Document B5v7Qp98Lky42q4z9z0Dw8NYm

FILE NAME: Insulators Workers' Comp Claims (IWC) DATE: 1962 DOC#: IWC062 DOCUMENT DESCRIPTION: Claimant - Greischar, Paul J. [From J-M Archive] File Name Contract Unit Claim File: Paul J. G reischar Apr. 24/62 Scanned ? ye s Source JMA: NS-JM Start Year 1962 Stop Year 1962 Contents claim Notes APPLICANT PAUL J. GREISQHAR Asbestos Worker DATE CLAIM FILED April 24, 1962 INJURY ALLEGED Asbestosis ALLEGED DATE OF INJURY 1942-present CASE # OAK 8188 EMPLOYER/INSURER Plant Rubber & Asbestos Works, et. al. including J-M S.ales/Travelers _No apparent Canadian carrier THER NTES enchvs----- -,<ses the ,, _asbesto3ls" Dr. Hinshaw report of Oct. 4, 1965 to state Comp. Ins. Fund _TAsbstosis... severe pulmonary insufficiency. DATE OF RESOLUTION March 17, 1966 RESOLUTION Compromise & Release DOCUMENTS COPIED 1) Compromise & Release # OE page: CLAIMANT -P& U /7 California Workers* Compensation Appeals CARRIERS INVOLVED: The AETNA Casualty & Surety Co. oAmerican Automobile Ins. Co. American Employers Ins. Co. American Motorists Ins. Co. oArgonaut Ins. Co. Associated Indemnity Corp. *^a^f^orn^a Casualty Indemnity Exchanae California Compensation & Fire Co * ' 2 s?alty Ins* Co. of California * oEmploy Liability Assurance Corp.Ltd. Employers Mutual Liability Ins. Co. of Wisconsin JideUty & Casualty Co. of New York Wlsconsi*. oFireman's Fund Ins. Co. s s r y s i g V 1" s oGuarantee Insurance Co. oGreat American Ins. Co. corp. w . SISnidSusit?r.ia?l" ?In"d;e1mnCiatsyuaClot.l' c- gentry In5. olndustrial Indemnity Exchange olnsurance Co. of North America Liberty Mutual Ins. Co. Lumberman's Mutual Casualty Co. oMaryland Casualty Co. * Michigan Mutual Liability Co. oMission Insurance Co. oNational Automobile & Casualty Ins. Co oNew Amsterdam Casualty Co. ' oOcean Accident & Guarantee Corp.Ltd. Pacific Employers Ins. Co. oPacific Indemnity Co. co.) C o * (standard Accident Ins. Co.) oRoyal Indemnity Ins* c?* of Hartford (U.S. Casualty Ins Co ) State Compensation Insurance Fund * ' oTransport Indemnity Co. The Travelers Ins. Co. oThe United Pacific Ins. Co. oU.S. Fidelity & Guaranty Co. oZenith National Ins. Co. oZurich Ins. Co. o _____ ________ - . o -------------- ;------ -------------- - o ~ ----------------- ---------------- -- ----------------- --------- ------------------------------------- O " "-- ------------------------------- ---------- - O ` -- ---------------------- -- ________________ _ 5/81 WORKERS' COMPENSATION APPEALS BOARD STATE OF CALIFORNIA PAUL J. GREISCHAE j C ase N o. 62 OAK 8188 Applicant I 6 VS. > . 7 PLANT RUBBER & ASBESTOS WORKS et al 8 9 Defendant 10 -- -------------------------------------------------------------- ------------------------------------------- ------ ----- CERTIFICATION " 11 I hereby certify that the attached documents are true 12 and correct copies of the original documents filed in the records' 13 of this office in the above-entitled matter. ` 14 AiTziT my hand and the Seal of the Workers1 Compensation 15 Appeals Board of the State of California. 16 17 18 19 20 21 22 23 24 Bated at San Francisco, 25 California, this day 26 April, 1981 27 DCRAMTMBHV o r IN DUSTRIAL ABLATIO N * D IV IS IO N O F IN D U S T R IA L ACCID ENTS ACC1C:N*. * f> ;i c s . v SM ITH. P A R R IS H . P A D IJ C K Oc C L A N C Y \vO;k .v,:w 5 CC'/'S": .1 BZPOIiZ THE WOCZiJ'S COZPENSATION APPEALS BO\APRPcDAlS RCA 2 o? the state op Ca l if o r n ia 5 PAUL J. .GREISCHAR ) 4 Apolicana c a s e ::o. o2 OAK 3l55 5i 6 PLANT RUBBER L- ASBESTOS WORKS ) and OTHERS, 7 Defends nts co;i?ro: z s e a id r e l e a se ____________ AGRZ2ME2,'T _ns paru.es nereto, for tne purpose of compromise only, 10; hereby suenit the following agreed statement of facts: ;i 11;! x. Paul J. Creischar, employee herein, born September 11 12!! claims that he -..-as employed in California and other states whe: 13 the Place of hiring was California during the years 1943 throu: 14 19c5.- au a variety of places by various employers, dura a is *s|0 5*1? ie; m 55N s*C0Jl"O#l 17 0<z U 1 R whicn period he sustained an injury consisting of pulmonary an: c..eSu disable!uy, the nature and extent of 'which is more fully forth in the medical reports of record, which are hereby inccrt atea by reference as if set out in full. cS 19 20 21 During such perioa of employment as described above, aoolt was employed by certain employers whose names or their insurant carriers during such periods are set forth below. 221i 2. The actual weekly 'wages of the employee at the tine c' 23; injury were sufficient to entitle him to a maximum 'weekly ccrape !! 24 ;i sation rate. 25'! 1 3. Tne employee's present disability is in dispute. Tne 26'! applicant has returned to "work end is working on a part time 27 1 basis. 28 : 29,. 30 31 il ! 32 | (a) No temporary disability has bean paid ana it is a; sppj.i.c3riu* concii.c j.or. D3ociu3 c.ni w3.*cic'.'iai*y Lo^ p -i j . A* iSriC O i w u b i i i w j p cl i*C 0 w 3 c i o Ql *j a2 ., ' 1 , 1 ^ 0 ^ ) . (>) r:rna:i3.nt uicabiiity in.icar.i;.;,- has not been pal; : employ . ( i P A D U C K 6c C L A N C Y .1 5. The parties hereby agree to settle any and all claims on 2 account of said injury by the payment of the sin of $3,735.00; . 3 siad sum to be paid by the follov?ing entities and in the amounts 4 stated belov/: 5 Aetna Casualty & Surety Company $1200 6 American Employer Insurance Company 625 7 State Compensation Insurance Fund 3300. 8 Travelers Insurance Company 170 10 11 12 13 14 M i*\ if; American Motorist Insurance Company 250 Fidelity & Casualty Company of 100 Now York Liberty Mutual Insurance Company 100 California Casualty Indemnity Exchange 25 Pacific Employers Insurance Company 500 ECnopmlpoayneyrsofMuWtiusaclonsLiinability Insurance 365 Plant Rubber & Asbestos Works < 1150 Industrial Indemnity Company TOTAL 950 $o,735 The above stated sum of $8,735 is to be paid to the applicant in one lump sum, less attorneys fees and litigation costs of 20 $309.25 consisting of the following: 21 Dr. J. Lloyd Eaton $268.00 22 Palmer Multigraphing 1,25 23 California Inspection RatingBureau 2.00 24 Bureau of Old Ag^= Survivors for Social Security Records 25 TOTAL ' 37.00 * S3Q3.23 26.; 6. Tne amount of medical and hospital expanse incurred or ii 2 7 jj paid by the employee is in dispute, as is the amount of unpaid bill 28 Un? a Jl and futur e medical and hospital expenses are to be assumed 29 by ~ V*n employee, applicant herein. 30 1 The nom e and address of emplo yes's attorneys, Cr.-.itn , Parri 51 rr.:'UCiT & Clancy, 315 Financial Center Bullring, Onklsr. i 12, Calif. 32 >! C Sexe at torn-ays request a fee of $375.00. A m r net of " fi** iM IT H . ( .1 attorneys fees previously paid, if any $0. 2 9- The reason for compromise is that tr.ere is a serious and 3 substantial dispute between the parties as so both m e nature and 4 extent of disability, if any, caused by the variety of emnloyments 5 in Ix-omia, as indicated above* ehe parties *`io.i to avoid, the 6 further expense and hazards of litigation by means of the within 7 Compromise and Release agreement. 10. It is specifically understood and agreed that this agree-"1' msnt encompasses all periods of employment by the above mentioned 10 employers, whether such periods are specifically set forth above 11 or not, and includes all employers insured by the above mentioned 121 insurance companies, whether or not previously Joined in this actio 13 11. The undersigned requested this Compromise and Release 1 4 ! agreement be approved. s< 15 12. Upon approval of this Compromise and Release agreement by " <li 16 <9<58yj^ 17 the Workmen's' Compensation Appeals Board, a panel thereof, a Commissioner, or a Referee, and payment in accordance with the Ig^Si 18 e. -l; <o 19 1 b 2 20 ID 21 provisions hereof, said employee releases and forever discharges said employers and insurance carriers from all claims and causes of action, whether now known or ascertained, or which may hereafter arise or develop as a result of said injury, including any and 22 all liability of said employers and said insurance carriers and 23 each of them to the dependents, heirs, executors, representatives, 24 j administrators or assigns of said employee. 25! ! 13. It is agreed by all parties hereto that the filing of 26 :j this document is the filing of an application for adjustment of 27 || claim on behalf of the employee, and chat the Appeals 3oara may 28,! in its discretion set the matter for Hearing as a regular applicate 29 1 reserving to the parties the right to put in issue any of she facts 30 ccinittec Herein, and that if Hearing is next .in this uocunv.'.c use 31 as an application the defendants shall have eve liable to tnem all 32 defenses '.;hicnn are available as of the date cf filing of this I \ SM ITH ' 'R IS K . P A O U C K <k C L A N C Y TORNEYS AT L A W rlMANCIALCCNTC* DUILOtNO .1 docuiBenx, ana that the Appeals Board may thereafter either approve 2 ^.Compromise Agreement and Release or disapprove the someone is 5j Fancings and Award after nearing has been helu and che matter 41 regularly submitted for decision. 5! ) 6 14` f'r ihe ?u-^ose - ^termining the l - n claim filed herein for the unemployment compensation disability benefits which have been paid under or pursuant to the California Unemployment " insurance Code, as aforementioned, it is agreed that applicant's * 9 permanent disability, if any, commenced July l, 1355. furth2r rht 10 any unemployment compensation disability benefits paid out after 11 July 1 , 1965 was for a cause and condition unrelated to the indus 12 trial injury herein. . 131 1 hinCBSS^the si^nafure he(eof this . day of l / \ 1/ 14 1?65' a- V V - A . ' K , A , , 1 151 O0 I I f 16! i 1 7 | o " 53 181 1 S 19 5 PliiV T r 1 ' prelschar hjSpr, 'AiiSISK, RAbuCK > LAlh'Y Applicant's Attorneys ' 201 * 21,1 <* , "a ' & sdkbTY CCllRaKY*1b'v" Attorneys - 22 j 25 jj A h E R I C A h ^ n O Y E R iliuRAhUjl COlI^AnY ^ -- ~ /by its Attorneys **M ,x > * 24, ' i 25! :! 26 J 27;| '/y~ / < '>4n.O'i M a t S cO:tJ.n;sATTa;; 1 ,./^, its Attorneys ~Z ----- xuwB, oy J!n~, {* L f l i f a Q__,,^Qr- t-j'j.AVai^RS IRSURAlCfe C T O A r ^ "-IulsS p.."z^znorrtnnaevyes-^ 9 ^ 28 ij 29 ' bhyv its^'Attoj^ueys `" V 3 0 :j Cu C^iSLjvlii'Y COYYAi'Y > YQKi\.t fy ita^'Atcorpsvs` Hi 32 I JlyJ h " 0 /.v ^xi^bUru;;:^ I i. 2 3 4 ;] 10 ! Il1 i 12i 13 ! >o Z< J U 5* 5 X< . w Sii , >* (A04 t 2 1 " c S *- 14 il 15 !j H 17i! 18 19 i 1 h 2 20 (fi 21 221 i 23 jj z>d ! ~ - i :l 25'; ;i 26 !| 27 i 28 ; its Attorr^ys - r. i f~. \ f \ --- >__ --- W'V^OO --j^yOYi.Tt -'UaL LAILi 'pj>--'.`r ------- G&AlTZ OP WISCONSIN, by It ittwneys s&m l ' a ----- - orporation^y ^'Attorney?' ` >' f 1 ' /! JT On t o r s / d before n s , y'^ Z . ~ - ` ' /-i ^o f / ' A. D. 1966, tu'ae naine" *' -------- kn TM t0 me 1 bs 'the Person S & H R B : S * unto se t my nana s,,a a m S l l y i / t l l L ?* aay and year i,, t h is W J ^ l ' i S S ' i b & t O K w , - / - / - .<5 ,;-v ...,., Jotay Puoiic in ana" ror aie-- County and State of California 'rr -=-rHc-'. vor?.-.- ru-.,jc Coti: iait , ly u 31 32;!