Document 7RmrMmkdDQENanVgyE0JqewKe

FILE NAME Mundet Cork MCK DATE 1978 DOC MCK126 DOCUMENT DESCRIPTION WC Claim of Staples Armstrong List -- John Staples California owens CorningCorning The had only defendant about 10 years of of interest besides Armstrong is pipe covering work including Mundet Cork Mr. Staples less than a year total with Armstrong Construction The to the Commission for approval claim was filed of a Compromise May and 17 1962. The parties applied Release Agreement January 11 1063 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 July 25 1978 Nellie Xerox one The had Armstrong List -- John Staples California Copy original only defendant of interest besides Armstrong is Mundet Mr. original about 10 years of pipe covering work including less than a year total with to Barry 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 reports 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 July 25 1978 to hd Pes 1 e rc nd 4 os, i } 2 3745 Long Beach Blvd. Long Beach California 3 | Telephone Garfield 4-0411 | i JAN 1 1963 i Ooh . wan thxx : 5 BEFORE THE INDUSTRIAL ACCIDENT COMMISSION OF THE | 6 STATE OF CALIFORNIA ' 7 ; 8 | JOINT COMPROMISE AND RELEASE 9 CASE NO 62 LB 19396 ; : 10 | JOHN D. 11 STAPLES 221902-28 VEe Applicant 221902-28 | ARMSTRONG CONSTUCTION 221902-28 | C. F. BRAUN 221902-28 41 CAL STATE COMPANY 221902-28 1 COAST INSULATING 221902-28 R. T. DINWIDDIE 221902-28 7 FIBERGLAS ENGINEERING 10634 Ceres Whittier Calif ; j 4400 E. Bandini Los Angeles : 1000 Freemont St. Alhambra \ 8823 Mettler St. Los Angeles 2684 Lacy St. Los Angeles ; 8627 So. Atlantic South Gate 5933 Telegraph Los Angeles : 221902-28 | LA LA CORK 221902-28 | KIRCHER ASBESTOS 2 || MUNDET CORK CORP 2 | OIL FIELD CONSTRUCTION 4180 E. Washington Los Angeles Box 6652 Phoenix Arizona , corporation . 6116 Walker Maywood California Box 947 Bakersfield California 3 | PLANT ASBESTOS Co. corporation 1540 West 9th Long Calif 3 || BAKER PERKINS 1000 Hess Saginaw Michigan i 8 || REECE INSULATION COMPANY Clark 4563 Valley Blvd. Los Angeles | Reece dba ; 8 2 J. T. THORPE 948 E. 2nd St. Los Angeles 8 WEBER BAKING COMPANY Employers Addresses 29 5 || AETNA CASUALTY AND SURETY CO ~ 7 if AMERICAN MOTORIST INS CO 32 AMERICAN EMPLOYERS INS CO 810 South Spring Los Angeles ; 3545 Wilshire Los Angeles | 639 S. New Hampshire Los Angeles San wet @ ) o 1 | ARGONAUT INSURANCE CO 1001 Wilshire Wilshire Blvd. Los Angeles 2 | CASUALTY INSURANCE CO OF CALIF a corporation 3 COMPANY 4 INDUSTRIAL INDUSTRIAL INDEMNITY 810 South Spring Los Angeles . 3745 Long Beach Blvd Beach 16 | MICHIGAN MUTUAL LIABILITY o Brown Bros. Adjustors 3517 West Sixth St. Los ^ ngeles 8 7 NATIONAL AUTOMOBILE AND CASUALTY 633 South Spring Los Angeles 8 9 Ff PACIFIC EMPLOYERS INS CO || STATE COMPENSATION INS FUND 2484 Pacific Avenue Long Beach 3629 Atlantic Ave. Long Beach 10 || TRAVELERS INSURANCE COMPANY Ocean Center Bldg Beach 11 | ZURICH INSURANCE COMPANY 12 . Insurance Carriers 13 Box 3203 Terminal Annex Los Angeles Addresses 14 The parties hereto for the purpose of Compromise only here- 588 588 | by submit the following agreed statement of fact 588 | 1. That John D. Staples the applicant herein was born on June 18 | 24 1925 19 | 2. That John Staples while employed as a heating and air con20 || ditioning Installer for Armstrong Construction C. F. Braun Cal 21 | State Company Coast Insulating R. T. Dinwiddie Fiberglas Engin- 22 || bering L. A. Cork Kircher Asbestos Mundet Cork Corp a corpora- 23 | 24 | tion 011 Field Construction Company Plant Asbestos Company a 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 sald 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 oh bd leanne cil : | , 4 : ; : } 3 5 1 . 4 . os 1 | 3. That John D. Staples alleges that as a result of the said 2 | injuries he has suffered a permanent disability 3 & That during the periods alleged the insurance companies were 4 | as follows b a Armstrong Construction Travelers Insurance Co. , 1955 to July 29 1955 $ January 6 April 23 1957 to 31 1957 July March 2 1962 to March 8 1962 7 b C. F. Braun American Motorists Ins Co. 1 to January 1 8 January 25747RPE 1954 MOTORists IKS CO 9 c Cal State Company NoRecord of Coverage 2 d Coast Insulating Pacific Employers Ins Co. May , 1961 to May , 1962 2 e R. T. Dinwiddie State Compensation Ins Fund 12 July , 1958 to July , 1959 Engineering 3299 .. f Fiberglas Aetna Casualty and Surety Co. March , 1954 to September , 1959 3299 September , 1961 to September , 1962 3299 3299 52982 52982 52982 52982 52982 23 23 . 23 g ; L. A. Cork October 27 Zurich Insurance Company 1959 to October 27 1960 h Kircher Asbestosi No Record of Coverage F 1 Mundet Cork Co a corp Aetna Casualty and Surety Co. 7 : December 31 1960 to December 31 1961 J : Oil Field Construction Co January , 1954 to January Casualty , 1955 Ins Co. of Calif k Plant Asbestos Co. corp Industrial Indemnity Co. ' a corporation January January , 1960 to January , 1961 : American Employers Ins Co. January , 1962 to January , 1963 . 1 Baker Perkins and Weber Baking Co Michigan Mutual January , 1953 to January , 1954 Liab 23 m Reece Insulation Co. Clark Reece dba : 1. National Automobile and Casualty 2 Insurance Co. 2 March , 1956 to October 1 1957 . July 1959 to July , 1960 2. Industrial Indemnity Co. a corporation 2 October , 1957 to October , 1958 j 2 % 5 % n J. T. Thorpe Pacific Employers Ins January , 1953 to January , 1959 Co. That the above employers and insurance carriers are by agree | ment parties to this Compromise and Release That it is expressly o3~ 1 understood and Intended by each and all of the parties hereto 2 that the amount set forth below will be paid and received in con- 3 sideration of the release of the above named insurance carriers ee and each of them together with a release of each and all of the 5 above named employers -- It is further agreed that the release herein and hereby granted by the applicant shall extend and inure to the benefit of 7 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 11 wages are in dispute 12 12 6. That applicant contends that he was temporarily disabled as a E5 E5 result of his injuries that defendants and each of them deny that 14 applicant was temporarily disabled from his employment due to any 2816 injury or injuries 7. That medical treatment was necessary and that such treatment 17 was obtained by applicant on a procurred basis 8. That the parties hereby agree to settle any and all claims on account of said injuries by payment of the sum of 9,250.00 2 5 apportioned as follows (a) b) c} d} e) f) 4 i) k ( k Industrial Indemnity Company Aetna Casualty & Surety Co. Pacific Employers Ins Co. American Motorist Ins Co. Travelers Ins Co. State Compensation Ins Fund National Automobile & Casualty Ins American Employers Ins Co. Zurich Insurance Co. Casualty Michigan Argonaut Ins Co. of California California Mutual Liability Mutual Liability Total . Co. 2,221.95 1.918.70 1.415.05 1,005.90 821.80 800.00 703.85 120.75 120.40 57.40 39.20 9,2590,.20500.090,250.00 The above sum of 9,250.00 shall be paid in _ r applicant except as otherwise provided in Item 8 one a lump sum to below less 500.00 advanced by Industrial Indemnity Company less any allow- able lien claims of record not satisfied as itemized in item 8 a below that applicant agrees to pay any and all expenses incurred -4- es oe AT 9 fi PRET 1 | which may have otherwise been properly claimed under Labor Code 2 Section 4600 to have been the responsibility of the defendants 3 | herein 4 1 8. a That the sum of 9,250.00 shall have deducted the follow- 6 ing disbursements which shall be made directly to those persons -- companies corporations or firms as set forth below and such dis- 7 | bursements shall be made from the amount designated to be paid by 8 Industrial Indemnity Company as set forth in item 8 above that 9 the herein disbursements represent reduced lien claims of record 10 and are payable in amounts as follows 12 996 .22 To DEPT OF EMPLOYMENT EMPLOYMENT EMPLOYMENT 13 ; 14 That any sums due by sald Company not exhausted by disburse- 15 ment or attorneys fees set forth in item 10 below shall be paid 16 | directly to the applicant or as the Honorable Commission may 17 | direct 18 | 9. That all self procurred medical if any shall be the sole 19 responsibility of the applicant and that the defendants or any 20 21 of them shall not be liable for any of said expense That the defendants or their carriers are responsible for medical treat- 22 _ ment and examinations here authorized by them but iil 3 that all future medical shall be the sole responsibility of the 24 applicant herein jc 25 26 10. That the name and address of applicant's attorneys is Silver McWilliams and Sherman 3051 North Avalon Boulevard Wilmington 27 California that said attorneys request a fee to be paid directly 28 to them by Aetna Casualty and Surety Company as set forth in we: 29 asset by 30 Item # a above in the total amount of said attorneys have expanded expanded the sum of $ asset none IAC That as te 31 reasonable litigation costs eA a il Reason For Compromise Multiple issues exist which make -5- aoe 2 Oo ee B oe 8 10 11 12 13 1414 16 17 settlement the most practical solution to the problem posed by protracted litigation arose out of and were as follows sustained in whether applicant's injuries the course and scope of employ- ment date of injury Issue of of the Statute of Limitations occupational disease applicability extent of apportionment allowable as between defendants applicant's actual earnings applicant's average earnings extent and duration of temporary disability if any nature extent and duration of permanent disability if any need for further medical treatment liability for self procurred medical liability for medical legal costs allowance of reduction of lien claims coverage for the periods of employment alleged The applicant desires a lump sum settlement and to take con- trol of his own medical treatment The applicant and the de- fendants separately and as a group desire to buy their peace and to avoid the expense delay hazard and uncertainty of extended certain litigation and to settle their differences for a sum applicant feels that the liens of and should be allowed in the sum of 19 ARPT $ On of the amount claimed 12. The undersigned request that this Compromise and Release Eh Agreement be approved by the Honorable Commission TEE IRE 13. Upon approval of this Compromise and Release Agreement by the Industrial Accident Commission or a panel thereof and payment in accordance with the provisions hereof said employee releases and 32 5 forever discharges ald employers and Insurance carriers from all claims and causes of action whether known or ascertained or which may hereafter arise or develop as a result of said injuries 28 Including any and all liabilities of said employers and sald Insurance carriers and each of them to the dependants heirs 30 32 32 executors representatives administrators or assigns of said employee 14 it is agreed by all parties hereto that the filing of this -6- wo / | I | document is the filing of an application for adjustment of all f rues 2 claims on behalf of the employee and that the Commission 3 its discretion may in set the matter for hearing as a regular 4 application reserving to the parties the right to put in issue S facts submitted any of the B herein and that if hearing is held with this document used as an 7 able to them all application the defendants shall have avall | 8 defenses that were available as of the date of filing of this document and that the Commission may thereafter 9 elther approve such a Compromise and Release 10 Agreement or dis- | approve the same and issue Findings and Award after hearing has | 11 been held and the matter 12 15. In further regularly submitted for decision 13 consideration of the payment in accordance here- | with applicant agrees that this release 14 applies to all unknown and unanticipated injuries and damages resulting from such 587 casualties events and actions 587 employments as well as those now dis- closed and all rights under section 1542 of 587 the Civil Code of | the State of California are 18 hereby waived California Civil Code Section 1542 reads as follows 19 20 materially 21 day November 22 A general release does creditor does not know not extend to claims which the at the time of or suspect to exist in his favor have f. h thiem dmeubst tohrave materially tehfefercetleedasehiswhsiecthtleimfenktnowwinth by , the Signature here this 1st ay 1962 Wilmington Wilmington , Caly 24 John D. Staples Applicant 25 Cp SO ILS VER MCWILLIAMS & SHERMA MCWILLIAMS 26 Attorney | N | by Auf ; | U N Witnesses By __ ve La. C C ---- ---- be Olt The Injured Applicant's Attorney for Applicant ture must be attested Sitgwnoa- AE_T-NAf- CASUALTY AND SURETY CO . disinterested persons OR acknowledgacknowledgeded before a Notary By Bef J ULAR o f ee Public / N U | STATE OF CALIFORNIA CountyCounty of AMERICAN MOTORIST INS CO meee By Lae prcny AMERICAN EMPLOYERS INS EMPLOYERSEMPLOYERS CO By LineLnisnens hy f -7- Y at, ( ( |. ~ o . @ 2 By ig CASUALTY 3 & INSURANCE S. CALIF 4 By Ce & 6 -- 7 8 ; ; INDUSTRIAL INDEMNITY COMPANY INDEMNITY By Oth MICHIGAN MIMCICHHIIGAGNAN Wren Attorney at Law MUTUAL LIABILITY BY x Kropp : 9 - 10 | 11 , 23 13 ; ; Kropp . NATIONAL AUTOMOBILE =| AND CASUALTY | By {bee viet PACIFIC EMPLOYERS INS CO q R. By Cloptons Penny ~ Robert Wills Penny 2 15 a OS INS FUND i By COMPZEiNeSlATV IOL N 2522222 2522222 2522222 | SS TRAVELERS By ZURICH INSURANCE COMPANY ( Lee Z ZURICH INSURANCE COMPANY By [ 2522222 2522222 Thomason . i i: C. On this ; has A.D. has 1962 , before me -7 en ye appeared : z 2522222 for the a Notary Public said County and State residing in and there- * . in duly commissioned and personally 2522222 . . John D. sworn personally Staples known to q ae me to be j ; the person whose name is subscribed to the 5 23 within instrument and acknowledged to me that he executed the same 2 25 Certificate In Witness Whereof I have hereunto set hand and affixed official seal the my t year this Certificate day and Certificate first above written 2 2 2 . . - . Notary Public in and State of California County and f f 9 31 32 | . -84 1092 y 4 3388 NOV f NOV j Bry, @ ^' 4 | | 1 i : | s it ih 1 2 3 4 5 -- 7 8 9 10 11 12 13 14 15 BEFORE THE INDUSTRIAL ACCIDENT COMMISSION CASE NO 62 LB 19396 OF THE STATE OF CALIFORNIA | ( LONG BEACH OFFICE OFFICE INDUSTRIAL COMMISSION STATE OF CALIFORNIA tf | | : | JOHN D. STAPLES FILED OCT 5-1962 -- -- -. ae a par arerne Applicant v8 BAKER PERKINS J. T. THORPE C. F. BRAUN ) COAST INSULATING OIL FIELD CONSTRUCTION ARMSTRONG CONTRACTOR FIBERGLASS ENGINEERING ) REECE INSULATION R. T. DINWIDDIE KIRCHER ASBESTOS LOS ANGELES CORK ) PLANT ASBESTOS MUNDET CORK CORP CAL STATE COMPANY ) AMERICAN MOTORISTS INS CO CASUALTY INSURANCE CO OF CALIFORNIA ) STATE COMPENSATION INS FUND ZURICH INSURANCE CO ) PACIFIC EMPLOYERS INS CO ARGONAUT INSURANCE CO AMERICAN EMPLOYERS ) INS CO TRAVELERS INSURANCE CO NATIONAL AUTO & CAS CO AETNA CASUALTY ) & SURETY CO MICHIGAN MUTUAL LIAB CO INDUSTRIAL INDEMNITY > MINUTES OF HEARING OE { if f ig ; if iF if iy if ne ; a f b, i 18 Defendants ) ; 18 THIS CAUSE came on for hearing October 5 1962 at 9 A.M. F 19 in Department D of the Industrial Accident Commission Long Beach Ir 20 | California before Honorable GEORGE WESTWICK Referee E ki 21 T. Hanagami Reporter 22 | PRESENT F N | Silver McWilliams & Sherman by Richard McWilliams N attorneys for applicant : N F. W. Carignan representative for American Motorist F N Herlihy & Herlihy by Kennis Jones attorneys for a | 27 Argonaut Ins Co. and American Employers i N John Montgomery representative for Travelers Ins iy | N Murray H. Roberts by James Thomason attorneys for E W Zurich Ins Co. : 12149 330 No test tn Hl 4 E q 4 4 q 4 I 3 4 5 B 7 10 12 13 16 7 20 21 N N N N N N PRESENT Cont'd Clopton & Penny by Robert Wills attorneys for Pacific Employers Eugene Barnes attorney for Industrial Indemnity Paul Klein attorney for State Compensation Ins Fund Wallace & Brown by W. Gerald Brown attorneys for Aetna Casualty and Surety Co. Maury & Schuyler by Rob R. Schuyler attorneys for Michigan Mutual Licker & McClure National Auto & Casualty by Robert Licker attorneys | for EXHIBITS Applicant's 1 - Reports attached and 6-19-62 Industrial Indemnity Co. Ex A - of 10-3-62 9-11-62 Pacific Employers Ex - Report 9-11-62 to letters of 8-29-62 Reports attached to letter attached to letter of DISPOSITION 45 days to file compromise and release agreement N pT SET eR Bete ah a me rey cea ont Ra Cs re TE RET e.Ta re Tete eRe, fo SMO ' h 8- FORM 339 1214911 1214911 aM oo ee ad EDWIN SILVER RICHARD L. MoWILLIAMS ARTHUR SHERMAN ERNEST L. GRAVES LOUIS BERSON LAWRENCE WEITZEA gs ~y OFFICES SILVER McWILLIAMS & SHERMAN 3054 NORTH AVALON BOULEVARD WILMINGTON CALIFORNIA TERMINAL 4-2595 ' SPRUCT 5-0120 August 29 1962 BANTA ANA OFFICE METCALFE AND SILVER 1830 NORTH MAIN STREE KIMBERLY 0011 (Berne AUG 30 30 1962 Industrial Accident Commission - 236 East Third Street Long Beach California Re John D. Gentlemen Staples vs. Plant Asbestos 62 LB 19396 et al Please find enclosed the following medical reports for filing in the entitled matter cdinatsiea Report of George E. Fralick M.D. dated Aug. 24 1962 tea te set rbith Please be informed that the applicant in sh the entitled matter now resides at Please be informed that I now represent the applicant in the entitled matter and hereby request that copies of all material documents be served upon me Very truly yours enclosure SILVER McWILLIAMS & SHERMAN SHERMAN RICHARD m- iniiliane miniliane miniiliane Cc Please see attached sheet ne eet ee er BERTRAM P. P. HUSBAND M. Dra Husban^dno fralicK PHYSICIANS - BURGEONS 1610 E. WHITTIER BLVD WHITTIER CALIFORNIA PHONE 696-1101 GEORGE E. FRALICK FRALICK M. D. August 24 1962 Mr. McWilliams 3054 North Avalon Wilmington California 27 AUG Re John D. Staples Dear Mr. McWilliams On April 25 1962 I sent John Staples Please refer to this Mr. Staples prior to this date a letter to you regarding Mr. letter for information concerning This patient has been seen subsequent to the last letter as follows q 4-30-62 Conjunctivitis - Cough continues - Rales inchest continues 5-10-62 Worse past 2 days had to goto bed etc. Cough and rales | persist Diathermy 4 5-15-62 Some improved complains of weakness 5-28-62 5-31-62 Pt failed to keep appointment Complains of difficulty breathing normal Rales in left lung field Temperature persist remains 6-25-62 7-2-62 About the Capacity same Sent Laboratory to the report laboratory for patients vital lung vital capacity is 50 of normal rays ordered to Patient still complains of weakness Patient instructed be repeated at the La Mirada Hospital to completely stop smoking on 8-21-62 I found ; Upon contacting La Mirada Hospital They informed me Mr. Staples had failed to have follow rays that I had ordered that the patient had not been in for the rays since July 2 1962 . on July 2 1962. I have not seen this patient in my office stated in the letter of 4-25-62 remain My recommendations as not be employed in any occupa unchanged I feel this patient should and laboratory tests tion where lung irritatants are involved ray and probable asbestosis substantiate the diagnosis of pulmonary fibrosis Vital capacity is reduced to 50 of normal GPP jn new mecemaemeggtemenines coma TR ES ATT ~ Geo: rge P f. h Fralick Fralick M. D. ~ eo. me a Etee ae McCartney Hall & Ryan Attorneys at Law 639 South Spring Street Los Angeles California Murray Roberts Attorney at Law 750 Broad Wimington Calif Herlihy & Herlihy Attorneys at Law Ocean Center Bulding Long Beach California American Motorists Ins 3545 Wilshire Blvd. Los Angeles Calif Co. Casualty Ins Co. 810 So. Spring St. Los Angeles Calif State Compensation 3629 Atlantic Ave. Long Beach Calif Ins Fund Zurich Insurance Box 3203 Terminal Annex Los Angeles Calif Pacific Employers 2484 Pacific Ave. Ins Long Beach Calif Co. Argonaut Ins Company 1001 Wilshire Blvd. Los Angeles Calif American Employers Ins 639 So. New Hampshire Los Angeles Calif Co. The Travelers Ins Co. Ocean Center Building Long Beach California National Auto & Casualty 639 South Spring St. Los Angeles Calif Co. Aetna Casualty & Surety 810 South Spring Street Los Angeles California Co. Michigan Mutual Liability / Brown Brothers Adjustors 3517 West Sixth Street Los Angeles Calif Industrial Indemnity Company 3745 Long Beach Boulevard Long Beach California " ~ POW5 INSILVERRICHARDRICHARD ARTHUR ARTHUR ERNEST L. ERNEST GRAVES : LAW OFMIGES SILVER . LAW OFFICES SILVER McWILLIAMS McWILLIAMS McWILLIAMS 3054 M' cWAIVLALLIOANMBSOULEVARD TenminaL WILMINGTON " SHERMAN oe SHERMAN SHERMAN - santa ana OFFICE eere eet vi A ciusenty 7-008) LOUIS LOUIS LAWRENCE LAWRENCE lik AV June TERMINAL SPRUCE 4 yreaiyty peaeraial ACeINEME COMMISSION LEMS tan COMMISSION COMISION - LONG . ayo JUN Industrial Accident Commission 236 236 East Accident Long Long California Re: John Staples . Staples vs. Reece Insulation vs. Reece Insulation FILED REFERER Company, et al Gentlemen Please find reports for the following medical enclosed following filing enclosed the 5 matter M.D. dated April Report of E. Fralick Report 25, 1962 tae Please be informed the entitled that the applicant matter applicant applicant ae, in in that now now represent the Please be informed represent entitled the applicant in the that copies entitled matter material hereby request me served upon documents be Very truly yours SILVER Keihard MCWILLIAMS SHERMAN SHERMAN monilliam monilliam Keihard monilliam Keihard Keihard Keihard monilliam monilliam National cc: Spring Casualty Company South Spring Street Angeles 639 South Spring Company Angeles on >_< e E. Fralick D. 0 B. P. HUSBAND O. 1610 E. WHITTIER BLVD WHITTIER CALIFORNIA Oxrono 6118t ' e@ April 25 Mr. McWilliams 305-1 North Avalon Willmington California 1962 19612 916962 2 28 Ark 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 rays of his lungs have shown evidence of chronic irritation He has consistantlyhad 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 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 due there to was evidence of chronic irritation And the fact that the patient is working in asbestos where he is exposed to asbestos dust and fiber's 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 NR I feel that continued exposure to lung irritants will lead to more fibrosis and repeated acute f pulmonary episodes which he had when I first saw TET TER him The likelihood of active tuberculosis and RE disease would be increased 3 . It is therefore my recommendation that Mr. John Staples seek employment in a field of endeavor not requiring contact with lung irritants j GEF yours 0. Sincerely r 4 -< yours | metre Frulick Frulick D. 0 LAW OFFICES CLOPTON & PENNY ae) BUITE 1828 83 SOUTH SPRING STREET LOS ANGELES 14 CALIFORNIA cesire Pe I ERR. nacht Te RC e Lo. TELEPHONE MAGISON 7-1568 September 11 1962 WHEN REPLYING PLEASE REFER TO # 19963 and A Industrial Accident Commission Commission 236 East Third Street Long Beach California ne _ d Re John Staples vs. Coast Insulating et al Case No. 62 LB 19396 Hearing Date Oct. 5 1962 Gentlemn Please find enclosed the following following the above entitled matter medical report for filing in R.T. Johnstone Very truly yours ------- --,------- 2.-- ----,--,... WILLIAM H. KENNEDY Office Manager WHK kb Encl CC Silver McWilliams & Sherman Zurich Insurance McCartney Hall & Ryan Murray Roberts Herlihy & Herlihy American Motorists Ins Casualty Ins Co. State Comp Ins Fund Ind Ind - L.B. Co. Argonaut Ina Co. American Employers Ins.co. Travelers Ins Co. National Auto & Casualty Co. Aetna Cas & Surety Co. Michigan Mutual Liability oi Pac Emp - L.A. 71 PC 73643 & 73644 OR SRR MTT METI, HEE eat ae OCCUPATIONAL DISEASES INDUSTRIAL INDUSTRIAL HEALTH RUTHERFORD T. JOHNSTONE M.D. BROCKHAN BUILDING BRO WEST SEVENTH STREET Los Angeles 14 Calif MADISON 3-2968 August 22 1962 ~ INDUSTRIAL TORICOLOGY PLANT SURVEY Pacific Employers Insurance 1033 S. Hope Street Los Angeles 15 Calif Co. Re JOHN STAPLES Coast Insulating Products Claim 71 PC 73643 Our File 6108 Gentlemeni ~ the above captioned individual was examined by the 10634 Cores Whittier At your request his address as on 8-9-62 He gave : writer as an insulator Calif His occupation Mr. Staples states that in March of 1962 hedeveloped pneumocared for by Dr. Frolick and was HISTORY nia For this he was in Whittier rays in the Murphy Memorial Hospital first suspected hospitalized and according to the patient the doctor run but were taken have tuberculosis A number of tests were showed evidence of pulmonary that he might of these according to the patient none that the lungs might have was then told tuberculosis The patient and asbestos Mr. Staples also been affected by the fiberglas test which according to states that he had a car cdaipoacreistpyiratTohe rypatient has not worked since him showed about 50 the recommendation of his doctor - March on Present Complaints 1. . -. 2 . 3. I do not have any energy This has I am short of breath on effort been coming on for the past year Occasionally I feel a sort of constriction in my chest Past Medical History Had an appendectomy years ago and also in He had pneumonia two March of 1962 -- -- had a whiplash injury two years ago states that he has been in the Occupational History Mr. Staples insulating business for approximately ten months He has with the exception of oneperiod of nine of time If I years worked for various companies for various periods worked the longest for the Mr. Staples correctly he has three to four understood This being approximately Plant Asbestos Company He has worked for the Coast years although not constantly Armstrong Corporation and Baker- Insulating Products for the Perkins Company is primarily as follows For these various companies his work ae ame I ene Hs ERE tlhe ld SNe tae ek FS & a : ; "No, 2 Ret John p, Staples - ae 8+22-69 words Re John Olas Staples Staples ducts ip as Some instances with fiberglas He wrapped ducts ig fiberglas cloth clot thop of the fiber- fiber- wrapped instances instances iw sith fiberglas asbetos The asbetos fiber. glas some placed estimated covering useof asbetos asbetos -. has previously been the molded fiberglas that considerably considerably other other considerably considerably Ip, Other with with fiberglas The patient is Personal Personal History The ppaattiieenntt knoiwss marriw ed iwif fe e tuberculosa is nd four children children of diabetes tuberculosis in Cancer family Inventory removehdeadache tinnitus Inventory of Inventory Systems : he has Head States that occasional oocccasiconaal sional dizziness are dizziness His system system false occasionally Respiratory productive productive has Respiratory never morning blood productive expectorated expectorated . dyspnea effort occasional occasoiocncalasional discomfort intestinal constriction like normal no orthopnea orthopnea intestinal Appetite normal no symptoms symptoms diarrhea indigestion indigestion ~ constipation urinary constipation nocturia diarrhea dysuria nocturia frequency normal of frequency are normal, pounds Weight states nocturia dysuria loose about 17 pounds on diet is regaining regaining Nervous system States that . the doctor irritable pounds nervous is not irritable and he Miltown irritable and he i es beverages drink EXAMINATION Auscultation enlarge- Respiratory His The patient cooperative PHYSICAL Was Head His weight was intelligent cooperative year pounds 177 cooperative Temperature 37 reacted to male pupils equal light Head Head ment Ears Neck throat were round teeth ment nose negative cervical glands The teeth false false enlarge- were Note the no Chest Slightly emphysemateous in ap earance note throughout percussion lungs percussion percussion no friction friction rubs rales Respiratory Respiratory 18 B.P. revealed Heart Rate of regular or heard heard 110/70 110/70 Acuoment Rate Hack: elicited elicited Obese There organs organs masses palpated masses present present were from previous previous operation BACK Motions of the painful due strain i Normal Normal anbkulcek edema present preser nt eacent Operation, } Extremities examinations Normal Present, recent strain, Normal i I No. Re 3 John D. Staples 8-22-62 LABORATORY Urinalysis Blood count yellow Reaction- pH 5.5 Albumin - 0 Micro Appearance Sp Gravity - 1.010 Sugar - 0 negative 7 Hemoglobin - 13.8gms - 95 Erythrocytes 4,180,000 Leucocytes Polys Lymphs 8,600 65 30 . Monos 4 Eosins 1 Blood sedimentation rate - ELECTROCARDIOGRAM Normal 16 mm 1 hr | Wintrobe a RAY EXAMINATION Posterior anterior and lateral views of the chest reveal the cardiac shadow to be within normal limits There are old shell calcifications of both hilar areas There is one small calcification in the left lower periphery There is slight accentuation of the bronchovascular markings and a few scattered micronodules DISCUSSION : The physical examination of Mr. Staples was essentially poet normal Likewise the urinalysis blood count were ale normal The blood sedimentation rate was slightly elevated The aw yee electrocardiogram was normal a a From this the history there are two types of dust case The first is that of fiberglas to be considered This material is in notorious it is not for causing a mechanical irritation to the skin However known to cause any effect upon the pulmonary tissue This is not any arbitrary statement based upon my own experience is based upon the additional opinions of other clinicians and engaged in research in industrial toxicology The references the following quoted material are appended to this report It those to 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 glass wool dust is being demonstrated by an inhalation experi- le ment for over a year animals have now been exposed to as high nt ty concentrations of this material as could be obtained with no Aare serious effect upon their lungs Penatsrnd In 195 Schepers et al of the Saranac Laboratory Trudeau Found- ation reported on the biological action of fiberglas dustien dustien ratu rabbits guinea pigs and monkeys According to these anvestigators this fiberglas dust behaved like an inert subutance This is a most portentous finding as it is so ae Babe No. 4 Re 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 animals were carefully studied with these tuberculosis these complications in mind The fiberglas 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 case of Mr. Staples no positive opinion can be given at this time Certainly this is so from the standpoint of inter- preting the ray films Pendergrass a radiologist who has probably the greatest experience in interpreting 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 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 size 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 ; wa ae RTU 2." a ae at at Yours very truly Ritonstone Ritonstone mo R. T. Johnstone M.D. yt oe rae oN shee ad : . Rh - ot aig ae) "es OO \ No 5.- ae Re John D. Staples References 8-22-62 1 Schepers G. W. H. et al The Action of Fiberglas Plastic Dust AMA Archives of Ind Health 18:34 1959 2 Carpenter J. L. and Spolyar L. .: Negative Chest Findings in Mineral Wool Industry J. Indiana M.A. 389 1945 3 Pendergrass Eugene P The Pneumoconioses Evaluation and Management Council on Occupational Health American Medical Association 1962 dis veil ar ie Pa : vt Ss oem 3745 4 hONG s BOUN acu . q. . ' ,erAcH ao BB @ 0411 ivonnca + GARFIELD t (2a iv DS - ? ; INDUSTRIAL INDUSTRIAL Lo ng Long BeacCahlif a COMTANY INDUSTRIAL INDEMNITY moon October 3, INDEMNITY COMMISSION oreut t 4 OCT 4 an . wee 1 eee cate ce 1.A.C. Nor I.A.C. I.A.C. Applicant Employer Employer 62 LB 19396 62 LB 19396 John 19396 Co. Asbestos Gent Gentlemen your attention Request Request { ) ro) attention respectfully hereby hereby made directed directed the following; cross examination further hearing to following cross examination and presentation Please take above matter off calendar because . { ) Please and Release for your attached attached duly executed Compromise ( ) ( You will approval on all normal issues calendar for hearing ( ) Please place place matter matter prosecution above matter for lack of ( ) Please dismiss the we request that we attorney be served copy this letter to applicant's in your possession request that Industrial ( ) ) be pursuant with all medical reports Accident control pursuant the rules of the Industrial Attached ro ] Attached for filing herein are 27 and dated September Dr. Simmons Smolens reports dated September , 1962 Dr, D. Simmons report August 1962 1962. 3051 McWilliams McWilliams Wilm Sharman Avalon 3051 Wilm. 3054 N. Avalon, Sincerely INDUSTRIAL INDEMNITY COMPANY Karr J. Karr ee peembentic comet oe - cpuccie - ht nlc ae eA A oe ate ae Nm en ~~ URES WERENT TT SS -43-9355 -43-9355 BERNARD M. Smolens M. DANIEL A. Lang M. e 1248 OLENDON AVENUE WESTWOOD VILLAGE LOS ANGELES 24 CALIFORNIA GRANITE 8-01 DIPLOMATES OF THE AMERICAN BOARD OF INTERNAL MEDICINE 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 results of Mr. Staples on my examination as follows September 11 1962 and the and laboratory studies are A. Chief Complaint Shortness of breath chest pains chest colds and pneumonia in March 1962 from Trequent which he feels he has never fully recovered and which he feels all are due to asbestos inhalation B. History of Present Illness Mr. Staples is a year white male who has been a the following occupaheat and frost insulator tional history He has with asbestos for the past nine years Prior working 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 involved installations of heating or air conditioning insulation on the job in many types of building construc- tion This involved carrying asbestos or fiberglass to of installations cutting and fitting it various parts around pipes or ducts The asbestos was occasionally put on in a liquid form cast molded and dried on a He never wore a mask fitting like a plaster occasion when he was opening bags of as- except bestos on one and pouring it.into He had no other occasion to use a mixer or pour bags of asbestos mo eens adverse any adverse affects from this work until He never noted he began noticing shortness of breath about one year of He noted that he was getting tired and short ago breath in the early afternoons at the job He would it very far because pick up something and couldn't carry ahah ale rey as ts Rte Sra a oS SERN TEES RARE oo, -- RENEE RT SAM SMR CE Rae EE Hs 4. 4. 4. u ahd ee hub RR * RAS vectors 7 "os . e**. e Re John D. Staples Employer - Plant Asbestos of this shortness of breath He noted an increase in his usual cigarette cough Leas 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 rays and sputum studies and tuberculosis was not found although initially suspected He was given antibiotics but re- quired no oxygen He was told that this was due to as- bestos and he should not return to his usual occupation He has a cold had and episodes of feeling better but then if he gets 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 broncho- dilators 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 half to two packs per day for many years and two to two and half packs the year prior to the pneumonia He has smoked one pack a day since his pneu- monia C. Past History He was born in Missouri and came to California in 1939. He served in the U.S. Navy 1943 to 1946 and spent two years in the Pacific from 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 There are four children one who has a ventricular septal is 40 and in good health of whom is a son age eight defect There is no fam- ily history of disease except tuberculosis cancer or any other serious for the pulmonary disease which his father has He had the usual childhood illnesses Adult Illnesses - 3 He had mumps Surgery >> He in the had an servicaned tonsilitis in 1959 appendectomy for a ruptured appen- dix in 1952 and tonsillectomy 1959 System Review - 3 His maximum weight has been 184 pounds average weight 170 to 175. His hearing is decreased bilaterally because of the perforated ear drums He sleeps with one pillow + 4 Ty eT ae and on his side appetite has been There good has . Re John D. Staples Employer - Plant Asbestos been no - ankle edema His D. Physical Examination Height 519 Temperature 98 Pulse 80. Blood Pressure 100/70 Weight well 175 as ordinarily dressed He appeared as a devel- oped 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 mild respiratory distress Head and Neck Revealed no venous distention thyroid enlargement or adenopathy Eyes Pupils external ocular muscles and fundi were normal Ear Nose and Throat examination Both panic membranes appeared to be intact and there tym- was no decrease in hearing of the wrist watch tick Chest Revealed symmetrical respirations bilaterally with mini- mal restriction of chest motion Lungs Revealed slight decrease in breath sounds bilaterally with per- sistent rales at the left base laterally Heart Not clinically enlarged There was regular sinus rhytam without thrills murmurs or rubs The second aortic sound equaled the second pulmonic sound Abdomen Obese There were no organs masses or tenderness noted there was a well healed right lower quadrant scar Genitalia Revealed an atrophic left testicle Neurological Neurological examination Produced physiologic responses Extremities Revealed no clubbing cyanosis or edema The remainder of the physical examination was not able remark- E. Laboratory Data Complete blood count - hemoglobin 15.6 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 002 combining power 26 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 art was in an intermediate electri- cal position with a transition zone at - and normal R wave progression although there were slightly large R waves on the right side of the precordium The in- pression was that of an electrocardiogram within normal limits 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 be unremarkable Both hilar shadows were somewhat promi- nent and extensive calcification was present in both hilar areas The lung markings were exaggerated throughout The inspiratory and expiratory study revealed good motion of the diaphragms and no evidence Re John D. Staplea Employer - Plant Asbestos .of emphysema radiographically Pulmonary function tests performed at the Pulmonary Laboratories of the Mt. Siani Hospital revealed a slightly decreased or low normal vital capacity and moderately reduced maximal breathing capacity with low air velocity index aeshdbe The impression was that without hyperinflation of minimal airway obstruction 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 ray findings of exaggerated lung markings consistent with early pulmonary fibrosis plus additional evidence of dyspnea on exertion make asbestosis 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 lute diagnosis the degree of of asbestosis fibrosis can only present be made An abso- however on histologic grounds after a lung biopsy The chest 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 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 incontradistinction 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 BMS ; Bernard M.Smolen 17.0 BERNARD M. SMOLENS M.D. TEST BE cy 2 201711385 LA = Crary eotmer: See op see Bernard SMOLENS M. DANIEL A. Lang D. 1245 OLENDON AVENUE WESTWOOD VILLAGE LOS ANGELES CALIFORNIA GRANITE 6-0111 DIPLOMATES OF THE AMERICAN BOARD OF INTERNAL MEDICINE August 31 1962 355 355 355 [ J.A. Karr Claims Adjuster Industrial Indemnity Company 3745 Long Long Beach Boulevard Beach 7 California J / 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 Doce n.D. n.D. Bernard Smolens M.D. BMS 9/26 ad wae ET a a a. oot ee a Se ee . of Sa% ? " MOUNT SINAI HOSPITAL ? . REPORT OF PULMONARY FUNCTION TESTS . r 'Staples John ROOM POP Case No. Age ; 37 yrs Height 5 ft g Dr. _in Weight 175 Date _ 9/14/62 B. M. Smolens Time lbs Surface area OBSERVED VALUES 1.95 m Sex M PREDICTED NORMAL % PREDICTED NORMAL SPIROMETRY Vital Capacity Total VC cc 1 sec V.C. % of VC 3 sec V.C. % of VC Maximum Breathing Capacity MBC min Air Velocity Index ( AVI Minute Vol of Resp at rest MVR min Expiratory Reserve ER cc Respiration Rate RR min 3494 71 92 81 0.7 9 1112 14 A117 83 97 138 08-12 4-8 85 59 Oz saturation % Ear oximeter Rest air ; Rest O Normals Air 92-102 O 97-105 7 Exercise ; Forced ventilation Ys) LUNG VOLUMES Functional Residual Copacity FRC cc Residual Volume RV cc Total Lung Capacity TLC cc TLC ^ 100 % TLC TLC ^ 100 % TLC 3038 1926 5420 56.1 35.5 3330 2033 6440 49.4 49.4 32.1 BLOOD GASES pH PCO Arterial Hg ___; venous arterialized venous) O saturation % Rest air Rost Ox ExercExericisesExeercise meme mer SPECIAL PROCEDURES 917 95 847 1147 110 IMPRESSION ' INITIALS FORM 6B reduced MBC with low AVI Lung volumes are within normal limits obstretch Minimal airway obstretch obstretch without no This would be consistent with mild There is emphysema 19305 19305 eee hyperinflation asthma or bronchitis - a ; CARDIO PULMONARY LABORATORY ; i - 3 i i ha PRES ed EA oe : j 4 i AC an AC ~ 3 . BEFORE THE INDUSTRIAL ACCIDENT COMMISSION OF THE STATE OF CALIFORNIA Rotico and Request for Allowance of Liem erry COMPLE Rea Case No 62_13_19396 62_13_19396 Date of injury From 195t3o 12arch 1962 eg To ttn OT TE STATE OF CALIFORNIA DEPARTMENT or EmployUENT ns ve. JohD n Stanles LIXO CLAENANT EERLOVES O. Box PQ ox 11:06 Santa Ana cdif ABGEESS 10631 Ceres Shittier Calif ASOTESS 197.12.2206 197.12.2206 EXPLATES'S EXPLATES'S SOCIAL SECURITY KUNSCA KUNSCA -- Armstrong Contracting- Contracting- EMPLOYER Zandini -41 2 Zandini MI el idl catia + FR Irzalera_Incutuca Irzalera_Incutuca Co. Irzalera_Incutuca Irzalera_Incutuca Irzalera_Incutuca Irzalera_Incutuca Irzalera_Incutuca en vee nent SPACE SPACE CAURIEN 1110 10 11 11 CcC ec ne u nu IlaId lad La La CoCa oach chCoach Clif Clif Clif AUDRE the Industrial Accident Commission to determine and allow as a lien the sum stated 1. The undersigned hereby requests the amount of unemployment compensation disability benefits paid to date and in abdedliotwioans aTloietn aislrewquheiscthedrefporreasennytsfurther benefits which may be paid up to the amounts stated in paragraph 3. below 2. Filed under Labor Code Section 4903 f 70.00 - 70.00 Disability benefits at the weekly rate of paid for the period 2 to 9662 9662 inclusive 182 days at $ per day including days paid for waiting period waived Filed under Labor Code Section 4903 b Additional benefits for hospital confinement at the daily rate of 12.00 paid for the period 3962 te 3.13.62 inclusive TOTAL 1820.00 3. Further unemployment compensation disability benefits may be pai$d to the0 employeaendfosr both daily indreemsnpietcytivaenldy additional benefits for hospital confinement which will not exceed September 21 1962 4. The undersigned declares he has delivered or mailed a copy of this document on to each of the parties listed Also copies served on the following representatives and attorneys of recordi Silver Skorman McWilliams & Silver McWilliams 205 11 Avalon Elvd Wilmington Calif State of CaLIFORNIA DEPARTMENT of EmploymeNT HCBrock HCBrockHCBrock _ if LIEN CLAIRANY See reverse : r EMPLOYEE'S CONSENT TO ALLOWANCE OF LIEN . the total amount of disability benefits that claim 3 3 understand that the amount shown above as Total tm heayComnmoitssreiporne'ssendtecision on my workmen's compensation of Employment pending shown on final I may be paidthbeyalthleowDaenpcaerotfmea nltien in the total amount am paid by the Department of Employment as any consent to Notice and Request for Allowance of Lien filed by the Department of Employment CF 2581 REY 3 1.58 EEPLOTES EST 1-1- 01284 01284 01 20m D aes f INDUSTRIAL ACCIDENT COMMISSION . i STATE OF CALIFORNIA rn : CASE 19396 JOHN D. STAPLES : VS. Notice of Time \ Applicant_ and Place of Further Hearing { KIRCHASESTOS PERKINS J.T. THORPE C.F. C.F. BRAUN COAST : PAKEN PERKINS OIL OIL FIELD CONST ARMSTRON CONTR : ONE DAY .- INSULATING FILERCLASS FILERCLASS EXO REACE INSULATION INSULATION PLANT R. T. DINWIDDIL ASBESTOS L.A. CORK KIRCHASESTOS KIRCHASESTOS MUNDET CORK CORP CAL ST CO NOTICE TO ALL PARTIES . further hearing will be held in the entitled action at You are hereby notified that 236 EAST THIRD STREET 237 LONG BEACH CALIFORNIA OCTOBER 5 1962 9 A.M. i . i : Dated at Long Beach - INDUSTRIAL ACCIDENT COMMISSION aeirten tinsth tabiehnscatien wank catay cores oe baton 5 90S fobs Sainbmlne Mi at ch mnt kn Member ee mande Llanes eg AND FURTHER HEARINGS ARE NOT FAVORED NOTE CONTINUANCES NAME AND ADDRESS OF PERSONS SERVED DATE 8-3-62 ip bf i i John D. Staples 10634 Ceres Whittier Amer Motorist Ins 3545 \ Edwin Silver 305 N. Avalon Wilmington Wilshire L. A. t LA Dept. of Employment Box 1466 Santa Ana Cas Ins Co. 810 S. Spring Baker Perkins 1000 Hess Saginaw Mich J. T. Thorpe 948 E. 2nd Los Angeles 12 Zurich Ins Eox 3203 Terminal OWE C. F. Braun 1000 Fremont Alh Bakersfield Annex Los Angeles 54 eM Oil Field Const Box 947 Pacific Employers Ins 2484 Coust Ins 2684 Lacy Los Angeles 31 Pacific Long Beach 4400 Armstrong Const Bundini Los Angeles L. 8. 32 Argo Ins 1001 Wilshire L.A. cea .. Fiberglass Eng 5933 TelegraphTelegraph d Amer Emp 639 S. New Hampshire R. T. Dinwiddie 8627 S. Atlantic S.G. L.A. L.A. Kircher Asbestos Box 6652 Pnx ^ riz Travel Ins Ocean Center bldg LA Cork 4180 E. Washington L.A. 23 Long Beach Plant Asbestos 1540 W 9th LB. Nat'l Auto & Cas Box 5760 L.A. Walker Mundet Cork Corp. 6116 Maywood Aetna Cas & Sun 810 S.Spring , Cal St. Co. 8823 Mettler Los Angeles 3 Beach Mich Mut Liab / Brown bros Wallace et al 300 W. Coast Hwy Newport Newport L.A. Adjs 3517 W. 6th L.A. 5 | McCartney et al 639 S. Spring 750 Broad Wilmington Murray Roberts Herlihy & Herlihy Ocean 456300-1031 Bldg L.B. 2 t 456300-1031 yOR & Herlihy 456300-1031 456300-1031 456300-1031 456300-1031 CLOFTON & PENNY 639 S. SPRING LOS ANGELE1S 4 CALIFORNIA Se ee nna conte mp Teese tes ~~" SignofaPertsonuSer rvineg Notice 4-400 5-02 TON @ SPO Before the Industrial Accident Commission of the State of California JOHN D. STAPLES Case No. 62 LB 19396 Applicant Joining VS. Order Joining Party BAKER PERKINS J.T. THORPE COAST INSULATING OIL FIELD CONST ARMSTRONG CONT FIBERBLASS ENG REECE INSUL R.T. DINWIDDIE KIRCHER ASBESTOS L.A. CORK PLANT ASBESTOS MUNDET CORK CAL ST CO C.F. BRAUN Defendants Defendant Good Cause Appearing Therefor IT IS HEREBY ORDERED THAT AMER AMER LIAB MTRST CAS INS ST FUND EIP TRAVELERS NTL AUTO & INDUST INDEM ZURICH INS PACIFIC EMP ARGONAUT INS CAS AETNA CAS & SURETY MICH MTU be joined as a party defendant in the above entitled cause Salh SEE NOTICE OF HEARING NAMES AND . ADDRESSES FOR -- -- S ERVEDON 8-3-62 KEITH L. JENSEN ReRfeefreereee INDUSTRIAL ACCIDENT COMMISSION Foru 348 RFV 6-58 6-58 nsieiaiclas anea a a ncn 213 3-02 1 ' STO > nc = 4 BEFORE THE INDUSTRIAL ACCIDENT COMMISSION OF THE STATE OF CALIFORNIA 2 : Mollco and Request for Allowance of Lien -- -- 62 LB 19396 : i Case No Date of From19to5Ma3 rch 1962 i Box 1466 Santa Ana Calif ; bapeine , STATE OF CALIFORNIA DEPARTMENt of EmployMENT , Meir VI D 10634 Ceres Whittier Calif _ ; John Staples een ~ e ; e Abentes A Tee EXPLOYER i ; - ee ee PLOYEE'S DOCIAL SECURITY M^ NSTA Armstrong Contracting oom" 0 OmPLCTRs 4400 Bandini E Los Angeles 22 Calif ABOUT eng Th Inia Jy ___ Travelers Ins Co INSURANCE INSURANCE CAERIET 110 W Ocean Long Beach 2 Calif epaairss the Industrial Accident Commission to determine and allow as a lien the sum stated 1. The undersigned hereby requests the amount of unemployment compensation disability benefits paid to date and in below as Total which represents benefits which may be paid up to the amounts srated in paragraph 3. below addition a lien is requested for any further 2. Filed under Labor Code Section 4903 _days including / Duablity Duablity benefits at the weekly rate of 70.00 6-17-52 inclusive paid for the period 3-9-62 to 10.21er at $ 10.21er day days paid for waiting period waived Filed under Labor Code Section 4903 b Additional benefits for hospital confinement at the daily rate of 12,00 3-7-62 3-13-62 inclusive 1 paid for the period TOTAL : 1,0101.00,010.00 . 48.00 1,058.00 r disability benefits may be paid to the employee for both daily indemnity and 3. Further unemployment compensation additional benefits for hospital confinement which will not exceed 810.00 and $ 2 respectively ' 4. The undersigned declares he has delivered or mailed a copy of this document to each of the parties listed 1952 June document on 27 Silver McWilliams & Sherman 305 n Avalon Blvd Wilmington Calif STATE OF CALIFORNIA DEPARTMENT DEPARTMENT OF EMPLO / 711. K necLf. LL ; LIKE CLAIMANT are able a aos sotnbaht p jb EMPLOYEE'S CONSENT TO ALLOWANCE OF LIEN NED the total amount of disability bene^-ts that ALAS I understand that the amount shown above as Total may not represent decision workmen's compensation claim final I may be paid by the Department of Employment pending the Commission's on my of Employment as shown on any of a lien in the toral amount I am paid by the Department PN I consent to the allowance for Allowance of Lien filed by the Department of Employment Notice and Request tbalc? sa wet DE 2581 Ray 3 .54 Abie eye A way what boy meee JLl eee wee SPLOYEE SPLOYEE BT Dr trey 49124 4 oe soo mR REWORE PpraTE me ee poe Before the Industrial Accident Commission of the State of California JOHN D. STAPLES VS. C. F. BRAUN et al Applicant Defendant ORDER TAKING OFF CALENDAR GOOD CAUSE APPEARING THEREFOR It Is HEREBY Ordered 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 of any of the parties hereto 5.52.299..662 2 INDUSTRIAL REFEREE ACCIDENT COMMISSION MAY 29 1962 eg cpy wist FILED SERVED EBELA MAY 29 29 19612962 g EBELA w Dated Long Beach California ER EBELA VERA INS |. INSA MAY 29 1962 4 J LN CL SUIF____ FORK 40 REV 6-51 EIN ne omnes s 40893 4-41-2516 4-41-2516 S"PO ap caiiailing Pied scnieatctnsafi TP SPICE SILVER FDWIN RICHARD L McWILLIAMS ARTHUR SHERMAN ERNEST L. GRAVES LOUIS BERSON LAWRENCE WEITZER ra o~, e 2 LAW OFFICES SILVER McWILLIAMS & SHERMAN BOULEVARD 305 NORTH AVALON WILMINGTON CALIFORNIA TERMINAL 4-2505 SPRUCE 5-6138 SANTA ANA OFFICE METCALFE 1525 uMApIN NORTH 811 VER STREET STREET KIMOTALT 7-0011 roe a = ii May Twenty Fourth Nineteen Hundred Sixty Two ee F ALL a 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 a pending determination of such information it is al requested that the matter be taken off Calendar Very truly yours SILVER McWILLIAMS & SHERMAN Lf A ae, By RICHARD * - ule va ag! L. MCWILLIAMS RLMC encl STATE OF CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION APPLICATION ET dy ...ned, aanereey MAY28 1947 rd re ee ee FILE SIGNED ORIGINAL AND SEX COPIES PLEASE PRINT OR TYPE NAMES AND ADDRESSES . me 62 CASE NO LB 19396 JOHN D. STAPLES SEE LISTING ATTACHED APPLICANT 10634 Ceres | APPLICANT'S ADDRESS Whittier California Social Security No. 497-12-2206 497-12-2206 497-12-2206 UNKNOWN AT THIS TIME INSURANCE CARRIER & ADDRE 1 John D. Staples HASE OF EMPLOYEL Between 1953 and , March 19.62 19.62 , 6-24-25 DATE OF BIRTH alleges that while employed DATE OF BILJERT heat & frost insulator OCCUPATION AT TIME OF INSURT Los Angeles County & vicinity_..CITY TOWN OR PLACE WHERE INJURY OCCURRED C al ifornia by See listing attached MANE OF EMPLOYER _____, The The sustained injury arising out of and in the course of the employment as follows ___._._ Exposure to asbestos dust fiberglass&otherirritants resultingin EXPLAIN HOW INJURY WAS RECEIVED Lungs and respiratory systemAND STATE WHAT PARTS OF BODY WERE INJURED AND GUBSEQUENT RESULTS Unknown employer's INFUSED UNINSURED 2. NAME OF INSURANCE COMPANY ON 18 EXPLOTEN WAS NOT INSURED INSURED STATE WHETHER SELF OR _ was the insurance carrier on date ofinjury SiMn archc 7 e 1962 3. e PERIOSE OFF WORK BUE TO THE INJURY DATE INJURED RETURNED TO WORT MATE LAST BEDICAL BAISKELI cteihe 4. Was compensation paid No. TES DE NO $ TOTAL PAID $ WEEKLY BATE DATE OF LAST PAYMENT 5. Earnings at time of injury -Max- @ MONTH OR WEKE The basis of pay was STATE PAY PERIOD OR HOURLY RAT^ KOURS A DAY AND DAYS A WEEK 6. Was medical needed Yes Who furnished treatment TE ONS KO Dr. George Fralick GIVE GANTS OF DOCTORS WHO TERATED THE INJURY AND STATE WHO PATE THEIR HILL 7. This application is filed to determine liability for a Temporary disability_yes YEA DE RO e Litigation expense TES OF NO disability b Permanent yes TES OR WO f c Medical treatment YES OR NO yes d Medical yes NO TES ON NO STATE ANT OTHER REASON 8. NUMBERS NUMBERS ANY acne enn LIST CASE NUMBERS OF ANY OTHER APPLICATIONS FILES WHEREFORE it is requested that time and place be fixedfor hearing and that an award be proper Laws of Wilmington made undundee r r the Workmen's Workmen'sWorkmen's CompenCsaotimonpensation CompensationCompensation Laws California California | California granting such relief as may be made May 17 1962 CITY MATE Long Hearing requested Beach CITY * Number of witnesses unknown Estimated of time da day y * } SILVER Staples Staples Staples Staples McWILLIAMS APPLICANT S ATTORNEY SHERMAN 305 North Avalon Boulevard Wilmington California TE 4-2595 ATTORNEY'S ADDRESS AND TELEPHONE TELEPHONE SURREN EXPORTE CAR LLS ES PLEASE BIV^ NO NO CITY DRET^ ZRAZONOD ZRAZONOD ZRAZONOD LIN PAZ HE SET FON CITY 39 WEAR~ TYCONVERT CONVERT CITY WF BE OPE Each or WINKLERS EXPORTERS EXPORTERS TE A CONTSURANCE CONTSURANCE CONTSURANCE AGE ZKI 17 74 Ta">stomitych for KEYGE PO KOPLE 1:01 CAN BE ALLOWES COMP ATT cast w APPLICANT ^ 14 COMPENSAT MATURE *** THE POST POST THE WHERES & COMPENSAT DI IVAN IVAN > BASE LTS THE APPLICANT GLED ONLY STATE THE SEVERAL MATURE OF THE CLASEBt asC NO O TIN CETWR ILY L TWHHEE RN EAF AT PP EL RIC BA E FY TYON KAY TEEN PLAKO SOT KES E EMA DI APPLICATE SE MERT OR FILES WITH DU MA Eto the EASEAT OFFICE OF THE INDUSTRIAL ACCIDENT COMMISSION WITHOUT RELAY MERT ATTORNEY f WIT^ EOF THE TSEE ALS PLACE OF HEARIN ITNERPARTY KAY BE DEPARKENYRO IN PRSSON AT OR OTHER AGENT for 34 REV 8-61 hh ha ase em a 63831 6-41 1740 ' spa |  & - JOHN DE STAPLES 3-1952 1953 Oct. B^,ker Perkins 1000 Home Ave. Saginaw Michigan 56 hours Nov. Dee 948 Los E. 2nd Angeles St. 12 Calif 1954 ante Jan. J.T. Thorpe hare " Feb. : Mar. . kt + Apr. * 939 ie Key * a June =" 288 July C. F. Breun Aug. 1000 Fremont St. Alhambra Calif - . Sept. Const insulating 88 2684 Lecy St. Loa Anyoles 31 Colir # Sept. J. 7. thorpe thorpe | Oct. 011 Field 118 82 1 Constr ; P.O. Boz 947 \ Bakersfield Calif . \ Nov. 011 Field Constr 40 | December J.t. Thorpe 360 1955 ho. | fang Armstrong Contr * 2991 1. , 4400 E. Bandini Los Angeles Calif n abe tr, J.T. Thorpe R 196 " - ril Armstrong Contr 678 15 15 . . . ne . ly 7 TES ga eee ceanrine April May June July Aug. Sept. Oct. Nov. Dec. Oct. Jan. Feb. Mar. Apr. May June ' July Aug. Sept. Oct. Nov. Dec. Jan. Fab March Apr. May June July Aug. Scot Oct. Nov. Dec. 1956 APR Fiberples Engineering 1409 5933 Telegraph Rd Los Angeles 22 Calif " wren, ar 1 ee ee " hrs meme ape " THA F " ae CASE Insulation ne Reece Insulation 4563 Valley Los Angeles Blvd. 32 Calif RULE " 56 j . ; . 1957 Piberglas n bf Engineering Armstrong Contr " Insulation Co. " " 684 497 809 1958 Resce Insulation J. T. Thorpe * 219 H 1149 R. T. Dinwiddie " Jan. Feb. 1959 R. T. Dinwiddie 8627 So. Atlantic South Gets Calif 657 hrs Fiberglas Engineering 366 Reece Insulation 5926 ere rT nite sale ne ee Ng og we tal neste aah oratetell gable woo se he Jan. Mar. April May June July Aug. Sept. Oct. Nov. Dec. 1960 Reece Insulation Kircher Asbestos 7.0 Box 6652 Phoenix Arizona Los Angelez Cork 4150 E. ington Los Angeles 23 Plant Asbestos 1540 W. 9th St. Long Beach , Calif 172 1208 1208 Jan. Feb. Mar. Apr. & June Aug. Sept. Oct. Nov. Dec. - 1961 Plant Asbestos 872 Mundet Cork Corp. 4116 Welker Ave. 102 Meywood Culif Cal State Compent 7623 Mettler St. 32 Loa Awele 3 Calif Fiberries engineering Plant Asbestos Co. 190 " 386 hi Jan. Feb. Feb. Mar. ben, ^' 1 py ich A tt se oy a 281962 281962 281962 ' 281962 281962 aot | Le 1962 ae ; de cee seenR. ULTEF Plant Asbestos Company Coast Insulating Armstrong Contr 172 hr 38 ang men cree ot sen Sea mapena Fe cunderey cee OS 4 LONG BEACH oo BOULE oo LONG BLACH oo 7, LA ORNIA ' GARFIGARFIELE D 4-L 04D 11 ote ee ee ; | oo be , eee: INDUSTRIAL INDEMNITY COMPANY January 16 1963 Industrial Accident Commission 236 East Third Street Long Beach California pia JAN 17 1953 . ; store L det oat _- se at _ a Rt I.A.C. No Claimant Employer Claim No 62 LB 19396 John D. Staples Plant Asbestos Co. C62-43-09355 Gentlemen A fully ment is below executed copy of the being served on this Compromise and Release Agree- date to the Carriers listed a has been submitted to the The original of this agreeomfenSttephen J. Grogan and copy Commission by the officeas well as the office of Silver retained by Mr. Grogan McWilliams & Sherman Very truly yours James A. Karr a it 4 Claims Adjuster , deal JAK fa ee 3545 Aetna Casualty and Surety 810 South Spring Los Angeles American Motorist Ins Co. Wilshire Los Angeles American Employers Ins Co. 639 S. New Hampshire Los Angeles , Argonaut Insurance Co. 1001 Wilshire Blvd. Los Angeles Casualty National Pacific Ins Co. of Calif 810 Los Automobile and Casualty Casualty Employers Ins Co. 2484 South Spring Los Angeles 639 South Spring Angeles Pacific Ave. Long Beach 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 STEPHEN J. GROGAN - MAURICE R. HOGAN JR JAMES NELSON : Gw LAW OFFICES GROAN^VENTY GROGAN^ VENTY STEPHEN J. 6 SOUTH WESTMORELAND AVE U~ {Af . HA LOS ANGELES 5 MEN aun DUNKIRK 4-310 JAN 3 1963 nh January 10,1963 Industrial Accident Commission 236 East Third Long Beach California Re J Ca os he n DN.o. St62aplLeBs 19vs 3. 96 Armstrong Construction al Gentlemen Enclosed for approval you will and Release in the above case find executed Compromise itd Very truly yours a a: SJG Enclosure SO , ma . cc Attys Silver McWilliams Sherman 305 North Avalon Boulevard Wilmington California ES TO arnt - SAO eo HIBR n cnt* Phiten an s Smee Ro ct A BIN pO RCI then ey ala dn tr ie waiieonthuc cians a EDWIN SILVER RICHARD ARTHUR SHERMAN LOUIS BERSON LAWRENCE WEITZER LAW OFFICES SILVER McWILLIAMS & SHERMAN 30614 NORTH AVALON BOULEVARD WILMINGTON CALIFORNIA fl TERMINAL 4-7595 SPRUCE 8-6128 METCALFE ANA BILVER 18ME3T5CALFE STARST KIMBLY 7-0012 fl oe November November Nineteen Sixth Hundred Sixty Two Industrial Accident Commission 236 East Third Street Long Beach California vr THA COMING a] NOV 8182 HOP_ Sa t AND HOP_ AND semmmnees Mae Meer Faea amt ee . teen manmne He 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 claim in the sum of 1,868.00 this letter is written to assist the Commission in allocating a portion of the proceeds to said lien claimant al Medical expenses to date are 451.00 consisting of 166.00 lt to Dr. George Fralick 145.00 to LaMirada Hospital and 140.00 for 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 1,000.00 is allocated to future medical treatment and observation leaving a balance of 7,800.00 for temporary and permanent disability The period of temporary disability involved is March 7 1962 1962 to October 1 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 payable under the terms of the per day and inasmuch as settlement at the rate of the Department's lien covers 943.22 a period of 182 days they would be entitled to the sum of plus 48.00 expended for hospitalization benefits or a total of 996.22 SC 4-4 me aee! Enya i i De scelbitss HRe. caesce-. emi eee Page 2 Considering said all the facts and circumstances of the sum is considered fair and equitable to all case as the amount to be allocated to the parties Department Yours very truly SILVER McWILLIAMS & SHERMAN Richard McWilliam Richard McWILLIAMS RICHARD McWilliam L. RLMCW: bc CC CDleoppatrotnme& ntPeonfnEymployment P.O.Box 1466 Santa Ana State Compensation Ins Fund Long Beach . Travelers Long Beach . Aetna Cas & Surety Herlihy & Herlihy Long Beach Industrial Indemnity Long Beach National Auto & Cas Murray Roberts Michigan Mutual Liab American Motorists Mr. Thomason . - American Employers Pacific Employers Long Beach aldensiaen si EDWIN SILVER RICHARD McWILLIAMS LOUIS PERSON LAWRENCE WEITZER ie LAW OFFICES SILVER McWILLIAMS & SHERMAN 305NORTH AVALON BOULEVAND WILMINGTON CALIFORNIA TERMINAL 6-3593 SPRUCE 5-6126 SANTA ANA OPPICS MITCALFE AND SILVER 2035 STREST KIMOSELY STREST November Seventh Nineteen Hundred Sixty Two - Industrial Accident Commission 236 E. Third Street Long Beach California AND #FO - Bc eeneate eee pert 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 RICHARD MCWILLIAMS MCWILLIAMS RLMC : bWc CC Department of Employment P.O. Box 1466 Santa Ana oe 4 CLOPTON & PENNY Attorneys at Law 639 South Spring Street Los Angeles 14 California Madison 7-1566 : TE AUG AUG 1962 ' 1962 2 -, INDUSTRIAL ACCIDENT COMMISSION Long Beach California August 1 1962 OES oy RE John Staples vs. Coast Insulating ot al Gentlemen Case No. 62 LB 19396 Hearing Date Oct. 5 1962 Our File # 19963 and A Your attention 1 ) Attached for your is respectfully invited to the following please find approval duly executed Compromise & Release ( ) 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 WHK kb Copies sent to aha Silver McWilliams & Sherman Pac Emp - L.A. . 71 PC 73643 & 73644 Very truly yours CLOPTON & PENNY B.B. B. B. f WILLIAM H. KENNEDY Office Manager cAaLE aporess HERANDHER . 20-5 4 ^' 1 HERLIHY & HERLIHY HERLIHY BUITE B16 PARE HERLIHY HERLIHY ain BUITE PARK ATTORNEYS Low 412 14. CENTRAL BIXTH LOS ANGELES August 22, 1962 0 to LoMo anacK OFFICE OCEAN CENTER SUILDING Ho WEST OCEAN BLVD. OCEAN LONG BEACH OFFICE CENTER BUILDING OCEAN aienasil Accident Commission Industrial 236 236 East Third Long Long California Rest PLANT ASBESTOS JOHN JOHN STAPLES vs PLANT ASBESTOS ASBESTOS EMPLOYERS STAPLES vs ASSURANCE ASSURANCE COMPANY COMPANY A. M. 62 62 19396 19396 LIABILITY ASSURANCE LIABILITY Dear Dear of record in the enter appearance as attorneys of record the above captioned for the attorneys EMPLOYERS captioned case COMPANY EMPLOYERS ASSURANCE jssued by the of all documents the we Industrial Industrial Accident with copies documents issued By documents letter of Accident Commission this letter serve requesdt ocuments applicant's attorneys with copies of future all which they may in the Commission Commission the defendant oF serve upon Commission truly truly Yours _ HERLIHY HERLIHY HERLIHa Y T e Jones Keris Keris Keris Keris Jones Jones 00 SILVER ce: ATTORNEYS ATTORNEYS LAW SHERMAN SHERMAN Wilmington Avalon Avalon Wilmington Wilmington Calif Blvd. Wilmington, calif. oo na aA By ona ot DED ac ba RE sili, PETS. CORE itteriaedtnoaReati an cea: oe vce otal 10-5 10-5 DOUGLAS K. WALLACE W. GERALD BROWN 7) WALLACE & BROWN ATTORNEYS AT LAW 300 WEST COAST HIGHWAY NEWPORT BEACH CALIFORNIA August 8 1962 TELEPHONE MIDWAY 6-445D Industrial Accident Commission 236 East Third Stree Long Beach California AUG AUG : 91952 91952 Subject John B. Staples vs. Perkins I.A.C. No. 62 LB 19396 et al . Pins Gentlemen Gentlemen This office represents the Aetna Casualty and Surety Company carrier for defendant Mundet Cork Corp. in the above titled matter Defendant submits no medical none are in its possession reports at this time as By carbon copy cant are asked of to this letter attorneys for the applisubmit copies of all medical reports in their possession to this office Very truly yours W. Gerald Brown WGB sr CC Silver McWilliams & Sherman Attorneys at Law 305 North Avalon Wilmington California in = creer gies en nn SE ee ele cee a meee woe BO a Ne ve eR lee tenisnat yom CN ET a bo aM TED O. BROWN GENERAL MANAGER HEAD OFFICE SAN FRANCO FRANCO CALIFORNIA RANDY F. NOWGJITH MANAGER BOUTHER^ IFORNIA BROWN BROTHERS ADJUSTERS FOUNDED I924 BY ARTHUR E. BROWN PLEASE ADDRESS LY TO 3517 WEST SIXTH STREET . LOS ANGELES 8. CALIFORNIA = RANDY F. HOWORTH MANABER July 27 1962 PHONE DU NKIRK 7.3256 IN YOUR REFLY PLEASE GIVE OUN FILE NO LA C NO 28717 Department of Industrial Relations 236 East 3rd Street Room 237 Long Beach 12 California RECTART INDOS PAL ACCI ON: COMMISSION = LONG BEACH JUL901963 JUL901963 JUL901963 JUL901963 Attention Lenore M. Kruger Clerk Industrial Accident Commission Re Case No. 62 LB 19396 JOHN D. STAPLES -VS- C. F. BRAUN ET AL Gentlemen This will acknowledge your letter of May 29 1962 addressed to Baker, Perkins in Saginaw Michigan Please be advised that Perkins Inc. is insured for Workmen's e e 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 MLP Ea ADJUSTING OFFICES CALIFORNIA MAJAYD MAJAYD tae | IL CINTAIN ~~ M VENTURA FRING FRING HAYWARN HAYWARN OFFICES INGLEWOOD LONG BEACH LOS ANGELES MAHLE MATO MONTEREY OAKLAND OAKLAND PALM SPRINGS PASADENA Powys MY 13 REDWOOD CITY 43 SACRAMENTO BALINAS BAN BENNARDING SAN GO SAN FRANCISCO SAN 2 FE EAN LUIT DISPO BAN RAEL SANTA ANIA KE MANGANA SANA MARIA RAFIA MA STOCKTON TULARE VALLEJO VAN NUTS ARIZONA PHOLNER TUCSON OFFICES NEVADA OFFICES LAN YEOAN N OREGON OFFICES JUDENE PORTLAND WASHINGTON SATIR POKANK POKANK OFFICES ee ERR Ta RRA REED ue Foo ere atresia cB. Staainite - MTA cote. A BER | ASK Foe temaaninre rece oo Page 2 12. 1.13 14. / C15 16 17 18 19. 20. 21. 22. 23. DinwiddCloerp18.0247b-58 yState 1-1-62 T. Thorpe by American Motorists Ins Co. Policy No. 431898 1-1-58 Ins Fund R. T. Compensation Policy No. 180247-58 180247-58 7-1-58 Fiberglas Engineering by Aetna Cas & Surety Policy No. 926 Nati9o-na 1l-A5u8to & Cas Ins Co. Reece Insulation Policy No. 22C 628498 7-1-59 Kircher Asbestos - - No record of coverage Los Angeles Cork by Zurick Ins Co. Policy No. 22-24-4I0n8dus1t0r-ia2l7-In5d9emnity Plant Asbestos by Policy No. 600091 1-1-60 Policy No. 611154 1-1-61 Mundet Cork by Aetna Cas & Surety Policy No. 23413 12-31-60 - - No record of coverage Cal State Company Fiberglas Engineering by Aetna Cas & Surety Policy No. 3241 9-1-61 Co. Plant Asbestos by American Employers Ins Policy No. 019-8102-001 1-1-62 Pacific Coast Insulating by Employers Policy No. 28645 5-1-61 that the foregoing insurance carriers It is requested defendants herein A copy of the be joined as party with a copy of medical reports application togetwheirth the Commission Commission is being heretofore filed the carriers named served con- currently on each of requested that the matter be restored It is respectfully for a day hearing to calendar and set Yours very truly SILVER McWILLIAMS & SHERMAN , ia RLMCW : bc CC with enclosures RICHARD L. McWILLIAMS all carriers listed K. DOUGLAS W. GERALD WALLACE SHOWN WALLACE & BROWN ATTORNEYS AT LAW JOO WEST COAST HIGHWAY NEWPORT BEACH CALIFORNIA June 14 1962 Industrial Accident Commission 236 East Third Street Room 237 Long Beach California TELEPHONE 6-4459 INDUSTRIAL ALCIDER INDUSTRIAL ALCIDER COMMISSION LONG BEACH JUN 181962 181962 181962 AND FILED abel _ CASE Subject Gentlemen Gentlemen John D. Staples vs. C. F. Braun et al I.A.C. No. 62 LB 19396 This office represents the Aetna Casualty and Surety Company carrier for defendant Fiberglas Engineering oa ie Company in the above titled matter Defendant submits no medial reports none are in defendant's possession at this time ai By carbon copy of this letter attorneys for the applicant are asked to submit copies of all medical reporta in their possession to this office Very truly yours vo W. Gerald Brown WGB 1 CC Silver & McWilliams Attorneys at Law 305 North Avalon Boulevard Wilmington California a ower ee NATIONAL -Automobile -Automobile and Casualty Insurance Co. HOME OFFICE ANGELES a 3 BOUTH SPRIN STREET MAIL ADDREAK 780 METRO STATION LOS ANGELES 33 CALIF MADISON 6-9592 | June 12 1962 Silver MeWilliams & Sherman 3051 North Avalon Blvd. @. Wilmington California Gentlemens Demand is hereby all medical reports on or under his control this applicant's attorney for matter in his possession y.. truly yours os ids H.Cummings ce! Compensation Claims isthe mo act Industrial Accident Commission 236 East Third Street Long seach California . SURFYY INSURANCE FIRI AND CARUalty CARUalty . FIDELITY AND NONO .. a DIVISION OF ADMINISTRATION MARGARET CRITCHIE CRITCHIE ONIEF CONCILIATION SERVICE GLENN BOWERD SUPERVISOK DIVISION OF APPRENTICESHIP STANDARDS oo er STATE OF CALIFORNIA 6 EDMUND O. BROWN Governor JOHN F. HENNING Director DIVISION OF INDUSTRIAL SAFETY THOMAS H. GAUNDEAD ANIRF 5 of | } DIVISION OF INDUSTRIAL WELFARE FLORENCE 8. CLIFTON CHIEP DIVISION OF LABOR LAW ENFORCEMENT CIGMUND ARYWITZ CHISP DIVISION OF HOUSING LOWELL NELSON CHIEF DIVISION OF LABOR STATISTICS AND RESEARCH MAURICE 1. GERAMYNBON CHISF DIVISION OF INDUSTRIAL ACCIDENTS B. W. RECEIVED RECEIVED RECEIVED RECEIVED RECEIVED RECEIVED RECEIVED JUN ACCIDENT DEPARTMENT OF INDUSTRIAL RELATIONS HEADQUARTERS 965 MISSION STREET SAN FRANCISCO 3 STATE COMPENSATION INSURANCE FUND SARL R. HOWARD SENSRAL MANAGES ADDRESS REPLY TO May 29 1962 COMMISSION INDUSTRIAL COMMISSION FRANC SAN 236 D. Third Street Room Long Beach 12 California HEmlock 5-8367 237 Baker Perkins 1000 Hess Ave. 62 LB 19396 ANO JUN EXIT 11 ao FILCO Saginaw Michigan On May 28 1962 Claim was filed by AdjustmCASeE nt 42 ALMENT 03612632 an Application for 9 25 > 4 A11 alleging John D. Staples injury 99 between 1952 to March 7 1962 lek The application does not show the name of your workmen'workmen's s insurance carrier Will you please give us this al compensation information in the space provided below If you are not insureinsuredd please state the reason eal Since carrier Since the Commission joins the insurance carrier as defendant defendant in a cases your carrier should be notified that the above application has been filed placed on the calendar Notice of Hearing as soon as the claim has been If you are neither 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 Lenorem Kruger Lenorem Kruger . Lenore M. Kruger Clerk INDUSTRIAL ACCIDENT COMMISSION COMMISSION . NAME OF WORK'IN'S COMPENSATION Michigan Mutual Liability Company Chamber Commerce Bldg INSURANCE COMPANY - LSaginaw -Saginaw Michigan The law provides provides : NNOTICO E TICE provides that failure on the part of the employer ten days to furnish this information 3 constitutes prima facie evidence that the failed or neglected to secure the payment employer has of compensation The law payment further provides that failure to secure of compensation is a misdemeanor the. << oan, . a cent Lange guy a sigui omjera jina SARE ee ee nens STATE OF CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION eo Mundet 6116 Cork Corporation Walker Avenue Maywood California May 29 1962 236 E. Third Street Room 231 Long Beach 2 Califorrner i)a Hemlock 58367 INDUSINDUT STRIAL ReI tAE L ** OMM03B 62 LB 19396 JUN11 1962 ani wee DIEHL eee se ep BES On May 28 1962 was filed by John injury of between 1953 an Application D. Staples and March 7 1962 for Adjustment of Claim alleging The application does not show the name of compensation insurance carrier Will you information 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 these cases your carrier should be notified that the above application has been filed in You will receive Notice of Hearing as soon as the claim has been placed on the calendar If you are neither insured nor have my 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 Pausen Pausen . es Lenore M. Kruger Clerk pea INDUSTRIAL ACCIDENT COMMISSION NAME OF WORKMEN'S COMPENSATION INSURANCE COMPANY - AETNA CASUALTY & SURETY COMPANY 23 oo NOTICE The law for a provides that period of ten failure days to on the part of the employer furnish this information constitutes prima facie evidence that the employer has failed or neglected to secure The law further provides that the payment of compensation failure to secure the payment of compensation is a misdemeanor o~ . ~ OR OR STATE OF CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION INDINGAN PHINIU COMMISSIGKU INDINGAN ACT COMMISSIGKU COMMISSIGKU eneny JUN 81962 81962 AND FILED EAMIENT oe _ CASE CASE . Reece Insulation 4563 Valley Blvd. Los Angeles 32 California May 28 1962 236 E. Third Street Room 5-8367 Long Beach California Hemlock 5-8367 237 62 LB 19396 On May 28 1962 an Application was filed injury on by 1953 John D. Staples to March 7 1962 ** for Adjustment of Claim alleging The application does not show the name of your workmen's rr compensation insurance carrier Will you please give us this information the space provided below If you are not insured please state the reason Since the Commission joins the insurance carrier as defendant these cases your carrier should be notified that the above application has been filed in a You will receive Notice of Hearing as soon as the claim has been a placed on the calendar If you are neither insured nor have a workmen's compensation insurance policy you should attend the Whearing for your own protection The prompt return of this form will be very much appreciated truly Yours very aT f Ag a L^nore M. Kruger > Clerk INDUSTRIAL ACCIDENT COMMISSION NATIONAL AUTOMOBILE AUTOMOBILE AND INSURANCE NAME OF WORKMEN'S COMPENSATION CASUALTY INSURANCE CO L.A. 6455BB_S 6455BB_S INSURANCE COMPANY Policy Policy 22 6455BB_S 6455BB_S 6455BB_S NOTICE The law for a provides that period of ten failure days to on the part of the employer 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 oo @ , ) ( STATE OF CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION Armstrong Contractor 4400 East Bandini Los Angeles Angeles California California May 28 1962 236 E. Third Street Room Long Beach 12 California Hemlock 5-8367 237 62 LB 19396 RECEIVED ae JUN 6 1982 we Boe aa May 28 1962 was filed by John D. injurmyy between 1953 an Application Staples and March 7 1962 for Adjustment of Claim alleging The application does not show the name of carrier Will you compensation insurance information the space provided below your workmen's please give us If you are not this insured please state the reason Since these joins the insurance carrier as defendant that the above the Commission carrier should be notified cases your in application has been filed as soon as the claim has been You will receive Notice of Hearing neither insured nor have placed on the calendar If you are you should attend the a workmen's compensation insurance policy hearing for your own protection return of this form will be very much appreciated dicted The prompt Yours very truly Fruga m Fruga almbre stn Lenore M. Kruger Clerk INDUSTRIAL ACCIDENT COMMISSION NAME OF WORKMEN'S COMPENSATION = INSURANCE COMPANY 2 oo _TRAVELERS INSURANCE COMPANY- = = NOTICE that failure on the part of the employer The law provides to furnish this information for a period of ten fac di ae ys evidence that the employer has of compensation constitutes prima failed or neglected to secure the payment the that failure to secure The law further provides is a misdemeanor payment of compensation 6 rr PLANT ASBESTOS COMPANY ENGINEERS 1300 64th STREET 1540 - WEST 1th STREET CONTRACTORS EMERYVILLE 8 CALIFORNIA LONG BEACH CALIFORNIA OL 8-5378 HE 7-0443 June 1 1962 State of California Industrial Accident Commission 236 E. Third Street Room 237 Long Beach 2 California Attention Lenore M. Kruger Clark Subject 62 LB 19396 John D. Staples *** *** COMMISSION DYS BACH BACH JUN JUN 61952 61952 61952 61952 Saw He, . E fee ee, 6802 wee saree Bod 6802 Gentlemen Gentlemen letter dated May 29 1962 con- With reference to your of Claim alleging Application for Adjustment filed cerning an 1953 and March 7 1962 which was injury between have requested the name of John D. Staples you Carrier which is by Workmen's Compensation Insurance our as follows American Employers Insurance Co 639 South New Hampshire Street Los Angeles California Our Policy No. 19-8102-001 Expires 1/1/63 j Should there be any further desire please let us know information which you may Very truly youre PLANT ASBESTOS COMPANY Paul Mieto Paul G. Nieto Vice President PcCaN bAwmerican Employers Insurance Co. . dae nine neem pnts STIONh pe INPERTHIAL INPERTHIAL FO * Fit PAL KINGS Mi CHANT . with STIONh STIONh nen wee _ ee 4 we ceamsiniem nerarennt STATE OF CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION Kircher Asbestos Post Office Box 6652 Phoenix Arizona May 28 1962 236 E. Third Street Room 237 HeHmleomclkocBk eac5h-85-3836677 California RECEIVED 62 LB 19398 COMMISSION f JUN 4 1963 1963 4 aa ated ate ) en Lond auuste On was May 28 filed by 1962 John D. an Application Staples injurp y between 1953 and March 7 1962 for Adjustment of Claim alleging The application does not show the name of compensation insurance carrier Will you information the spac provided below please state the reason your workmen's please If you give us are not this insured Since the Commission joins the insurance carrier as defendant in these cases your carrier should be notified that the abova 3 application has been filed q You will receive Notice of Hearing as soon as the claim has been placed on the calendar If you are neither 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 ... ...Kiagen Lenore M. Kruger Clerk Policy INDUSTRIAL ACCIDENT COMMISSION 18148 ern, > NAME IndustrialCo mmission NAME OF WORKMEN'S COMPENSATION The IndustrialCo mmission mmission mmission mmission argona NOTICE The law for a provides that period of ten failure days to on the part of the employer 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 os w INDUSTRIAL ACCIDENT COMMISSION wenn EXCENTS . JUN 1962 AND LID LID EUISIT awe woe GN ee a me OT ge Art Fiberglass Engineering Telegraph Road Los Angeles Angeles 22 California 1962 | May 28 1962 Mail 236 E. Third Street Room Long Beach 2 California HemlockHemlock 5-8367 5-8367 237 62 LB 19396 19396 On May 28 1962 for Adjustment of Claim an Application alleging March was filed by John D. Starles injury on between 1953 and 7 1962 does not show the name of The application compensation insurance carrier Will you below information the space provided your workmen's workmen's please If you give us are not this insured please state the reason Since these the Commission joins the insurance carrier as defendant be notified that the abova cases your carrier should in application has been filed soon as the claim has been You will receive Notice of Hearing as insured nor have placed on thecoc mpaelnesnadtairon I if nsy uo ru ana cr eepnoeliitchyeryou should attend the a workmen's hearing for your own protection The prompt return of this form will be very much appreciated eis: Yours very truly alia Lenore Krugl Lenore M. Kruper Clerk INDUSTRIAL ACCIDENT COMMISSION AETNA NAME OF WORKMEN'S COMPENSATION INS COU MPAR NY A 2 owNuC eE me AETNA AETNA LIFE Los ANGELES INS INS . CALIF Co. NOTICE The law provides that failure to on the part of the employer furnish this information for a period of ten days that the employer has constitutes prima facie evidence of compensation failed or neglected to secure that the payment failure to secure the The law further provides payment of compensation is a misdemeanor ' @ STATE STATE OF CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION ACTRONI REGAVED IMPORTERIAL COMMISSION -- LONG BEACH JUN 4 1962 FIND - ET CASE KO Red May 28 1962 R. T. Dinwiddie 8627 South Atlantic Avenue South Gate California 236 E. Third Street Room Long Beach 2 California Hemlock 5-8367 237 62 LB 19396 On May 28 1962 an Application was filed by John D. Staples injury of between 1953 and March 7 1962 for Adjustment of Claim alleging The application does not show the name of compensation insurance carrier Will you information 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 these cases your carrier should be notified that the above application has been filed in You will receive Notice of Hearing as soon as the claim has been placed on the calendar If you are neither 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 -- ----,---- timorem timorem Lenore M. Kruger Clerk INDUSTRIAL ACCIDENT COMMISSION NAME OF WORKMEN'S COMPENS INSURANCE COMPANY _ State Compensation f Compensation Compensation ... ... 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 QTATE OF CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION Cal State Company 8823 Nettler Street Los Angeles 3 California May 29 1962 236 E. Third Street Room 237 Long Beach 2 California Hemlock 58367 62 LB 19396 RECEIVED COMMI-SLSONGIBOEANCH JUN 4 1962 AND FILED Be CASE On May 28 1962 an Application for Adjustment of Claim was filed by Joh Johnn D. D. StaplStaples es alleging injury on between 1953 and March 7 1962 TEP The application does not show the name of compensation insurance carrier Will you information the space provided below please state the reason your workmen's please give us If you are not this insured Since these the Commission joins the insurance carrier as defendant cases your carrier should be notified that the above application has been filed in You will receive Notice of Hearing as soon as the claim has been placed on the calendar If you are neither insured nor have isa a workmen's compensation insurance policy you should attend the hearing for your own protection iia The prompt return of this form will be very much appreciated Yours very truly Lenore M. Kruger INDUSTRIAL ACCIDENT Clerk COMMISSION N, \ NAME OF WORKMEN'S COMPENSATION INSURANCE COMPANY _ Argonaut Insurance Co. Wilshire Blvd. Los Angeles 17 Calif NOTICE The law for a provides that period of ten failure days to on the part of the employer 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 om yeae we STATE OS CALIFORNIA DEVIN GE LEVERE LEVEN REN ie gg LEVEREN Gancuage erheme WARGANET AMMINISTRATION AMINSTRATION AMMINISTRATION b WITCH J.T STATE STATE STATE ae ae ee 7 PONE CONCILIATION AT THOMPE pack? diane Qoaeee sirens: CONCILATION WN Govissom > crass es OF AMR RE DIVISION DIVISION BAMA, CHASI a Clvisian OF DIVISION bower. Seren, LOWELL SERVICE J.T OF APRENTILARION APPRENTILARION APPRENTILARION AP RENTILARION are CHILF ee HOUSING ws Ne ie SPA . CHILE OALee INDUSTRIAL RELATIONS DIVISDII VIO SIN ON or ACCIDACIDENTSEIPO DNETPDAESPRATIRMTPMEENONTT aw maceonaca. W.NACSONALU W.NACSONALU 7 GRGARAIIN N et tee : Gg AN veut Vay yas 72 . OH ee wen OF DEPARTMENT DEPARTMENT INDUSTRIAL INDUSTRIAL INDUSTRIAL 3 Pa) Ll, ees nen wean SRT Cee prawunr an AND peetaark oF LABOR ETATIOTICS CEE OIviston eRe bom DIVISION apenea tion buk ... ... ... evaTe CO! SEM BMAL BARASEN LABOR STATISTICS RELATIONS STATE COMPENSATION vy Third Room 237 Mav Mav 1962 1962 California co C. 12 _ 236 ? Long aa rs. A? Le 5-8367 5-8367 erreytnr Cera ty T. T. Second ang BE. E. California Los Los Angeles Yee ase Phe 1152 ae 1152 of pe for Adjustment an Application alleging sternbtahae On Claim May 2fil" ed John John St Appll icatioe n s injury injury was between 1953 . SE a injury between worknen's injury the name of your va this rer application does show name of your workmen's this qnsured, compensation application carrier please give please please Tha insurance Will Re provided ipnl foermaas tie on state theresapsaocn e defendant in Since state state carrier as defendant the insurance as defendant these cases joins should be carrier these carrier application application has filed has been has been will soon the the Jaim been have claim of Hearing as the the calendi You placed compensation are neither If you self insurance policy insured insured have hearing word men's compensation a hearing hearing own protection ated. ; The prompt return form will very much appreciated appreciated appreciated 0 of this The prompt rezurn truly truly Yours aw KurKguerge a Kurge ... Lenore Kruper Kurge INDUSTRIAL ACCIDENTClerk Slerk Clerk 1 LSSTON : 0-FF Company ployees Company 1953-5149-5535-54-55 : Company Company 1953-54-55 Gat. . ployees NOTICE INSURANCE INSURANCE COYPANY provides ployees ployees fromance employer dete i NOTICE period provides furnish the part of employer days information constitutes constitutes period facie evidence evidence this nas employer has NOTICE: prima fallet fallet constitutes the secure evidence compensation has furtuor wevlected provides that fire payment of accure the compensation compensation payment of furtuor compesnation misdemeanor fire accure aoe Tre TW compesnation meyers OR misdemeanor misdemeanor misdemeanor misdemeanor mek oes paycent STATE OF CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION . WFCTIVID UMTS ag Arey COMMISSION iar ofth May 29 1962 JUN 11962 arn p ~ bbe OT oF 236 E. Third Street Room Long Beach 2 California Hemlock 5-8367 238 Los Angeles Cork 4180 East Washington Los Angeles 22 California 62 LB 19396 On May 28 1962 an Application was filed by John D. Staples injury filed between 1953 and March 7 1962 for Adjustment of Claim alleging The application does not show the name of compensation insurance carrier Will you information the space provided below please state the reason your workmen's please give us If you are not this insureinsurd ed carrier Since the Commission these cases your joins the insurance carrier as defendant should be notified that the above in application has been filed You will receive Notice of Hearing as soon as the claim has been attend have placed on the calendar a workmen's compensation If you are neither insured 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 __ _ _ _. Zurich Insurance Company - 4465 Wilshire Blvd Los Angeles 5 Cal law period NNOOTITCEICE The The constitutes of ten prima failure on the part of the employer days to furnish this information facie evidence that the employer has neglected failed or to secure the payment of compensation The law further provides that failure to secure the payment of compensation is a misdemeanor a G _ STATE OF CALIFORNIA Ww INDUSTRIAL ACCIDENT COMMISSION RICEWED INILISTRIAL STRIGENT canary we JUN 71962 71962 Oil Field Construction Post Office Box 947 Bakersfield California May 29 AS a 1962 a - th _ ui an, E 1 E 236 Long East Third Street Room Beach 12 California 237 237 62 LB 19396 +, ar On May was filed injury on 28 1962 by John between 1953 an Application D. Starles and march 7 1962 for Adjustment of Claim alleging The application does not show the name of compensation insurance carrier Will you information the space provided below please state the reason your workmen's please give us If you are not this insured Since these the Commission joins the insurance carrier as defendant cases your carrier should be notified that the above application has been filed in You will receive Notice of Hearing as soon as the claim has been placed on the calendar If you are neither 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 INDUSTRIAL ACCIDENT Clerk COMMISSION NAME OF WORKMEN'S COMPENSATION Casualty Ins 1953 thru 1957 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 law further provides that the payment of compensation failure to secure the payment of compensation is a misdemeanor ; 17 ae DIVISION OF ADMINISTRATION MARGARET . RITCHIE CHIEP CONCILIATION SERVICE LENN BOWERS SUPERVISOR DIVISION OF APPRENTICESHIP STANDARDS CHARLES P. PANNA CHIEF DIVISION OF HOUSING LOWELL HELYON CHIRP DIVISION OF INDUSTRIAL ACCIDENTS 6. W. MACDONALD CHAIRMAN oe) STATE OF CALIFORNIA w EDMUND O. BROWN fee Sane : <earwae 1 t, 8 JOHN F. MENNING Director DIVISION OF INDUSTRIAL SAFETY THOMAS N. SAUNGONE CHIEF DIVISION OF INDUSTRIAL WELFARE PLONENCE 6. CLIFTON ~NIES DIVISION OF LABOR LAW ENFORCEMENT BISMUNG ARTWITZ CHIEF DIVISION OF LABOR STATISTICS AND RESEARCH MAURICE 1. MENDON CHIEF DEPARTMENT OF INDUSTRIAL RELATIONS HEADQUARTERS 965 MISSION STREET SAN FRANCISCO 3 COMPENSATION INDURANCE MANAGER ADDRESS REPLY TO May 29 1962 C. F. Braun 1000 Fremount Street Alhambra California 236 E. Third Street Room Long Beach 12 California HEmlock 5-8367 237 62 LB 19396 On May Claim was injury on 28 1962 filed by between 1953 an Application John D. Staples to March 7 1962 for Adjustment of alleging 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 these the Commission joins the insurance carrier as defendant cases your carrier should be notified that the above application has been filed in You will receive Notice of Hearing as soon as the claim has been placed on the calendar If you are neither 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 Kruge Lenorem Lemore M. Kruger Clerk INDUSTRIAL sarees meme ACCIDENT COMMISSION COMMISSION NAME OF WORKMEN'S COMPENSATION INSURANCE COMPANY - . AMERICAN MCTORISTS INSURANCE 3545 WILSHIRE BOULEVARD BOULEVARD CO 106 ANGELES 5 -CALIFORNI eAe NOTICE failure The law provides that failure on the part for a period 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 STATE CALIFORNIA COMMISSION Coast Insulating 7 2634 Lacy Insulating Coast Insulating Insulating Calis, 29 1962 1962 E. Third Street Beach 12 Room California 237 23 ? Beach California California Cn May filed 28, , 1962 On filed May On zr John b, Application Application Application Adjustment Adjustment alleging Claim injury between John and March alleging between between 1962 1962 application 1953 show the application does application show name your workmen Will workmen insurance compensation compensation in insurance provided please please not insured space below you are insured not insured please please state insured Since the reason Commission joins the insurance Since cases joins your should be carrier notified defendant above in carrier that above above You application - You application Notice of a will receive Notice of Hearing as soon self insured placed calendar you are neither insured have have placed workmen's workmen's compensation insurance policy should you the have protection should attend the 5 The hearing return return this form will be } very much &ppreciated, Yours very truly NAME OF WORKMEN'S COMPENSATION - INDUSTRIAL INDUSTRIAL INDUSTRIAL ACCIDENT Ge IDENT COMMISSION COMMISSION i NOTICE NOTICE The NOTICE for provides provides days period constitutes period prima facie evidence to furnish this evidence the employer has failed failed constitutes neglected secure payment compensation The The neglected law provides provides payment failure payment secure has payment payment compensation is misdemeanor misdemeanor secure compensation. compensation ig a4 misdemeanor . the i misdemeanor, APPLICANT John D. Stables ATTY FOR APPL Silver & Mc Williams LEIN CLAIMANT Sept. of Employment Employment Employment DEFENDANTS 1 Baker Perkins J. T. Thorpe 3.C. -F Braun Coast Insulating 5. 011 Field Construction 6. Armstrong Contractor 7. Fiberglass Engineering 8. Reece Insulation 9. T. Dinwiddie 10. Kircher Asbestos 11 Los Angeles Cork 12 Plant Asbestos 13 Mundet Cork Corp. Cal State Company ATTY FOR DEFENDANT 10634 Ceres Whittier 305 N. Avalon Blvd. Wilmington 1000 Hess Ave. Saginaw Michigan 945 E. 2nd St. Los Angeles 1 6-28-62 6-28-62 ( 1000 2684 P.O. Fremont St. Alhambra y Lac St. Los Angeles 31 Box 947 Bakersfield u wn dase 4400 E. Bandini Los Angeles te 5933 Telegraph Rd Los Angeles 22 Ne 4563 Valley Blvd. Los Angeles 32 E N OAR P.O. Box 6652 Phoenix Arizona PRN 4180 E. 1540 Washington Los Angeles 9th St Long Beach 23 6116 Walker Ave. Maywood 8823 Mettler St. Los Angeles 3 HE 7 Rae, INSURANCE CO 9 % American Motorists Ins Co + Casualty Insurance Co. & Cauf 3545 Wilshire Blvd. 810 LA -, , 9 State Compensation Ins Fund S. Spring St. LA Sa 25 Sat Ba Zurich Insurance Co. LS x Pacific Employers Ins Co. ' 3629 Atlantic Ave. ' LB Box 3203 Terminal Annex " LA 54 Argonaut insurance Co. 2484 Pacific Ave. LB 7 12 2 } 12 American Employers Ins Co. 1001 Wilshire Blvd. LA 639 S. New 5 6 Travelers Insurance Co. Hampshire LA & National Auto & Cas Co. Ocean Center , LB 2 Bldg 13 Aetna Casualty & Surety 1 Michigan Mutual Liab Co. Co. Box 5780 LA 55 810 S. Spring St. 14 LA 14 / Brown Bros. Adjusters 4 uninsured 3517 West 6th St. LA 5V Industrial Industrial Indemnity P.o Bo. x 2251 INSURANCE CO ATTY Wallace & Brown McCartney Kyan Trout & Dally Murray Roberts Herlihy & Herlihy 300 W. Coast Hwy Newport Beach Beach 639 S. Spring St. LA 14 ~ 750 Broad Avenue Wilmington Ocean Center Bldg , LB 20 -widg Sacko Tomm ... arnold Smith Smith ... CLOPTON & PENNY . , 639 5. SPRING LOS ANGELES 14. CALIFORNI~ ll te as isisinoni otitis ee tito ec ag Ab ENO SA MET Re AERE ie | ela 0 us TEI le on at ser ttieth. PEE a Rete A iil RE Oe aa tts STL . sac la V ' ane ss NATIONAL wn Automobile and Casualty Insurance Co. 639 SOUTH SPRING STREET HOME OFFICE LOS ANGELES November 30 1972 MAIL ADDRESS- BOX 5780 METRO STATION LOS ANGELES CALIF 90055 626.9552 Workmen's Compensation Appeals 107 South Broadway Los Angeles California 90012 Board WCAB NO 72 SD 31086 Arthur L. Hauk vs. Various Our File 20815 Employers Gentlemen Stapples Would you kindly pull WCAB NO 62 Various Employers and advise this LB office 19396 John office when it vs. is available for review Thanking you for your courtesy we remain Very truly yours MC Marjorie Cummings Compensation Claims . Examiner DIVISION DIVISION PROCESS PROCESS PROCESpSe ADORFSS 10 ADORFSS 54 DIVISION RECEIVED INDUSTRIAL RECEIVED INDUSTRIAL INSERT ADORFSS INSERT AH '72 INSERT '72 FIRE MARINE AND CASUAL " See SURANCE SURANCE FIDELITY ANO me eae sen SUNFTSUY NFTY BONDK BONDK Sa haeri, s _ BEFORE THE INDUSTRIAL ACCIDENT COMMISSION OF THE STATE OF CALIFORNIA 2 | JOHN D. STAPLES CASE NO 62 LB 19396 = ) Applicant ) OO -VS30 1 7 BAKER PERKINS J. T. THORPE C. P. BRAUN COAST INSULATING 8 OIL FIELD CONSTRUCTION ) ORDER APPROVING ) COMPROMISE AND RELEASE 9 ARMSTRONG CONTRACTOR ENGIERING ENGINEERING REECE ) INSULATION ; R. T. DINWIDDIE MUNDET 10 KIRCHER ASBESTOS LOS ANGELES CORK CORK CORP ) ; 11 11 PLANT ASBESTOS ) AMERICAN MOTORISTS INSURANCE CO 12 CASUALTY INS CO OF CALIFORNIA ) STATE COMPENSATION INS FUND 14 13 ZURICH INSURANCE COMPANY 1 PACIFIC EMPLOYERS INSURANCE CO 14 ARGONAUT INSURANCE COMPANY ) ee TRAVELERS INSURANCE COMPANY ae 15 NATIONAL AUTO & CASUALTY COMPANY ) AETNA CASUALTY & SURETY COMPANY 18 MICHIGAN MUTUAL LIABILITY COMPANY 1 INDUSTRIAL INDEMNITY COMPANY i ^' 18 AMERICAN EMPLOYERS INSURANCE CO 1 Defendants ) 2 2 2 2322 25 27 29 29 30 The parties to the above entitled action having filed a Com- promise and Release herein on January 11 1963 settling the above em aw case for 9,250.00 in addition to all sums which may have been paid previously and requesting that it be approved and this Commission having considered the entire record including said Compromise and . Release now finds that it should be approved and ) GOOD CAUSE APPEARING THEREFOR IT IS ORDERED promise and Release be and it is hereby approved | that said Com- | payable as follows a By Industrial Indemnity Company + To Dept. of Employment lien claimant Silver McWilliams & Sherman lien John D. Staples applicant " 2,221.95 claimants : 996.22 50.00 1175.73 -1- . b By Aetna Casualty & Surety Co. 4 Silver McWilliams & Sherman 1918.70 : AW John D. Staples applicant as attorneys fee 750.00 4 1168.70 y 3 T dh eesifgonlaltoewding sums are to be paid to applicant by carriers as c 4 Pacific Employers Ins Co. d American Motorists Ina Co. 5 e Travelers Insurance Co. f State Compensation Insurance Fund g National Automobile & Casualty Ins Co. h American Employers Ins Co. 7 i Zurich Insurance Company J Casualty Ins Co. of California 8 k Michigan Mutual Liability 1 Argonaut Insurance Company 9 1,415.05 1,005.90 821.80 800.00 703.85 120.75 120.40 57.40 39.20 25.00 Total 89,250.0089,250.00 ; 4 i fp he | & | 7 i ty ; i 1 ff A tg ij 1 E ii i} i GWica INDUSTRIAL ACCIDENT COMMISSION . 62 LB 19396 DATE FEB 1-1963 1-1963 g Referee Names and Address of Persons Served John D. Staples 10634 Ceres Whittier 305 Silver McWilliams & Sherman N. Avalon Wilmington Dept. of Employment P. Box 1477 1477 Santa Ana , C. F. BraunConstructFire omnont 44S 00t.E. ABlh aanmdbirnai Los Angeles 1919 2020 2 2 \plbuejpdaygMundet Cork Construction 23 2 3 wlshire 2 2 % % % Cal State Company 8823 Mettler St. Los Angeles Coast Insulating 2634 Lacy St. Los Angeles R. T. Dinwiddie 8627 So. Atlantic South Gate Fiberglass Engineering 5933 Telegraph Rd Los Angeles Los Angeles Cork 4180 E. Washington Los Angeles Kircher Asbestos Box 6652 Phoenix Arizona 1540 6116 Walker Maywood Oil Field Construction Box 947 Bakersfield Plant Asbestos Co. W. 9th Long Beach 4 Baker Perkins 1000 Hess Saginaw Michigan R4eece Insulation Co. by Clark Reece 4563 Valley Blvd. Los Angeles J. T. Thorpe 948 E. 2nd St. Los Angeles yj Aetna Casualty & Surety Co. Spring Los Angeles American Motorists Ins Co. 3545 Wilshire Los 2404 Angeles American Employers Ins Co. 639 S. New Hampshire Los Angeles Argonaut } Insurance Co. 1001 Wilshire Blvd. Los Angeles Casualty Ins Co. of Calif 810 South Spring Los Angeles ~{ Industrial Indemnity Co. 3745 Long Beach Blvd. Long Beach Michigan Mutual Liability / Brown Bros. Adjustors 3517 W.6th L.A. National Auto & Casualty Co. 639 S. Spring St. Los Angeles Pacific Employers Ins Co. 2484 Pacific Ave. Long Beach 4State Compensation Ins Fund 3629 Atlantic Ave. Long Beach Travelers Insurance Co. Ocean Center Bldg Long Beach Zurich Insurance Company Box 3203 Terminal Annex Los Angeles : 1 ve i , i ; ; 4! a | i i? | i i | 4, /f Le | i at FORM 339 02037 NOM -2- Dat ateLod ng Beach California FEB 1- 1963 -- -- : & ^ i ik: E a) } ms FEB 1- FEB 1-1963 Drant H(icognhtiwnauyed) etna Ryan address Persons served l Names and continued continued 2 Served Herlihy Herlihy Herlihy Herlihy 110 OceaOn cean Blvd. 2 Murray Roberts Herlihy 110 Broad Ave. Wilmington Long 3 Clopton Clopton Penny 750 Broad 639 South Spring 3 Wallace Wallace Brown Wallace West Coast ow Cartney ald ald ee > 62 LB 19396 forw 338 agen th ae oe -3- weno" om oN CASE NO 62 LB 19396 JOHN D. STAPLES -48- 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 ANGELES 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 Referee Dictated GEORGE WESTWICK January 31 1963 1962 InIjnjuur ryy Between 1953 March 7 and Silver McWilliams & Sherman by Richard McWilliams attorneys for applicant F. W. Carignan representative for American Motorists Herlihy & Herlihy by Kennis Jones attorneys for Argonaut Ins Co. and American Employers John Montgomery representative for Travelers Insurance Co. Murray H. Roberts by James Thomason attorneys for Zurich Ins Clopton & Penny by Robert Wills attorneys for Pacific Exployers Eugene Barnes attorney for Industrial Indemnity Paul Klein attorney for State Comp Insurance Fund Wallace & Brown by Gerald Brown attorneys for Aetna Casualty and Surety Company Maury & Schuyler by Rob R. Schuyler attorneys for Michigan Mutual Liability Company Licker & McClure by Robert Licker attorneys for National Auto & Casualty Company as REPORT OF REFEREE ON ORDER APPROVING COMPROMISE Based upon adequate the record RELEASE the proposed settlement will AND be approved 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 of Silver McWilliams & Sherman are entitled to a lien in the sum 50.00 for living expenses advanced Both of the above liens are payable by Industrial Indemnity Company -I- tee ae, Pee nes Rat eeu eR ote JOHN D. STAPLES CASE NO 62 LB 19396 from the amount designated to be paid by them fee Applicant's attorneys are is payable from the amount Casualty & Surety Company entitled to a designated to fee of 750.00 be paid by Aetna Said Referee GW . . o COMMISSION INDUSTRIAL ACCIDENT STATE OF CALIFORNIA \ JOHN D. STAPLES 2ST Pe Saw NOTICE OF Oe Applicant INTENTION TO ee Ys aeRL ARMSTRONG CONSTRUCTION et al AETNA CASUALTY AND SURETY ALLOW LIEN CLAIM OF DEPARTMENT OF EMPLOYMENT a, COMPANY et al TO THE EXTENT OF 996.22 and bat iid, Defendant IT APPEARING THAT pursuant to allocation proposed by the parties NOTICE will be will be IS HEREBY GIVEN that lien claim of the Department of allowed to the extent of 996.22 and Compromise and approved within Employment Release seven said time days after service hereof unless Good Cause to the contrary is shown in writing within GW 1.17.63 Name and Address of Persons Served fenge Wistwick Referee Department of Employment P. O. Box 69 Long Beach Silver Aetna McWilliams & Sherman 305 N. Avalon Wilmington Casualty & Surety Co. American 810 S. Spring St. L.A. Motorist Insurance Co. 3545 Wilshire American Employers Herlihy & Herlihy Ins Co. by Kennis Blvd. L.A. 637 S. New Hampshire L.A. T. Jones 110 W. Casualty Ins Co. of Calif 810 5. Ocean Blvd. Spring St. L.A. L.B. 2 Industrial Indemnity Co. P. O. Box 2251 Long Beach Michigan Mutual Liability / Brown Bros. Adjusters 3517 W. 6th C. Anderson Signaturoef Person Serving Notice FORM 410 REV 4.88 631 4-42 1 4 L.A. Ta er oe e on ' CONTINUED SERVED 1-17-63 National Auto & Casualty Co. Box 5780 Los Angeles 55 Clopton & Penny State Comp Ins 639 South Spring St. Los Fund 3629 Atlantic Ave. Angeles Long Beach Travelers Insurance Co. 110 W. Ocean Blvd. Long Beach 2 Zurich Ins Co. by Jas Thomason 750 Broad Ave. Wilmington 4 sic Da