Document 7O5Yq8OobJYRrrYrn6LeG2dZj

FILE NAME: Contract Unit Workers Comp Claims (WCC) DATE: 1978 DOC#: WCC032 DOCUMENT DESCRIPTION: Workers Comp File - Staples, John D Contains all documents found in the Claimant's file, with one blank page between each separate document Armstrong List -- John Staples, California ^7 The only defendant of interest besides Armstrong is Mundet Cork. Mr. Staples had about 10 years of pipe covering work, including less than a year total with "Armstrong Construction". The claim was filed May r t , 1962. The parties applied to the Commission for approval of a Compromise and Release Agreement January 11, 1963 and this was approved February lip 1 9 6 3 . Total amount paid was $9,250, of which $821.80 came from Armstrong's carrier, Travelers. It appears from the reports of doctors from both sides that Staples had partial disability from asbestosis, at the age of 37. July 25, 1978 Armstrong List -- John Staples, California The only defendant of interest besides Armstrong is Mundet Cork, Mr. Staples had about 10 years of pipe covering work, including less than a year total with "Armstrong Construction". The claim was filed May 17, 1962, The parties applied to the Commission for approval of a Compromise and Release Agreement January 11, 1963, and this was approved February 1,. 1963. Total amount paid was $9,250, of -- which $821.80 came from Armstrong's carrier, Travelers, It appears from the reports of doctors from both sides that Staples had partial disability from asbestosis, at the age of 37* fawiKiJ U ^ a iiiia i t it tt'ik iinn iLyMHk *. . ' i ---------- -i... .... ------------ -- .. ..... 1 John J. Wren Attorney at Law 2 37*5 Long Beach Blvd., Long Beach California 3 Tlphonai GArfleld L-Ohll -J. ' 1 * - < ' ,.Vfc JAHi } ls63 JL4. 4 8 BEFORE THE INDUSTRIAL ACCIDENT COMMISSION OF THE 6 STATE OF CALIFORNIA 7 8 JOINT COMPROMISE ANO RELEASE CASE NO. 62 LB '19396 9 10 JOHN 0, STAPLES 11 Applleant 1063** Ceres, Whittier, Calif, 12 VI* 13 ARMSTRONG CONSTUCTION MtOO E, Bandinl, Los Angeles 14 C. F. BRAUN 1000 Freemont St., Alhambra 16 CAL STATE COMPANY 823 Mattier St., Los Angeles 16 COAST INSULATING 117 R. T. OINWIODIE 18 FIBERGLAS ENGINEERING 19 L A CORK 268* Lacy St., Los Angeles,Cal if. 8627 So. Atlantic, South Gate 5933 Telegraph Rd.,Los Angeles AI80 E. Washington, Los Angeles 20 KIRCHER ASBESTOS Box 6652, Phoenix, Arizona 21 MUNPET CORK CORE- * corporation 6116 Walker, Maywood, California 22 OIL FIELD CONSTRUCTION Box 9**7, Bakersfield, California 23 PLANT ASBESTOS Co.a corporation 15**0 West 9th, Long Beach,Cal if. 24 BAKER PERKINS 1000 Hess, Saginaw, Michigan 25 REECE INSULATION COMPANY, Clark **563 Valley Blvd., Los Angeles Reece, dba 26 J. T. THORPE 27 9**8 E. 2nd St., Los Angeles,Cal. WEBER BAKING COMPANY 28 Employers Addresses 29 30 AETNA CASUALTY AND SURETY CO. 810 South Spring, Los Angeles 31 AMERICAN MOTORIST INS. CO. 35**5 Wl Ishire, Los Angeles 32 AMERICAN EMPLOYERS INS, CO. 639 S. New Hampshire, Los Angele* A 1 ............................ 'inni. I * : V 1 ARGONAUT INSURANCE CO. V 1001 Wilshire Blvd., Los Angeles 2 CASUALTY INSURANCE CO. OF CALIF. 810 South Spring. Los Angeles corporation 3 INDUSTRIAL INDEMNITY COMPANY 4 a corporation 37*5 Long Beach Blvd.Long Beach 6 MICHIGAN MUTUAL LIABILITY c/o Brown Bros. Adjustors, 3517 West Sixth St., Los Angeles 6 NATIONAL AUTOMOBILE ANp CASUALTY 633 South Spring St.,Los Angeles 7 INSURANCE CO. 8 PACIFIC EMPLOYERS INS. CO. 2L8L Pacific Avenue, Long Beach 9 STATE COMPENSATION INS. FUND 3629 Atlantic Ave. Long Beach 10 TRAVELERS INSURANCE COMPANY Ocean Center Bldg.,Long Beach 11 ZURICH INSURANCE COMPANY Box 3203. Terminal Annex Los Angeles 12 Insurance Carriers Addresses 13 14 15 The parties hereto, for the purpose of Compromise only, here 16 by submit the following agreed statement of fact. 17 1. That John 0. Staples, the applicant herein, was born on dune 18 2L, 1925. 19 2. That John Staples, while employed as a heating and air con 20 ditioning installer, for Armstrong Construction, C. F. Braun, Cal 21 State Company, Coast Insulating, R. T. Dinwiddle, Fiberglas Engin 22 eering, L. A. Cork, Klrcher Asbestos, Mundet Cork Corp, a corpora 23 tion, Oil Field Construction Company, Plant Asbestos Company, a 24 corporation. Baker Perkins, Reece Insulation Company, Clark Reece, 25 dba, J. T. Thorpe and Weber Baking Company, at various wages, at 26 various geographic locations within and without the County of Los 27 Angeles, State of California, during the periods of October, 1953 28 through March 7, 1962, alleges that he sustained one or more 29 Injuries to his lungs and respiratory system during said periods 30 of employment by being continually exposed to asbestos dust, fiber* 31 glass and other irritants from materials handled and used during 32 said employment. 2- - ' " li ... . .......... -- ' irTr. H I |||IH ||1r"i " " I'lltl- itn n m tm ttim 1 3. That John D. Staples, alleges that as a result of th? said 2 Injuries, he has suffered a permanent disability. 3 Ii, That during the periods alleged, the insurance companies were 4 at followst 5 (a) Armstrong Construction! Travelers Insurance Co. (January I, 1955 to July 29 1955s> 6 (April 23, 1957 to July 31, 1957 ) (March 2, 1962 to March 8, 1962 ) 7 (b) C. F. Braunt American Motorists Ins. Co. 8 JanujarTy* r t1f,l h r19r5*t** cto. - JAannue aftriyt A*1,/r1c9T5v5x>sn /*-s> c ot 9 (c) Cal State Company! No Record of Coverage 10 (d) Coast Insulating! Pacific Employers Ins. Co, May 1, 1961 to May 1, 1962 11 (a) ft. T, Dinwiddle! State Compensation Ins. Fund. 12 July 1, 1958 to July 1, 1959 13 (f) FI berg!as Engineering! Aetna Casualty and Surety Co, (March 1, 195* to September 1, 1959 ) 14 (September 1, 1961 to September 1, 1962 ) \ 15 (9) U A, Corki Zurich Insurance Company October 27, 1959 to October 27, I960 16 (h) Kircher Asbestosi No Record of Coverage 17 {{) Mundet Cork Co, a corpj Aetna Casualty and Surety Co. 18 December 31, I960 to December 31, 1961 19 20 >*1 21 22 23 24 CJ) Oil Field Construction Co! Casualty Ins, Co. of Calif. January 1, 195** to January I, 1955 (k) Plant Asbestos Co.,a corpi Industrial Indemnity Co, a corporation January 1, i960 to January I, 1961 (2) American Employer* Ins. Co. January 1, 1962 to January 1, 1963 (l) Bnker Perkins and Weber Baking Coi Michigan Mutual Liab. January 1, 1953 to January 1, 195* 25 (m) Reece Insulation Co. Clark Reece dbai 1. National Automobile and Casualty 26 insurance Co. (March 1, 1956 to October 1. 1957 ) 27 (July 1, 1959 to July 1, I960 ) 2. Industrial Indemnity Co., a corporation, 28 October 1, 1957 to October, 1, 1958. 29 (n) J, T. Thorp! Pacific Employers Ins. Co. January 1, 1953 to January I, 1950 30 31 That the above employers and Insurance carriers are, by agree 32 ment, parties to this Compromise and Release. That it is expressi/ *r* 3- - Av liifiit'rin i mmMd A --1*11 mm**-'-- i 1 pnderstood, and Intended by each end ell of the parties hereto, 2 that the amount set forth below will be paid and received In con* 3 s(deration of the release of the above named Insurance carriers 4 end each of them, together with a release of each and all of the 5 above named employers. 6 It Is further agreed that the release herein and hereby 7 granted by the applicant shall extend and inure to the benefit of 8 any and all employers, whether named In this proceeding or not. 9 5. That the actual weekly wages of the employee at the time of 10 the claimed Injuries are In dispute; that the average weekly 11 wages ere In dispute, 12 6. That applicant Contends that he was temporarily disabled as a f 13 result of his Injuries; that defendants and each of them deny that 14 applicant was temporarily disabled free his employment due to any a 15 Injury or injuries, 16 7 That medical treatment was necessary and that such treatment 17 was obtained by applicant on a self-procurred basis. 18 8, That the parties hereby agree to settle any and all claims on 19 account of said injuries by payment cf the sum of $9,250.00, 2 0 apportioned as follows; 21 a Industrial 1ndemnIty Company; 22 b Aetna Casualty 8 Surety Co. c Pacific Employers Ins. Co, d American Motorist Ins. Co. $2,221.95 1,918.70 l,kl5.05 1,005.90 23 e Travelers Ins. Co. 821.80 f State Compensation Ins. Fund 800.00 24 National Automobile 8 Casualty Ins. Co. 703.65 American Employers Ins. Co. j 25 Zurich Insurance Co. Casualty Ins. Co. of California 120.75 120.L0 57.k0 26 Michigan Mutual Liability 39.20 Argonaut Insurance Co. 25.00 27 Total ?9,25]ofi -J! 28 The above sum of $9,25000 shall be paid in one lump sum to 29 applicant except as otherwise provided in item 8 (a) below, less 30 $500.00 advanced by Inc'istria! Indemnity Company, less any allow 31 able lien claims of record not satisfied as itemized in item 8 (a) 32 below; that applicant agrees to pay any and all expenses incurred -k- Tfiftliin imenehrtmsientm 9 which may hava otherwise been properly claimed under Labor Code Section 4600 to have been the responsibility of the defendants herein* 8* (a) That the sum of $9,250.00 shall have deducted the fo!1ow ing disbursements which shall be made directly to those persons, companies, corporations or firms as set forth below and such dis bursements shall be made from the amount designated to be paid by Industrial Indemnity Compfny as set forth in item #8 above; that the i*erein disbursements represent reduced lien claims of record and are payable in amounts as follows / That any sums due by said Company not exhausted by disburse ment or attorneys' fees set forth in item #10 below shall be paid directly to the applicant or as the Honorable Commission may di rect. 9. That all self procurrad medical, if any, shall be the sole responsibility of the applicant and that the defendants, or any of them, shall not be liable for any of said expense. That the defendants or their carriers, are responsible for medical treat ment and/or examinations here-to-fore authorized by them, but that all future medical shall be the sole responsibility of the applicant herein. 10* That the name and address of applicant's attorneys Is Silver McWilliams and Sherman, 305i North Avalon Boulevard, Wilmington, California; that said attorneys request a fee to be paid directly to them by Aetna Casualty and Surety Company, as set forth in Item #8 (a) above, In the total amount of %/Za ^ I Ac,. That said attorneys have e x u n d e d the sum of $ as reasonable litigation costs. 11. Reason For Compromises Multiple issues exist which make 5 XV . I # 1 settlement the most practical solution to the problem posed by 2 protracted litigation as follows, whether applicant's injuries 3 arose out of and ware sustained In the course and scope of employ* 4 mentt date of injury) issue of occupational disease; applicability 5 of the Statute of Limitations; extent of apportionment allowable 6 as between defendants; applicant's actual earnings; applicant's 7 average earnings; extent and duration of temporary disability, if 8 any; nature, extent and duration of permanent disability, If anyj 9 need for further medical treatment; liability for self procurred 10 medical) liability for medical legal costs; (pilowance of reduction 11 of lien cltilms^ coverage for the periods of employment alleged. 12 The applicant desires a lump sum settlement and to take con* 13 trol of his own medical treatment. The applicant, and the de 14 fendants, separately and as a group, desire to buy their peace anc 15 to avoid the expense, delay, hazard and uncertainty of extended 16 litigation and to settle their differences for a sum certain.^fhe ,12 17 applicant feels that the liens of a nd 18 should be allowed in the sum of 19 wMz. JL of the amount claimed. 20 12. The undersigned request that this Compromise and Release 21 Agreement be approved by the Honorable Commission. 22 13. Upon approval of this Compromise and Release Agreement by the 23 Industrial Accident Commission or a panel thereof and payment in 24 accordance with the provisions hereof, said employee releases and 25 forever discharges laid employers and insurance carriers from ali 26 claims and causes of action, whether known or ascertained, or 27 which may hereafter arise or develop as a result of said injuries. 28 Including any and all liabilities of said employers and said 29 Insurance carriers and each of them to the dependants, heirs, 30 executors, representatives, administrators or assigns of said 31 employee. 32 14. it is agreed by all parties hereto that the filing of this 6- * m<r>4i 4 * 1 document Is the filing of an application for adjustment of all 2 claims on behalf of the employee, and that the Commission may In 3 its discretion set the matter for hearing as a regular application, 4 reserving to the parties the right to put In issue any of the 5 facts submitted herein, and that If hearing Is held with this 6 document used as an application, the defendants shall have avail 7 able to them all defenses that were available as of the date of 8 filing of this document, and that the Commission may thereafter 8 either approve such a Compromise and Release Agreement or dis 10 approve the same and issue Findings and Award after hearing has 11 been held and the matter regularly submitted for decision. 12 15 In further consideration of the payment in accordance here 13 with, applicant agrees that this release applies to all unknown 14 and unanticipated Injuries and damages tesulting from such actions 15 casualties, vents and/or employments, as well as those now dis 16 closed, and atl rights under section I5*t2 of the Civil Code of 17 the State of Celifornia ere hereby waived. California Civil Code 18 Section I5h2 reads as follows: 19 "A general release does not extend to claims which the creditor does not know or suspect to exist in his favor 20 at the time of executing the release, which (f known, by him, must have materially effected his settlement with 21 the debtor," 22 ulTN$S the Slgnatur^ hereof this /''^dav otfl- 9 <* 23 -------- * ^ A aL ^ A --------------------- John u. S tap les,' A p p lic a n t 24 ___ __________________________ . 51 MCWILL1AMS & ^HERMAN 25 f _ / W! tnesses' ' " ' A tto rn e y f o r jAppi le a n t 26 The Injured Applicants Signe- AETNAoCASUALTY AND SURETY CO. tu re must be a t te s te d by two 27 d is in t e r e s t e d persons OR acknowledged b e fo re e N otary 28 Pubt ic . y. - j \ f \ s / t r>>L 29 STATE OF CALIFORNIA AME^ICA^MOTORIST INS. CO. By ' 30 County of 31 32 7- ^ Iliilr a 1 1 1I fimi, i-- ....ili., ....a...- .-.!. .... --1-.ina tuai .... 'rlBflBrIiI^iiliiTiBlmi.Miillnilf.lMiiAIB,i~~tii1fiK'iSJfliiShii.Tli'ir 1 BEFORE THE INDUSTRIAL ACCIDENT COMMISSION OF THE STATE OF CALIFORNIA t r WQ STtACH OFF J t 2 CASE NO. 62 LB 19396 i;cu$T?.ii ;.:ctssKT crisis* tat* or AureiwiA 3 4 JOHN D. STAPLES, ) It u OCT 5 -1962 i i i t w t b fii i o f i i t i m m ***"*** 8 Applicant, ) " MINUTES 6 va. ) OF 7 BAKER PERKINS; J. T. THORPE; C. F. BRAUN; COAST INSULATING; OIL FIELD CONSTRUCTION; ) HEARING 8 ARMSTRONG CONTRACTOR; FIBERGLASS ENGINEERING; ) REECE INSULATION; R. T. DINWIDDIE; 9 KIRCHER ASBESTOS; LOS ANGELES CORK; ) PLANT ASBESTOS; MUNDET CORK CORP.; 10 CAL STATE COMPANY; ) AMERICAN MOTORISTS INS. CO.; 11 CASUALTY INSURANCE CO. OF CALIFORNIA; ) STATE COMPENSATION INS. FUND; 12 ZURICH INSURANCE CO.; ) PACIFIC EMPLOYERS INS. CO.; ARGONAUT i 13 INSURANCE CO.; AMERICAN EMPLOYERS ) INS. CO.; TRAVELERS INSURANCE CO.; 14 SNcATSIUORNETAYL AUTO & CAS. CO.; AETNA CASUALTY CO.; MICHIGAN MUTUAL LIAB. CO.; ) Si 15 INDUSTRIAL INDEMNITY; ) 10 Defendanta. ) 17 18 THIS CAUSE came on for hearing October 5, 1962, at 9 A.M., 19 in Department D of the Industrial Accident Commission, Long Beach, 20 California, before Honorable GEORGE WESTWICK, Referee. 21 T. Hanagami, Reporter. 1- 22 PRESENT: 23 Silver, McWilliams Sc Sherman, by Richard McWilliams, 24 attorneys for applicant 25 F. W. Carignan, representative for American Motorist 26 Herlihy Sc Herllhy, by Kennls Jones, attorneys for ; k i f ! ( 27 I Argonaut Ins. Co. and American Employers 28 John Montgomery, representative for Travelers Ins. ; l J t i : i 29 Murray H. Roberts, by James Thomason, attorneys for ; ) i !j 30 Zurich Ins. Co. F o n ili 3 39 214" * N0 test. tn. s ,1 t...,<,.l.i ifr-rmMtfcMMMMMMlIlm ta rn hdm m Ii 1f.j I i 1 PRESENT (Cont'd): 2 Cloptoa A Penny, by Robert Wills, attorneys for Pacific !! iK` ! 3 3 Employers 4 Eugene Barnes, attorney for Industrial Indemnity 5 Paul Klein, attorney for State Compensation Ins. Fund 'k 6 Wallace A Brown, by W. Gerald Brown, attorneys for 7 Aetna Casualty and Surety Co. 8 Maury A Schuyler, by Rob R. Schuyler, attorneys for l u 9 Michigan Mutual 10 Licker A McClure, by Robert Licker, attorneys for 11 National Auto A Casualty 1 k 12 i 13 EXHIBITS: 14 Applicant's 1 - Reports attached to letters of 8-29-62 and 6-19-62 15 Industrial Indemnity Co. Ex. A - Reports attached to letter of 10-3-62 18 Pacific Employers9 -1Ex1.-6 2B - Report attached to letter of 17 18 DISPOSITION: fpt 19 45 days to file compromise and release agreement. 20 ! \ 21 \,, 22 23 24 25 26 27 28 29 *\<t 30 Foam 339 2149 1 7v>M 9 111* 1 III, II ID - lim n I I MMIlf W Elip w ii........I ip Iip im ii ; IDW IN SILVER RICHARD L. Me WILLIAMS ARTHUR SHERMAN ERNEST L GRAVIS LOUIS BERSON LAWRENCE WEI77ER 7 \ itfrorievs silver, mcw illiam s & sherman JOSH NORTH AVALON BOULEVARD WILMINGTON. CALIFORNIA TERMINAL 4 -3 8 9 5 SF A U C I S -6 1 M ANTA orfici MKTCAiri *m avi u n OATH MAIM ITRIBT tMm v*oii August 29, 1962 fcrw r,, . f r Ahl> f " 3 0 }<# Industrial Accident Commission - 236 East Third Street Long Beach, California Ret John D. Staples vs. Plant Asbestos, et al 62 LB 19396 Gentlemen: `Please find enclosed the following medical reports for filing In the above-entitled matter. Report of George E. Frallck, M.D. dated Aug. 24, 1962 T?lease be Informed that the applicant In the above-entitled matter now resides at: `Please be Informed that I now represent the applicant in the above-entitled matter and hereby request that copies of all material "documents be served upon me. Very truly yours, SILVER, HcWILLIAMS/6 SHERMAN BY enclosure cc: Please see attached sheet. BERTRAM B . H uaiA N D . M. O. Drb. HUBSXND ^ d FRAUCK l M V a iO IA N B lU D O IO N I 1*10 E. WHITTIER RLVD, WHITTIER, CALIFORNIA hon* O e or de E. F r a l ic k , M. O. August 24, 1962 Mr. McWilliams 3054- North Avalon Wilmington, California ,* v . v 3 o? Re: John D. Staples Dear Mr. McWilliamss _ . ,0n 25 > ^ 6 2 , 1 sent a letter to you regarding Mr. John Staples. Please refer to this letter for information concerning Mr. Staples prior to this date. * This patient has been seen subsequent to the last letter as follows: 4-30-62 Conjunctivitis - Cough continues - Rales inchest continue^ 5-10-62 Worse past 2 days "had to goto bed" Cough and rales persist. Diathermy, etc. 5-15-62 Some improved, complains of weakness 5-28-62. Pt. failed to keep appointment 5- 31-62 Complains of difficulty breathing. Temperature remains normal. Rales in left lung field persist. 6- 25-62 About the same. Sent to the laboratory for lung vital Capacity. Laboratory report patients vital capacity is 50^ of normal. 7-2-62 Patient still complains of weakness - X-rays ordered to be repeated at the La Mirada Hospital. Patient instructed to completely stop smoking. Upon contacting La Mirada Hospital, on 8-21-62, I found Mr Staples had failed to have follow-up x-rays. They informed me that the patient had not been in for the x-rays that I had ordered on July 2. 1962, I have not seen this patient since July 2, 1962 in my office. . ,, , Mv recommendations as stated in the letter of 4-25-62 remain tion*vhrrp lng iria iSm I S 0* S' '"ploe? i " " 7 CCUpa w a" ^ l . y L d & 1% r 5S ? " "a,, ^ br051' and Pr',a',le aS h eS ,0,is- V McCartney, Hall & Ryan Attorneys at Law 639 South Spring Street Los Angeles, California Murray Roberts Attorney at Law 750 Broad Wnington, Calif, Herlihy & Herlihy Attorneys at Law Ocean Center Balding Long Beach, California American Motorists Ins. Co. 3545 Wilshire Blvd. Los Angeles, Calif. Casualty Ins. Co. 810 So. Spring St. Los Angeles, Calif. State Compensation Ins. Fund 3629 Atlantic Ave. Long Beach, Calif. Zurich Insurance Box 3203, Terminal Annex Los Angeles, Calif. Pacific Employers Ins. Co. 2484 Pacific Ave. Long Beach, Calif. Argonaut Ins. Company 1001 Wilshire Blvd., Los Angeles, Calif. American Employers Ins. Co. 639 So. New Hampshire Los Angeles, Calif. The Travelers Ins. Co. Ocean Center Building Long Beach, California National Auto & Casualty Co. 639 South Spring St. Los Angeles, Calif. Aetna Casualty & Surety Co. 810 South Spring Street Los Angeles, California Michigan Mutual Liability c/o Brown Brothers Adjustors 3517 West Sixth Street Los Angies, Calif. Industrial Indemnity Company 3745 Long Beach Boulevard Long Beach, California EDWIN SILVEJt RICHARD L McWILUAMS ARTHUR SHERMAN ERNEST L. GRAVES LOUIS BERSOM LAWRENCE WEITZER i law Offices \ SILVER, McWILLIAMS & SHERMAN 30314 NORTH AVALON BOULEVARD WILMINOTON, CAUEQRH1A ' *n - AMTA AMA OrffCA M IT C A LFB a. b A ILV IA l i l t WORTH MAIM STAUT tlMItALY 7-OOU TERMINAL .JSBS SPRUCt 3 012 June 19, 1962 vrr*tv*i COMfMtflTSlIOVVKIA-l AL'f.^rLmfSWtACH \ JH 2 1962 &HD t\m _________ -. - A - - __ BOSH___ OBW3--- Industrial Accident Commission " 236 East Third Street Long Beach, California Re: John Staples vs. Reece Insulation Conany, et al I , 62 LB 19396; 700923 Gentlemen: `Please find enclosed the following medical reports for filing in the above-entitled matter. Report of G. E. Fralick, M.D. dated April 25, 1962 IPlease be informed that the applicant in the above-entitled matter now resides at: 'Please be informed that I now represent the applicant in the above-entitled matter and hereby request that copies of all material 'documents be served upon me. V e r y truly yours, SILVER, McWILLIAMS & SHERMAN / enclosure -CHARD L. McWILL- cc: National Auto & Casualty Ins. Company 639 South Spring Street, Los Angeles % e E. Fralick, D B. r . HUSBAND. D.O. I I 0 C. W HITTIKH a u v o . WHITTIER, CALIFORNIA oxrono < la t April 25, 1962 Mr. McWilliams 305-1/2 North Avalon Willmington, California Dear Mr. McWilliams: Re: John D. Staples Mr. Staples has been under my care for a chest problem since March 8, 1962. He has had a chronic cough, hemoptysis and pain in chest area, both right and left. He was hospitalized March 9, 1962 at Murphy Memorial Hospital with acute pneumonitis. Repeated x-rays of his lungs have shown i evidence of chronic irritation. He has consis- tantlyhad fine rales in left low lung fields and coughs frequently. His condition has become better with treatment but has not subsided entirely. Due to the pulmonary findings on the x-ray examination and after discussing this case with the radiologist at La Mirada Hospital, Dr. Richard Siggers, it was felt wise to advise this patient to seek a different occupation. It was so felt because the lung fields showed fibrosis and there was evidence of chronic irritation. And, due to the fact that the patient is working in asbestos, where he is exposed to asbestos dust and fibers and due to the fact that asbestos can cause and can irritate such a condition, I felt that he should definitely seek employment where his lungs would not be subject to this type of irritation. I I feel that continued exposure to lung irritants will lead to more fibrosis and repeated acute pulmonary episodes which he had when I first saw him. The likelihood of active tuberculosis and hearTdisease would be increased. II * ' >v " * * * * 1 ( 1 1 1 1 .!.. M R . Ml M l It is therefore my recommendation that Mr. John Staples seek employment in a field of endeavor not requiring contact with lung irritants. f GKKtrn Sincerely yours/ i IVTrailck, D. 0. law o r r i c t i CLOPTON & PENNY / liitc m a S 3 io u t h t a a iN a i t a ic t LO S A N O C LE S 14, C A LI TORN IA tiH' ' ''' tiliamonc MAoi.on 7-1SB# September 11 1962 W H IN PtEPLVIN O please niffeto # 19963 and A Industrial Accident C om m ission 236 East Third Street Long Beach California ,1-^1 2 U'L- Res John Staples vs* Coast Insulating, et al Case No* 62 LB 19396 Hearing Date Oct. 5# 1962 Gentlemens Please find enclosed the following medical report for filing in the above entitled matter* R.T. J o h n s to n e , M.D., dated Aug. 22, 1962 WHKskb Enel* cc 3 Silver, McWilliams & Sherman McCartney, Hall & Ryan Murray Roberts Herlihy & Herlihy American Motorists Ins. Co. Casualty Ins. Co# State Corap* Ins* Fund Ind. Ind. - L.B* Very truly yours, WILLIAM H. KENNEDx Office Manager Zurich Insurance Argonaut Ins. Co# American Employers Ins.Co# Travelers Ins. Co# National Auto & Casualty Co# Aetna Cas. & Surety Co# Michigan Mutual Liability Pac. Emp# - L.A. 71 PC 73643 & 73644 OCCUPATIONAL O T lC A ftC f iN O U tT H lA L HEALTH RUTHERFORD T. JOHNSTONE, M.D. NOCKMAN UlLOINa Lon A n g le s 14, Calif. MAoi.ON ) ! August 22, 1962 f '' *9? IN D U tT H lA L TOXICOLOGY Plant euhvct WWWIiWWIilW XWfJiiwHUIUnili111min e M... . Pacific Employers Insurance Co. 1033 S. Hope Street Los Angeles 15, Calif. Gentlemen* ^ Re* JOHN STAPLES Coast Insulating Products Claim: 71 PC 73643 Our File: 6108-R At your request the above captioned individual was examined by the writer on 8-9-62. He gave his address as 10634 Cores, Whittier, Calif. His occupation as an insulator. HISTORY: Mr* Staples states that in March of 1962 hedeveloped pneumo nia. For this he was cared for by Dr. Frolick and was hospitalized in the Murphy Memorial Hospital in Whittier. X-rays were taken and according to the patient the doctor first suspected that he might have tuberculosis. A number of tests were run but, according to the patient, none of these showed evidence of pulmonary tuberculosis. The patient was then told that the lungs might have been affected by the fiberglas and asbestos. Mr. Staples also states that he had a cardio respiratory test which, according to him, showed about "50JS capacity." The patient has not worked since March on the recommendation of his doctor,> Present Complaints: . 1. "I do not have any energy." 2, "I am short of breath on effort. This has been coming on for the past year." 3. "Occasionally I feel a sort of constriction in my chest." Past Medical History* Had an appendectomy. He had pneumonia two years ago and also in March of 1962. He had a whiplash injury two years ago. Occupational History* Mr. Staples states that he has been in the insulating business for approximately ten years with the exception of oneperiod of nine months. He has worked for various companies for various periods of time. If I understood Mr. Staples correctly he has worked the longest for the Plant Asbestos Company. This being approximately three to four years although not constantly. He has worked for the Coast Insulating Products, for the Armstrong Corporation, and BakerPerkins Company. For these various companies his work is primarily as follows. ' No. 2 Re: John D. Staples 8-22-62 He wrapped pipe or ducts with fiberglas cloth. On top of the fiber glas in some instances is placed an asbetos covering. The asbetos has previously been molded. He estimated that the useof asbetos as compared to the use of fiberglas was considerably less. In other words the percentage of asbestos was very little compared with that of fiberglas. Personal History The patient is married, wife and four children living. He knows of know tuberculosis, cancer or diabetes in the family history. Inventory of Systems* Head - States that he has occasional headache, no dizziness or tinnitus. His tonsils have been removed. Teeth are false. Respiratory system - Has a morning cough which is occasionally productive. He has never expectorated any blood. Cardiac - Has some dyspnea on effort, occasional palpitation and occasional constricticn-like discomfort. Has no orthopnea. Gastro-intestinal - Appetite is normal. Has no symptoms of indigestion. Has no constipation or diarrhea. Gtoois are normal. Genito-urinary - No nocturia, dysuria or frequency. Weight - Patient states tnat he did loose about 17 pounds on a diet but is regaining some of this. Nervous system - States that the doctor placed him on Miltown because of he was somewhat nervous, he is not irritable and he sleeps well. Extremities - No history of ankle edema, joint pain or joint enlargement. Habits: Smokes about one pack of cigarettes * day. drink alcoholic beverages. Does not PHYSICAL EXAMINATION: The patient is a normal appearing, normally intelligent cooperative 37 year old male. His weight was 177 pounds. Temperature normal. Head and Neck? The pupils were round, equal and reacted to light. Ears, nose and throat negative. The teeth were false. No enlarge ment of the cervical glands. Chest: Slightly erophysemateous in appearance. The percussion note was resonant throughout. Auscultation of the lungs revealed no friction rubs or rales. Respiratory iste 18. Heart: hate of 76; regular, no murmurs heard. B.P. 110/70. Acqomen: Obese, no organs or masses palpated. No tenderness elicited, There is present an old scar from previous operation. R ack: Motions of the back were painful due to a recent strain. E<xr<>mities: Normal. No ankle edema present. oroicqj col examination: Normal. No. 3 Bet John O. Staples 8-22-62 LABORATORY Urinalysis Color-yellow Reaction- pH 5.6 Albumin - 0 Micro: Appearance-clear Sp. Gravity - 1.010 Sugar - 0 negative Blood count* Hemoglobin Erythrocytes Leucocytes Polys Lymphs Monos Eosins 138gms. - 95$ 4,180,000 8,600 65 30 4 1 Blood sedimentation rate* 16 mm 1 hr. (Wintrobe) ELECTROCARDIOGRAM: Normal. .. . X-RAY EXAMINATION; Posterior anterior and lateral views of the chest reveal the cardiac shadow to be within normal limits. There are old egg-shell calcifications of both hilar areas. There is one small calcification in the left lower perionery. There is slight accentuation of the bronchovascular markings and a few scattered micronodules. DISCUSSION: The physical examination of Mr. Staples was essentially normal. Likewise the urinalysis, blood count were normal. The blood sedimentation rate was slightly elevated. The electrocardiogram was normal. From the history there are two types of dust to be considered in this case. The first is that of fiberglas. This material is notorious for causing a mechanical irritation to the skin. However it is not known to cause any effect upon the pulmonary tissue. This is not any arbitrary statement based upon m y own experience. It is based upon the additional opinions of other clinicians and those engaged in research in industrial toxicology. The references to the following quoted material are appended to this report. In a clinical study by Carpenter and Spolyer, "In a clinical study negative chest findings were observed in a mineral wool industry." According to Gardner, "The lack of pulmonary damage from exposure to alass wo ment* i-or ol ov e d r u st a y is ea r b ea innimg adl es m onst have r ated now b by ee n an e x inhal posed a ti to o n as exper high i concentrations of this material as could be obtained, with no seyicup efiect upon their lungs." In l?5&j^Schepers et al of the Saranac Laboratory (Trudeau Found- ati')'*reoorted on the duet'erf rats', rabbits, bgiuoinleoagicpailgs acantdionmonokfeyfsi.berAglcacso-rpdliansgtitco .investigators, "this fiberglas Hui.t behaved like an inert substance. Inis is a most portentous finding, as it is so No. 4 He: John D. Staples 8-22-62 frequently assumed that all siliceous dusts necessarily must be injurious when inhaled." In view of the fact that in the pneumo conioses "the main causes of disability or death are pulmonary fibrosis, emphysema and bronchitis, vascular occlusion with cor pulmonale and secondary infection, mainly tuberculosis these animals were carefully studied with these complications in mind. "The fiberglas-plastic dust provoked no serious lesions of the foregoing categories." On the other hand asbestos fibers are respirable. Under a given set of circumstances they can five rise to a pneumoconioses known as asbestosis. It is believed that it takes from seven to ten years in a fairly high concentration of asbestos fibers to develope asbestosis. In the cas< of Mr. Staples no positive opinion can be given at this time. Certainly this is so from the standpoint of inter preting the x-ray films. Pendergrass, a radiologist who has probably the greatest experience in interpreting x-ray films in the field of pneumoconioses states "a roentgneological diagnosis of early asbestosis is unreliable." With this I agree and I fail to understand how any other doctor could state that the x-ray films of Mr. Staples represent asbestosis or any other pneumoconioses. Before any opinion can be offered in this case an investigation is necessary that would include a determination of the presence or absence of asbestos fibers in the working environment, a determination of concentration and particle sire and an estim ation of actual or fairly approximate length of time that there has been any exposure to asbestos. After this is done and there remains evidence of the need, a lung biopsy could be made. As previously stated, no positive opinion can be made presently. At this time it is my impression that Mr. Staples does not have asbestosis or any pulmonary disturbance from fiberglas. Further more, I believe he could return to work. Yours very truly, No 5.* Ret John D* Staples 8-22-62 References* 1. Schepers, G. W. H. et al* The Action of Fiberglas Plastic Dust, AMA, Archives of Ir.d* Health, 18*34, 1958 2 Carpenter, J. L* and Spolyar, L* W . * Negative Chest Findings in Mineral Wool Industry* J* Indiana M*A*, 38*389, 1945 3 Pendergrass, Eugene P* The Pneumocenioses-Diagnosis, Evaluation and Management: Council on Occupational Health, American Medical Association, 1962 :iVv t.* . ^ * 3745 I 4 o NQ BEACH BOU ABO t,,'0 N , B t ' A C H 7 , IFORfHA 0A R F I C I O 4 04U r .- ' - v? V ? u INDUSTRIAL i n d e m n i t y INDUSTRIAL ACCIDENT COMMISSION October 3 ' 1962 comtany Long Beach, Calif. OCT 4 1 Gentlemen: ` .. ... I.A.C. No: Applicant: Employer: Claim No: 62 LB 19396 John D. Staples Plant Asbestos Co. C62-43-09355 Your attention is respectfully directed to the following; ( ) Request is hereby made for further hearing to permit cross examination of _________ __________________ ________________ ~ ' and presentation rebuttal evidence. ( ) Please take the above matter off calendar because ____________ _ ______ ___ ___ .___ ( ) You will find attached a duly executed Compromise and Release for your approval. ( ) Please place this matter on calendar for hearing on all normal issues ( ) Please dismiss the above matter for lack of prosecution. ( ) By a copy of this letter to applicant's attorney, we request that we be served with all medical reports in your possession or control pursuant to the rules of the Industrial Accident Commission. OCX) Attached for filing herein ares Dr. Bernard Smolens' reports dated September 27 and August 31, 1962. Dr, D. Simmons' report dated September 14, 1962. Copies served on: Silver, McWilliams . Sherman 305$ N. Avalon, Wilm. Sincerely, INDUSTRIAL INDEMNITY COMPANY Bvt J. A Karr___________ r .... r - - --------- ---------- ................ - - T B e r n a r d M. S m o l e n s , M, D D a n i e l A, La n g , M. D. |24B OlINDON AVCNUC WtlTWOOD VILtAOC LOB A N O C LC * * 4 , CALIFORNIA GRANITE 6 - O m i O IPIO M ATCS o r TMC AMERICAN BOARD O f INTE R N A L M ED IC IN E September 27, 1962 Re: John D. Staples Employer - Plant Asbestos J. A. Karr, Claims Adjuster Industrial Indemnity Company 3745 Long Beach Boulevard Long Beach 7, California Dear Mr. Karr: I examined Mr. Staples on September 11, 1962, and the results of my examination and laboratory studies are as follows: mmtiwHirNiAi A. Chief Complaint: Shortness of breath, chest pains, frequent chest colds and pneumonia in March 1962 from which he feels he has never fully recovered and which he feels all are due to asbestos inhalation. B. History of Present Illn e s s :, fir. Staples is a 37-year-ola white male who has the following occupa tional history. He has been a heat and frost insulator working with asbestos for the past nine years. Prior to this, he drove a truck, owned and worked in service stations primarily. He worked for North American Aviation for six months in 1950. At no time in his prior occupations was he exposed to any dust or asbestos or any type of inhalant. In the past nine years, he worked for nine or ten dif ferent companies in the same occupation. His job always i- involved installations of heating or air conditioning r insulation on the job in many types of building construc f tion. This involved carrying asbestos or fiberglass to various parts of installations, cutting and fitting it around pipes or ducts. The asbestos was occasionally put on in a semi-liquid form, molded and dried on a fitting like a plaster cast. He never wore a mask i except on one occasion when he was opening bags of as bestos and pouring i, into;.*-Mixer. He had no other occasion to use a mixer or pour bags of asbestos, t * I ~ ' * '" He never noted any adverse affects from this work until he began noticing shortness of breath about one year a g o . He noted that he was getting tired and short of breath in the early afternoons at' the job. He w o u l d pick up something and couldn't carry it very far because -------- "gwwgjp \ jjMjm.HN.HU-JHWMWHJW* $ Res John D. Staples Employer - Plant Asbestos of this shortness of breath. He noted an increase in 'his usual ''cigarette cough." Less and less activity produced more and more shortness of breath but he con tinued to work until he got pneumonia in early March 1962. At that time, he was hospitalized with fever, chills, lightheadedness and a productive cough including streaks of bright red blood in the sputum. He had A-rays and sputum studies and tuberculosis was not found although initially suspected. He was given antibiotics but r e quired no oxygen. He was told that this was due to as bestos and he should not return to his usual occupation. He has had episodes of feeling better but then if he gets a cold and his cough increases, he gets very short of breath. Generally, he produces almost no sputum in the morning - if he does it is only a teaspoonful or two. It is very stringy and brown in color. He has taken penicillin but became allergic to It so now he takes sulpha^ when he gets an Infection. He takes no bronchodilators or other lung medication. He has had no wheez ing attacks prior or since the pneumonia. He has smoked cigarettes for 25 or 26 years at the rate of one and one-half to two packs per day for many years and two to two and one-half packs the year prior to the pneumonia. He has smoked one pack a day since his pneu monia. C. Past History: He was bor n in Missouri and came to California In 1939. He served in the.U.S. Navy from 1943 to 1946 and spent two years in the Pacific Theater. He was not sick or wounded except that both ear drums were ruptured from concussion blasts. He denies any intake of alcohol since 1949 but states that briefly before that date, he drank fairly heavily for one or two years. Family History - His father is living at age 60 and has pulmonary emphysema. His mother Is liv ing at age 57 and is in good health. One sister is living at age 40 and is in good health. He has been married 17 years. His wife is 40 and in good health. There are four children, one of whom Is a son age eight who has a ventricular septal defect. There is no fam ily history of tuberculosis, cancer or any other serious disease except for the pulmonary disease which his father has. He had the usual childhood illnesses. Adult Illnesses Ho had mumps in the service, and tonsilitis in 1959, Surgery - Ho had an appendectomy for a ruptured appen dix In 1952 and tonsillectomy in,,1959. System Review His maximum weight* had been*1^4 pounds, average weight 170 to 175. His hearing is decreased bilaterally because of the perforated ear drums. He sleeps with one pillow # -3 Res John D. Staplea Employer - Plant Asbestos and on his side. There has been no ankle edema. His appetite has been good, D. Physical Examination; Heights 59M . Temperatures 58. Pulse: 50. Blood Pressure: 100/70, ^Weight-: 175 as ordinarily aret-secTI tie appeared as a well developed, well nourished white male, alert, oriented and cooperative and in no breathing distress while at rest. On mild exercise in the office, consisting of rapid walking and bending, he exhibited objective evidence cf mild respiratory distress. Head and Necks Revealed no venous distention, thyroid enlargement or adenopathy. Eyes: Pupils, external ocular muscles and fundi were normal. E a r , Nose and Throat examination: Both tym panic membranes appeared to be intact and there was no decrease in hearing of the wrist watch tick. Chest: Revealed symmetrical respirations bilaterally wTtH~mini mal restriction of chest motion. Lungs: Revealed slight decrease in breath sounds bilaterally with per sistent rales at the left base laterally. H e a r t : Not clinically enlarged. There was regular sinus' rhytorn without thrills, murmurs or rubs. The second aortic sound equaled the second pulmonic sound. ADdomens Obese. There were no organs, masses or tenderness noted; there was a well healed right lower quadrant scar. Genitallas Revealed an atrophic left testicle. tieu.ro 1optical examinations Produced physiologic responses. Extremities: Revealed no clubbing, cyanosis or edema. The remainder of the physical examination was not remark able, E, Laboratory Data: Complete blood count - hemoglobin 1 5 .6 grams; packed cell volume 46; white blood count 8200 with a normal differential except for a slight lymphocytosis. Urinalysis - specific gravity 1.026; no abnormal chemical or urinary sediment findings. Sedimentation rate 18 mm. at the end of one hour. The CO2 combining power 26 mEq.with a normal for our lab oratory from 24 to 32 mEq. Electrocardiogram revealed a heart rate of 76; PR interval of .18; QRS .08; QT interval .36. The heart was in an intermediate electri cal position with a transition zone at V-3 and normal R wave progression although there were slightly large R waves on the right side of the precordium. The im pression was that of an electrocardiogram within normal limits. X-rays of the chest taken in the PA and left lateral projections in "the inspiratory as well as ex piratory phases revealed the cardiac silhouette to bo unremarkable. Both .hilar shadows were somewhat promi nent and extensive calcification was present in both hilar areas. The lung maraings were exaggerated throughout. The Inspiratory and expiratory study revealed good motion of the diaphragms and no evidence i . i ! lm f a il ito li l ll ll 11 I . 1 M. I . . . . . . . . . I un li M M * ...... . Re: John D. Staples Employer - Plant Asbestos .of emphysema radiographically. Pulmonary function tests performed at the Cardio-Pulmonary Laboratories of the Mt. Sianl Hospital revealed a slightly decreased or low normal vital capacity and moderately reduced maximal breathing capacity with low air velocity index. The impression was that of "minimal airway obstruction without hyperinflation. This will be consistent with mild asthma or bronchitis. There is no emphysema." F. Discussion; It is my impression that the combination of a long history of exposure to asbestos and the X-ray findings of exaggerated lung markings consistent with early pulmonary fibrosis plus additional evidence of dyspnea on exertion, make asoestosis a medical probabil ity. At this time, the degree of pulmonary impairment is minimal but a more exact evaluation of the pulmonary function can be determined by further and more elaborate tests such as blood gas analysis at rest and after ex ercise, as well as other studies which would indicate more precisely the degree of fibrosis present. An abso lute diagnosis of asbestosis can only be made, however, on histologic grounds, after a lung biopsy. The chest X-ray snows evidence of numerous calcifications which reflect prior inflammatory disease of a nonindustrial nature and the element of his very long and heavy cig arette smoking must be considered. However, the history he presents and the X-ray changes present at his rel atively young age make asbestosis a probability. There fore, I feel that this is an industrial condition. I feel that his condition is permanent and stationary because the changes brought about by asbestos inhalation are not progressive once the patient is removed from the offending irritant, in contradistinction to such diseases such as silicosis which progress regardless of further exposure. For this reason, I feel that it would be most wise that this patient seek employment in another field of endeavor. Very truly yours, BMSilc J[ ho BERNARD M. SMOLENS, U.D. l i i n - ii m i M ' u 1 - - , iHUl.1 |I. HUJgHlllP B ernard M. S m o l e n s , M. 0. a n ie l A. Lano , M. IS O U C N O O N A V tN U K W E S T W O O D V IL IA O C LOB AN 0C LC S 1 4 , CALIFORNIA O R a n it c e-O M I OlRLOMATCS OF THE AM ERICAN BOARD OF INTERNAL M EDICINE August 31, 1962 * f J.A. Karr Claims Adjuster Industrial Indemnity Company , 3745 Long Beach Boulevard / Long Beach 7 California Re: John B. Staples Employer Plant Asbestos Dear Mr. Karr: Pursuant to our telephone conversation of two weeks ago, and the letter dated August 22, 1962 to Mr. Staples, my office reserved two hours at 2.15 PM on August 30 for this examination. Mr. Staples failed to appear, nor was any notification of cancellation received from either him or your office. Enclosed please find my statement for this reserved time, and advise me as to any future arrangements in this matter. Sincerely, \ 1 Bernard Smolens, K.D. i- BMSsra ( T * MOUNT SINAI HOSPITAL REPORT OF PULMONARY FUNCTION TESTS PATIENT: S t a p le , John___________ ROOM:. _________ Coi* No----------------- Aoo 37 vr.: Height _____ f t . _ J L _ i n .; SPIROMETRY Vital Capacity, Total (V C ), cc. 1 toe. V.C.(VC,), S o f V C 3 we. V.C.(VC,), S o f V C Maximum Breathing Capacity (M BC), L /m in. Air Velocity Index ( A V I) Minute Vol. ol Retp. at rest (M V R ), L /m in. Expiratory Reserve ( ER ), cc. Respiration Rate ( RR) , /m in. Date: 9 / 1 4 / 6 2 Time: Dr. B . M. Sm olens 5 lbs.; Surlace area OVBASELURVEESD 1 .9 5 m*; Sex M PREDICTED NORMAL %PNROERDMICATLED 349A 7IX 92X 81 0 .7 9 I2 14 All 7 851 83* 97% 138 59X . 0.8-1.2 4-8 0 * saturation, S (E ar oximeter): Rest, a ir _________ Rest, 0 * __________ Normals: Air: 92* 102; 0 t : 97-105 xercise Forced ventilation ..... LUNG VOLUMES Functional Residual Capocity (FR C ), cc. Residual Volume (RV), cc. Total Lung Capacity (TLC), cc. F R C /TLC x WO. S TLC RV/TLC x 0 , S TLC 3038 1926 5420 5 6 .1 3 5 .5 3330 2033 6440 4 9 .4 _____ 3 2 * a _ BLOOD GASES: (Arterial____; PH__________________ pCO| mm Hg venous____ ; arteriali zed venous_____} Os saturation, S: Rest, oir Rest, Ot Exercise 91X 95X 84X 114X ____ nox SPECIAL PROCEDURES: REMARKS: V .C . low n orm al. Timed ? .C . s l i g h t l y lo w . reduced MBC with low ATI. Lung volum es a r e w ith in norm al li m i t s . M oderately IMPRESSION: INITIALS: M inim al airw ay^ob strtictitlrt w ith o u t h y p e r in f la t io n . T h is w ould be c o n s is t e n t w ith m ild asthm a o r b r o n c h it is . There i s em physem a* V!t v.A CARDIO-PULMONARY LABORATORY ! BEFORE Uff ITOUSTM ACODEHT COHHISSIOM Of THE 5IAIE Of CMI0SH1A l o t k t r a l R e q siil fw A ilsw aisce *1lia a iM t> j'J - *. I S ; "*V 'CM': 'K S E r 24 \?2 Um I M t Itajifft___ EtaaJ&i <*nri H-'.; Oil A, -UC.-O STATE OF CALIFORNIA D epartment op Employment n. John D Stanly lii* euiun P. O . Bo* P 0 or l K 6 Santa Ana Cdlf J l Q w l L C g x s 5 ,,.iij %U ? , r C l i .I2Z..12 -22S____ i B r i S T I l ' M U I ICC B U TT I t -- 3ra3&rofi-o-fcre%Mtf-- _ J & v f iI-i m .J m-ixiuiQoJki,- n H H I I t l U M I I I __ HQ_iL I. T he undersigned hereby requests th e Industrial A ccident Commission to determ ine and allow as a lien the sum stated below as "T otal," w hich represents the am ount of unem ployment compensation disability benefits paid to date, and in addition a lk n is requested fo r any fu rth e r benefits w hich may be paid, u p to th e am ounts stated in p arag rap h below. 2. Filed under Labor Code Section 490J (f) s D isability benefits a t the vgeekly rate o f $ ___i-klsPhL. paid fo r th e period -- --__ 1..'...................... --, to , inclusive ( __ iS iL d a y t a t $JLilaLofier day including__ &__ days paid fo r w aiting period w aived) <. 1 B 2 0 0 0 . Filed under Labor Code Section 450J (b ) t Additional benefits for hospital confinement at the daily rate of $-- 12. 0 0 paid for the period . 3-S-2- to . -2 -1 1 2 2 - incluve T otal S-- ^ 0 0 $- J. Further uaerr.ployraent compensation disability benefits may be paid to the employee for both daily indem nity and additional benefits fo r hospital confinem ent w hich w ill n o t exceed $_ and $- respectively. 4. T he undersigned declares he has delivered o r mailed a copy o f this do cu m en t on-------- 5 3 p tP I t V .g r I s I P 6.2-------- to each o f the parties fisted. A lr;o c o y ' c a s o r v e u o n t h e f o l l o w i n g r e p r e s e n t a t i v e s a n d a t t o r n e y s Ob? record: Silver, Kch'illians Sk.oraan 2 'Vt 0'/% ' T1*T!* Avalon 31vd 'wUni' igton Calif St a t e o p C a lifo rn ia D epartment op Employment UX> C U ISM T See reverse EMPLOYEE'S CONSENT T O ALLOWANCE O F L IE N I understan d th a t th e am o u n t show n s to v e as ' 'T o ta l" m ay n o t represent the to ta l am o u n t o f Usability benefits th a t I m ay be paid by th e D ep artm en t of E m ploym ent pending tlw Com m ission's decision o n m y w o rk m en 's com pensation claim . 1 consent to the allowance o f a lien in the total am ount I am paid by the D epartm ent of Em ploym ent as shown on any final "N o tice and P.equest for Allowance o f Lien" filed by the D epartm ent o f Em ploym ent. C*r 250! ntv. 9 M ) tartarei CST. 0-i-**oo. tem * ei aow 3) **** lMi L! 4 IN D U S TR IA L A C C ID E N T C O M M ISSIO N i STATE o r CALIFORNIA I t I c * N o 62_ L B J L 9396 JOHN D. STAPLES A p p l ic a n t__ TS. P ; v* H PERKINS , J T . T H O R P E , C . F . B R A U N , C O A S T X.j i.La ti Li/j O I L F I E L D C O N S T . A R M S I R O N C O N T R * , FI LLr. J.LAS3 , Pair, I N S U L A T I O N , R. T. D I N W I D D I Kir.2 H-A. .-'.SL-1.3T03, L . A . C O R K , P L A S T A S B E S T O S , MUNDET CORK CQRP., CAL* ST., CO. Defendants^ Notice of Time and Place of Further Hearing ONE DAI : NOTICE TO ALL PARTIES You are hereby notified that further hearing w ill be held in the above-entitled action at 236 EAST THIRD STREET--ROOM 237 i- LONG BEACH, CALIFORNIA I O C T O B E R 5, 1 9 6 2 9 A.M. D ated a t; Long Beach l i INDUSTRIAL ACCIDENT COMMISSION NOTE: CONTINUANCES AND FURTHER HEARINGS ARE NO T FAVORED. NAME AND ADDRESS O f PERSON'S SERVED: John D. Staples, 1 0 634 Ceres, 'Whittier Edwin Silver, 305i N. Avalon, W i l m i n g t o n Dept, of Employment, Bo 146h. Santa Ana Baker Perkins, 1000 Hess, Saginaw, Mich* J. T, Thorpe, 948 . 2nd, Los Angeles 12 C. F. Braun, 1 0 0 0 Fremont, Alh. Oil Field Const., Box 947 Bakersfield C o a s t Ins, 2684 Lacy, Los Ang e l e s 31 Armstrong Const., 4400 Bandini, L0s Angeles l i b a r g l i s o E n g . , 5 9 3 3 T e l e g r a p h icd., L. A . 3 2 R. T. Dinwiddie, 8627 S. Atlantic, S.G* Kircher Asbestos, Box 6652, Pnx. Ariz, LA Cork, 4180 E. W a s h i ngton, L.A, 23 Plant Asbestos, 1540 W, 9th, LB, Mundet Cork Corp., 6ll6 Walker, Maywood Cal St. Co., 8823 Mettler, Los Angeles 3 Wallace, et al, 300 W. Coast Hwy., Newport Beach M c C a r t n e y , et al, 6 3 9 3. Spring, L.A. 14 Murray Roberts, 750 Broad, Wilmington Hrrlihy &,,,Herlihy. Ocean Center Bldg, L.B. 2 -3-V-w a a V S (jCS' T ^ g) ' 1 'l date 8-3-62 ip * f Amer. Motorist Ins., 3545 W i l s h i r e , L. A. Cas, Ins. C o . , 8 1 0 S. S p r i n g , L.A. St. Comp., 3629 A t l a n t i c , L.B. Z u r i c h Ins., E o x 3 2 0 3 , " Terminal Annex, Los Angeles 54 P a c i f i c E m p l o y e r s Ins., 2484 Pacific, Long Beach Argo Ins., 1001 Wilsnire, L.A. Ame r . E m p . , 639 3. N e w Hampshire. L.A. 5 Travel. Ins., Ocean Center Bldg*, Long Be^ch N a t 'l. Auto & Cas, Box 57O, L.A. Aetna Cas, & Su, 810 S.SpringLA Mich. Mut. Liab., c/o Brown Bros, A d j s . , 3 5 1 7 W. 6 th, L.A. 5 Indust. Indem., Box 2251, L.5. CLOfTON & PENNY 639 S. SPRING LOS N&ftUe-Mi 'OAL'I P O H f M ft (Signature of Person Serving Notice) i m i ton aeo wir iaSssawMM* Before the Industrial Accident Commission of the State of California JOHN D. STAPLES Cast No, 62 LB 19396 Applicant vs. Order Joining Party BAKER IE REINS, J.T. THORPE, COAST INSULATING OIL FIELD COD ST., ARMSTRONG CONT. FIBERGLASS ENG. REECE IHSUL. R.T. DINWIDDIE, KIR CHER ASBESTOS, L.A. CORK. PLANT ASBESTOS, KUNDET c|RK CAL ST. CO., C.F. BRAUN Defendants Defendant Good Cause Appearing Therefor: IT IS HEREBY ORDERED THAT AKER. MTRST, CAS, INS., ST. FUND, ZURICH INS. PACIFIC EMP. ARGONAUT INS., AKER. ElIP. TRAVELERS, NTL, AUTO & CAS. AETNA CAS. & SURETY, MICH. MTU. LIAB. INDUST. INDEK. ~ be joined as a party defendant in the above entitled cause. SEE NOTICE OF HEARING FOR NAMES AND ADDRESSES S CURVED ON 0-3-62 jul KEITH L. JENSEN. Rtftrtt INDUSTRIAL ACCIDENT COMMISSION t Fon 4# mrv. *.#) ma a-aa aro  K fORE THE IKDUSTRL ACCIDENT COHMSSION CE THE STATE CE C&UEORKU Hoik and Eeqaoi! for Aowantt of Um Ulhc- 62 LB 19 39 6 tajary. Fronl953 to March 1962 jU H * i j-f 3r STATE OF CALIFORNIA D epartment op Em piov m ent n. John D Staples 111 z u k ia x n r P. o . Bos lk 6 6 Santa Ana Calif 1 0 6 3 k Ceres Whittier Calif_ If97 12 2206 **Mevcr*cutineuniTT Armstrong Contracting JfkOO E Ban&ini E Lo3_Angeles 22_Calif Travelers Ins Co 110 W Ocean Blv Long Beach 2 Calif MtQftAftCl Qtltll* M tltl 1. The undersigned hereby request* the Industrial Accident Commission to determine and allow u a Lea the sum stated badeldoiwtioan*a"Tlieontaisl,"rewquheiscthedrefporreasennyt*futrhtehearmboeunneftitosfwuhnicemh pmloayymbeenptaicdo,muppentosatthioenamdiosuanbti*litsytabteedneifnitps apraaigdratpoh date, "3.", and in below. 2. Filed under Labor Code Section 490J ( f ) ! DUab.I.l.ty be.nefit* *.t .the wentIJfyi raote of t 22*20. paid f or the period___ 2 2 " 5 _________ __t o _______ inclusive (_ i2 i_ jd ay s at $J!2i2?piT day including J2. day* paid for waiting period waived) Filed under Labor Code Section 4903(h) s Additional benefit* for hoemsiptitaa!l confinement at the daily rate of |_.-!i2*2Q_ paid for the period , J d h to , -3=03=62. inclusive T otal $___ kSa-QQ-- f..l#Qgfl.QQ__ 3. Further unemployment compensation disability benefit* may be paid to the employee for both daily indemnity and additional benefits for hospital confinement which will not exceed $_JhLCL.S!2----- and $------------2-----, respectively. 4. The undersigned declare* he has delivered or mailed a copy of this document on-- to each of the parties listed. --^- 2 Silver, McWilliams & Sherman 3C'5| n Avalon Blvd Wilmington Calif State o p C alifornia D epartm ent op Employment ----- ---- ---- UOCUIIT P /jb EMPLOYEE'S CO N SEN T T O ALLOW ANCE OF LIEN I understand that the amount shown Stive as "Total" may not represent the total amount of disability benefits that I may be paid by the Department of Employment pending the Commission's decision on my workmen'* compensation claim. I consent to the allowance of a lien in the total amount I am paid by the Department of Employment as shown on any final "Notice and Request for Allowance of Lien" filed by the Department of Employment. iO- orassin*vah .s *i T Ui \ *52** # 6 Before the Industrial Accident Commission of the State of California C g f# jyv 6 2 l b 1 9 3 9 6 JOHN D. STAPLES n. C. P. BRAUN, et al Applicant DtftndanJ ORDER TAKING OFF CALENDAR GOOD CAUSE APPEARING THEREFOR: It Is H e r e b y O r d e r e d That the above entitled matter be and the same hereby is taken off calendar, and all further action on the matters now pending herein suspended, subject to being reset, after notice, upon request o f any o f the parties hereto. KLJsob 5.29.62 rm 40 imv. -.i> fP MAY 29W6Z *'} seL W M 2' "s EE ..yf. H A ERX^t v R A _____ INS.... INSA ___ IN. Cl___ SUIF_____ ,ii[.^pp.iniri Cel'*** MA/ %9 1962 ` FDWIN J IIV H RICHAHD L MctVILUAMS ARTHUR SHERMAN ERNEST L. GRAVES LOUIS BERSON LAWRENCE WEITZER LAW OFFICES silver, McWilliams & sherman 303H NORTH AVALON BOULEVARD WILMINGTON. CALIFORNIA TlRMIHAk 4-ZS#3 SPAUCt 5-6138 IAKTA ANAo nil'l METCALF1 D S U VIA 11 NOArK At TAUT FIMMIIT 7 0011 Hay Twenty Fourth Nineteen Hundred Sixty Two V V nr n Ll/V k3A ^ Ff Industrial Accident Commission 236 East Third Street Long Beach, California Re: John D. Staples vs. Plant Asbestos, et al Gentlemen: Enclosed please find original and approximately 27 copies of application in the above captioned matter. Copy of said application together with copy of the attached employment record has been served on each of the employers named. We are now attempting to ascertain the identity of the workmen's compensation insurance carriers and pending determination of such information, it is requested that the matter be taken off-Calendar. Very truly yours, s i l v e r , McW illiams & sherman s J ' t * ' ' Jl frii L. M c W i l l i a m s RLMCrll STATE OF CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION APPLICATION <*. 'If'*, >'XH K W 2& A> * ~ h f ; . r ' FILE SIGNED ORIGINAL AND SEX COPIES (PLUSE P m ORTYP* NAMES AMOADDRESSES) CASE N O . < 19396 _____J OH N D. S T A P L E S _________ _______ A m K Jin f--- 1 0 634 Ceres APPLICANT' A0 OCKS0 ^..Whittier, .California,. n. Social Security N o . 4 9 7 r 1 2 ~ 2 2 0 6 SEE LISTING ATTACHED (PLO Y C Rf A 000EM UNKNOWN AT THIS TIME ta n n ili m m m miiiu INSUIAHCC C A R tlt* A0 0 0 S00 i. John D. 9Aheat & Staples A OR I B M O T tt frost Insulator Between 1953 and " 2 4 " 2.5.--, alleges that while employed on___M a r c h 7 _____ 19-62-- dati or iu n __al__ Los Angeles County & vi c i n i ty California, by J3j llstlng a-ttached ------- ,-- , --Ke austained injury arising out of and in the course of the employment, at follows: asat er tanoTta E x p .Q 8 r e . ,, t Q L . _ a & b e j ? . t p s _ d u s t a . . f i b e r & l a s a . J S ( . . . a t h . e r . . i r r i t a n t a _ EXPLAIN HOW INJURY WAS RECEIVER ____resulting in Lun g s and r e spiratory system_____________________ ___ __ TA TI WHAT PACTS OP SOOT WEM ICJUAI ARO SUSSIOUINT S U IT S 2. ..Unknown. . was the employer's insurance carrier on date of injury. ANE OP IHSUCA0 CS COMPART 0 1 , IP IM PLO Ttl WAS ROT IHSVMO, STATI W HITM II E iriN IU R E R O l UNINSUBE j _____ 5 tn c J te .T c h .7 ._ ._ .1 .9 6 2 _____ ______________________ r t u o o t e rr wo 01 to T a t la ju tt e * T i INiOIKD l I T V I N t TO W OK ATI LAST BK01CAL n H W I I 4. Was compensation paid?--------Mo----------- I ----------------------- T tf 01 10 TOTAL TA10 ~ $........... ............ ................ WCKKLT A T I ATS e r LAST r A T e i iT f. Earnings at time of injury $------- M&X-t------- @----- __ The basis of pay was.. aONTM 0 1 W i t t STATI TAT r ia lO B O t BUILT BATS. NOBIS A BAT ABB NATO A W i l l 6. Wat medical treatment needed?- Yes Who furnished treatment?- Dr. George Frallck a m i b i s o r e o c r o ts w ao t m a t s b T a t i i j a n t a o s t a t i w ao r a ta T a ti sills 7. This application is filed to determine liability for: a. Temporary disability--y e s b. Permanent disability_y&S-~ c. Medical treatment.}!e S ---- d. Medical < t i s oa wo T ts e* no t is oa no e. Litigation expense-- X *t- f. -- ....-- ... -- ----------------------------------------------------------------------- TCS 0 * 0 STATt ANT O T H tt MASON I. rucA T ioas riL i W H E R E F O R E , it it requested that a tim e and place be f i xed fo r bearing and that an award be made granting stu b relief at m ay b t prober under th e W o rkm en 's Com pensation Law s o f Californiau ^ . . Dated a L - W i i m i n g t e m ______ California, -- M a x i .? a .J-962_________ Hearing requested at-- ---- ^ n g ^ B e a c h ----------- CITI Number of witnesset- __ " " " unknown Estimated time of triaL Jusx -mYE&a-]fcmLIMS-&. SHERMAN, APPLICANT S A T T O IC tf 305^ North Avalon Boulevard Wilmingtonf California TE 4-2595 ATTORNEY A D O R ISI A l l T I U P W R I 0 1 0 i o t i -- h u m o n m s w c m ww w m u h 1 10-- c m wax M i n f t * c m H m r t i m m u c h t e a n a i r c m . Ip m u r i , m m m o p p w i m w a n c r i a m CALL-- , mm a r 4' i *p -a n i -- FiR t m u m m h i n t i u * s u m * t i c s m i n u m pitpipt a c o v * * 4e. T*t>* M h i* TiU* r-*trw, MmISc$iisfsitMa w tm . t u n teumiAt, MINIKItt ITMil M fU.CS *tt M UHU iatiti u t t ru sm tittr T TPi RABIAT Offici Of TPS ri mit stats ti m u i u m i m m tutta m fWTWWiit. |SUT|iAL ACUMRT COMMISSION ITROrV SCLAV, R*S avict VlU. TVSKKStaRAimPTUiom- f ti s# ts rm$ ass placs op rasm i m u nun tut ac iinusntii imprsso. tv attoamii m sthir asbmt. 4 M 1 4*4t r?SM <D 3} P [, z J '4 JOIiU Dfe STAPLES 1953 Oct. Bpker Perkin* 1000 Hess Ave* Saginaw Michigan 5 6 hours Oct. J. T. Thorpe 360 Kov* 948 E. 2nd St* Dee* Loa Angelaa 12 Calif. 1954 $ i Jan. J.T. Thorpe 939 w 1 Feb. M 1 Mar* W 4 % Apr, w i May n j June It July C. F. Braun 288 m Aug. 1000 Frecsont St. \ Alhanbra Osi if. \ Sept. \ i%* \ 4 Sept. -i OC-1 , Coast insulating 2 6 cu L a c y Efe. 88 H Loa Andales 31# Calif. J, T. `-arpe lid n Oil Field Gon&trm 8 2 4 p.o. Bex 9 4 7 4 BakerefIcld* Califl 1i K o v . Oil Fieid C o m tr* *40 ! December J.t. Thorpe 360 a | 1955 ! - j ran. S m e t r o n g Confer, i , 44CO E. Lendini 299 * i 1 ab. Los Angele* Calif ir, J.T. Thorpe 19 * rii Armstrong Confer* 6 ?8 " '7 * na M m ly mn % 1956 April May Juna July Aug. Sept. Oct. Hov* Dec. Oct. FiberrlaB Engineering i W 5933 Telegraph Rd, t o a Angele* 22 Cel if. ^ Y 2 $ 4v v5 Abii Hi *5 Reece Insulation 1,563 Valley Blvd. Los Angeles 32 Calif* OrL M 56 1957 Jan Feb* Her* Apr* May June July Aug* Sept. Oct. Kcv. Dec. Pibergla* Engineering Armstrong Confer. ft ft RecenIru3uletion Co. ? M m 632j 49? 509 Jan* Feb* March Apr* Hay June' July Aug. Sent. Oct. Kov. Dec. 1958 Reece Insuletion J* T*BTharp * n ff It R. T. Dinwiddle ? M 2X9 11^9 86 G ' r Jan. Feb. Mar, Apr, July Aug. Sept. Oct. Kov. Dee, 1959 R. ? Dinwiddle 662? So. A tla n tic South Gfte, Calif. n 657 hra. F ib enr g la s E n gin eerin g 366 " Reecen I n s u la tio n n ff 592* " Jan. Feb* Feb. Mar. Q t / v ": '' M f ;"V I p n UOC fllz 1962 -~ lAi,, &f~ ' * ------ P la n t A sfbf estos Company Coast Insulating Armstrong Contr. 172 l hr; 38 * [0 * I960 Jan. Mar. April May June July Aug. Sept. Oct. Kov. Dec. Reece Insulation Kircher Aebastoa ?.0 , box 6 6 5 ? Phoenix. Arisons Los Angeles Cork iflSO 2 . W ashington oa Angeles 23* n Plant Asbestos I3 I4O V . 9th St. Long Beech, C a lif. K 1961 33 ; 0 * 172 * 1208 * 1 a- Jan. Feb. Kar. Apr. May June Aug. Sspt. Oct. K ov . De c. Plant nA sb e sto s * H 872 " Mundet Cork Corp. 102 * 6116 Welker Ave. Maywood, C a lif. Cel Etat Company 32 " 6023 Met tier St. Xio s j.e & ^, Cel if . i-ibarrj.fi engineering 1 0 Plant Asbestos Co. 3 C6 j ?4 S IONS B FA C H BO U Ir L O N G B l A C H 1, t.A O R N IA G M F i a D 4 0411 f- ' b INDUSTRIAL INDEMNITY COMPANY January 16, 1963 Industrial Accident Commission 236 East T h i r d Street Long Beach, California frrr'^ I** -, ' ,. jArj 1 7 V vi s fiui. t I.A .C .N : 62 LB 19396 Claimant: John D. Staples Employer: Plant Asbestos Co. Claim No: C62-43-09355 Gentlemen: A fully executed copy of the Compromise and Release Agree* ment is being served on this date to the Carriers listed below. The original of this agreement has been submitted to the Commission by the office of Stephen J. Grogan and a copy retained by Mr. Grogan as well as the office of Silver, McWilliams & Sherman. Very truly yours, James A. Karr Claims Adjuster ftp* Aetna Casualty and Surety, 810 South Spring, Los Angeles American Motorist Ins. Co., 35^5 W i 1shire, Los Angeles American Employers Ins. Co.. 639 S. New Hampshire, Los Angeles, Argonaut Insurance Co., 1001 Wilshire Blvd., Lcs Angeles Casualty Ins. Co. of Calif, 810 South Spring. Los Angeles National Automobile and Casualty, 639 South Spring, Los Angeles Pacific Employers Ins. Co., 2^84 Pacific Ave., Long Beach 9 State Compensation Ins. Fund, 3629 Atlantic, Long Beach Travelers Insurance Co., Ocean Center Bldg., Long Beach Zurich Insurance Co, Box 3203, Terminal Annex, Los Angeles y TCMCN J.OHOOAN MAUICt , HOOAN, J, JAMZt . NCLr.ON caw o r r ic e * STEPHEN J. G ROGANfM^'> I* * O U tH W t*TM O R H A N D A v t ' ` ,' 'r * LOS ANGE L E S S in Ou. J?\H 1 i !*ihj ~ s a 1 1 1\c.v T " ----- ------- J&B0 January 10,1963. Industrial Accident Commission 236 East Third Long Beach, California Re; John D. Staples vs. Armstrong Construction,et al. Case No. 62 LB 19396 _______ ___ Gentlemen; Enclosed for approval you will find executed Compromise and Release in the above case. Very truly yours, SJG;a8 Enclosure h* cc Attys. Silver, McWilliams &Sherman 305f North Avalon Boulevard Wilmington, California ' &---;**aS3 . EDWIN SILVER RICHARD L. M oW tlUAM S ARTHUR SHERMAN LOUIS BER50N LAWRENCE w u r e r 6l> LAW OFFICES silver, McWilliams & sherman S08H NORTH AVALON BOULEVARD WILMINGTON, CALIFORNIA TERMINAL 4-3599 8PRUCS B-913R urn amaomci MITCALU 0 LVIR U M N O * MAIN * * KJWMU-T 9*0t U n r r rr>;^ CCMHijj'OH-- 1. ' ; `H November Sixth Nineteen Hundred Sixty Two NU'' fel-nil' AH!>f-H/0______ _____ * .? c.yr Industrial Accident Commission 236 East Third Street Long Beach, California Re: John D. Staples v. Plant Asbestos, et al, 62 LB 19396 Gentlemen: Compromise and-Release will be submitted in the captioned matters in the near future in the amount of $9,250.00. Inasmuch as the Department of Employment has filed a lien c laim in the sum of $ 1 ,8 6 8 .0 0 , this letter is written to assist the Commission in allocating a portion of the proceeds to said lien claimant. Medical expenses to date are $451.00, consisting of $166.00 to Dr. George Fralick, $145.00 to LaMirada Hospital and $140.00 for X-rays and laboratory tests, or, in round figures, $450.00, leaving a balance of $8,800.00* Due to the nature of the applicant's condition, the sum of $1 ,0 0 0 . 0 0 is allocated to future medical treatment and/or observation, leaving a balance of $7,800.00 for temporary and permanent disability. T h e period of temporary disability involved is March 7, 1962, to October 1, 1962, or, for purposes hereof, $2,100.00. Based upon the nature and extent of the applicant's con dition as reflected in the medical file and also because he will be unable to return to his trade, the potential permanent disability is estimated at 60 to 65%, or for purposes hereof, $13,000.00. Total potential liability is therefore $15,000.00, and, consequently, that portion of the balance of the proceeds which may be deemed based on liability for temporary disability is represented by the fraction 21/151 or $1,084.00. For the period of temporary disability involved, compensation is payable under the terms of the settlement at the rate of $5.21 per day; and Inasmuch as the Department's lien covers a period of 182 days, they would be entitled to the sum of $9 4 3 . 2 2 plus $48.00 expended lor hospitalization benefits or a total of $996.22. Page 2 Considering all the facts and circumstances of the case, said sum is considered fair and equitable to all parties as the amount to be allocated to the Department Yours very truly, SILVER, McWILLIAMS & SHERMAN KLMcW:bc cc: Department of Employment, P.O.Box 1466, Santa A n a Clop ton 6s P e n n y State Compensation Ins. Fund, Long Beach Travelers, Long Beach Aetna Cas. 6e Surety Herlihy & Herlihy, Long Beach Industrial Indemnity, Long Beach National Auto & Cas Murray Roberts(Attn: Mr. Thomason) Michigan Mutual Liab. American Motorists American Employers Pacific Employers, Long Beach EDWIN SILVER RICHARD L MoWlLUAMS ARTHUR SHERMAN LOUIS PERSON LAWRENCE WEHUR y LAW OFFICES silver, McWilliams & sherman 303H NORTH AVALON BOULEVARD WILMINGTON, CALIFORNIA TERMINAL 4-3593 * SPRUCE 3-313S ANTA ANA O m C t METCALF* flLVtt IS I S N O T * MAIN f f T t m EINMAL? f*001l November Seventh Nineteen Hundred Sixty Two <3 flifo -- L.^> Industrial Accident Commission 236 E. Third Street Long Beach, California Re: John D. Staples v. Plant Asbestos, et al, 62 LB 19396 Gentlemen: Line 7 of paragraph 3, page 1, of my letter dated November 6 , 1962, should read $15,100.00 instead of $15,000.00 as the amount of total potential liability. Thank you. Very truly yours, silver, mcwilliams & sherman RLMcW:bc cc: Department of Employment, P.0. Box 1466, Santa Ana 4 \ O M ik l rfiiMMAMh MfeMM 1 4 CLOPTON & PENNY Attorneys at Law 639 South Spring Street Los Angeles l4, California MAdison 7*1566 >r A INDUSTRIAL ACCIDENT COMMISSION August d , 1962 Tf Long Beach, California RE: John Staples vs. Coast Insulating, et al Case No. 62 LB 19396 Hearing Date Oct. 5, 1962 Our File # 19963 and A Gentlemen: Your attention is respectfully Invited to the following: ( ) Attached please find duly executed Compromise & Release for your approval. ( ) Request is hereby made for further hearing to permit cross examination of .________________________________ , and presentation of rebuttal evidence. ( X ) Please notify us of any hearings or other proceedings in the above matter. We anticipate making an appearance, either special or general, on behalf of__Pacific_________ Employers Ins. Co______ at the appropriate time. ( ) The parties request that you withhold further action herein pending the filing of a Compromise and Release Agreement. { ) Attached for filing herein are: VACTF VHKkb Copies sent to: Silver, McWilliams le Sherman V a n . A n n . _ T. A 11 Very truly yours Office Manager C A *LS AODftCftft HERLIHY & HERLIHY ATTORNEYS AT LAW SUITS SIS TASK CENTRAL SUILOIMS I t WEST SIETH STSSST LOR ANGELES 14. CALIFORNIA Telephone MAdison 7-4BM August 22s 1 9 6 2 r ^ - v v T .................. *- Iv LONO REACH OFFICE OCEAN CENTER SUILDINS IIO W EST OCCAM BLVD. LONO REACH , CALIFORNIA Telephone hemlock B-I4BB A'1.';9 iCi? Industrial Accident Commission 236 East Third Street Long Beach, California Rel JOHN D. STAPLES vs PLANT ASBESTOS EMPLOYERS LIABILITY ASSURANCE COMPANY 6 2 L B 1 9 3 9 6 - October 3 1962 - 9:00 A. M. Bear Sirs, Please enter our appearance as attorneys of record in the above captioned case for the defendant insurance carrier, EMPLOYERS LIABILITY ASSURANCE COMPANY. Please serve us with copies of all documents issued by the Industrial Accident Commission* By oopy of this letter we request that applicant's attorneys serve ua with copies of all documents which they may in the future filb with the Commission or serve upon the defendant* Yours very truly, HERLIHY ft HERLIHY___, ; KTJ/rahh A t t o l8foTr* d S m h t m . cc: SILVER, MC WILLIAMS & SHERMAN ATTORNEYS AT LAW 305^ North Avalon Blvd. Wilmington, Calif. 4/ D O U 9 1A I K. WALLACE w. QERALD SHOWN i 0 w e s t W a l l a c e 8 c B h o w n ATTORNEYS AT LAW lo o C O A S T M IO H W A V WEWBOHT BEACH, CALIPO BN IA August 8 , 1962 TELEPHONE M ID W AY G - 4 4 Q 9 r Industrial Accident Commission 236 East Third Street Long Beach, California AJC y js,,,/ 'c Subject: John B. Staples vs. Baker-Perklns, et al l.A.C. No. 62 LB 19396 Gentlemen: This office represents the Aetna Casualty and Surety Company, carrier for defendant Kundet Cork Corp., in the above titled matter. Defendant submits no medical reports at this time as none are in its possession. By carbon copy of this letter, attorneys for the appli cant are asked to submit copies of all medical reports in their possession to this office. Very truly yours W. Gerald Brown WGB*IV CC: Silver, McWilliams & Sherman Attorneys at Law 305% North Avalon Wilmington, California T*D D. SHOWN SfcKKItAi. MANAGER SAN ri ; 0 CoOr. fCi cALi IFORNIA -- SANDY K. HOWOITH M A N A IE *. C O U T H A R ^ ^ iro R M IA >_ - v3a& BROWN BROTHERS ADJUSTERS FOUNDED 1 **4 DY ARTHUR B. DROWN I , I PLC A IK A D O R I S I M P L Y TO 3917 WEST SIXTH STRICT LOS ANOCLCS 9. CALIFORNIA RANDY F. HOWORTH M ANA.E* July 27, 1962 RHONE DU NKIRK 7-3 131 In Yo u* Reply RLIAtE OlVE O u * PILE NO. LA C /R NO. 28717 Department of Industrial Relations 236 Cast 3rd Street, Room 237 Long Beach 12, California Attention: Lenore M. Kruger, Clerk Industrial Accident Commission RrTPm Wivi '&rcinK; COMMISSION-- i.U& DIACH jytgoi*? ALi> f ":.* ...... ___................ Re: Case No. 62 LB 19396 JOHN D. STAPLES -vsC. F. BRAUN, ET AL Gentlemen: This will acknowledge your letter of Nay 29, 1962 addressed to BakerPerkins in Saginaw, Michigan. Please be advised that Baker-Perkins, Inc. is insured for Workmen's Compensation with the Michigan Mutual Liability Company and that this insurance company is represented by the undersigned. Kindly show copies of future correspondence to the Michigan Mutual Liability Company care of this office. Your kind attention to this matter will be appreciated. Very yours, BROWN BROTHERS ADJUSTERS CALIFOWNIA OFFICII SAP1Rl";i 1 INSI.I4 0 0 D > LONU BEACH tu LOS ANQELEB * A W**tY*viLU ton tiNi-7 TO MA'**!** MONTEBf V OAKLAND BALM SBRINO FASAT't sa BO' -NA BET . M4 AEOSOOO C<TT 43 ADJUSTING OFFICES bacaamento BALiNAS BAN Bi RNAROINO ban ; h u O BAN HUNG lCO SAH J. t AN LL'i't OB'BFO BAH FA*ACL A N T A NA A N 1A ASBABA ANI* MARMA A F . t A M't A BTOCKTON TULASI VAL LfJO VAN NUTB VINT USA ARIZONA o f f i c e s FHOl'iH TUCson NEVADA OFFICES 1> I VtA M M) onrooN offices lUUINC Fo*H AND WABHJNOTON OFFICES BAT FIS WROKANS Page 2 ^12. 1/13* C15. 16. 17. 18. 19. 2210.. 22. 23. J. T. Thorpe by American Motorists Ins. Co., Policy No. SCM-431898, 1-1-58/59 R. T. Dinwiddle by State. Compensation Ins. Fund, Policy No. P-180247-58, 7-1-58/59 Fiberglas Engineering by Aetna Cas. & Surety, Policy No. 31C-926-RR, 9-1-58/59 Reece Insulation by National Auto & Cas. Ins. Co., Policy No. 22C-628498, 7-1-59/60 Kircher Asbestos - - No record of coverage. Los Angeles Cork by Zurick Ins. Co., Policy No. 22-24-408, 10-27-59/60 Plant Asbestos by Industrial Indemnity, Policy No. CC-600091, 1-1-60/61, Policy No. CC-611154, 1-1-61/62 Mundet Cork Corp. by Aetna Cas. & Surety, Policy No. 1C-23413-PT, 12-31-60/61 Cal State Company - - No record of coverage. Fiberglas Engineering by Aetna Cas. & Surety, Policy No. 2C-3241, 9-1-61/62 Plant Asbestos by American Employers Ins* Co., Policy No. WCP-019-8102-001, 1-1-62/63, 1-1-62/2-1-62 Coast Insulating by Pacific Employers, Policy No. 1WC-28645, 5-1-61/62 It is requested that the foregoing insurance carriers be joined as party defendants herein. A copy of the application together with a copy of medical reports heretofore filed with the Commission is being served con currently on each of the carriers named. It is respectfully requested that the matter be restored to calendar and set for a one-day hearing. Yours very truly, s i l v e r , M cW i l l i a m s & s h e r m a n RLMcW :bc V r i c h a r d l . M cW i l l i a m s cc: (with enclosures) all carriers listed ...... . It.llll. DOUOLAB * , WALLACE W. O tA A L D MOWN Wa l l a c e Be B row n A T T O R N E Y S AT CAW J O O W C S T C O A S T M IO M W AY KKW PO RT r e a c h , c a l if u k n ia Jun 14, 1862 TC LC AH O N C MIOWAY o * 4 4 5 t h 1,. WDHVU AiflWRi COMMijilOH-- LfG BtAOf JUN 181962 Industrial Accident Commission 236 East Third Street, Room 237 Long Beach, California Subject: John D. Staples vs. C. F. Braun, et al I.A.C. No. 62 LB 19396 Gentlemen: This office represents the Aetna Casualty and Surety Company, carrier for defendant Fiberglas Engineering Company, in the above titled matter. Defendant submits no medial reports at this time as none are in defendant's possession. By carbon copy of this letter, attorneys for the appli cant are asked to submit copies of all medical reports in their possession to this office. Very truly yours W. Gerald Brown WGB:sr CC: Silver & McWilliams Attorneys at Law 305% North Avalon Boulevard Wilmington, California , MOM "Automobile and Casualty* Insurance Co. h o m i o rric i-L O B a noclib a* iq u t h i m i n o arneC T MAIL AODM CBS-BOX 7 * 0 , MITRO. STATION LOB ANOCLCS BB, OALir. MADISON S-BSB3 SeI*i# * Starata 305k fcorth Avalon Blvd. WXIttinfiton, California *?* Cl; 7 J i u m 12, l<j62 t'uu A > iSQf uQ to/f ' HQ, Ion Co, i/et al Gentlemens Damata la ha all medical importa or under hia !Pllont*a attorney for matter la hie poaaeaeloa truly youre, M Cummings * Compensation C l a i m ac* Indue trial Aeoldent 236 East Third * e e t on Beach, California M l * risi amd casualty U It A M c t AC U ITI AND B U *T ONO D DIVISION o r ADMINISTRATION N A R R A R tV M tT C m t. ONF CONCILIATION SCRVJCK L IN N ROW S, M M TNVtSAR d iv is io n or arrmcnticcsmir standards DIVISION o r MOUtINO LOW I L L N t lt O M , CHIBS OIVISION o r in d u s t r ia l a c c id k n ts , W . M A C O O N A LS , C M A IN M A * Q STATE OF CALIFORNIA d iv isio n o r in d u s t r ia l s A rrrv TNO W At M. A W N O IM *. OM IS* IDMUND 0. SOWN Oovomor JOHN . HINNINO Dlmtoc D IV IS IO N o r IN D U S T R IA L W KLFARC rLORSNet .LirroN, ernsr D IV IS IO N o r LASO A LAW KNFORCKMBNT SIRMWMO A R V W IT t. CM IS # d iv is io n or Lab or s t a t is t ic s a n d rsscarch W AUniCS I . T N S 9 N , C HISF DEPARTMENT OF INDUSTRIAL RELATIONS HEADQUARTERS' 96i MISSION STREET, SAN FRANCISCO 3 STATS eO M R C N S A TIO N IN S U R A N C FU N D ADDRESS REPLY TOi yj e o f ^ Mav 29, 1962 ^ c p {S-''- Baker Perkins 10n0 Hess Ave. Saginaw, Michigan 236 C. Third Street, Room 237 Long Beach 12, California HEmlock 5-8367 O 62 LB 19396 CO r\> in On May 2B, 1962 Claim was filed by an Application for Adjustmert oft John D. Staples aildgiri^* injury pp between 1952 to March 7, 1962 The application does not show the name of your workmens compensation insurance carrier. Will you please give us this information in the space provided below. If you are not insured, please state the reason. Since the Commission joins the insurance carrier as defendant in these cases, your carrier should be notified tiat the above application has been filed. You will receive Notice of Hearing as socn as the claim has been placed on the calendar. If you are neither self-insured nor have a workmen's compensation insurance policy, you should attend the hearing for your own protection. The prompt return of this form will be very much appreciated. Yours very truly . Lenore M. Kruger * Clerk INDUSTRIAL ACCIDENT COMMISSION Sagbnawr Mirhtgan M E OF K O R K I N ' S COWEIvSATION INSURANCE COITAl'Y: _____ NOTICE: The law provides that failure on the part of the employer, for a period of ten days to furnish this information constitutes prima facie evidence that the employer has failed or neglected to secure the payment of compensation. The law further provides that failure to secure the , payment of compensation is a misdemeanor. STATE OF CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION Mundet Cork Corporation 6ll6 Walker Avenue Maywood, California May 29, 1962 236 E. Third Street, Room 2 3 f Long Beach 2, California Hemlock 50367 *,v! iMMi; ft 62 LB 1939 JUN 1 1196? \m On May 2S, 1962 an Application for Adjustment of Claim winajsurfyilendp / by between John 1953 D# s t a p le s and March 7, 1962 alleging The application does not shew the name of your workmen's compensation insurance carrier. Will you please give us this information in t he space provided below. If you are not insured, please state the reason. * Since the Commission joins the insurance carrier as defendant in these cases, your carrier should be notified that, the above application has been filed. Tou will receive Notice of Hearing as soon as the claim has been placed on the calendar. If you are neither self-insured nor have a workmen*s compensation insurance policy, you should attend the hearing for your own protection. The prompt return of this form will be very much appreciated. Yours very truly Lenore M. Kruger Clerk INDUSTRIAL ACCIDENT COMMISSION NAME OF W O R K M E N 'S COMPENSATION INSURANCE COMPANY: AETNA CASUALTY & SURETY COMPANY mm * * mm- mm> mm mm mm mm mm mm mm mm M * NOTICE: The law provides that failure on the part of the employer, for a period of ten days to furnish this information constitutes prima facie evidence that the employer has failed or neglected to secure the payment of compensation. The law further provides that failure to secure the payment of compensation is a misdemeanor. STATE OF CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION COM1MM/j/,)/i;i,'.. I . M 819S2 V AkcrtiFo .. __ IXiliM ____CASiW. ___________ _ BiHff Reece Insulation 4563 Valley Blvd. Los Angeles 32, California M a y 23, 1962 236 E. Third Street, Room 237 Long Beach 2, California Hemlock 5-&3o7 62 LB 19396 On May 2S, 1 9 6 2 an Application for Adjustment of Claim was filed by John D. Staple. alleging injury on 1953 to March 7, 1962 -t -- '-- . The application dees not show the name of compensation insurance carrier. Will you information in t he space provided below. please state the reason. your w o r k m e n s please give us If you are not this insured, Since the Commission joins the insurance carrier as defendant in these eases, your carrier should be notified that the above application has been filed. You will receive Notice of Hearing as soon as the claim has been placed on the calendar. If you are neither self-insured nor have a workmen*s compensation insurance policy, you should attend the /hearing for your own protection. The prompt return of this form will be very much appreciated. Yours very truly NAME O F W O R K M E N 'S COMPENSATION INSURANCE COMPANY* Ignore M. Kruger * Clerk INDUSTRIAL ACCIDENT COMMISSION / V W w * * v/fi. / V jY/'^Vk ^ ^ ^ C NOTICE* The law provides that failure on the part of the employer, for a period of ten days to furnish this Information constitutes prima facie evidence that the employer has failed or neglected to secure the payment of compensation. The law further provides that failure to secure the payment of compensation is a misdemeanor. Q STATE OF CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION Armstrong Contractor kUOO East Bandini Los Angeles, California May 28 , 1962 236 E. Third Street, Room 237 Long Beach 12, California Hemlock 5-#36? 62 LB 19396 iiFrnytn IV'' -11 M l BOS' On May 28, 1962 an Application for Adjustment of Claim was filed by John D. Staples alleging injury y y between 1953 and March 7, 1962 The application does not show the name of compensation insurance carrier. Will you information in t h e space provided below. please state the reason. your workmens please give us If you are not this insured, Since the Commission joins the insurance carrier as defendant in these cases, your carrier should be notified that the above application has been filed. You will receive Notice of Hearing as soon as the claim has been placed on the calendar. If you are neither self-insured nor have a workmens compensation insurance policy, you should attend the hearing for your own protection. The prompt return of thia form will be very much appreciated. Yours very truly Ienore M. Kruger Clerk INDUSTRIAL ACCIDENT COMMISSION NAME OF WORKMEN'S COMPENSATION INSURANCE C O M P A N Y * ___ ______ NOTICE* The law provides that failure on the part of the employer, for a period of ten days to furnish this information constitutes prima facie evidence that the employer has failed or neglected to secure the payment of compensation. The law further provides that failure to secure the payment of compensation Is a misdemeanor.  i PLANT ASBESTOS COMPANY ENGI NEERS C O N T R A C T O R S 1)0014thSTREET EMERYVILLE I. CALIFORNIA * OL 04371 1540 . WEST tth STREET LONG BEACH. CALIFORNIA HE 74443 June 1, 1962 C0MMi5il0W i i/ir'r(r.f!`^T?^ 'J'JN 6 fas? State of Cellfornle Industrial Accident Commission 236 E. Third Street, Room 237 Long Beech 2, Cellfornle Attention: Lenore M. Kruger, Clerk Subject: 62 LB 19396 John D. Staples W G entlem en: With reference to your letter dated May 29, 1962 con l cerning an Application for Adjustment of Claim alleging Injury between 1953 and March 7, 1962 which was filed by John D. Staples, you have requested the name of our Workmen's Compensation Insurance Carrier which is as follows: wmimm Aawrleen Employers Insurance Co. 639 South New Hampshire Street Los Angeles, California Our Policy So. A-19-8102-001 Expires 1/1/63 Should there be any further information which you may desire, pleaae let us know. Very truly yours. PLAKT ASBESTOS COMPART w w w '.niDII.nWWPIIIImm. Paul G. Risto Vice President PGR:bw cc: American Employers Insurance Co. i H' I I RTHI AL si 1I C1^ b Ml C H A M a i (* * r k i b i STATE OF CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION Kircher Asbestos Post Office Box 6652 Phoenix, Arizona May 2ft, 1962 2 3 6 E, Third Street, Room 237 I.on Beach 2 California Hemlock 5-S3o7 PfCctVTJ 62 LB 1939% Krmn'W h w i COKMiSyCK- Atow t.u .>***^ _ , Stinti On May 28, 1962 an Application for Adjustment of Claim was filed by John D. Staples alleging injury p p between 1953 and March 7, 1962 The application dees not show the name of your workmen's compensation insurance carrier. Will you please give us this information in the spac "provided below. If you are not insured, please state the r e a s o n jp Since the Coaanission joins the insurance carrier as defendant in these cases, your carrier should be notified that the above application has been filed. You will receive Notice of Hearing as soon as the claim has been placed on the calendar. If you are neither self-insured nor have a workmen's compensation insurance policy, you should attend the hearing for your own protection. The prompt return of this form will be very much appreciated. Yours very truly Yw v' a - LenoreTu Kruger clerk INDUSTRIAL ACCIDENT COMMISSION NAME OF W O R K M E N 'S COMPEL .TION< -- INSURANCE COMPANY -- e m -- "-- -- ff-- NOTICE The law provides that raillire on the part of the employer, for a period of ten days to furnish this information constitutes prima facie evidence that the employer has failed or neglected to secure the payment of compensation. The law further provides that failure to secure the payment of compensation is a misdemeanor* # w> STATE OF CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION `(TT*, IWW-- ^ 4M ((rp 4 9g? - <r` Fibers]ass Engineering 5q 33 Telegranh Road Los Angeles 22, California May 23, 236 E. Third Street, Room 237 Long Beach 2, California HEmlock 5 - 3 W 62 LB 1Q396 On Kav 23, 1Q62 an Application for Adjustment of Claim was filed by ,Tohn D. Star! es injury i a between 353 and March 7, 1962 alleging The application does not show the name of your workmen's compensation insurance carrier. Will you please give us this information, in t h e space provided below. If you are not insured, please state the reason. Since the Commission joins the insurance carrier as defendant in these cases, your carrier should be notified that the above application has been filed. Tcu will receive Notice of Hearing as soon as the claim has been placed on the calendar. If you are neither self-insured nor have a workmen's compensation insurance policy, you should attend the hearing for your own protection. The prompt return of this form will be very much appreciated. Tours very truly T.enore M. Krnp-er 1 Clerk INDUSTRIAL ACCIDENT COMMISSION NAME OF W O R K M E N 'S COMPENSATION INSURANCE COMPANY t ___ T//\ -Xvtf. C q , NOTICE* The law provides that failure on the part of the employer, for a period of ten days to furnish this information constitutes prima facie evidence that the employer has failed or neglected to secure the payment of compensation. The law further provides that failure to secure the payment of compensation is a misdemeanor. *r-N " STATE OF CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION KKrVR COMMi'CN - l Pi G "C4CH JUN 41962 U fit.!?) .USMO___ ____ u-.**! May 2R, 1962 R. T. Dinwiddie R627 South Atlantic Avenue South Gate, California 216 E, Third Street, Room 237 Long Beach 2. California Hemlock 5-&3o7 62 LB 1939*6 On May 2S, 1962 an Application for Adjustment of Claim was filed by John D. Staples alleging injury oty between 1^53 and March 7, 1962 The application does not show the name of your workmen's compensation insurance carrier. Will you please give us this information in the apace provided below. If you are not insured, please state the reason. Since the Commission joins the insurance carrier as defendant in these cases, your carrier should be notified that the above application has been filed. You will receive Notice of Hearing as soon as the claim has been placed on the calendar. If you are neither self-insured nor have a workmen's compensation insurance policy, you should attend the hearing for your own protection. The prompt return of this form will be very much appreciated. Yours very tru^Ly Lenore M Kruger * Clerk INDUSTRIAL ACCIDENT COMMISSION NAME OF W O R K M E N 'S COMPENS INSURANCE COMPANY: _ NOTICE The law provides that failure on the part of the employer, for a period of ten days to furnish tnis information constitutes prima facie evidence that the employer has failed or neglected tr secure the payment of compensation. The law further provides that failure to secure the payment of compensation is a misdemeanor* STATE OF CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION M a y 29, 1962 Cal State Company 882} Mettler Street Los Angeles 3, California 236 E. Third Street, Room 237 Long Beach 2, California HEmlock 5^367 62 LB 1 9 3 9 6 rerrn A'Ti-KI C0MMiICK-- LCN'j 3ACH 'JUN 4 m 2 a w w o .. ___ __ Eiiiaa___ tAsi _ _____________ ifftaoE On Way 28, 1962 an Application for Adjustment of Claim was filed by john d . Stanles , injury Hd between 1953 and March 7, 1962 alleging The application does not show the name of your workmen's compensation insurance carrier. Will you please give us this information in t he space provided below. If you are not insured please state the reason. Since the Commission joins the insurance carrier as defendant in these cases, your carrier should be notified that the above application has been filed. You will receive Notice of Hearing as soon as the claim has been placed on the calendar. If you are neither self-insured nor have a workmen's compensation insurance policy, you should attend the hearing for your own protection. The prompt return of this form will be very much appreciated* Yours very truly Lenore M. Kruger, Clerk INDUSTRIAL ACCIDENT COMMISSION \ NAME OF W O R K M E N 'S COMPENSATION ^ Argonaut Insurance Co. INSURANCE COMPANY: 1001_ V i l s h i r e J L o j s mm mm mm mm ~ mm * Angles Ylju Calif. NOTICE: The law provides that failure on the part of the employer, for a period of ten days to furnish this information constitutes prima facie evidence that the employer has failed or neglected to secure the payment of compensation. The law further provides that failure to oecure the payment of compensation is a misdemeanor. K T. 'i'horne A3 E, Second Street Los ^-npe]es If. C a ;1 ferula 236 E. Third Street, Room 237 Long Beach 12, California HLmlock 5-^367 T v, x wf . 6 / .d 1 0 3 0 ^ ^1 XH' *v 45 `f,"s r On iV-iv 23, l^i? Claim was filed by injury <tvi between an Application for Adjustment of J - h n h . St u U*s . alleging to * 't i . ", '^62 The application does not show the name of compensation insurance car-ier. Will you information in the space provided below, please state the reason. your workmena please give us if you are not this insured, Since the Commission joins the insurance carrier as <defendant in these cases, your carrier should be notified t at the above application has been filed. Y o u will receive I'otice of Hearing as soon as ^ne claim has been placed cn the c a l ends. If you are neither self-insured nor have a workmen*s compensation insurance policy, you should attend tne hearing for your own protection. The prompt return of this form will be very much appreciated. Ypurs very truly burtort* ' Kruf'r Clerk IHDbSTrjAL aCCDwTT coi 1JSSION p a m e o f V O R K 'O '.; c ^ / V U S k I I O N INSURANCE CV-.TkVY: . /<?rt / v . jV ZyiTSfcJg- - ~ ,, vomirp. m h o la w ^rovi les that f a i l u r e o n the part o ^ / t h e e m w x o y e r , r ,, pcriod of ten days to furnish this information c o n s t i t u t e s p**ima f a c i e evider.ee t h a t t h e e m p l o y e r h a s f r i l c l o r tr,r'e c t e d t o s e c u r e t h e p a y m e n t Ot c o m p e n s a t i o n . T '-i. j~ w f * * r t *<> p r o v i d e s U . n t f " 1 ' r n * t o s e c u r e t n e p - i v - ^ i u 01 ; o n i s a rd f,-j>Meanor. STATE OF CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION fftnvro COMMr.StON... m> ftfu May 2 0 , 1962 JUN 1 9F2 A*::' n -f) ; 1 -:! ; 236 K. Third Street, Room 23$ Leng Reach 2. California Hemlock 5-S3o7 Los Angeles Cork 4180 East Washington Los Angeles 22, California ,,, TR t m * 62 L 1 ) 0 0n May 26, 1962 an A p p lic a tio n f o r A djustm ent o f Claim wi najsu rfyi l efadfnf bbye tw e e n Jo19h5n3 D.andStMaaorlcesh 7, 1962 a e The application dees not shew the name of thia compensation insurance carrier. Will you Plea t insure(i information in the space provided below. If you are not insured, please state the reason. Since the Commission joins the in ^ anf?rfdrthIta^ e eabovent *** these cases, your carrier should be notified tha application has been filed. You will receive Notice of Hearing as f?n a n u r ^ d ^ n o r ^ h a v e pa lwacoerkdmoenn*tahec ocmapleennadaatri.o n IInfs uyor aun caerep noelii ctyhe, ryaelf-insured nor hare h e a rin g f o r your own p ro te c tio n . The prompt return of thi. form ill be very ouch appreciated. Yours very truly Ignore M. Kruger * Clerk INDUSTRIAL ACCIDENT COMMISSION NAME OF WORKMEN'S COMPENSATION T n m r s n ,, Comnanv INSURANCE COMPANY. _________ f t j r l P t t . -- - "" 4466 Wilehire Blvd, Los Angeles 5* Cal. NOTICES The law provides that failure ^ rnishP?hLinforinatiinyer' for a period of *?d;,,ea that the employer has constitutes prime Ja5^e 8 " re the payment of compensation, failed **r neglected t o secur ^ to eeCure the The law further P ^ ^ i ^ . ^ J l d e m e a n o r . payment of compensation is STATE OF CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION INI' l ( ,v- JUN 11G2 Oil Field Construction Post Office Box 947 Bakersfield, California , . U; ,*15____ LUi ;>>.------May 29, 1962------------- 236 East Third Street, Room 237 Long Beach 12, California 62 LB 19396 On Mav 2#, 1962 an Application for Adjustment of Claim iwnajsurfyilet fdd by between John 1953 D. Starles and i*arch 7, 1962 alleging The application does not shew the name of your workmens compensation insurance carrier. Will you please give us this information in t h e space provided below. If you are not insured, please state the reason. Since the Commission joins the insurance carrier as defendant in these cases, your carrier should be notified that the above application has been filed. You will receive Notice of Hearing as soon as the claim has been placed on the calendar. If you are neither self-insured nor have a workmen's compensation insurance policy, you should attend the hearing for your own protection. The prompt return of this form will be very much appreciated. Yours very tnily Lenore M. K r u r e r Clerk INDUSTRIAL ACCIDENT COMMISSION NAME OF WORKMEN S COMPENSATION INSURANCE COMPANY* _ Casualty Ine. 1953 thru 1957 115^-thru JL96 NOTICE* The law provides that failure on the part of the employer, for a period of ten days to furnish this information constitutes prima facie evidence that the employer has failed or neglected to secure the payment of compensation. The law further provides that failure to secure the payment of compensation is a misdemeanor. DIVISION OS ADMINISTRATION MAMSASST S. MITCH'f eMIF C O N C IL IA T IO N SCRV1CV LSNN lO W I M , S U FtH VISO It D IV IS IO N o r A P T R IM T IC C S H ir S T A N D A R D # c n a n l m r , Ma n n a c h u s D IV IS IO N O F H O U B tN O k S W S L L N S LS Q N , CW 'BF DIVISION OF INDUSTNIAL ACCIDCNT# S. W . M A C D O N A L O . C N A IS N A N STATE OF CALIFORNIA %* DIVISION OS INDUSTRIAI. SAFfTV TM OM AS N . A U W B A M S . CM1SF EDMUND 0. MOWN Oa w a n JOHN f. NINNINO DJre c to r DIVISION OF INDUSTRIAI. W U FA R I f l o n b w c . e w i r r s N , .h i c f DIVISION OF LARON LAW CNFORCCMtNT SISMUND ASTRITI. CMICF D IV IS IO N O F LA R O R S TA T IS T IC S A N D RSSCARCH t f A U S IC I I. S B S IN lN fO N . CMISF DEPARTMENT OF INDUSTRIAL RELATIONS T.coMr..*,.eN1..uH,u,.D (A IM . . M O ... , . A M K A N A .n HEADQUARTERS. 965 M ISSIO N STREET, SAN FRANCISCO 3 ADDRESS REFIY TO. May 29, 3962 C. F. Braun 1000 Fremmint Street Alhambra, California 236 E. Third Street, Room 237 Long Beach 12, California HEmlock 5-S367 62 LB 19396 On Mav 2S, 1962 an Application for Adjustment of Claim was filed by John D. Staples alleging injury between 1953 to March 7, 1962 The application does not show the name of compensation insurance carrier. Will you information in the space provided below* please state the reason. your workmen's please give us If you are not this insured, Since the Commission joins the insurance carrier as defendant in these cases, your carrier should be notified t'.at the above application has been filed. You will receive Notice of Hearing as soon as the claim has been placed on the calendar. If you are neither self-insured nor have a w o r k m e n 's compensation insurance policy, you should attend the hearing for your own protection. The prompt return of this form will be very much appreciated. Yours very tru^y Lernore M. Ki uger w Clerk INDUSTRIAL ACCIDENT COfMISSION NAME OF WORKMEN'3 COMPELSATI m AMERICAN MOTORISTS INSURANCE CO 3545 WILSHIRE BOULEVARD INSURANCE COMPANY : - -LOS -ANGELS -5>,-GAIriPGRNI-A - - - NOTICE: The law provides that f a i l u r e ~ m ' T ilg - p a r y `Of 'ttiC"npl y r r * for a period of ten days to furnish this information constitutes prima facie evidence that the employer has failed or neglected to secure the payment of compensation. The law further provides that failure to secure the payment of compensation is a misdemeanor. o - .-***-- 4 STATE OF CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION Coast Insulating 2664 Lacy Street Los Angeles el, Calif, May 20, 1962 236 E. Third Street, Room 2 3 7 Long Bench 12, California Hemlock 5 -6 3 6 7 62 LB 193/96 On May 26, 1962 an Application for Adjustment of Claim inlury1^ ** JohlJ D * StaPle [} between 1953 and March 7, 1962 alleging The application dees not show the name of your workmen's compensation insurance carrier. Will you please give us this information in the space provided below. If you are not insured, please state the reason. Since the Commission joins the insurance carrier as defendant in these cases, your carrier should be notified that the above application has been filed. f You will receive Notice of Hearing as soon as the claim has been , placed on the calendar. If you are neither self-insured nor have p a workmen's compensation insurance policy, you should attend the hearing for your own protection. ' The prompt return of this form will be very much appreciated,' Yours very truly Lenore M, Kruger Clerk INDUSTRIAL ACCIDENT COMMISSION NAME OF WORKMEN'S COMPENSATION INSURANCE COMPANY*. NGTICKi The law provides that failure on the part of the employer, for a period of ten days to furnish this information constitutes prima facie evidence that the employer has failed or neglected to secure the payment of compensation.. The l a w further provides that failure to secure the payment of compensation ia a misdemeanor. *kifc (OhMMwUMi U u i 1 '** APPLICANT: John D. Stan]es ATTY. FOR APPL: Silver & Me Williams, I.KIN CLAIMANT: 10634 Ceres, W h i t t i e r `S 3 0 5 i N. A v a l o n B l v d . , W i l m i n g t o n 1' . ^4* 'v\tVo , ^ DEFENDANTS: \ Baker Perkins 1000 Hess Ave. Saginaw, Michigan-*/ 5, J. T # Thorpe 943 E, 2nd St., Los A n g e l e s 5 .C. -F, Braun 1000 Fremont St., Alhambra $ Coast Insulating 2684 Lacy St., Los Angeles 31 T. Oil Field Construction P.O. B o x b A 7 , B a k e r s f i e l d v/ (.Armstrong Contractor 4400 E, Bandini, Los Angeles^ *] Fiberglass Engineering 5 9 3 3 T e l e g r a p h R d . , L o s A n g e l e s 22*"y & Reece Insulation 4 5 6 3 V a l i e v B l v d . , L o s A n g e l e s 32*'' j.R. T; Dinwiddle 10* Kircher Asbestos K L o s `Angeles C^rk -- A t l a n t i c , .S o uthrOafcc'*' I P.0. Box 6652 Phoenix, Arizona*^ 4 1 3 0 E. W a s h i n g t o n , Los a n g e l e s 23*^ r1 Plant Asbestos 1540'W. Qth St.. Long Beach v J3 Muhdet Cork Corn. 6116 Walker Ave., Maywood J Cal State Company, 3323 Mettler 3t., Los Angeles 3 ^ ATTY. FOR DEFENDANT INSURANCE CO. A m e r i c a n Motorists Ins. Co., 3545 Wilshire Blvd,, LA*'' 1 v "Casualty Insurance Co.^ 810 S. Spring St., LA ll'v - v .9 State Compensation Ins. Fund v N j v v s l Zurich Insurance Co. 3629 Atlantic Ave., LB- ^ Box 3203, Terminal Annpx, LA 54 % Pacific Employers Ins. Co. 2434 Pacific Ave., LB y \ Argonaut insurance Co, 1001 Wilshire Blvd., LA v 3"American Employers Ins, Co* 6 3 9 S. New Hampshire, LA 5 i fr Travelers Insurance Co. Ocean Center Bldg., LB 2*' National Auto & Gas. Co. Box 57O, LA 55 ^ ^ 1 "JAetnA Casualty & Surety Co, 810 S. Spring St., LA 14 , 1 Michigan Mutual Liab. Co. c/o Brown Bros. Adjusters.* . .. 3517 West 6th St., LA 5 u i 1 INSURANCE CO. ATTT. rf Wallace & Brown McCartney, Ryan, Trout & Dally Murray Roberts Herlihy & Herlihy 300 W. Coast Hwy., Newport Beach 639 S. Spring St., LA 14 ^ 750 Broad Avenue, Wilmington*^ Ocean Center Bldg., LB 2 ^ j Xcv o 1 - y * 'u CLOPTON & PENNY 61 3. SPRING LOS ANGELES 14. CALIFORNIA utiii .... yn"1m-- HUU'I mwww. mnyiii n, -W lliw . s is .-! NATIONAL .Automobile and r.*nBtty Insurance Co. homb orncc - los anoblcs November 30, 1972 6 3 0 S O U T H S P R IN G STREET MAIL ADDRESS-- BOX 5780 METRO. STATION LOS ANGELES. CALIF. 0095 2-959 Workmen's Compensation Appeals Board 107 South Broadway Los Angeles, C a lifo r n ia 90012 WCAB NO: 72 SO 31086 Arthur L. Hauk vs. Various Employers Cur F ile : 20815 Gentlemen: Would you k in d ly p u ll WCAB NO: 62 LB 19396. John Stapples vs. Various Employers, and advise th~Ts o f f ic e when 1't" is a v a ila b le fo r review. Thanking you fo r your courtesy Very t r u ly yours, MC:an M a rip rle Cummings, Y Compensation Claims examiner I ft C MARINE AND C A U A 4 * V I N S U R A N C E r t D C t I T V A N D 4 l) * r T V I O N O f* /V itedBWMMBMUth m i m U m t x"\ V HU dMMil t 1 BEFORE THE INDUSTRIAL ACCIDENT COMMISSION OF THE STATE OF CALIFORNIA 2 CASE NO. 62 LB 19396 3 4 JOHN D. STAPLES, ) 5 Applicant ) 6 vs ) 7 B A K E R PERKINS; J. T. THORPE; ) ORDER APPROVING C. F. BRAUN; COAST INSULATING; 8 OIL FIELD CONSTRUCTION; ) COMPROMISE AND RELEASE ARMSTRONG CONTRACTOR: 9 *FTBEHuE?f5?^ REECE ) r I INSULATION; R. T'.'~DINWIDDIE; 10 KIRCHER ASBESTOS: MUNDET CORK CORP.: ) LOS ANGELES CORK; THTL STA'i'k ( J U M M f ; 11 PLANT ASBESTOS; ) AMERICAN MOTORISTS INSURANCE CO.; 12 CASUALTY INS. CO. OF CALIFORNIA; ) STATE COMPENSATION INS. FUND; 13 ZURICH INSURANCE COMPANY; ) PACIFIC EMPLOYERS INSURANCE CO.; 14 IARGONAUT INSURANCE COMPANY; ) !TRAVELERS INSURANCE COMPANY; 15 NATIONAL AUTO 8s CASUALTY COMPANY; ) AETNA CASUALTY 8c SURETY COMPANY; 19 MICHIGAN MUTUAL LIABILITY COMPANY; ) INDUSTRIAL INDEMNITY COMPANY; 17 AMERICAN EMPLOYERS INSURANCE CO., ) 18 Defendants ) f 19 20 The parties to the above entitled action having filed a C o m : i 21 promise a n d Release herein, on January 11, 1963, settling the above I I{ l' 22 case for $9,250.00 in addition to all sums which may have been paid 1 I M 23 previously, and requesting that it be approved; a nd this Commission ! ; 24 having considered the entire record, including said Compromise and > J j j 25 Release, now finds that it should be approved; and, ; * ; i 26 GOO D CAUSE APPEARING THEREFOR: IT IS ORDERED that said Com- 1 | 27 promise and Release be, and it is hereby approved, payable as follows: 28 (a) By Industrial Indemnity Company: $2,221.95 To: Dept, of Employment, lien claimant $996.22 I 29 Silver, McWilliams 4 Sherman, lien claimants 50.00 I John D. Staples, applicant 30 ____ 1175.73 i - 1- i Mow* 339 * *;u'i S) r u y ip 'JH" m y t k w mnimm n u il iiiiiilfcyatfrtiiiMiM i 1 (b) B y Aetna Casualty & Surety Co. $1918.70 TojSllver, McWilliams fe Sherman as attorneys' fee $750.00 2 John D, Staples, applicant __________ 1168.70 3 The following sums are to be paid to applicant by carriers as designated; 4 c Pacific Employers Ins. Co. $1,415.05 d American Motorists In. Co. 1,005.90 5 e Travelers Insurance Co. 821.80 f State Compensation Insurance Fund 800.00 6 National Automobile & CasualtyIns. Co. >g American Employers Ins. Co. 703.85 120.75 7 Zurich Insurance Company 120.40 Casualty Ins. Co. of California 57.40 8 : Michigan Mutual Liability Argonaut Insurance Company 39.20 25.00 9 Total " 9,250.00 10 11 12 INDUSTRIAL ACCIDENT COMMISSION 13 QWtca I.3 I .6 3 14 62 L B 1 9 3 9 6 DATE 15 FEB 1 -9 6 3 Referee Names and Address of Persons Served: 16 IJohn D. Staples, 10634 Ceres, Whittier Silver, McWilliams Is Sherman, 305^ N. Avalon, Wilmington 17 Dept, of Employment, P. 0. Box 1477, Santa Ana .Armstrong C o n s t r u c t i o n . 4400 E. Bandini, Los Angeles 18 C. F. Braun, iooo Fremont St., Alhambra Cal State Company, 8 8 2 3 Mettler St., Los Angeles Coast Insulating, 2684 Lacy St., Los Angeles R. T, Dinwiddle, 8627 So. Atlantic, South Gate Fiberglass Engineering, 5933 Telegraph Rd., Los Angeles Los Angeles Cork, 4l8o E, Washington, Los Angeles Kircher Asbestos, Box 6 6 5 2 , Phoenix, Arizona rifltnopif f l p m ... fin 6 Walker, Maywood Field Construction. Box 9^7, Bakersfield ,,Plant Asbestos Co., 1540 W. 9th, Long Beach 23 -- I Baker Perkins, 1000 Hess, Saginaw, Michigan -- I Reece Insulation Co., by Clark Reece, 4 5 6 3 Valley Blvd., Los Angeles 24 J. T. Thorpe, 9^8 E. 2nd St., Los Angeles Aetna Casualty 3e Surety Co,, jtiO > O p r i n g , Los A n g e l e s - ^ y\o *V -uiSu&aM,1, 25 American Motorists Ins, Co., 3545 Wilshire, Los Angeles American Employers Ins. Co., 639 S. New Hampshire, Los Angeles j j 26 Argonaut Insurance Co., 1001 Wilshire Blvd., L0 3 Angeles j Casualty Ins. Co. of Calif., 8l0 South Spring, Los Angeles 27 Industrial Indemnity Co., 37^5 Long Beach Blvd., Long Beach ; M i chigan Mutual Liability c/o Brown Bros. Adjustors, 3517 W.6 th, L.A. i 4 28 -- 4 National Auto & Casualty Co., 6 3 9 S. Spring St., Los Angeles Pacific Employers Ins. Co., 2484 Pacific Ave., Long Beach 29 State Compensation Ins. Fund, 3629 Atlantic Ave., Long Beach i Travelers Insurance Co., Ocean Center Bldg., Long Beach : 30 Zurich Insurance Company, Box 3203, Terminal Annex, Los Angeles ! tFo*rj m11*3*3v$:* - 2- ! Dated at Long California FEB 1- 1963 / N ^ \ okI atm FEB 1 - 1963 ^ 1 Names and address of Persons Served (continued): 2 Herllhy & Herllhy, 110 W. Ocean Blvd., Long Beach 2 Murray H. Roberts, 750 Broad Ave., Wilmington 3 Clopton & Penny, 639 South Spring St., Los Angeles Wallace & Brown, 300 West Coast Highway, Newport Beach 4 5 i B i f1 6 I f 7 8 9 10 i 11 12 i ? 13 14 15 i 16 17 18 19 20 21 22 23 24 25 26 27 28 29 62 L B 19396 30 9 3 - Daied crt long Booth California FEB 1- 1963 *9 -- UMMMWW mp -S'Sift+.-r - -Hi**'- `jf^sssfc'v-v-jsws&i -.rJ-*->**. - CASE NO. 62 LB 19396 JOHN D. STAPLES vs- Referee; GEORGE WESTWICK Dictated: January 31* 1963 BAKER PERKINS; J. T. THORPE; C. F. BRAUN; COAST INSULATING; OIL FIELD CONSTRUCTION; ARMSTRONG CONTRACTOR; FIBERGLASS ENGINEERING; REECE INSULATION; R. T. DINWIDDIE; PLANT ASBESTOS; MUNDET CORK CORP.; LOS ANOELES CORK; KIRCHER ASBESTOS; CAL STATE COMPANY; AMERICAN MOTORISTS INS. CO.; CASUALTY INS. CO. OF CALIFORNIA; STATE COMPENSATION INS. FUND; ZURICH INSURANCE COMPANY; PACIFIC EMPLOYERS INSURANCE CO.; ARGONAUT INSURANCE COMPANY; TRAVELERS INSURANCE COMPANY; NATIONAL AUTO & CASUALTY CO.; AETNA CASUALTY & SURETY CO.; MICHIGAN MUTUAL LIABILITY CO.; INDUSTRIAL INDEMNITY COMPANY AMERICAN EMPLOYERS INS. CO. Injury: Between 1953 *nd March 7# 1962 Silver, McWilliams k Sherman, by Richard McWilliams attorneys for applicant F. W. Carignan, representative for American Motorists Herllhy k Herlihy, by Kennls Jones, attorneys for Argonaut Ins. Co. and American fnployers John Montgomery, representative for Travelers Insurance Co. Murray H. Roberts, by James Thomason, attorneys for Zurich Ins. Clopton k Penny, by Robert Wills, attorneys for Pacific Employers Eugene Barnes, attorney for Industrial Indemnity Paul Klein, attorney for State Comp. Insurance Fund Wallace k Brown, by Gerald Brown, attorneys for Aetna Casualty and Surety Company Maury k Schuyler, by Rob R. Schuyler, attorneys for Michigan Mutual Liability Compary Licker * McClure, by Robert Licker, attorneys for National Auto k Casualty Company REPORT OF REFEREE ON ORDER APPROVING COMPROMISE AND RELEASE---- - ' Based upon the record the proposed settlement will be approved as adequate. Lien claim of Department of Employment will be allowed to the extent of $996.22. This is pursuant to allocation proposed by the parties. Notice of Intention to allow said lien in said amount was Issued, and no objection was received during the time provided. Silver, McWilliams k Sherman are entitled to a lien in the sum of $50.00 for living expenses advanced. Berth of the above liens are payable by Industrial Indemnity Company -1- JOHN D. STAPLES CASE NO. 62 LB 19396 from the amount designated to be paid by them. Applicant's attorneys are entitled to a fee of $750.00. Said fee Is payable from the amount designated to be paid by Aetna Casualty & Surety Company. ng^timiiiiii n a ir rtfr i i k * 0 IN D U S T R IA L A C C ID E N T C O M M ISSIO N STATE O F CALIFORNIA \ JOHN D STAPLES, Applicant ARMSTRONG CONSTRUCTION, et al) AETNA CASUALTY A N D SURETY COMPANY, et al, Case N o... 62 LB 19396 NOTICE OF INTENTION TO ALLOW LIEN CLAIM OF DEPARTMENT OF EMPLOYMENT TO THE EXTENT OF $996.22 Defendant IT A P P E A R I N G T H A T pursuant to allocation proposed by the parties, N O T I C E IS H E R E B Y G I V E N that lien claim of the Department of Employment will be allowed to the extent of $996.22, and Compromise and Release will be approved within seven said time days after service hereof unless Good Cause to the contrary is shown in writing within GW:ca 1.17.63 Uf<m 'iime and Addrew of Persons Served ^ yf^ Department of Employment, P. 0, Box -^s^t Long Beach Silver, McWilliams is Sherman, 305| N. Avalon, Wilmington Aetna Casualty & Surety Co., 010 S. Spring St., L.A. American Motorist Insurance Co., 35^5 Wilshire Blvd., L.A. American Employers Ins. Co., 639 S. New Hampshire, L.A. Her31hy Se Herlihy, by Kenni3 T. Jones, 110 W. Ocean Blvd., L.B. 2. Casualty Ins. Co. of Calif. 810 S. Spring St., L.A. Industrial Indemnity Co., P. 0. Box 2251, Long Beach Michigan Mutual Liability, c/o Brown Bros. Adjusters, 3517 W. 6th, ------- CL-Anderson (Signature o f Pertoa Serving Notre) L.A. mtr* ipigjp ivpijsiiffiimw1 i 0 6 CONTINUED SERVED: 1-17-63 National Auto Ss Casualty Co. Box 5780, Loa Angeles 55 Clopton & Penny, 639 South Spring St., Loa Angeles State Comp. In3. Fund, 3629 Atlantic Ave., Long Beach Travelers Insurance Co., 110 W. Ocean Blvd., Long Beach 2 Zurich Ins. Co., by Jas. Thomason, 750 Broad Ave., Wilmington -2-