10 * \ r/> a p* t, i OO rs q " *' r ; ' . { ) \-J /'v a o fl M CO r r i*> r* f 1' i* * ? * VJ > i ( P r* Vi-* )-' -* i O V, * 3 CT $- o w fJ ! H* O C* ; j C> C C f'i t4">. P r S 4 > . * ,, ; ,x - c i - 'i , -i 2 ! *- s. I.f u r.j i * o fi i ; f. i > t.i P t. r.\ 1 O P > G i-,i p 11 O {-* !>l*i > \', P o i; l '' l'1 - '0 J .X */ . - : 4 fp '~ Lf h '. H * . r o; p . V. - * - ' t"' *'1 X. * r * P i.. - i h* * w i 1 \> r - o o T* f 1) ` w\ t j 1 f / N N 4 >' P t-: O n !-X < -i K ri* r - ii i j -, * ' f 1 O H ' fJ t=) P H ?' M R r* ' ' C 0 U? . i -> !- > ut U 7 * C K H -r r i ^ y r ; 1 j.H r; r- t * r * r* y > ' i- -> ' -- y *, * " -. ' r j r *) r . !.. . c b t:> . v C' - n ' ' -;: * V. *< < U:> \+ CT : :J !1-it > . ic-/r TO bn'ij * J-K ' ' T> ` " .J ril Coset Insulation Products, 2336 Saxi ici.on.ando Road, Los Angclcc, Cailiorraa Thc-jaac C. rcuglas, Jr., Douglas Insulating Company, 2233 Ingalls, San. Francisco, California J. It Thorpe u Sons. 1351 Ocean Avenue, Eliar-yrilie, California A n i'.i:ti'o n .g Cojvoraofcias & Supply, o/o Armstrong C o lic , 304 Shaw Road, So. San. Francisco, California national Insulation Inc., 503 folic Street, San Francisco, California j Jacfcacn Kopicxrs Company, Irxe., P.0, box 490, Bakersfield, I! California ICally Asbestos Inc., 2030 Giax-.d Avenue, Kansas City 8, Missouri j AsboVtos Prodncva luo., 710 Ray.acrid Avenue, St. Paul 4, J |>ii M innesota i Asbestos Products & Fabricators Ccr-p., 2316 San Fernando Road, Los Angelec, California Aetna Casualty & Surety Co,, 92-6 J Building, Boors 1318. Sacramento 14, California Employers Mutual Liability Insurance Company of Wisconsin, 114 Sanscsia Street, San. Francisco 4, California Standard Accident insurance C-cnpany, 433 .Califorrsia, San Francisco, California Industrial Indesinity Company, 350 S&nsoma, San Francisco, California United Spates Fidelity cc Guarantee Co., 444 California St., f1 San Francisco, CallfcrrMa Employers Liability Assurance i-orporation, Ltd,, 1050 Russ Building, San Fran cicco 4, CA liform'a Firemanfs Fuad Insiranos Company, 330 IJth Street, Calsiand 12, Califernia State* Ccr-pezuation Insurance" Fuiq, Personal Service Travelers Insurance Company. 1556 Ivebater Street, Oakland 12, California Aianricc-n Motcristo Insurance Company, 417 Montgomery Street, San Bruneiaco 4, California American Employers" Insurance Company, Zurich General Accident, 417 Montgomery Street, San Francisco, California Industrial Indemnity Exchange, 350 Sar.3cr.-~, San Franti:co, California Associated Indemnity Corporati co, 332 Rine, San Francisco, California California Casualty Iscemi*!iy Exchange , 550 Iloamy Street, San Francisco c, da iforola Pacific Employers In.aurar.-ce Company. ?44 Pire Street, San Francieco 4, California Zenith Rational Insurance C,,,, 3$2 -..a:. ;e : Street, Sen 7 raneas co. Cali fornir - "> ' Argonaut Insurance- Exchange, 552 Calliornic Street, San Francisco. California CO OI i i 1 BEFORE THE UJEOSTRIAL ACCIDENT COMMISSION OF THE STAIT! OF CALIFORHI 2 CLAIM 63 Oal: 11052 3 ROBERT 00 GOANS, } 4 Applicant, ORDER JOINING PARTIES EEFEUBAIiT 5 vs. ) . 6 LOREIiTZEH 3 COMPANY and ARGONAUT IESURAHCE COMPANY, et al, Da .tenda n t s , On 9 GOOD CAUSE APPEARH-IG THEREFOR; 10 IT IS HEREBY ORDERED that the follcnlrs parties be, and 11 they hereby are joined as parties defendant in the above entitled 12 cause; WESTERN ASBESTOS, MOHBET CORK COMPANY. FLAIIT RUBBER 3 13 ASBESTOS WORKS, PLATT ASBESTOS COMPANY, ARMY PORT CONTRACTORS* 14 VAN ARSLANS KARRIS LUMBER CO,. EAT CITIES ASBESTOS CO,, LTD,, 15 EARLY A. DUTTON, JR,, C,, F. ERABN cs COMPANY, ASBESTOS COMPART OF 16 CALIFORNIA, JOHNS MAHSVILLE SALES COR?.. MARINE EHGBJEEREiG & 17 n n A n K D k s in v n n f t u riT O T ir / .m r o w o ! TSTX,siliVAL IL L L iF IX r E ioS A i'C ar AOSOCTAPEI) e e s s e 2 cok?oiuxi?j:o6 s C A L xroiiilA x>mn-n.mrz exchahge, PACIFIC EsfEMKEnS HTSOPJI-.'CE COKFAHY, SA33EFH HASI01TAL 4 INSBAEOE CO* 5 6 // n 7 / / (7 . fejfnXi S, 7117, ?. na^stPiAL aocxteiit e o m z s s x Q U 9 FIEED AI" SER O Ts (Jvh) 10 R o b e rt 0 , G onna, 4 2 3 2 23>th S t r e e t , San .s a n c is c o , C a l i f o r n i a Siale:*, P a r lis i? ., Paducic sn<3 C la iic y , 33.5 F i n a n c i a l Cento:? 13, B u i l d i n g , 0 f r i e n d 12., C a l i f o r n i a l o r a c t s a n & C o ., 1153 51*- S t r e e t . O a h la n d , C a l i f o r n i a 12 W a rrc n H e B lo y , <3/0 H i t r i c r e i X ncu.latn.on C crspany, 503 P o li: S t r e e t , San 2ter.nei.30o, Coalfooor a 3-9 Argonauta jj/r.r.ranoe C v x ? p & 550 Halifernia Sfc., San Frane!e c o . itilllo rric 14 H anna A; jav ep h y , .1560 San, l a , I l o Atc. . , C a ld a n i 1 2 , C a l i f o r n i a J . L a trio k oem tin, 41 S u t t e r , San F ra n c is c o 4 , C a lif o i- iia 15 F , E. C a rie : ne, e /o A ro ric o n H o to r is tc n ic u ra n c o C crr-an t, 4X7 liontgorery Street, Sii Francisco 4, California 16 W est 227; A s b o s t o s , ? . 0 . Boa: 3784,, E in c c n A lm e::, S a n F r a n c i a c o , C alifo rn ia X? K rn a e a Oc-ri: O o isp an j, 43.0 l a l b c r t S t r e e t , S a n F r a n c i s c o , G a li:? , PXcafc Rubbe." & A t b e s t e a 'x t -Iid, Xj CO 6 4 t h S t r e e t , C a l d a n i , 19 C*il T^L*^ * F lc .n t A sfe& stos Oonrosv^v, 1 3 0 0 6 4 t h S t r e e t , B b i e r g r i l l e 0 , C e l l i . 1? A rr^ F o r t C o n tr a e te :* 0. IG C l B a r i t i n a S t r e e t , C a ld a n a , J d i i "e r n i a l a n A r e n a lo Wa"::3.s X rv b e v C o ., j j t h a n i B ra n n o n S t r e e t &, ZKi Siia F r a n e :- .te e , S a l i i ora 3 a B a r 3 i t i c s A n tn o to a d o . , 1 -td . , o oli a n i E a s t 12tr-. frtrsc .'.;, r .* . !! G a tf.c a d , l - a X i f o r a i n E a r r p A- I l f 't o n , <7:-*., l i t x A nb^r.bon C cn p an :?. 5 3 2 F a to r i S t r e e t 2 San Fr.-sncinco, C a lli or: d u H C, F , E . m f*. Ooripaa r , L i t e S e n t a 'troncr-t i - 'c n v r , A i t a r t r e . , C alifo rn ia A s b e s to :; C crraanF o f Co l i f e - r - i r - c l i t i l i S i r e s in Sai: r i - m : i o 00 7 c/; C alifo rn ia" Iiarnr.'r i l l - o S a lt.? `J e e jp ,, F .O . I r : 3 7 8 4 , B in o c u A n -n r:, 23 S o r Frxnct.ceo,: G allio :.: .a I n v i n e 3 f t i i r e r i n g 1; S a r a r C o ., 57". o a a t l i t i S i . , L ee iii; v a - l 23 Ca i n i : te n ie A m t t r e n a i'.v.nl:, *3,04 S t a : l o : . ! , ;l? . ;3ov I r a ; : c i a o ; - , C a 'l i v n n v r 27 n . il. C o n ;p o rta r, 3*.'*? X.>*.:!: n n ' ;, S acra rao r.t-a, C n ;.ir-rr:o :a Con j j n : i . a t : o : : o , , d r ; S "' t v n v 3 n r v a r a n t e 11', G a li f o n . La 26 i d b a r g i n e 0 I f c i n a r n ; 1; Go.: ' I g . FILO X 7 th S t r e e t , S an F r : - c i e c o C alli f-rri:: 29 Ctfens C a re n a ; a lb a n a ::m :- C o i r - 3 X t O l ? t h S t r e e t , San F ra i:c ic c e , C cilif-vrnl:. 30 C h a r le s A ^ ro s C c n o a n ', 048 l i l a n t o c - n S t r e e t , San T r a n c ia n o . C alfi.ro.ia. _i \ i , > v i Ji - ' - - Vr.*M* \i n f''' u v r ^ ' i v ' `'T k i^ ie * * * i:>oi , vT| ~;\ 70 U >} A -l J v 9 . s t - .r . `r -- - w- s 'J 'v , VA UT CU V ) i - - --r ---- V f - -- r --- - : ~ r r * - -- - :, ; _r ,, '* ' _ _ o . i l > s r - , r 1 * - X.M ' '* r" * J :j r) - f- J l-. -- 1 . U .i 4.- r tA . i / > < ' * i -i'; . --- i 7 -V ^ *`- 7 D a r * *1 t} \ ; ; o ey i - o , . V. v : ' t p ; ' ;- . t Ua . c\ ^ . * r ) * Mn m o T> . ; , f . , a C ; v *> ^; ; i. j r \ .* ' |A / r p' ' <O i r f r*1 d / M i I-* A -i rT 1* ' Ml ! #_1 t 0} -! ''7*' * . *-;* X * t '" 4 . / l r\ V ' f -% X ; ; \J . W1 s i ;vi t*> n M co UJ i j i -} *. !' f ,i . i p * -, J. ; ,.r u H 1t- .' >,, j L > V. P o r;s->vV) ;o-. j- Pc , r->s .J l\-* /''> r% Vt>. C>',>Ct rCi* tp.s uP Wrr*< h J , --N ' /* ' s, < * * 'ts l r' ) .->-'';?-','-;;*-'</:>.*-'tf noo;-fj; kW*-TV**' P***V''*1}l_/!'-7!P~>'t '-<J". ?PCr-\> J f*;.' tr->ij 7\ J* *.11) -- v--*' lK'**- i-- f. r .- 1 r-. h * i- n CJ cv P f i i-> h u c ~* * r` r : Li o /' f y - * s ` \ >> , - J -, r ' v) i**- j ` f,i *' : -/ H I V -1 P * Uj n r- 7 * * f : ' "1 w ) * H * r r L \ [V ., { . V * P H -J l ' t C 5 ,. *7 t ' * > - - - ' . ' T s' ; - o r , 1 '% \ .' -- ri A 0 ,l `, * .' : "v , f ) " **. 7 i r. -0 i 4v . ;j V i l i 'i lt - . 'n k -> -4 pj . - ' .*, f O V > b ' fil o \ ,j: ;s i-*0 e , f ; j ;- fi h j ty , :... ' .. s* r ri s -* ; v 5 C rt r r 4 f \ n o V* t - t . . *T* M r r * ^ ; s /* * ' ' - p ' i r . - < k *" ? r - i 1 lr * J r i * " e ? f*S $ H U . ' *' -< < -% a > r > -- U i'- i . , % M r>*. *-< * * ' M f i . ^ r ~ / > V--* s. . , 0 H i p -- ' p d r * I C* C i* ^ , t : i P r > k P tk w a ' r. re ri O A n (*i /~: * "i* - r- {- j ; '- V } , , # , , , b " !* * * -s '- J - 3 '* ; ; p * * - \ ** . - ' \ > i? i "> is- r * c! i -i ' * ~ - i ) V f vi V t ,;i V. li. ?> c i' . * i" " * -* i r O V * v 'i ! . . % f H. * . . . ' ;~ H -` * " P 7s^/ * r : i r b ^ 7 ^ ' i " l *4` > ' J re ^ * o v ; :, r."> r / `w ' . **! ` '* "L 'J C : O r_ C * H (.> r". : h r * . .. C i' 'J H i` i ir * o 'V P ' " / *' 1 ! 5 i' ' '> -.J o 6 < A t-' ri ( .* - !* * i * t-A o r i ; T v \f< i^3 r . r i .1 r- e v' ; JM. ^ ~ v J J * 0 '* r * '* V/ H| w i t ; c i'3 ( l) * ri' 1 '1 r.J , H O p f->i V* r J. ( j J 1 --V 'j J o r**, i .r,* V w * < ^ i*"7<J *- ,v f .i o i / *- Hi v v r * O - s X.* P i o -Z{* CVV:* lwi** oiql Ob" ,**V1 ) f'i C2 s 2 u O j-i Ti r' oP P O ri t ' /-* P C3 sO > ' , t v .: t ; |.j O c i* VM p lo* l>.* U 'J l l i 0 t.. r .\ \'J \*i4 C-. o n VJ?:.J rr 1 b ka - < i tJ !J ^P i 1- J kA 1 -'* l *- i <> o i-**! t ! P n , J 'c ! C r-- j . a f -i fi w p o ; cf o CO O O :j H ,, ( ? h f p P* u M cn f <"l> C j o rJ P -" * 1 j i ( * *j? -* > ,r_- ci* ' i ; t r .. -. h*"* \ S / \ / < f'v U .I * r ^ - J- W sJ 7 L i.w ---- . w ; .; ' ] ' P ^r w-> *7 1 * i,,"J e * ' i ' l" r : t> v J ' 1> ; CO O C j :L tO 0 > j'3 ^ V t (T> J... 'g ri ` } b* p e ^ - u P *7 o s s * o w za H ~ fT C i- P-> P 1 * J j.'/ ^ ,n w ,.'. V i ili IU V? p u i l; U1 H P V? lo r 1 (* P. w' r cv >>* : - -f ' Tj r r . * ; L . 1; 't* i ' 4 r* ' r. <\ *" . '- r J Vy f , o , . r 1 r; 9?i - ;K r* ' LJ ,, <n v'-* C 5 -s - - * n t- ^ .i 7 -~l # 1 V J r> O Lo ' ! 1 rt m r*>v'i -/~t O 1 > r-> :*t \ ! ? j ;' <** '1 uy ' >k * j* i */ j Lv C2 P r> f-i r o V/ O '5 r A L> <. t tw r * ri c r-> - v^` p: rj ~ f-, M cr ;- i % j * .( *v^ . * *S-~ .7 / . '\ r a n -* X* 3 i-- !* OT c> V* rr Fi *:7r M P i , . * 1 i ,** P i o 'p p ! r* u : *. . C . 4 -~s O I'* - p* P ' > * ) K * [1 i s p '/ p r Va i j X O -! t * o b H (r> V -U !-- C 'i o * ' t ,i ' " o j *i r 'i % J i * O j 5 * }"< i* 't rr , ^* fi r -- * ' * j ;j r H, fN-- / V \, V* ' J-r 's,-, t O -o J * ,} J~0* (.) i~ > C u t er N ! * \o 0 r - i ; o r. rr i-, Pj rs p Cq V t-* ; ; i O V' * rl f ) i-* ` i\- . >-* P 1 1- o 't V> V* V* t- -i % *' 0 r) r> '* : r* <j U P i (V i o n C i '. > rv> .t -P -H LO < * 1 >\ ,i. ' u rt j. c. : , .1 r ,* - i KJJ V ri I * 'tA `j i r e >- ' 7* O w \ 3 C' i* k rN*' ' [ ' * *' - *< o i p M r_i C* Li* r* *A l - `v ' * * ' s , l J il rA  r STATE OF CALIFORNIA ui IN D U ST R IA L A C C ID E N T COMMISSION FILED MAY 4U 1903 APPLICATION t F !U SIGNED ORIGINAL AND SIX COPIES mm pbjht o tm urn m m sss) Oakland Office CASE NO. 61 c ' . r /< ROBERT 0. GOANS applica iit - 4232 -- 25th Street APPUCAMT * A O D ttM San Francisco, California vs. LORENTZEN & CO. (and others) Social Security No. ....................... 1155 - 5th Street KinoTiri Atomi Oakland, California ARGONAUT INSURANCE CO. i s p L o r t i s h sv iia m c i C A Stif _55Q__Cal3X2CIlL.a_fiJirejLt____________ IM U IA IC I C A X SIC tf A l t l l U San Francisco. California_______ 1. .JRobert 0. Goans r a si er lin o n i , 9/2/00 M n er u m alleges that while employed on A P T 1 3 j ______ 1 9 .-,i? 3 DATI o r IMJUSY . asbestog worker and/ lnsula.^ion mover______ Various places_____ t California, by oceorATM R at n Of iR Jfitr citt. tow s o i r u e t s s i a c iim viy a c c e s s e s Various t u n o r u n i r t i -------, -- be sustained injury arising out of and in the course of the employment, as follows: doing insulation work for many years pneumonochoniosis t x r u i* row iK ju rr was b ic i iv i * ..resulting in s t a t i w is t p a r t a r boot v i ir j o r ib so s u r b iib t r t r is b i.tr 2. Various was the employer's insurance carrier on date of injury. 3. April 3s 1963 to present a im o r ttr e o iA n c t u i t a i t o . *r u p v y i s a mot t***. r tA T t w m i t h i s t L P - i w s s s t ok u k m i i c i u K i w H e rr m i et to twk M Jrr B A TI IS JV S ID S IT V S K C B TO V O IK I A T I LAST I t DICA I P U S H IS * 4. V ia compensation paid?___ 5 ? .___________ %----- T IIM M $ -- V f f K L T M TC IA T I o r LAST P STITIIT . ,, ... . Maximum - ) . E a r a i c g s a t t a m e o f o j u rj $ _____________________________( _ boots osnvc The baeis of pay waa___ S T A T I RAT M IM BR MOB B IT RA T I , M OVtt A BAT ARB D i n 1 W SIA 4. V ia medical treatm ent needed?. Yes YSTso furnished treatm ent?. Seif m R A M I! o r BOCTORt WWS T I C A T t TUR r J 5 T AIO STATI W* 0 BAI T B I 1R 11IX I 7. Tbis application k filsd to dccennine liabiiity for: a. Tem pcrary diaabihty . r a m so e. Lrrigation expenas_________ TTT o c s e b. Perm anfnt disabili ty __XJ? c. Medicai treatm ent___ X rat i n tts or so d. Medicai costa___________ t iih n f . _______________________________________________________________________________________ BTATB ART B TH iB K A S 0 1 u r r c u t mb u n s cefi a r a k t * t p i i A rru r* T io * < a r iu so WHEREFORE, U it respusitJ tbet / **d piace br fired fo r hterin i t n i that a awtrd br m *Jt grsw/sng such relief s n u y ht proper nnirr t!?e W crkeu n 't Con^pexsHcK Ia x 'S of Celifornii. Dated a t___ O JLK iiLQ . _____ 1 C eiifcri i 6 . 1 Q 6 3 ............ .... RATI H earing re-rirertad a t____Q f i . p j j ______ .( / N um ber of w it* * * ______________________ ____________ _ ***ue" ' ," " TM* EatsMted time o f trial_____ l Z 2 _ ______ _____________ . . tea-- l i: , P A R R I S H , P A D K C ff Se. fTLAMHV A rrucA o r s ATTeufcr 315 Financial Center Building ___ Qakl&&lJL2.a C a lifo rn ia ________ A T T o e s i r s j a b i y m a s s T I L I P i e t t V I S U Giencourt 2-2000 ****Cf V ' I - T -i-E E t* S * iM r '1 BALTIMORE NEW YORK CLARKSBURG TULSA ST. LOUIS CHICAGO LOS ANGELES ATLANTA PITTSBURGH SAN FRANCISCO NEW ORLEANS MIAMI PHILADELPHIA A l e x a n d e r & A i X A ^ rim E a * INCORPORATED INSURANCE AVERAGE ADJUSTERS CONSULTING ACTUARIES 2 2 2 5 NORTH CHARLES STREET, BALTI MORE 18, MD. November 4 th , 1963 TELEPHONE TUXEDO 9-4304 BELL SYSTEM TELETYPE BA 582 CABLE ADDRESS "ALEXBLUE" Mr. W allace B . H o ffe r th A s s is ta n t G eneral Manager Insurance Department A rm strong Cork Company L ancaster, P ennsylvania Dear Mr. H o ffe r th : Workmen's C om pensation r e : R ob ert 0 . Goans P o l i c y RUB 7226992 ARMSTRONG CORK COMPANY R eferring to previou s correspondence w ith you in co n n ectio n w ith th e above c a se , we a tta c h h ereto copy o f l e t t e r dated O ctober 28th w hich we r e c e iv e d from th e Oakland, C a lifo r n ia O ffic e o f th e T ra v elers In su ra n ce Company, fo r th e c o m p le tio n o f you r f i l e . When we h a v e a f u r t h e r r e p o r t , t h e in fo r m a tio n w ill be passed on to you. S in cerely ALEXANDER & ALEXANDER, INC. GENERAL ADJUSTER R HOME OFFICE AT HARTFORD, CONNECTICUT THE TRAVELERS INSURANCE COMPANY THE TRAVELERS INDEMNITY COMPANY r October 2 8 , 1963 Alexander & Alexander 2255 North Charles Street A d d r e s s a ll re p lie s to: Claim Department, The Traveler* 1956 Webster Street, Oakland 12, Calif. u Baltimore 18, M . Attn: Mr. FinlayGeneral Adjuster ona r e t e r /a 2-585651 \ I Armstrong Cork Co. & Re: Robert Goans ^ d/a 11-22-5? ecykj &' C'o. Gentlemen: Please be advised that we have received the amended application the *" above captioned claim and are protecting your insureds interests., . A Hearing was held 9-16-63 but little was accomplished and the matter will be reset for further hearing. WJS:ces Compensation Adjuster * * NEW YORK ATLANTA BALTIMORE CHICAGO CLARKSBURG LOS ANGELES MIAMI MONTREAL NEWARK NEW ORLEANS PHILADELPHIA PITTSBURGH SAN FRANCISCO ST. LOUIS TORONTO TULSA Si AXJSXANINBR INCORPORATED INSURANCE AVERAGE ADJUSTERS CONSULTING ACTUARIES 2 2 2 5 NORTH CHARLES STREET, BALTI MORE 13, MD. TELEPHONE TUXEDO 9-4304 CABLE ADDRESS "ALEXBLUE" August 2 3, 1963 Mr. W allace B. H o ffe r th , G eneral Manager Insurance Department A rm strong Cork Company L an caster, P ennsylvania A ssistan t __. ,t ^ .___ r e : T r a v e l e r s ' P o l i c y : RUB 7226 9 9 2 Workmen's C om pensation r e ; __ R o b e r t 0 . Goans _____ D ear Mr. H o ffe r th : T his w i l l acknow ledge your l e t t e r o f August 22nd e n c lo sin g Amended A p p lic a tio n f o r Workmen's C om pensation C laim and l e t t e r from a tto r n e y s, Sm ith, P a rrish , Paduck & C lancy dated August 8th in con n ection w ith the captioned ca se. We h a v e fo rw a r d e d t h e s e docu m en ts t o th e O ak lan d , C a l i f o r n i a o f f i c e o f th e T r a v e le r s In su r a n c e Company f o r a t t e n t io n and p r o t e c t io n o f y o u r i n t e r e s t s . We s h a l l a d v i s e you o f d e v e lo p m e n ts i n t h i s c a s e . Yours very tr u ly , ALEXANDER & ALEXANDER, INC. GENERAL ADJUSTER sjm ) August 22, 1963 G Mr. G. H. Finlay Alexander & Alexander, Inc. 2225 North Charles Street Baltimore 18, Maryland Dear Mr. Finlayx Subject: Robert 0. Goans vs Lorentzen & Company and Argonaut Insurance Company and others Case No. 63 OAK 11052 A hearing on the amended A pplication o f Robert 0. Goans i s scheduled before the C alifornia In d u strial Accident Commission on September 16, 19^3, in Room 3000 o f the S tate B uilding, 1111 Jackson S tr ee t, Oakland, a t 9 A.M. Both Armstrong and Armstrong Contracting and Supply Corporation are named in the Application. Mr. Goans vas employed by Armstrong Cork Company for a period prior to March 31, 1955, from June 21, 1955 to November 2, 1955, and from October 21, 1957 to November 22, 1951 We say "fear a period of time" prior to March 31, 1955, because ve are unable to determine Just hov long due to the records being destroyed in accordance with our established retention of records schedule. Even though ve have the employment dates for 1955, the records shoving therages earned during 1955 have been destroyed. Mr. Goans vas in the employ o f our su b sid iary, Armstrong Contracting and Supply Corporation from October 1 , 1958, to December 23, 1958* Please forward t h is amended A pplication fo r Workmen's Compensation Claim to the proper o f f ic e o f The Travelers for- handling and p rotection o f our in t e r e s t s . Very tru ly yours SLK Enclosure Wallace B. Hofferth A ssista n t General Manager Insurance Department 1 tltTt OFFF!/ 1MUIIICATI0N To J . E . Z e l l e r , L a n c a s t e r From A. L . S t o k e l y , San F r a n c is c o Subjeef Robert 0 . Goans I n d u s tr ia l A c cid en t Com m ission C ase N o. 6 3 '.OAK 1 1 0 5 2 ( A V m s t r o n g cCoOrvN T R A C T I N G August 13, 193 1 r A ttack ed a re amended a p p lic a tio n s fo r th e su b je c t c a s e , c o v e r in g b o th Armstrong Cork Company and A rm strong C o n tr a c tin g & S u p p ly C o r p o r a tio n . You w i l l n o te t h a t b o th th e T r a v e le r s and A etna have a ls o b een se r v e d w ith th e s e papers. DJM M C * Z C iS \ S - 3 / - <s~s~ A /-/.S7 - //-jj-r7 A /* !- % /a-i3 . -rt FORM 1501 P r in t s In U.S.A. 5 5 S S -?~ / *-C .?7 3 EPWIN A. LANCY, JR. ROBERT S. JURE ROBERT H. LAWS, JR. C. PAUL PADUCK WM. SHANNON PARRISH JAMES B. SCHNAKE JOSEPH EDWARD SMITH DEAN W. WRIGHT LAW OFFICES OF SMITH, PARRISH, PADUCK & C L A N C Y FINANCIAL. C E N T E R B U ILD IN G 4 0 5 . 14TH STREET O A K L A N D 12, C A L I F O R N I A GLZNCOURT 2 - 2 0 0 0 August 8, 19^3 Industrial Accident Commission 1111 Jackson Street Oakland, California re: Robert 0. Goans vs Lorentzen & Company and Argonaut Insurance Co. 63 OAK 11052 Gentlemen: Enclosed herewith find Amended Application showing additional employers and insurance companies and we would request these parties to be joined and Notice of Hearing be sent out for September 16, 1963* at 9:00 A. M., in Oakland. As stated by the Referee, this will be a pre-trial conference to get the names of the employ ers and employment. With a copy of this letter, I am sending a copy of the Amended Application with a total list of employers and advising that the Hearing is scheduled for September 1 6 , 1963* Room 3000, State Building, 1111 Jackson Street, Oakland, California, at 9:00 A.M. before Referee Witt. Very truly yours, SMITH, PARRISH, PADUCK & CLANCY JES:skm Joseph E. Smith STATE OF CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION APPLICATION FILE SIGNED ORIGINAL AND SIX COPIES (PLEASE PRINT OR TYPE NAMES AND ADDRESSES) CASE NO. 23 & S9C //O c 5 ^ ROBERT 0. GOANS___________________ APPLICANT-- 4232 - 25th Street_______ APPLICANT'S ADORISI San Francisco California vs. LORENTZEN & COMPANY (and others) Social Security N o. 1155 - 5th Street EMPLOYER'S ADDRESS Oakland. California ARGONAUT INSURANCE COMPANY_______ EMPLOYER'S |NSURANCX CARRIER 550 California Street INSURANCE CARRIER'S ADDRESS San Francisco, California Robert 0. Goans NAME OP EMPLOYEE - , __ ,,, alleges th at while employed on DATE OP MIRTH j : --~L DATS OP INJURY .19 63 as a_ asbestos w orkjgr_&_nmilai^ii..iiiQver. Various places OCCUPATION AT T IN I OF INJUN! CITY, TOWN OR PU C E WHERE INJURY OCCURRED California, by .Various. NANI OP INPLOTER __he sustained in jury arising o u t of and in the course o f the em ploym ent, as follows: .doingvlnaulatlori ..work..EorunanyvEfiara__ EXPLAIN HOW INJURY WAS RTCEtVED ^resulting in _____ pne_uraon.Q_ch_Qnlos.i_3_ STATE WHAT PARTS OP SOOT WERE INJURED ANO SUMCOUENT RESULTS 2. _ V a r io u s . .w as the employer's insurance carrier on date o f injury. NANE OP INSURANCE COMPANY OR, IF EMPLOYER WAS NOT INSURED, STATE WHETHER SCLF'lNSURED OR UNINSURED 3____A p r il.3s- 1963._t.CL_prgasnfc. PERIODI OPP WOHN DUI TO T H I INJURY DATI INJUNID RETURNED TO WORK DATI U S T RIDICA!. PURNIRHID 4. Was compensation paid?---- NO. ------- TE5 OR NO $ --- I- WIIKLT RATI DATI OF'LAST PATMINT J. Earnings at tim e of injury $-- M.S-X-l&US----- MONTH OR W i l l The basis o f pay w as. ITA TI PAT PERIOD OR HOURLT T I , HOURS A DAT AND DATS A W i l l 6. Was medical treatm ent needed?__ Y .6S_________ Who furnished treatm ent?------- RIVI NA NIS OF DOCTORS WHO TREATED TN I INJURT ARO STATI WHO PAID THEIR SILLS 7. This application is filed to determ ine liability for: -rt- a. Tem porary disability_JYiL3 e. Litigation expense. T IS ON NO b. Permanent disability-- Y SS. TES OR NO f. c. Medical treatm ent-- YSJJ-- STATI ANT OTHER RIASON d. Medical costs. 8. LIST CASE N U N B IIS OF ANT OTHER APPLICATIONS PILED W H E REFO RE, it is requested that a time and place be fixed for hearing and that an award be made granting such relief as may be proper under the Workmen's Compensation Laws of California. Dated st Oakland __________, C alifornia,____ A U J g U g ^ jB , . 13.6.3____ CITT OATE H earing requested at__ Q j k l & n d N um ber of witnesses. Estim ated time of triaLD D 6.~fociI X _ S V . /s/ Robert 0, Goans APPLICANT'S SIS NATURE SMITH, PARRISH, PADUCK & CLANCY 315 Financial Center Building APPLICANT' ATTORNEY Oakland 12, California GLencourt 2-2000 ATTORNET-S ADDRESS AND TELEPHONE NU NSEI NOTE-- P L , . . . 1 . . . . . O F c i r r N . A . I N , D . . . . . . . CAM WILL > M 7 AO. CITT 0. ,, ,, ,, ,, ,, (ITT. IF A O M I.ll, A N . AN IT IN A T , OA T H . T IN , I I W I I D AON H I M I N . > 0 A N A L . T I N , CAN I , A L L O W ,. TO C O N A L .T , C A M W ITNOOT A C O N T IN .A N C t, ,, ,, ,, 0P W I T ..,.., , , , ........... I T , , , , , M A ,C T ,0 ,0 ,, C A L L , T IO . N O T E -- U N O ., T N , A .O T ..IO H . OA T H , C O N A .N .A T .O N , N , l i n A IL L .O P U T . ANO ,IO N ,0 M A A A LIC A N T IT N U .T M A IL IO W ITH O , OA T H , T I N , AND A L A C , OA N I A . I - O , E lT N M A A .T T N A T ,, M A M M N T , . ,, ,, 0 S .A .T T LA -- , T N . A A A I,C A N T O .LT M A T , T N , . ,, ,, . I , N A IL IO TO T H , N l A . , 1 T O A r iC , OA 1 H , I N . . . T . I A L A C C IO .N T C O N H IM IO N ,, 0T H .. ' A C C IO ,,, C O N R IM IO . O , T N , C L A IR IN C O N T .O M ..T W .ThL , I . . . V i . W ITHOUT O .L A T , DU, N O T , W ILL ................. A A IICA T H ,, ,A ,T ,, . . C P B U 3 J IRCV. s.e t! EMPLOYERS 1. Western Asbestos P.O. Box 3784 Rincon Annex San Francisco, California 2. Mundet Cork Company 410 Talbert Street San Francisco, California 3. Plant Rubber & Asbestos Works 1300 - 64th Street Oakland, California 4. Plant Asbestos Company 1300 - 64th Street Emeryville 8, California 5. Army Port Contractos 1501 Maritime Street Oakland, California 6 . Van Arsdale Harris Lumber Co. 5th and Brannan Streets San Francisco, California 7. Bay Cities Asbestos Co., Ltd. 6th and East 12th Street Oakland, California 8 . Harry A. Dutton, Jr., Dutton Asbestos Company 532 Natoma Street San Francisco, California 9. C. F. Braun & Company 1000 South Fremont Avenue Alhambra, California 10. Asbestos Company of California 941 - 16th Street San Francisco 7, California 11. John Mansville Sales Corp. P.O. Box 3784 Rincon Annex San Francisco, California 12. Marine Engineering & Supply Co. 941 East 12th Street Los Angeles, California 13. Armstrong Cork 304 Shaw Road So. San' Francisco, California l4.*M. R. Carpenter 907 Front Street Sacramento, California 15. Caw Insulations 36OO - 20th Avenue Sacramento 17, California 16. Fiberglass Engineering & Supply 1200 - 17th Street San Francisco, California 17 Owens Corning Fiberglass Corp. 1200 - 17th Street San Francisco, California PERIODS 1926-1943, 1946-1950, 1955- 1963 and others 1937, 1939, 1940, 1941, 1962 and others 1941-1944 and others 1957, 1959, I960 and others 1941 and 1942 and others 1942 and others 1944-1946 and others 1941, 1954 and others 1938 and others 1944 and 1945 and others 1949 and 1950 and others 1938, 1950 1950, 1954, 1955, 1957, and others 1950-1953, 1959, 1962 and others 1950, 1961 and 1962 and others 1953, 1954 and others 1955-1957, 1961, 1962 and others (1) EMPLOYERS PERIODS 18. Charles Ayres Company 698 Minnesota Street San Francisco, California 1955, 1957-1959 and others 19. Coast Insulation Products 2316 San Fernando Road Los Angeles 65, California 20. Thomas C. Douglas, Jr. Douglas Insulating Company 2233 Ingalls San Francisco, California 1958 and others 1956 and others 21. J.T. Thorpe & Sons 1351 Ocean Avenue . Emeryville, California 1959, I960, 1957 and others 22. Armstrong Contracting & Supply c/o Armstrong Cork 304 Shaw Road So. San Francisco, California 2 3 . National Insulation Inc. 503 Polk Street San Francisco, California 1958 and others 1962 and others 24. Lorentzen Company 1155 " 5th Street Oakland, California 1955, 1962 and others 25. Jackson Hopkins Company, Inc. P.0. Box 490 Bakersfield, California 1957 and others 26. Kelly Asbestos Inc. 2030 Grand Avenue Kansas City 8, Mo. 1949 and others 27. Asbestos Products Inc. 710 Raymond Avenue St. Paul 4, Minnesota 1949 and others INSURANCE COMPANIES State Compensation Insurance Fund, 525 Golden Gate Avenue San Francisco, California Industrial Indemnity, 300 Grand Avenue, Oakland, California Aetna Casualty Insurance Company, 1330 Broadway, Oakland, California Travelers Insurance Company, 1956 Webster Street, Oakland, California American Motorists, Russ Building, San Francisco, California Argonaut Insurance Company, 550 California Street, San Francisco, California Standard Accident, 433 California Street, San Francisco, Calif American Employers, Russ Building, San Francisco, California Hanna & Brophy, 1540 San Pablo, Oakland, California (PROOF OF SERVICE BY MAIL-1013a, 2015.5 C.C.P.) STATE OF CALIFORNIA) COUNTY OF ALAMEDA ) I am a resident of the United States and a resident of the aforesaid county; I am over the age of eighteen years and not a party to the within above action; my business address is: 315 Financial Center Building, Oakland 12, California On _ AUG 9 4 __ , 1963, I served the within AMENDED APPLICATION on the various parties in said action, by placing a true copy thereof enclosed in a sealed envelope with postage thereon fully prepaid, in the United States post office mail box at Oakland, California, addressed as follows: Western Asbestos, P.0. Box 3784* Rincon Annex, S.F. Calif. Mundet Cork Company, 410 Talbert Street, S.F., Calif. Plant Rubber & Asbestos Works, 1300 - 64th St., Oakland, Calif. Plant Asbestos Company, 1300 - 64th Street, Emeryville 0, Calif. Army Port Contractors, 1501 Maritime Street, Oakland, Calif. Van Arsdale Harris Lumber, 5th and Brannan Sts., S.F., Calif. Bay Cities Asbestos, 6th and East 12th St., Oakland, Calif. Harry A. Dutton, 532 Natoma St., S.F., Calif. C. F. Braun & Co., 1000 So. Fremont Ave., Alhambra, Calif. Asbestos Co, of Calif., 941 - l6th Street, S.F., Calif. John Mansville Sales, P.0. Box 3784, Rincon Annex, S.F., Calif. Marine Engineering, 941 East 12th Street, L.A., Calif. Armstrong Cork, 304 Shaw Road, So. S.F., Calif, M.R. Carpenter, 907 Front Street, Sacto., Calif. Caw Insulations, 3600 - 20th St., Sacto., Calif. Fiberglass Engineering, 1200 - 1 7 th St., S.F., Calif. Owens Corning Fiberglass, 1200 - 1 7 th St., S.F., Calif. Charles Ayes Co., 698 Minnesota St., S.F., Calif. Coast Insulation, 2 316 San Fernando Rd., L.A., Calif. Thomas C. Douglas, Jr., 2233 Ingalls, S.F., Calif. J.T. Thorpe, 1351 Ocean Avenue, Emeryville, Calif. Armstrong Contracting, 304 Shaw Road, So. S.F., Calif. National Insulation Inc., 503 Polk St., S.F., Calif. Lorentzen Co., 1155 - 5th Street, Oakland, Calif. Jackson Hopkins Co., P.0. Box 490, Bakersfield, Calif. Kelly Asbestos Inc., 2030 Grand Avenue, Kansas City 8, Mo. Asbestos Products, 710 Raymond Ave., St. Paul 4, Minn. State Compensation Insurance Fund, 525 Golden1 Gate, S.F., Calif. Industrial Indemnity, 300 Grand Ave., Oakland, Calif. Aetna Casualty Insurance Company, 1330 Broadway, Oakland, Calif. Travelers Insurance Company, 1956 Webster St., Oakland, Calif. American Motorists, Russ Building, S.F., Calif. Argonaut Insurance Company, 550 California St., S.F. Calif. Standard Accident, 433 California St., S.F., Calif. American Employers, Russ Building, S.F., Calif. Hanna & Brophy, 1540 San Pablo, Oakland, Calif. I certify, under penalty of perjury,* that the foregoing is true AUG 9 and correct. Executed on__________________ , 1963* at Oakland, California . /s/ Sharon McKay *The proof of service by mail form, being signed under penalty of perjury, does not require notarization. NEW YORK ATLANTA BALTIMORE' H IC A G CLARKSBURG LOS ANGELES MIAMI MONTREAL NEWARK NEW ORLEANS PHILADELPHIA PITTSBURGH SAN FRANCISCO ST. LOUIS TORONTO TULSA Alexander Alexande INCORPORATED / INSURANCE T AVERAGE ADJUSTERS CONSULTING ACTUARIES 2 2 2 5 N O R T H C H A R L E S S T R E E T , B A L T I M O R E I S , MD. December 23rd , Insurance Department A rm stron g Cork Company L an caster, Pennsylvania 1964 ic J TELEPHONE TUXEDO 9-4304 CABLE ADDRESS "ALEXBLUE" T r a v e le r s * P o l i c y No. RUB 6 4 8 3 8 1 4  NEW YORK ATLANTA BALTIMORE' H IC A G CLARKSBURG LOS ANGELES MIAMI MONTREAL NEWARK A lexander A lexander INCORPORATED / INSURANCE / AVERAGE ADJUSTERS CONSULTING ACTUARIES N EW ORLEANS PHILADELPHIA PITTSBURGH SAN FRANCISCO ST. LOUIS TORONTO 2 2 2 5 N O R T H C H A R LE S STREET, BA LTIM ORE IS, MD. TU LSA December 23rd, Insurance Department A rm strong Cork Company L an caster, Pennsylvania 1964 G entlem en:- T r a v e l e r s ' P o l i c y No. - RUB 6 4 8 3 8 1 4 TELEPHONE TUXEDO 9-4304 CABLE ADDRESS "ALEXBLUE" Very tru ly yours I n d ic a te Whether: Workmen' s C om pensation Auto L ia b ilit y - B . I . P.D. [ General L ia b ility - B. I., P. D." ROBERT 0. GOANS v. LORENTZEN i CO., LTD., and ARGONAUT INS. CO., et al MELVIN S. WITT, Referee August 3 1964 Claim OAK 11052 Inj: 4-3-63 REPORT OF REFEREE ON ORDER APPROVING COMPROMISE AND RELEASE Parties have submitted a Compromise and Release of $6750.00, which is adequate on the record and is being approved payable to ap plicant forthwith, less $309.40 payable to Department of Employment in satisfaction of its lien claim, $300.00 to Smith, Parrish, Paduck & Clancy for living expenses advanced, and $750.00 attorney fee. MELVIN S. WITT, Referee M S W :amm * \ 1 P] 0 r-t 'Di'GTRIAL ACCIDENT COMMISSION OF THE STATE CF CALIFORNIA CASE NO. 63 OAK 11052 3 4 U EG3EET 0. GOANS, ) ORDER APPROVING - COMPROMISE AND RELEASE 6 Applicant, \ 7 v. j 8 LOREHTZEN & CO., et al, j and ARGONAUT INSURANCE ) 9 COMPANY, et al, ) 10 Defendants. ) ______________________________ l 11 12 13 The parties to the above entitled action having filed - 14 a Compromise and Release herein, on July 29, 196*1, settling the 15 above case for $6750.00, in addition to all sums which may have 16 been paid previously, and requesting that it be approved; and 17 this Commission having considered the entire record, including 18 said Compromise and Release, now finds that it should be ap IS proved; and, 20 GOOD CAUSE APPEARING THEREFOR, 21 IT IS ORDERED that said Compromise and Release be, and 22 it is hereby approved, payable as follows; To applicant, in one 23 lump sum, as follows: 24 $800.00 payable by Aetna Casualty & Surety do., on behalf of Mundet Cork Co.,- Fiberglass Eng 25 ineering and Supply Co., and Owens-Illinois Fiberglass Co.; 26 25*00 payable by Zenith National Insurance Co., 27 on behalf of Jackson-Kopkins Co.; 28 75*00 payable by Employers Liability Assurance Co., Ltd., on behalf .of National Insulation, Inc.; 29 30 i 9M 1 f $ 7 5 .0 0 payable by U nited S ta te s F id e lit y & 1 Guaranty C o., 2 5 0 .0 0 p a y a b le by R oyal In d em n ity Company; 3 1 2 5 .0 0 payable by C a lifo r n ia C asu alty Indem nity Exchange; 4 1 2 5 .0 0 p a y a b le by A rgonaut In su r a n c e Company; 5 6 5 7 5 .0 0 p a y a b le by I n d u s t r ia l In d em n ity Company; 7 1700 .0 0 payab le by P a c ific Em ployers In su ran ce 8 Company; 9 2 8 5 0 .0 0 payable by S ta te Com pensation Insurance Fund, l e s s t h e sum o f $ 7 5 0 .0 0 p a y a b le t o 10 Sm ith, P a rrish , Paduck & C lancy as a t t o r n e y f e e , l e s s t h e sum o f $ 300.00 p a y 11 a b le to Sm ith, P a rrish , Paduck & Clancy fo r liv in g expenses advanced a p p lica n t, 12 and l e s s t h e sum o f $ 3 0 9 .4 0 p a y a b le t o S ta te o f C a lif o r n ia , D epartm ent o f Employ 13 m ent, in s a t is f a c t io n o f lie n cla im . 14 15 INDUSTRIAL ACCIDENT COMMISSION 16 17 18 19 20 AUG U 1964 21 -_______ __________________ S e r v i c e upon (b y A . M a r tin ): A ll p a r t ie s shown on O f f ic ia l A ddress R ecord. 22 23 24 Signature o f person serv in g order 25 26 27 (SEAL) 28 29 63 Oak IIO 52 MSW: amm 30 2. OM BEFORE T-2 'T n r I , '. - / r f i - A k * l. accident corrrssioii or rr^,ir? A . A4 . U ROBERT 0 . GOAKS, ) A pplicant, j va. 5 LQREKTZEH & COUPANT* AKD ) ARGONAUT XUSURAKCE COKFAKY, e t a l ; D efendants. j KO, OAK 1 1 0 5 2 KEHUTES OF HEARING (CONTINUED) H5 ORDER DISMISS USO PARTIES IOEFEHDAHTS Place and Tise: Oakland - April 22, 19&'b 9s00 a.sa, Referee; Reporter: Appearances;: WITT Jordan Applicant presenti represented by Sraith, Parrish, Sadici: & Classy, Attorneys (Joseph 2. SsdLth appearing) A f r i c a n storiata Ins,, Oo., represented by P 0 2, Carlgnsn, Attorney, Employers liability Assurance Corp., Ltd, and Zenith Hatl las Ce, represented by J Patrick Goodwin, Attorney Assoc, I&dsnRlty Cc-rp., and Pacific Ssployers Ins. Co., represented by Mullen & Filippi, Attorneys (Frank J. Filippi appearing) SoCdoFo^ represented by Willies Lotmdfis, Attorney. Argonaut Iiis. Co., Calif. Casualty Indemnity Esch., Royal lacoEsaity Co,,, Unitsd States Fidelity & Guaranty Cc., Standard Accident Ins, C o e, Travelers Ins. Co., and Firessn's Ik m S Ins, Co,, represented by Hanna & Brcphy, Attorneys {Uillien Broadbeek appearing). Aetna. Casualty & Surety Co., represented by Sedgwick, Deters, Movan L Arnold, Attorneys (Theodore Kalderttiilcr appearin'?) . xncoEtrisi Ind&sni Company represented by H 0 C. lynch, Attorney= A f r i c a n Motorists Xftsura' ?W -a* -*nrt V ir'ni 4 ^ s e been in 19**5. the d a i bvpio hags of C S Braun, ,}saving v;U3 in 193$, and 1 c-coD casse APrifmBiC: i-V-V w VViiiv'Kfre'J A/ .Lv .v tV ordered that American Motorists hereby ie dississed as party defendant. GOOD CAUSE APPEAR!* THEREFOR: It is orders d that Associated Indemnity Corporation and lirsi" s's Farid Insurance Coapary be? and they hereby are dlssaiseed a s parties defendants. GOOD CAUSE APFEASXSa THEREFOR; It is ordered that Standard Accident Insurance Coap&ny be and it hereby is dismissed as a party defendant. * I rV 1. w. SIKSjSP A. 7***T #".? T**"* WAJ --.Aior . J*-'5"' *>' **; m m m s 0 wrrr, R e f e r s Oakland - 4/22/64 goabs oak 11052 REPORT OP REFEREE p&r'ti.ss arrived at; a Coispi'osvl.se and Relase afrsassnt: in the? ase of ^6750 ,,00, RIS P O S I T I O N Thirty days to file Cosproz&lse and Release agreeassnt. t m i 'm * * ff/TE OFFICE C0MMUH1CAT! To From Subject J . E. Z eller, Lancaster A. L. Stokely, San Francisco In d u strial Accident Commission State of California Robert 0. Goans ( A r m s t r o n g Cc Oo Nf T R A C T I March 5, 1.^6b hu (3 Attached is notice of time and place of fu rth er hearing as w ell as the minutes of the previous hearing on the subject Asbestos Worker. I t is indicated th a t copies are served on Armstrong Cork, Armstrong Contracting, Aetna and Travelers. DJH FORM 1501 Printed In U.S.A. BEFORE THE UOTSTRIAL ACCIDENT CGI-MISSION OF THE STATE OF CALIFORNIA CLAIM 63 Oak 11052 * ROEERT 0. GOANS, Applicant.. vs. LORENTZEN & COMPANY (and others) and ARGONAUT INSURANCE COMPANY, et al Defendants NOTICE OF TIME AND PLACE OF FURTHER HEARING NOTICE TO ALL PARTIES You are hereby notified that further hearing will be held in the above-entitled action at 30C0 State Building 1111 Jaclcson Street Oakland, Califomia April 22, 1064 9:00 A.K. (ALL DAY) (Before VJitt) Dated at Oakland. California INDUSTRIAL ACCIDENT CCMHISSION PILED AlTD SERVED! Robert G. Goans, 4232 25th Street, San Francisco, California XfCipartsnent of Employment, State Building, Oakland, California Sedgwick, Bsterb, Horan & Arnold, 100 Bush Street, San Francisco, California Smith, Parrish, Paduck and Clancy, 3--5 Financial Center Building, Oakland 3.2, California Lorenteen & Co,, 1155 5th Street, Oakland, California Warren Manley, c/o national Insulation Company-, 5G3 Polk Street, San Francisco, California Argonaut Insurance Company, 550 California Street, San Francisco, California Hanna & Brophy, 1540 San Pablo Avenue, Oakland 12, California J. Patrick Goodwin, 41 Sutter, San Francisco 4, California F. E. Carignan, 6/1 Vernon Street, Oakland 10, California Western Asbestos, P,,0. Eox 3TS4, Rincon Annex, San Francisco, California Mundet Cork Company, 410 'Talbert Street, San Francisco, California Plant Rubber & Asbestos Works,, 12-00 64th Street, Oakland, California Plant Asbestos Company, 1300 4th Street, Fmeryvillo 8, California A m / Fort Contract ore- 1501 Maritime Street. Oakland, California Van. Ars aIs Harris Lumber Co., 5th er.d Brannaa Streets, San Francisco, ; Ca.lifemic Bay Cities Asbestos Co., Ltd., 6th nr-.d Ease 12th Stroct, Oakland. California Harry A. Putt or;, Jr., Button Asbestos Company, 552 Matona Street, San Francisco, California 0 . F. Braun & Company, 1000 South Fremorrb Avenue, Alhambra, California Asbestos Company of California, $41 16th Street. San Francisco 7 , California Johns Hansville Sales Cor-p., P.0. Box 37^u Hincon Annex. San Franc!sc Califomia Marine Engineering & Supply Co., 9^1 East 12th Street, Los Angeles, California '*Armstrong Cork, 304 Shan Road, So. San Francisco, California ML P.e Carp enter, $07 Front Street .Sacramento, California Cat; Insulations, 3500 20th Averu::: Sacramento "7, California Fiberglass Engineering c: Supply, L2X- l?t:. Street, Sau Francisco, Califera? a Ouens Com:*r-y Fibarglaso Corporalieu... 12 1 7 t h W,.. * V---- W- . O* *-K n 1-Tar.cioco, C alif Cbsrio;- C o a a f 1: :S C o m p a n y , 6 $ M i n n e , e i n S a n - Yf U1-.1 C ^ : C a n . i o n P r o d u c t : ; - 2316 i . m M i n n a H o d - 1 j A*. . _ . -. ---^w- . .V * *--t*. .-.5 ibieiass C . iL:auglasn. Ar.. luugia; .any, 2255 in poll.. fan r. on aiseo , C aadicania I . 7 . u-ni-pa L io n s , 1551 O cean i v u ^A ruai-trorg i - a a t r a e t a r y 0 S u p p ly , o/a- S o , S -~ 1 r a n c i s c o , f a l i f c:-r-;La H a t i c n n l a u a v f - i i c - u I n c . , 503 P o l k . j u c k s c n L a g k i r o C o m p a n y ; H u e , , p.. >a Ile liy A abeot-'u, a n a ., 2035 C ra n l .7 ' A sb este . L n o b v o tn , l i e , , 7 1 0 Eay:..u:. A a b a e a c ; lav a C u r t s A F a b r i c a t o r s : - _ mT-1 -- :v- 0. fAlirhunia A e tn a C r-uu?Ir.y . 1 S itrr" y F a ., 22-' 1 Stande:;.'. A c c io c u t .b ta v ra n c e C o r" * v ' L n . C a l i f e 7V a . T 8 , *r - s .. .- .j - 'L *' C;> v r v JJ . a n . . : ; ' ' ' U l l C i S 1C - C - a l i r o a v u a '-- ` 5 *f a y . , , _ f ^ . a u d . r ; . . J 0 . Y-V . i .Y Y 6 . .Y. . . la u f 1u a n c e u ra " - -- ' - .. . . . -. f a_;~. -'VF r y a uOr joy--.i. e c7-v: . , ur* C c a i 1 d sc r o . -y v { w .. C alifornio i n d u s t r i a l In d e iru L k y Co: p n r y , 53-.' U r i t e c S t a t e n B - i f o i i t y A C u a r a r o ' ->u . ^ ` " 0. ' * "<-n -r r*'i r? ***\ . . t- ^ r . :.-y- O *^u. C alifo --c c . rn f.a . .^v. San r-r-aneicco, C a li! o m ia E m p lo y e rs L i a b i l i t y A s s u r a n c e Co: p o v o i i : L i d . , 1 0 5 0 .`i t s a B u i l d i n g , Son F r a n c i s c o 4 , C a l i f o r n i a F irem an-s Fund In su ran ce Company, l ; l if , S ta t e C e m n f - n s a t i c n I n s u a * u . n c `2 *T*.T"!~* / 4 -34 *w_ 1^' J T r a v e l a r n : f n a i u . a i ; c e G c n r o a n y , 3.900 !. ' A m 2r i e m e d o u C i U . ' ws *V'- *r-, n C c - r . p a . , . Sa n 5 r . u n c i a e . o 4 , C a l i f o a r - L A m e j.j. c a i. Zi.ioln/ evv I n e u r a n c - - O a . u , ,. . . / o *. ' rt :n u . O akland 12, C a l i f 01 .'.v n ao r O ak lan d , C a lifc : -e c - U J-U , 3 \ ^ .. ..01 oar 20-77 Street. Ik-rM gcn .;, , Sou F alife nria A sso ciated Indem nity C o rp o ratio n , 332 Pine, San rru a s ic e o , a 2 Robert 0. Goans California Casualty Indemnity Exchange, 550 Kearny Street, San Francisco 8, California Pacific Employers Insurance Company, 244 Pine Street, San Francisco 4, California Zenith national Insurance Co., 582 Market Street, San Francisco, California Royal Indemnity Company, 201 Sanserne,- San Francisco, California Employers Mutual Liability Insurance Company of Wisconsin, 114 Sansone Street, San Francisco 4, California Zurich General Accident, 417 Montgomery Street, San Francisco, California jvh GO MIS 11052 i i y y y i i- ic riFAisGiA:.'.:-:, a c iiio k f c q e s e ,.-.:'.. o~ yzz srj.. *se <r c:..l i :?orza :-iC33R-J 0 . GOAIIS. Af.pIxCiUlu, VL'. ion:rr:i::H & coapani , and iHGONAUI5 "NJJNAIICb 1GAPANY, ei ki., JO J. '.'i.iO-'l:i ': .1. no ; ca?: 110 5 p. M IN U IO ; CF HEARING (c M ir iin iB ; A I'l C.1DHA; DI; MIAEINO- AND CR'DEA NCIAING ?AF'IES I7EF2A 1 P l a ^ - a a n d A ; n a : C a k i a n e ! * a i V A . i r y O y ] A i v . S ' : 0 C m .te ro rn e ; A or-ortc?: in "-:aranc.c-:3; )"1 nbh? Jordan A p p lic a n l p r& a en l." yj-. '-o s a n te d b y A kA tli, L*srri::Ij.. h c ;;c !: & G la n o y , A t t o r n e y s A ocoph E . Sri. Ah s p n o a r in a ) ,, E m ploye:?? L a b A liy y .r o v is r - o e C-crpcak.AAcn. IAci . c- an*: Z e n ifc h N y llo r r .A I n a . i r r :? C c a , r- by 11 F cO A ck G ood k L y. A t'-ic::-oaj { :iir -C lo appG arinj;) . A s s o c i a t e d In d o z n A v / ., and 1 r c i r i c Ebiploynrn Ir < r -sp j-sfltn to by H i I j,; 1 & FrJ.ippA* A A tc-rnays (F ra n k 1 . FAl :i-.r.-l a c p r a r i n o . l O s t b l a _ ..nt-. ,4 \r 1 ;n 1 I n f ^. kt.0>>^ ~bT. -.`. .rc.cn-; nA b v R - : c : ..l . :.i tir.i t l . j ' l l c i-o -5> - *HN5V.-:i: l c y e . N vev;a In ; ; . 15. l y Ir. . C*' 1? 0 :: VALsco: XVi n n n n i-a l ;:d b y A n::. '"1 er. n<-. c Aa l i . n Ga;;\ a l t ; . Lr>: ;iU. . So.... a n d /i.r 5 ah r a j.I'wS-.p)iv ' A b y S a l y :...c '- Dr-bar-bj 1.CH in 2j Ar-r-o F* N o id c x a ,: u ile ? r *-/e a x i r s ) . Ai1'KOricl'Ti 0 I n a . :. C a l J.'e , r Ins aalt- y .~idc nrnAty : F.dy e l I n n a w a it j T C o . ' A1 :0 . 3 l a t e \r .da l i l y S; Sb a n d a r d ho:rj.CK-$ 1 y : cC.1y y r I ' i FA r c r a n ' 3 F a n d iD J l. Ir- ? ^ ** .^ bV'r }>y.n . A l t o r r o y s ( lv ? `i A , 1 O. ".b a p j r o : : . ! 1 >%A'C i D U p a i i s r / : : c : : ii: A:ic:.*:r :;* A m r i c a n Ir `ararrja * 3.;r;A::d l y I . I- C-a:, .;.:e 0 .1 0 _____ .____ ^ \. -.v ; ^ ` .*-j--..*w** 1-- ;***,,*T"* i"iU'.-.D*J~SwV.*"' -- -,-v V7 \ v r r . l o ; b e a n d r.: :y h r r O r y r.'.r c.N I . dc-Tcrr 1 I iv k c.0 uj7 \ ' * : ~ 1 ; AOjD'.';:; ,,. .i j _V ; Q- Co y:; y Cl- .;-Li >w r --1 ~ ,,, **:.> '--.7** - .1-7 .1*. w-dOO. C-.rf O t' , .-; ... : 1 :. 1..c y X''. - ' l' 7:1 ._.v 7 j. ' . Ir.. x,, J' 7 v- . c:. . i 0 S.'*i W . V - . 5 . - V. -. ! ._.. L vw.. *r ,.t_. i - x . ' . - b . , .*. !'. :* - -cC, - ^--av bi.:.-.-.' - i / / /. o // . . /// 7/.' ' / / . V / ' . . 7 77' .Li- 1;.. O : : .: i:` IkANSkO..; L A l C lio : { LEI IHN IHAINES 110.7 1 1.3 ; n c i ~ v i e l y ; ; : r O oA Sv-. Lu;:e N c y O l a l a n d IN::- ::'' Aa-> l y i.O N t-IJ -lla 'a i k r <=<*-y; Oi; j . r---* Lkav Ih o ' v y . O k o r 1o n r A l u l :r . ' I JAO: v y r A r r c : < l u Ina 'i--. ._ ... n ,. . ' r-,- -ac; . aJKA 11 1; blrri5, I.Sj.2reo Oakland 1/29/64 GOA.X OAK 11052 REPORT OP REFEREE In a preliminary discussion, Mr, Smith indicated thot there ran erx"o^- ment with Western Asbestos lor the period 3.S20 to 1917, during which * West-era Asbestos was the sole er.p3.oyer. There are no records by Western prior to 19-1-6 as to employment. Hr. Filippi tentatively will stipulate to coverage by Pacific nraployers Insurance Company for the period November 1, ."-925, to November 1., 1932. The perioo of 1920 to 15 2 5 had not been (necked, since It was not alleged in th*. application Mr. McMillan will otipivUte to coverage of Western by the tate Fund from November 1* 3.''32, to date. There in no information regarding* employment prior to 194&, It was agreed tbo" as to Hindst o-.r-k Oo-xany* all periods prio:< to 1940 are dimini>rjU2 Nsic.srimllor- will tentatively stipulate 1:0 c o v e r a g e begiy'*-1^ -Q^e^-ber 31.: ~23i, to 1294,, and December 3 1 . T.)5l. through Ju n 1963 However Indus .rial Indemnity Exchange insured" Kundet r-ember 31, 1943, to 1944. according to Mr. Smiths so the <* t p records are apparently erronetus. In any event 'chere is p.-loyment claimed during that time du:inc 1943 to 1944. As to Plant Rubber & Asbestos Work3 . Pacific Fuoioybrs will tentative ly stipulate from October 1, 1940. to October 1-, /h;.2 i for "coverage. As to Plant Asbestos Company, Pacific E-nployers will tentatively stim ulate to coverage from May 18. 3.9?8, to January 1, 1952.. Aldustrial' Indemnity Company will definitely stipulate to coverage J a n ^ ry 1952, to January 1. 19 6 2 . It lias no information regarding As to Army Port Contractors.' Associated Indemnity Corp., has no iio^r- nation of coverage of that employer. Ilr, Schwab indicated that Fireman1 s Fund Insurance Company was unaware of Army Port Contractors as having been allegedly insured and this will be checked. Mr. Schwab stated that California Casualty Indemnity Exchange will definitely stipulate to coverage of C . F,, Braun & Company September 21. 1936,' to December 1, 1941. and to- coverage of Harry A. Dutton, Qi~-c. fatten Asbestos Company, November 1, 1952* to November l s 1958. Zurich General Accident had one-half cay coverage in 1937 and was exsniesed, as was Employers Mutual Iiabi3.it;.* Insurance Company-of Yiisccir i Many of the parties stated they had not- bad sufficient time as yet 'c cheek records regarding coverage and err.p.lovnent In view of the ir.ce'opieto pleadings regarding dates and places c-f employment, Mr. Sri/:-' indicated tint he will go through the entire work history wit^ the applicant today and then send the infor-rr."tier, o'.the parties, Vhc a:.0 then to advise in wri'eing regarding stipulation:; as tc covors.gr- end employment. Preliminary settlement mgo t i c n is undo:- way. Apparently the lien claim for U.C.D. Benefits is an connection with an* eye condition which is no pert of r-his action. D7S?0SIwI0N: Continued* to Vo reset cn notice to all parties< jniT.III So V i m , Referee