Document NeMndx76mzN7BxDQJoEDNmpdQ

FILE NAME: Insulators Workers' Comp Claims (IWC) DATE: 1962 DOC#: IWC032 DOCUMENT DESCRIPTION: Claimant - Staples, John Armstrong List -- John Staples, California #^7 The only defendant of interest besides Armstrong is Mundet Cork. Mr. Staples had about 10 years of pipe covering work, including less than a year total with "Armstrong Construction". The claim was filed May H , 1962. The parties applied to the Commission for approval of a Compromise and Release Agreement January 11, 1963, and this was approved February I9 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 s' Armstrong List -- John Staples, California The only defendant of interest besides Armstrong is Mundet Cork, Mr. Staples fp had about 10 years of pipe covering work, including less than a year total with "Armstrong Construction". The claim was filed May 17, 1962. The parties applied to the Commission for approval of a Compromise and Release Agreement January 11, ZZ' 1963, and this was approved February 1, 19 6 3. Total amount paid was $9,250, of C ~ which $321.80 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*  'inirimirmiiirtf * * J a*m tie'iilMba&tistiBumm t iLuaiiiMri I inM t.jK-immiMrMi'.ufi fc I John J. Wren Attorney at Law 37**5 Long Beach Blvd. Long Beach California Tlphonai GArfleld k-Okll JAN l \ M- Ea* before the industrial accident commission of the STATE OF CALIFORNIA JOINT COMPROMISE ANO RELEASE CASE NO. 62 LB 19396 JOHN 0, STAPLES 1063** Ceres, Whittier, Calif* Applleant VI* ARMSTRONG CONSTUCTION C. F. BRAUN CAL STATE COMPANY COAST INSULATING R. T. OINWIODIE FIBERGLAS ENGINEERING L A CORK KIRCHER ASBESTOS HUN PET CORK frORP- * corporation OIL FIELD CONSTRUCTION PLANT ASBESTOS Co.a corporation BAKER PERKINS REECE INSULATION COMPANY, Clark Reece, dba J. T. THORPE MtOO E, Bandinl, Los Angeles 1000 Freemont St., Alhambra 8823 Mattier St., Los Angeles 268k Lacy St., Los Angel es,Cal if, 8627 So. Atlantic, South Gate 5933 Telegraph Rd.,Los Angeles M 8 p E. Washington, Los Angeles Box 6652, Phoenix, Arizona 6116 Walker, Maywood, California Box 9**7, Bakersfield, California I5k0 West 9th, Long Beach,Cal if. 1000 Hess, Saginaw, Michigan **563 Valley Blvd., Los Angeles 9k8 E. 2nd St., Los Angeles,Cal. WEBER BAKING COMPANY Employers Addresses AETNA CASUALTY AND SURETY CO. AMERICAN MOTORIST INS. CO. AMERICAN EMPLOYERS INS, CO. 810 South Spring, Los Angeles 35k5 Wilshire, Los Angeles 639 S. New Hampshire, Los Angelej A -Ti>rrniNkiii.iiA> 1 6QNAUT INSURANCE CO. 1001 Wilshire Blvd., Los Angeles 2 SUALTY INSURANCE CO. OF CALIF^ 810 South Spring, Los Angeles corporation 3 IDUSTRIAL INDEMNITY COMPANY 37A5 Long Beach Blvd.Long Beach 4 corporation 6 CHIGAN MUTUAL LIABILITY c/o Brown Bros. Adjustors, 3517 West Sixth St., Los Angeles 8 m O N A L AUTOMOBILE ANp CASUALTY 633 South Spring St.,Los Angeles 7 4SURANCE CO. 8 fcCIFIC EMPLOYERS INS. CO. 2A8A Pacific Avenue, Long Beach 9 TATE COMPENSATION INS. FUND 3629 Atlantic Ave. Long Beach 10 RAVELSRS INSURANCE COMPANY Ocean Center Bldg.,Long Beach 11 URICH INSURANCE COMPANY Box 3203, Terminal Annex Los Angeles 12 Insurance Carriers 13 Addresses 14 15 The parties hereto, for the purpose of Compromise only, here16 y submit the following agreed statement of fact. 17 . That John D. Staples, the applicant herein, was born on June 18 A, 1925. 19 !. That John Staples, while employed as a heating and air con- 11tlonlng Installer, for Armstrong Construction, C. F. Braun, Cal State Company, Coast Insulating, R. T. Dinwiddle, Flberglas Engin eering, L. A. Cork, Rlrcher Asbestos, Mundet Cork Corp, a corpora tion, Oil Field Construction Company, Plant Asbestos Company, a corporation. Baker Perkins, Reece Insulation Company, Clark Reece, dba, J. T. Thorpe and Weber Baking Company, at various wages, at various geographic locations within and without the County of Los Angeles, State of California, during the periods of October, 1353 through March 7# 1962, alleges that he sustained one or more Injuries to his lungs and respiratory system during said periods of employment by being continually exposed to asbestos dust, fiberj glass and other Irritants from materials handled and used during said employment. -2-  iai 4wMkii 1 3. That John 0. Staples, allege* that as a result of th* said 2 Injuries, he has suffered a permanent disability. 3 k. That during the periods alleged, the insurance companies were 4 as follows 5 (a) Armstrong Construction Travelers Insurance Co, (January I, 1955 to July 29 1955*) 6 (April 23, 1957 to July 31,1957 J (March 2, 1962 to March 8, 1962 ) 7 (b) C. F. Braun American Motorists Ins. Co. 8 January 1, 195U to January 1 * * 3 5 5 . C>, 9 (c) Cal State Canpany No Record of Coverage 10 (d) Coast Insulating Pacific Employers Ins. Co, May 1, 1961 to May l, 1962 11 (a) R. T. Dinwiddle State Compensation Ins. Fund. 12 July l, 1958 to July l, 1959 13 (f) Flberglas Engineering Aetna Casualty and Surety Co, (March 1, 195* to September 1, 1959 14 (September l, 1961 to September 1, 1962 { 15 (g) L. A. Cork Zurich Insurance Company October 27, 1959 to October 27, I960 16 (h) Klrcher Asbestos No Record of Coverage 17 (!) Mundet Cork Co, a corp* Aetna Casualty and Surety Co. 18 December 31, I960 to December 31, 1961 19 20 >1 21 22 23 24 (J) Oil Field Construction Co Casualty Ins. Co. of Calif. January 1, 1951* to January 1, 1955 (k) Plant Asbestos Co,,a corpi Industrial Indemnity Co, a corporation January 1, i960 to January l, 1961 . (2) American Employers Ins. Co, January l, 1962 to January 1, 1963 (l ) Boker Perkins and Weber Baking Co Michigan Mutual U a b . January 1, 1953 to January l, 1951* 25 () Reece insulation Co. Clark Reece dba* 1, National Automobile and Casualty 26 Insurance Co. (March 1, 1956 to October 1. 1957 ) 27 (July 1, 1959 to July 1, 19b0 ) ,,, , 2. Industrial Indemnity Co., a corporation. 28 October l, 1957 to October, 1, 1958. 29 (n) J. T. Thorpe Pacific Employers Ins. Co. January 1, 1953 to January 1, 1950 30 31 That the above employers and Insurance carriers are, by agree 32 ment. oartles to this Compromise and Release. That It Is expressly **"* -- n "" 1 T 3- Av ivXIm- itih imn * I A ..... , J, -H-i.. i ndtritood, and Intended by each and all of tha partias hereto, 2 hat tha amount *at forth below will be paid and received In con- 3 {deration of tha release of the above named insurance carriers 4 nd each of them, together with a release of each and all of the 5 bcve named employers. 6 It Is further agreed that the release herein and hereby 7 ranted by the applicant shall extend and Inure to the benefit of 8 ny and all employers, whether named In this proceeding or not. 9 . That the actual weekly wages of the employee at the time of 10 he claimed injuries are In dispute; that the average weekly 11 rages are In dispute. 12 >, That applicant contends that he was temporarily disabled as a 4 13 result of his Injuries; that defendants and each of them deny that 14 ipplleant was temporarily disabled fro* his employment due to any 15 Injury or injuries. 16 7* That medical treatment was necessary and that such treatment 17 as obtained by applicant on a self-procurred basis. 18 3. That the parties hereby agree to settle any and all claims on 19 account of said Injuries by payment cf the sum of $9,250.00, 20 apportioned as follows; i 21 Industrial Indemnlty Company* $2,221.95 Aetna Casualty Surety Co. 1,918.70 22 Pacific Employers Ins. Co, l,kl5.05 American Motorist Ins. Co. 1,005.90 23 Travelers Ins. Co. 821.80 State Compensation Ins. Fund 800.00 National Automobile C Casualty Ins. Co. 703.85 I American Employers Ins. Co. 120.75 Zurich Insurance Co. 120.L0 Casualty Ins. Co. of California 57. Michigan Mutual Liability 39.20 Argonaut Insurance Co. 25.00 Total IWSiira The above sum of $9,250.00 shall be paid in one lump sum to applicant except as otherwise provided in Itern 8 (a) below, less $500.00 advanced by incustrial 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 -k- 9 which may hava otherwise been properly claimed under Labor Code Section 4600 to have been the responsibility of the defendants herein* 8* (a) That the sum of $9,250.00 shall have deducted the fo!1ow ing disbursements which shall be made directly to those persons, companies, corporations or firms as set forth below and such dis bursements shall be made from the amount designated to be paid by Industrial indemnity Compfny as set forth in item #8 above; that the i*erein disbursements represent reduced lien claims of record and are payable in amounts as follows That any sums due by said Company not exhausted by disburse ment or attorneys' fees set forth in item #10 below shall be paid directly to the applicant or as the Honorable Commission may di rect. 9* That all self procurrad medical, if any, shall be the sole responsibility of the applicant and that the defendants, or any of them, shall not be liable for any of said expense. That the defendants or their carriers, are responsible for medical treat ment and/or examinations here-to-fore authorized by them, but that all future medical shall be the sole responsibility of the applicant herein. 10* That the name and address of applicant's attorneys Is Silver McWilliams and Sherman, 305i North Avalon Boulevard, Wilmington, California; that said attorneys request a fee to be paid directly to them by Aetna Casualty and Surety Company, as set forth in Item #8 (a) above, in the total amount of %/Z-o ^ ( u I Ac,. That said attorneys have exunded the sum of $ as reasonable litigation costs. 11. Reason For Compromises Multiple issues exist which make 5 t O 1 lement the molt practical solution to the problem posed by 2 otracted litigation as follows* whether applicant's Injuries 3 osa out of and were sustained In the course and scope of employ 4 ing date of injuryi Issue of occupational disease; applicability 5 * the Statute of Limitations; extent of apportionment allowable 6 ; between defendants; applicant's actual earnings; applicant's 7 /erege earnings, extent and duration of temporary disability, If 8 ny, nature, extent and duration of permanent disability, if any, 9 eed for further medical treatment, liability for self procurred 10 edical, liability for medical legal costs, (pilowance of reduction 11 f lien claims}) coverage for the periods of employment alleged 12 The applicant desires a lump sum settlement and to take con- 13 rol of his own medical treatment. The applicant, and the de 14 endants, separately and as a group, desire to buy their peace an 15 :o avoid the expense, delay, hazard and uncertainty of extended^ 16 litigation and to settle their differences for a sum certain, fh ipplleant feels that the liens of ------ and should be allowed in the sura o1 of the amount claimed.*I The undersigned request that this Compromise and Release ireement be approved by the Honorable Commission. I, Upon approval of this Compromise and Release Agreement by th* idustrlal Accident Commission or a panel thereof and payment in xordance with the provisions hereof, said employee releases and ,rever discharges laid employers and insurance carriers from all Iaims and causes of action, whether known or ascertained, or ,lch may hereafter arise or develop as a result of said injuries, ncludlng any and all liabilities of said employers and said nsur.nce carriers and each of them to the dependants, heirs, xecutors, representatives, administrators or assigns of said mployee. I. It Is agreed by all parties hereto that the filing of this 6* WfPieliii document I, ,h. f,|,,,, of appl|eat(on fQp ^ ^ . "* 00 fc- " ' ' ' ........... d that the CanilI,, |on .rvlng to th, partth.*.,TM ttht.,rrl.>..h.t..t.p...p.u.t............>..n.y.. ^ J C , su Kitted herein, and that If hearing Is held with this .bI. T r n *" ,pp" cat'0n th# to thton , 1 1 defense, ............. . PI' " h.v. ,V,I1. of thl data n, of th., document, end th.t th. CcTM,.,,. may ther,, fter U h . r approve ,,,ch , C o m p r TM ..... . ReIea,, Asreanent pr ^ approve tha and l ,, u . Finding, .nd Award after hearing ha, hald and the matter regu.arIy .ubm.tted for . . .n further eon.ld.r.tlon of th. payment accor<(aiK# ,,.r_ ' ' *PP 'eant * Sr" ' th" th,` ' ' - P P M 0 ... unknown end unanticipated inlurl* nA a casualties nJ urf *" -- > -suiting f.o. ,uch action I ' ........ .. and/0r CTP' ^ t ........ . thus, now d ,, . o.e . and all right, under section 15 of th. Civil Cod. of Sac*t,07 ; f ................... . Section 15^2 reads as follows* Cal ffornla C v l , Cod. creditor*does*noteknowSorsijntt t0 c,a,m* which the et the time of executina th to exj** 1 his favor i h S ' d i b U r ^ ' * m* t, r u i ? * " * o t d sh[,wiitiii!*!;nt':"thby S/i ~yj thV sna^ i r of *h " T. , , Witnesses " tSi APPlcnta SJgna- ? u,t ba ^tested by two disinterested persons OR Pubt'fc ed9*d bafora Rotary STATE Of CALIFORNIA ,,County :f A-E~%^ r ICcJAa/SsAUu Aa.LlrTtJYyiPAaplnNcD,cSaUnRtE--T-Y--C-O.- ` iv (1l\'yfAlhf,`>'n`iL / / 0 - AME^ | 5 ^ > M5ITOR,ST i r s . co. By _ . SMPLOYEr/ j n S. co. 7- / `'V JDMRl H 1 2 3 4 6 6 7 8 9 10 11 12 13 14 15 10 17 18 19 20 21 22 23 24 25 26 27 28 29 30 EFORE THE INDUSTRIAL ACCIDENT COMMISSION OF THE STATE OF CALIFORNIA CASE NO. 62 LB 19396 t .r n a O T A C H O F F . - s. k,cu$t?.;i ;.:ctSEKT c::..asis* Tat* or CAureiwiA OHN D. STAPLES, ) OCT FILED 5-1962 J Applicanti ) " MINUTES VS. ) OF JAKER PERKINS; J. T. THORPE; C. F. BRAUN; JOAST INSULATING; OIL FIELD CONSTRUCTION; ) HEARING ARMSTRONG CONTRACTOR; FIBERGLASS ENGINEERING; ) IEECE INSULATION; R. T. DINWIDDIE; [IRCHER ASBESTOS; LOS ANGELES CORK; ) >LANT ASBESTOS; MUNDET CORK CORP.; JAL 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 4; CAS. CO.; AETNA CASUALTY ) 8e SURETY CO.; MICHIGAN MUTUAL LIAB. CO.; INDUSTRIAL INDEMNITY; ) Defendants. ) THIS CAUSE came on for hearing October 5, 1962, at 9 A.M., in Department D of the Industrial Accident Commission, Long Beach, California, before Honorable GEORGE WESTWICK, Referee. T. Hanagami, Reporter. PRESENT: Silver, McWilliams 8e Sherman, by Richard McWilliams, attorneys for applicant F. W. Carignan, representative for American Motorist Herlihy & Herlihy, by Kennis Jones, attorneys for Argonaut Ins. Co. and American Employers John Montgomery, representative for Travelers Ins. Murray H. Roberts, by James Thomason, attorneys for Zurich Ins. Co. a N0 test, tn o* uto mito l*Sf fWliMriiiiiriifr- r i It 1 PRESENT (Cont'd): I * 2 Clopton & Penny, by Robert Wills, attorneys for Pacific V i 3 Employers ! 9 4 Eugene Barnes, attorney for Industrial Indemnity i 5 N Paul Klein, attorney for State Compensation Ins. Fund 'k S Wallace & Brown, by W. Gerald Brown, attorneys for >. 4s' ' S* 7 Aetna Casualty and Surety Co. 8 Maury & Schuyler, by Rob R. Schuyler, attorneys for 9 Michigan Mutual 10 Licker & McClure, by Robert Licker, attorneys for k 11 National Auto & Casualty ! r 12 13 EXHIBITS: 14 Applicant's 1 - Reports attached to letters of 8-29-62 f and 6-19-62 i 15 Industrial Indemnity Co. Ex. A - Reports attached to letter of 10-3-62 18 Pacific Employers Ex. B - Report attached to letter of 9-11-62 17 18 DISPOSITION: !1ffcc* 19 45 days to file compromise and release agreement. 20 ! 21 22 23 24 25 j 26 ; ti i 27 28 , 29 *\t< 30 Foam 339 1a49 *`_JJ 7i>H 2 f EDWIN SILVER r ic h a r d l . McWilliam s ARTHUR SHERMAN ERNEST L GRAVIS LOUIS BERSON LAWRENCE WEITZER L W ` \ la'omets silver, McWilliams & sherman JOSH NORTH AVALON BOULEVARD WILMINGTON. CALIFORNIA TERMINAL -389S SPRUCE S 61JS August 29, 1962 r AUG 3 0 AhlJ t" SANTA * OWIC MITCALFI . . . IILVIR llll NOATN MAIN STAIIT IIMIttlT T-MIl Industrial Accident Commission 236 East Third Street Long Beach, California Re: John D. Staples vs. Plant Asbestos, et al Gentlemen: 62 LB 19396 'Please find enclosed the following medical reports for filing in the above-entitled matter. Report of George E. Fralick, M.D. dated Aug. 24, 1962 please be informed that the applicant in the above-entitled matter n o w resides at: please be informed that I n o w represent the applicant in the above-entitled matter and hereby request that copies of all material 'documents be served upon me. Very truly yours, s i l v e r . M cW i l l i a m s & s h e r m a n enclosure cc: Please see attached sheet. B E R T R A M P. H U S B A N D . M . O . D rh. H U B B X N D /Ad FRALICK A m v iio ia n * lu a iiO N i 1*10 E. W HITTIER RLVO . W HITTIER. C ALIFO RN IA p h o n i **-uat O E O R O E E. F R A L IC K . M. D. August 24, 1962 P*\. n* Mr. McWilliams 3054- North Avalon Wilmington, California Re: John D. Staples Dear Mr. McWilliams: John stapl.APn s e 're9fer'ti t " s l e t t e ^ f o ^ i ^ o r ^ f i o n ' c c n c ^ n i n g Mr. Staples prior to this date. This patient has been seen subsequent to the last letter as follows: 4-30-62 conjunctivitis - Cough continues - Rales inchest continue* 5-10-62 Worse past 2 days -had to goto bed- Cough and rales " persist. Diathermy, etc. 5-15-62 Some improved, complains of weakness 5- 28-62. Pt. failed to keep appointment 55.3311-6622 cCoommplpa^insRoafU gdififnicluelfttylburnegathfiinegi.d peTresmipsetr.ature remains g. 62 6- 25 About the same. Sent to the laboratory for l u n g J t ^ i s Capacity. Laboratory report patients vital capacity is 50^ of normal. 7- 2-62 Patient still c o m p l a i n s o f weakness - X ^ instructed be repeated at the La Mirada Hospital. Patienx ihdl to completely stop smoking. Upon contacting La Mirada Hospital, on 8" ^ " 6^ fQr5}ne hr. StaplesPhnd fail.h to have follow-up * - TM ^ ' that i pad ordered r U i V 'w ! T h S S i no^seen^thimpatient since July 2, 1962 in my office* Mv recommendations as staatAed in the ii*Aefiter unchanged I feel this patient should not be tion where lung irritatants are involved. J substantiate the diagnosis of pulmonary fibrosis ana Vital capacity is reduced to 50^ of normal. ^HicereU, o.f 4-25-v62OCrCeUmDaain 'S S K . probable asbestosis. p , OFF:.in ^ Godrgce' SV,r. V McCartney, Hall & Ryan Attorneys at Law 639 South Spring Street Los Angeles, California Murray Roberts Attorney at Law 750 Broad Wnington, Calif. Herlihy & Herlihy Attorneys at Law Ocean Center BuLding Long Beach, California American Motorists Ins. Co. 3545 Wilshire Blvd. Los Angeles, Calif. Casualty Ins. Co. 610 So. Spring St. Los Angeles, Calif. State Compensation Ins. Fund 3629 Atlantic Ave. Long Beach, Calif. Zurich Insurance Box 3203, Terminal Annex Los Angeles, Calif. Pacific Employers Ins. Co. 2484 Pacific Ave. Long Beach, Calif. Argonaut Ins. Company 1001 Wilshire Blvd., Los Angeles, Calif. American Employers Ins. Co. 639 So. New Hampshire Los Angeles, Calif. The Travelers Ins. Co. Ocean Center Building Long Beach, California National Auto & Casualty Co. 639 South Spring St. Los Angeles, Calif. Aetna Casualty & Surety Co. 810 South Spring Street Los Angeles, California Michigan Mutual Liability c/o Brown Brothers Adjustors 3517 West Sixth Street Los Angies, Calif. Industrial Indemnity Company 3745 Long Beach Boulevard Long Beach, California # edwin silver .......... RICHARD L. MoWlLUAMS ARTHUR SHERMAN ERNEST L. GRAVES LOUIS BERSON LAWRENCE WEITZER \] '*' law offices silver McWilliams & sherman S IL V E R ' Z NORTH AVAl^ WILMINGTON, CALIFORNIA r%*+r -tv %- t ir m .n a l < * S M U C f 5 e iM T` ** 7 ,v ,. M ITCALFI ML* III! FOH xl* rtM RlMtBSLf June 19, 1962 VFCWi tyl'IlWl/U kfrinfHI COMMISSION - -l MM 2 0 ibt>2 Ko m W ___E X CJLSiHO___ I _____ BEK* industrial Accident C o ! * 236 East Third Street Long Beasacchh,, Caliiftormnii.a- , Reece insulation Company, et al Re: John Staples vs^ " 700923 Gentlemen: report.^ tor Ellin^l^the^above-entltled*1 *--4 reports ,, 10<i2 matter. - * i"atter` f c E Fralide, M.D. dated April 25, Report of o. * wthe above-eSnStiEtSieSa - t U h^ S he tht^oples of all material -erred upon me. Very truly yours, SILVER. McWILLIAMSA S 1" /v' a . / X' .. i t BY CHARD L. HcWILLlAHS enclosure 3 .... x. casualty Ins. Company CC! Nf 9SltS Spring Street, ! *>*ele. ^ ^ < @ e E. Fralick, D. 0. B. P. HU SBAN D . D. O. 1IO e. W H IT T IIR RLVD. W HITT ICR, C A LIF O R N IA OXroRO C U R I April 25, 1962 Mr. McWilliams ^ 305-1/2 North Avalon ^ Willmington, California Dear Mr. McWilliams: Mr. Staples has been under my care for a chest problem since March 8, 1962. He has had 2 2 flrerho+hC4g!!i heB,Ptysis and pain in chest xl" h s % 8! nd i'f - Be "as h=Pi`alize<l a c u ^ pieu o n i U s P y MeBorlal Hospital Kith his lunE have shown toitiltaH chron1ic i m i t a t i o n . He has consistantlyhad fine rales in left low lung fields bp?tirUwith^frequently. His condition has become better with treatment but has not subsided i nrvei i R H S ^ 4t0 the Pulmnary findings on the i^ ti0nJand after discussing this case at La Mirada Hospital, Dr. Richard Siggers, it was felt wise to advise this J**?* h SCCk * dli>ferent occupation. It was ?and /th?er^e ewCaasuSeevi1d5encleunogf fciherlodnicshoiwrerditaftiibornosis inH asbes t o s ^ w h er * ihai th" p a t i t 1,'V o S ' A A "d ' S e?lKS * whe^eJhe is exposed to asbestos dust irdiibei S a n d d u e to fact that asbestos can cause and can irritate such a condition, I felt lluSnngMs wioouullddUnionttdbhefisnuibijelcyt.Setoek theimsPtotyypeentofwhierrreitahtiison wwiillll lleeaidr ttoo ^mnoirLe 0f?i^br1o"s"i?s11 aenxdPrSeupreeatteod taucnugteirritants pulmonary episodes which he had when I first saw The likelihood of active tuberculosis and hearTdisease would be increased. It is therefore my recommendation that Mr. John Staples seek employment in a field of endeavor not requiring contact with lung irritants. GKFtrn sincerely yours in f _ i*, -/ J). o 1 i law o r r i c t i CLOPTON & PENNY / h utrc i u b so u th iP N lN d STrC T L O S A N G E L E S 14, C A LI r O R N IA rH* ' .r^i TELEPHONE' MAoison 7 -IS0 S September 11, 1962 WHEN PEPLVINO please refer to # 19963 and A Industrial Accident Commission 236 East Third Street Long Beacht California Res John Staples vs* Coast Insulating, et al Case No* 62 LB 19396 Hearing Date Oct* 5# 1962 Gentlemens Please find enclosed the following medical report for filing in the above entitled matter* R.T. Johnstone, M.D., dated Aug* 22, 1962 WHKskb Enel* cc 3 Silver, McWilliams k Sherman McCartney, Hall k Ryan Murray Roberts Herlihy & Herlihy American Motorists Ins, Co* Casualty Ins. Co# State Corap, Ins, Fund Ind. Ind, - L.B, very truly yours, WILLIAM H. KENNED! Office Manager Zurich Insurance Argonaut Ins* Co# American Employers Ins*Co# Travelers Ins. Co# National Auto & Casualty Co* Aetna Cas* & Surety Co* Michigan Mutual Liability Pac* Emp, - L.A* 71 PC 73643 & 73644 OCCUPATIONAL 0<**ACi INDUSTRIAL H t A U h % RUTHERFORD T. JOHNSTONE, M.D. O C I I M A N U II.O IN O Lo A n jo l o 14, C a lif. MAoiSON J ** August 22, 1962 INDUSTRIAL TO*ICOLOOT HlAHT SURVEY Pacific Employers Insurance Co. 1033 S. Hope Street L o s Angeles 15 Caiii. Gentlemen* -xs Re* JOHN STAPLES Coast Insulating Products Claims 71 PC 73643 Our File: 6108-R . i C r or r 4 i 6 2 ! h^ f g a CS f t 2 d ^ a s li o ^ " c o r r s r ^ ei t t i L , Calif. His occupation as an insulator. * A * * h a+ in March of 1962 hedeveloped pneumo HISTORY: ------ Mnri.a. StF?porlet+hMiseahe!SW as cared fosroibtyJi Dri.n WFhriotltiicekr.and Xw-arsays hospitalized in the Murphy Mem i ^ ntP the d0ctor first suspected were taken and according to the p that he might have tuberculosis. according to the patient, none ber 0f tests were run but, evidence of pulmonary lungs might have been"affected ^ "W f i b ^ g l a . and asbestos. Jtates that ^ h a d ^ ^ a r d i o j e ^ p i r TheVpatlent h as not worked since H a K h S H h e recommendation of his doctor. . p re s e n * Com pla in t s * 1. "- t shor^of teasth^on^ffort.^This has 2, 3. .OccasCionaiy l in my chest." r t o\ constriction r,, . History. ^ " a ^ S d ' ^ i n ^ ^ o f " ! ^ 1* ^ " 0 h ad a whiplash injury two years ago. _ 4-hat. hfi hdS b@6H in Occupational History! ^ ; u^ g i " b f 5lness for approrimately^ten years with the exception of period^of time. If I worked for various companies for vario p ked the longest for the understood Mr. Staples correctly he h j ^ t e l y threJ to four Plant Asbestos Company. This He9has worked for the Coast * nsulatingProductsifo^the^rmstron, Corporation, and Baker- Perkins Company. For these various companies his work is primarily as follows. No. 2 Re' John O. S ta p le , The patient lt . 2 diab6US ln the Dventorv . lc t r Nead - j.u 8-22-62 - - e flbe, 6 -Uh sls# cancer and | . 1 i S 1'>c%eni'oi0'1"teiitinili -1^ p i t i L Ci^ C0mf tCCHasOno1 palPitation Genl?:. H?s n o n s t l S n ^ i * ls normal. TM orthopnea. ^eiqht Ur nary - No nocturiar^ Q ^arrhea otooi Syrn^ toms Of " a diet b,,; [,*?!"* ^ates `" 'h e ^ r d 1? or freoueney" n TM al* b e c a u ^ o T i e $ySt" * "t1 e r ? h eatfththls- 17 ^ slee p s ,,ell? was s0"<`*hat nervous, hed?ftor Placed him on Milt enlargement?***5 * No history of ankle ed r r `t a W e and he OW" iliilits: _ * * " ' * * P-m or Joint cfrink alcohnft 8 a^ut one nack ** alcoholic beverages. P Ck f S a r e t t e s a day n,, masK sutoiuN aT ^: The patUnt '' - " "esn"o0tt dm?* jj^arft U l77h pnnnd?.telx i dp ^ C" P e ? ? u ? e 37Py e nJjd noTM a U y 7he PuPiIs were round no^ a l . X la raale. litgZir1^ 9"Ms-''*' ^ ie^ aieredfarsae tedN t0 li^t. appearance. Ih 6013196 rufas or raieb. op uscultation of th6]Percussion Ofc f 76; re9uiar RnoPiiratory *** 18.* iun9i* revealed ' No. 3 Re: John D. Staples 8-22-62 LABORATORYi Urinalysis: Color-yellow Reaction- pH 5.6 Albumin - 0 Micro: Appearance-clear Sp. Gravity - 1.010 Sugar - 0 negative Blood count: Hemoglobin Erythrocytes Leucocytes Polys Lymphs Monos Eosins 138gms. - 95?6 4,180,000 8,600 65 30 4 1 Blood sedimentation rate: 16 mm 1 hr. (Wintrobe) ELECTROCARDIOGRAM: Normal. .. . X-RAY EXAMINATION: Posterior anterior and lateral views of the* chest reveal the cardiac shadow to be within normal limits. There are old egg-shell calcifications of both hilar areas. There is one small calcification in the left lower periohery. There is slight accentuation of the bronchovascular markings and a few scattered micronodules. DISCUSSION: *----------- The ohvsical examination of Mr. Staples was essentially normal. Likewise the urinalysis, blood count were normal. The blood sedimentation rate was slightly elevated. The electrocardiogram was normal. From the history there are two types of dust to be considered in this case. The first is that of fiberglas. This material is notorious for causing a mechanical irritation to the skin, however it is not known to cause any effect upon the pulmonary tissue. This is not any arbitrary statement based upon my own experience. It is based upon the additional opinions of other clinicians and those engaged in research in industrial toxicology. The references to the following quoted material are appended to this report. In a clinical study by Carpenter and Spolyer, "In a clinical study negative chest findings were observed in a mineral wool industry. According to Gardner, "The lack of pulmonary damage from exposure to alass wool dust is being demonstrated by an inhalation experi ment. for over a year animals have now been exposed to as high concentrations of this material as could be obtained, with no setlom etiect upon their lungs." No. 4 He: John D. Staples 8-22-62 frequently assumed that all siliceous dusts necessarily must be injurious when inhaled." In view of the fact that in the pneumo conioses "the main causes of disability or death are pulmonary fibrosis, emphysema and bronchitis, vascular occlusion with cor pulmonale and secondary infection, mainly tuberculosis these animals were carefully studied with these complications in mind. "The fiberglas-plastic dust provoked no serious lesions of the foregoing categories." On the other hand asbestos fibers are respirable. Under a given set of circumstances they can five rise to a pneumoconioses known as asbestosis. It is believed that it takes from seven to ten years in a fairly high concentration of asbestos fibers to develope asbestosis. In the cas< of Mr. Staples no positive opinion can be given at this time. Certainly this is so from the standpoint of inter preting the x-ray films. Pendergrass, a radiologist who has probably the greatest experience in interpreting x-ray films in the field of pneumoconioses states "a roentgneological diagnosis of early asbestosis is unreliable." With this I agree and I fail to understand how any other doctor could state that the x-ray films of Mr. Staples represent asbestosis or any other pneumoconioses. Before any opinion can be offered in this case an investigation is necessary that would include a determination of the presence or absence of asbestos fibers in the working environment, a determination of concentration and particle sire and an estim ation of actual or fairly approximate length of time that there has been any exposure to asbestos. After this is done and there remains evidence of the need, a lung biopsy could be made. As previously stated, no positive opinion can be made presently. At this time it is my impression that Mr. Staples does not have asbestosis or any pulmonary disturbance from fiberglas. Further more, I believe he could return to work. Yours very truly, No 5.* - Ret John D. Staples 8-22-62 References* 1. Schepers, G. W. H. et al* The Action of Fiberglas Plastic Dust, AMA, Archives of Ir.d* Health, 18*34, 1958 2 Carpenter, J. L* and Spolyar, L* W. * Negative Chest Findings in Mineral Wool Industry* J* Indiana M*A*, 38*389, 1945 3 Pendergrass, Eugene P* The Pneumocenioses-Diagnosis, Evaluation and Management: Council on Occupational Health, American Medical Association, 1962 .j V t .* ' a * ' y b***" HT***"- 3745 \ O H a BEACH BOU A R D 1,' O M . , ^ C H 1 ' L If ORN IA A R FIE10 4 0411 .^ > I N D U S T R I A L 1 N, nD cE Mu NM 1T Y C O M T A N Y u , >; ' " industrial accident COMMISSION October 3. 19^2 -------- --- , , a C. No 62 LB 19396 Long Beach, Calif. oc1( _4__f_oL`2-- , v claismtNoes 1 Ci62-nA3-/093S55 r co- r/z.-1. -- ( Re,ease for your ( , ; ; : r puce HU - caUn.r*^ ------ the above matter for lack of prosecution. ( ) Please d.smlss the , tto rn ey, we request that we , . copy of this letter to a P P H f ? i io!r "session or.control b ^ t S ' ^ r i i r s ^ r i h ^ a W Accident Commission. 00 Attached for filing herein are, ^ August 3 ,. 62. Si: s:rns t ^ ' T ^ K S Z & J Z C^ V r .SeMrc W ^ .u - 4 Sherman 305i N. Avalon, Wllm. Sincerely, in d u s t r ia l indemnity company >,,, J . A KarL Ei: Iw tjnfc- ' -- - 3ste J 9-^ B ernard M. Sm o len s, M. D Dan iel A, La n d , M. D. I24e OLCNDON AVCNUC WIITWOOO VI LLAOC tO * AN O C LC * t* .C A LIFO R N IA GRANITE B-O III ' DIPLOMATS* o r THE AMERICAN BOARD OF IN TERN AL MEDICINE September 27, 1962 Re: John D. Staples Employer - Plant Asbestos r"----- - -- "a-- -- 1 *-** J. A. Karr, Claims Adjuster Industrial Indemnity Company 3745 Long Beach Boulevard Long Beach 7, California Dear Mr. Karr: T examined Mr. Staples on September 11, 1962, and the results of my examination and laboratory studies are as follows: A. Chief Complaint: Shortness of breath, chest pains, freouent chest coTSfe and pneumonia in March 1962J * o m which he feels he has never f u l l y recovered and which he feels all are due to asbestos inhalation. History of Present Illness:, fir. Staples is a 57-year-old wnite male who nas the followingJcup" tiona^history. He has been a heat and frost insulator working with asbestos for the past nine years. Prl*\ to this, he drove a truck, owned and worked in service stations primarily. He worked for North American fcviation for six months in 1950. At no time in *** 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. H i s 7 involved installations of heating or air conditioning insulation on the job in many types of building construc tion. This involved carrying asbestos or various parts of installations, cutting and f ^ i n g it around pipes or ducts. The asbestos was occasionally put on in?a soni-liquid form, molded and dried on a fittine like a plaster cast. He never wore a mask exception one occasion when he was opening bags of as bestos and pouring 1 * ;lntp;.%,Mixer. He had no other occasion to use a mixer or pour bags of asbestos. He never noted anf Adverse arfetfts from this work until he began noticing shortness of breath about J L o . He noted that he was getting tired and short of ^ .t <n *he early afternoons at'the job. He w o u l d nici Sp L d couldn't carry It very far because  Re: John D. Staples Employer - Plant Asbestos ol this shortness of breath. He noted an increase in his usual ''cigarette cough." Less and less activity produced more and more shortness of breath but he con tinued to work until he got pneumonia in early March 1962. At that time, he was hospitalized with fever, chills, lightheadedness and a productive cough including streaks of bright red blood in the sputum. He had A-rays and sputum studies and tuberculosis was not found although initially suspected. He was given antibiotics but r e quired no oxygen. He was told that this was due to as bestos and he should not return to his usual occupation. He has had episodes of feeling better but then if he gets a cold and his cough increases, he gets very short of breath. Generally, he produces almost no sputum in the morning - if he does it is only a teaspoonful or two. It is very stringy and brown in color. He has taken penicillin but became allergic to it so now he takes sulphur when he gets an infection. He takes no bronchodilators or other lung medication. He has had no wheez ing attacks prior or since the pneumonia. He has smoked cigarettes for 25 or 26 years at the rate of one and one-half to two packs per day for many years and two to two and one-half packs the year prior to the pneumonia. He has smoked one pack a day since his pneu monia. C. Past History: He was born in Missouri and came to California in 1939. He served in the.U.S. Navy from 1943 to 1946 and spent two years in the Pacific Theater. He was not sick or wounded except that both ear drums were ruptured from concussion blasts. He denies any Intake of alcohol since 1949 but states that briefly before that date, he drank fairly heavily foot* one or two years. Family History - His father is living at age 60 and has pulmonary emphysema. His mother is liv ing at age 57 and is in good health. One sister is living at age 40 and is in good health. He has been married 17* years. His wife is 40 and in good health. There are four children, one of whom is a son age eight who has a ventricular septal defect. There is no fam ily history of tuberculosis, cancer or any other serious disease except for the pulmonary disease which his father has. He had the usual childhood illnesses. Adult Illnesses -- Ho had mumps in the service, a^d tonsilitis in 1959. Surgery - Ho had an appendectomy for a ruptured appen dix in 1952 and tonsillectomy in,,1959. System Review -- His maximum weight? had been 1^4 pounds, average weight 170 to 175 His hearing is decreased bilaterally because of the perforated ear drums. He sleeps with one pillow I -3- Re; John D, Staples Employer - Plant Asbestos and on his side. There has been no ankle edema, appetite has been good, , His rrr P^yflcal Examination; Height; 59 " . Temperature- -^ 34 ; j^iooh Pressure: 100/70, "'//eight :--- * oIfrta^ T ? inari^y areiiSe^ He appeared as a" well devel- c o o n f t r * q f nouT ifhed "bite male, alert, oriented and i !1 no breathing distress while at rest. w o i u 4ld eX^r w isL in the consisting of rapid an? bndln be exhibited objective evidence tf ^ i_ld_resP df abory distress. Head and Neck; Revealed ?vpI*n0Sf d ^stentfo n thyroid- enlargement- or adenopathy. ^es. Pupils, external ocular muscles and fundi were normal. Ear, Nose and Throat examination; Both tym panic m e m o r i e s appeared" to be intact and there was no decrease in hearing of the wrist watch tick. Chest- maT|e^ ! ^ ay??etri^al resPiratins bilaterally wTEITkini. ^ SlriCtion 0f chest motion. Lungs: Revealed slight (iecrease in breath sounds bilaterally with per sistent raies at the left base laterally. Heart; Not wwiitthhoouutt1 tt:hhTr.i?Tl1lT'sa,rgmeudr'murTsheorr rWuUbSs.reSTuhlear sescionunsd rahoryttincm eqaled ibe second pulmonic sound. ADdomen; There * ere no organs, masses or tenderness noted; there was a well healed right lower quadrant scar. Genitalia; Revealed an atrophic left testicle. Neurological examination; Produced physiologic responses Extremities; Revealed no clubbing, cyanosis or edema. ibe^remaTnaer of the physical examination was not remark- y*-- Laboratory D a b a i Complete blood count - hemoglobin Inn pacJte? c e l 1 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 C0g combining power 26 mEq.with a normal for our lab oratory from 24 to 32 mEq. Electrocardiogram revealed a heart rate of 76; PR interval of .18; QRS .08; 0T interval .36. The heart was in an intermediate electri cal position with a transition zone at V-3 and n o r m S R wave progression although there were slightly large R waves on the right side of the precordium. The im- v & S that f an electrocardiogram within normal limits. X-rays of the chest taken in the PA and left lateral projections in "the inspitrutory 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 b,iar areas- ^be markings were exaggerated throughout. The inspiratory and expiratory study revealed good motion of the diaphragms and no evidence TiTrrriiiTiiifrifini-- i . i ! lm f a il ito li l llll 11 I . 1M . I . l i i n - ii m i . . * . ! . '. . . . .-.. . . . . . , - . . . . . . . . I un liM M * .... . Re: John D. Staples Employer - Plant Asbestos .of emphysema radiographically. Pulmonary function tests performed at the Cardlo-Pulmonary Laboratories of the Mt. Sianl Hospital revealed a slightly decreased or low normal vital capacity and moderately reduced maximal breathing capacity with low air velocity index. The impression was that of "minimal airway obstruction without hyperinflation. This will be consistent with mild asthma or bronchitis. There is no emphysema." F. Discussion; It is my impression that the combination of a long history of exposure to asbestos and the X-ray findings of exaggerated lung markings consistent with early pulmonary fibrosis plus additional evidence of dyspnea on exertion, make asoestosis a medical probabil ity. At this time, the degree of pulmonary impairment is minimal but a more exact evaluation of the pulmonary function can be determined by further and more elaborate tests such as blood gas analysis at rest and after ex ercise, as well as other studies which would indicate more precisely the degree of fibrosis present. An abso lute diagnosis of asbestosis can only be made, however, on histologic grounds, after a lung biopsy. The chest X-ray snows evidence of numerous calcifications which reflect prior inflammatory disease of a nonindustrial nature and the element of his very long and heavy cig arette smoking must be considered. However, the history he presents and the X-ray changes present at his rel atively young age make asbestosis a probability. There fore, I feel that this is an industrial condition. I feel that his condition is permanent and stationary because the changes brought about by asbestos inhalation are not progressive once the patient is removed from the offending irritant, in contradistinction to such diseases such as silicosis which progress regardless of further exposure. For this reason, I feel that it would be most wise that this patient seek employment in another field of endeavor. Very truly yours, r BMSilc BERNARD M. SMOLENS, 11.D. rcr.c csvcH [H I $ u ''' B e r n a r d M. S m o l e n s , M. 0. ianiel A.UNO, M.D. IB * O L C N O O N A V C N U C W E S TW O O D V IL tA O C f L O t A N O E L E * 1 4 , C A L IF O R N IA O R a n it c OKI O lFLO M A Tt OF THC AM ERICAN BOARD OF IN TERN AL MEDICINE August 31* 1962 J.A. Karr Claims Adjuster Industrial Indemnity Company / 3745 Long Beach Boulevard Long Beach 7* California ^ Re: John B. Staples Employer Plant Asbestos Dear Mr. Karr: Pursuant to our telephone conversation of two weeks ago, and the letter dated August 22, 1962 to Mr. Staples, my office reserved two hours at 2.15 PM"on August 30 for this examination. Mr. Staples failed to appear, nor was any notification of cancellation received from either him or your office. Enclosed please find my statement for this reserved time, and advise me as to any future arrangements in this matter Sincerely, Bernard Smolens, M.D. MOUNT SINAI HOSPITAL REPORT OF PULMONARY FUNCTION TESTS PA TIFN T: S t a p l - , J Q to _______________ ROOM: _________ C o No----------- ______n,,., W " Be M# Snaolens Tim.* Aoe 37 yrt.; Height _5_____ ft.___? __ in.; Weight 175 lbs.: Surface area 1#95_______ m*; _M OBSERVED VALUES PREDICTED NORMAL % PREDICTED NORMAL SPIROMETRY Vital Capacity, Total (V C ), cc. 1 toe. V.C.(VC ,), W V C 3 sec. V .C.(VC ,), % of VC Maximum Breathing Capacity (MBC), L/min. Air Velocity Index ( A V I) Minute Vol. of Retp. at rest (MVR), L/min. Expiratory Reserve ( ER ), cc. Respiration Rate (R R ), /min. 3&9A 4117 851 7IX 92X -----------S I 83*^ 97% 138 59X 0.7 . . 0.8- 1.2 9 --------- m -------------. ___ 4 - 9 14 0 * saturation, X ( Ear oximeter): Rest, air_________ __; Rest, 0 * _____ Normals: Air: 92* 102; 0 t : 97-105 ; Exercise_____________ ; Forced ventilation LUNG VOLUMES Functional Residual Capocity (FRC), cc. Residual Volume (RV), cc. ' Total Lung Capacity (TLC), cc. FR C /T LC x WO. % T L C RV/TLC x 0, * TLC 3038 1926 5420 56.1 3 5 .5 ..... 3330 2033 6440 49.4 _____3 2 * a _ BLOOD GASES: (Arterial____; p H _______________ _ p C O *_________ mm H i v e n o u s____ ; orterialized v e n o u s_ _ _ ) 0 * saturation, %: Rest, oir R*, Ot Exercise 91X 95X 84X 114X .____ n o x SPECIAL PROCEDURES: REMARKS: V .C . low normal. Timed V .C . slightly low. Moderately reduced MBC with low ATI. Iarng volumes are within normal lim its. IMPRESSION: INITIALS: Minimal airway^obstrtictitlrt without hyperinflation. This would be consist^ept^^tL mild asthma or bronchitis. Thera ta seap^yBern*. w.i CARDIO-PULMONARY LABORATORY mm ini iHoomiAi acodfjct commissioi Of THE STATE Of CAUTGSHU lotkfi ral Reqseil (of klhmm ( Urn Ait ,J *. * iCMM,'.!, t- ,i Z H Sr 2 4 l (sm Ho.______62...1IL12326 1 . . / . I WiolinKn ---fiar1 *n ^ 10f STATE OF CALIFORNIA O lPAATMENT OF EMPLOTUKITT Tt John D Stanly3 im c u iu t P .O . Bo* p 0 or 1 K 6 Santa Ana GaLif. 106Sh G e ro s . ' .h i t t i e r CaI U L _i;2Z.-l -22x -- t s n v r l t ' CLAV C * IT T I 1 H * - Artssi-roft**- 2z t.JrmaisiLi- fUFLOTIi --fqrTrOe n n '? Ci^;m ;nvil L c - - . 2-Aa-liT-- I The undersigned hereby reque*. the Industrial Accident Commotion to determine and .Dow a lien the *um *ured ' bebw 11 "Total," which represent. the mount of unemployment compensation disabtLty benefit, paid to date, and addiUon hen isrequested forany further benefitswhich may bepaid,up totheamount, statedinparagraph 3. ,below. J. Filed under Labor Code Section 4903 (f) 1 Disabilitybenefitsat the vreekljprateof $-- .1..- paid ftor thne perniooad.-- ---------------- -7 t0 -----9--.6"-6^2- ; inclusive . , . ,, (__l2dayt at *JLfl^er day including-- -- days paid for wa.tmg penod waived) Filed under Labor Cod# Section 4903(b) J , . m Additional benefit, forhospital confinement at the dady rateof *--Lf*uu---- ; . ... , . , paid for the period .... at; { ----- 1t0n------ a * n (.0_____ inclusive Total ) lb?0QQ- 1^ .0 0 1 :'" .'0 Fonte wrrbj. .fat>iU>7 I*. >r 7 * both^il, " ^ , additional benefits for hospital confinement which will not eiceed $------- -- ind 1---- 2 * ^ * C.5T^^PIT^*.q y* i'T.. IOq O 4 The undersiened declare* he ha? deliver! or mailed a copy of this document on----- 'l ` ` toeach of the*partieslisted. Alr.o copies sorved on the followinc represents uxv..s an-- at.o... rf O" record: Silver, Kc'-alliars & Skoroan 1! Avalon Slvd , Allni- ipton Oalif State op California D epa&rTtMmeENntT OopF EJumMprLlOoTyMmWenAtt ... usa cuiun See reverse EMPLOYEE'S C O N S E N T T O A L L O W A N C E OF LIEN "Notice and Request for Allowance of Lien" filed by the Department of Employment, c*r 250! Wiv. 9 (i-MI ,___ _ _ , 6 k INDUSTRIAL ACCIDENT COMMISSION f t STATE O r CALIFORNIA C ub N o,62 LB 19396 JOHN D. STAPLES s. Applicant-- Notice of Time and Place of Further Hearing i ^ H f t * 4 ^ ^ a ! u u n o i l . IL T. DINWIDDX^ :a:HTA.rio, t.t. g m k , p u s , -vs^ios, HU'.iDT CORK CORP., CAL. SI., CO. Defendant^- ONE DAI - n otice t o All parties You arc har.br notified that further hearing will be held in the ,bove-mtUd action 236 EAST T H I R D S T R E E T - R O O M 237 L O N G BEACH, CALIFORNIA OCTOBER 5, 1962 9 A.M. Dated at: Long Beach i n d u s t r i a l ACCIDENT COMMISSION NOTE: CONTINUANCES A N D FURTHER HEARINGS ARE N O T f a v o r e d . n a m e a n d a d d r e s s o f p e r so n s SEKVTO: _ _ date 8-3-62 ip ^ \ t urr n 1063t1 Cs t g s * s`.tn Silver 305i N. Avalon, Wilmington AmerWiMlosthoirrei,st L.InsA.., 3545 De.pt of Employment, BoE 1 4 ^ , Santa Ana Cas. Ins. Co., 810 S. Spring, LA. Baker Perkins, 1000 Hess f ^ i n g e l e s ^ St. Comp., 3629 Atlantic, L.d * j. T, Thorpe, 9<+8 2nd Los Angele Zurich Ins., Eox 3203,' Terminal C. F. Braun, 1000 Fremont, Alh. Annex, Los Angeles 54 o u H e l d Con|t.>LBox 9 W , . Pacific Emoloyers Ins., 2484 Pacific, Long Beach ArastroS'ionstt, U & 6 banding . Angeles Argo Ins., 1001 Wilsnire, L.A. Fiburglisn Eng#, 5933 Telegraph "d., L. &. 32 Amer. Emp., 639 S. New Hampsnire, RK.irTc.herDinAwsibdedslteo,s, 06B2o7x 665c2o,^pPSnxx.^Awrriizz..* L.A. 5 Travel. Ins., Ocean Center Bldg. LA Cork, 4180 E. Washington, L.A. 25 Long Be^ch pi in* Asbestos 1540 a # 9th, LB# Nat'1. Auto & Caa,Box 5780, L.A. Mundet Cork Corp., 6II0 Walter, ``^ o o d Aetna Cas. & Sun, 810 8 .6prin^^A P *Y st Co.. 8823 Mettier, Los Angeles 3 K n f c e , e r al ,/30 0 W. Coast llwr.L Newport Beach Mich. Mut. Liab., Adjs., 3517 c/o Brown Bros 6th, L.A. j i/pOirtnev et Sil 639 *> Spring, Um*\m ** Indust. Indem., Box 2251, urrey Roberts, $50 Broad, Wilmington h u L fc Herllhy Ocean Center b d g L.B. ! R e x o Vv^A.VX H Y A . ') UO.-' - l, e. CLOfTON & PENNY 639 S. SPRING tos ANWU>M>,-OAtlPORMIA (Signature of Peraon Serving Notice) \ .t tom iwMoiwiiimiii.iiiP|ii ip1 Before the Industrial Accident Commission of the State of California Cat* No. 62 LB 19396 JOHN D. S T APLES Applicant vs. Order Joining Party BAKER PERKINS, J.T. THORPE, COAST INSULATING OIL FIELD CONST., ARMSTRONG CUNT. FIBERGLASS ENG. REECE IHSUL. R.T. DIlfJIDDIE, KIRCHER ASBESTOS, L.A. CORK. PLANT ASBESTOS, KUNDET Cl)RK CAL ST. CO., C.F. BRAUN Defendants Defendant Good Cause Appearing Therefor: IT IS H E R E B Y O R D E R E D T H A T AKER. MTRST, CAS, INS., ST. FUND, ZURICH INS. PACIFIC EMP. ARGONAUT INS. AKER. Eli. TRAVELERS, NTL. AUTO k CAS. AETNA CAS. & SURETY, MICH. MTU. LIAB. INDUST. INDEI-1. ~ be joined as a party defendant in the above entitled cause. SEE NOTICE OF HEARING FOR HAKES AND ADDRESSES. S E R V E D ON -3-62 KEITH L. JENSEN._______________ Rtjrrtt INDUSTRIAL ACCIDENT COMMISSION KORE T H IHDUSIRM ACCIDOTT COMMiSSlOM Of THf SIATE Of lIfO R H tt K o lk id R e p o r t fo t kWwm* *1U m U m IUl. 62 LB 19396 Dit* I lafur Fronl953 to March 19^2 inH ' if'. l 9r STATE OF CALIFORNIA D epartment op Employment n. Joh n D Staple^ Ul* cun**T *ruTtt P. o. Bos 1466 Santa Ana Calif UMIM 10 6 3 ^ Ceres Whittier Calif, BMIU U97 12 2206 novel'mcul*uirrmin* Arnstrong Contracting___ (fUQ'TIB Travelers Ins Co un s***. a u n t I. The nndBrripnid hereby requeue the^ du,ttul 1*1*00 E B a n d irti E L o 3_ A n g e le s 22 _ C a l i f '.... .......... ..... 4IMIM -1-1-0--W Oc-ea-n--B4l0vtdft Long Beach_2-- C a lif. benefiu pud to dele, end in 2. Filed under Labor Code Section 490J(O! 7 0 An Dual 'ity btctfit**t the w:J/ of t--a-- *-'ti--- jr . indurite p*(ai1"ddi0lf1lor et_theer p.etrriifoodTdI_HQ_._O^SrtrtdSafyi---ct-l-uJd*-i-n_-gjOrE~-- todJ--*avye. npAaii/df ifnofr"Vw-a-i-ti;-n-g-p-en"od .~7, waited) 1 l aOXQeQQ- Filed under Labor Code Section -4905(b): .... t . 17.00 Additional benefit* forhoyita! confinement at thedaily rateo f J P - V r - paid for the period -.3t2d& - -------- *------ inclusitc T otal J i&aQQtJun^fl.QQ -- Further unemployment enrepen.^ di.bdi.y benefit, mey K J * additional benefit* for fopittl confinement which will not exceed --- and *------ , P~ / * June 27 IS *52 4. The wadertigned declare* be ha. delitered or mailed a copy of thi* document on Ll -- J - ' to each of the parti lifted. Silver, McWilliams & Sherman 305| n Avalon Blvd Wilmington Calif State o p C alifornia D epartment of E mployment ^11L^ ^ -1 U a O A llA lT 6 6 Before the Industrial Accident Commission of the State of California C a t t N i 6 2 w 19396 JOHN D. STAPLES n. C. P. BRAUN, et al Applicant DtftndanJ ORDER TAKING OFF CALENDAR G O O D CAUSE APPEARING THEREFOR: It Is H ereby O rdered 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. KLJsob 5.29.62 rom w 4 0 (H IV . 4.011 mm MAY 291962 " j SEAVEOi M M EE HA E R X ^ t v R A ________ INS....... INSA ___ IN. Cl___SUIF_____ Cel'*** MA/ %9 1962 ` FDWIN SU.VH RICHARD 1. McWlLUAMS AHTHUK SHERMAN ERNEST L. GRAVES LOUIS BERSON 9 LAW OFFICES silver, McWilliams & sherman 303W NORTH AVALON BOULEVARD WILMINGTON. CALIFORNIA TERMINAL A-aSRS SPAUC* 3-6138 um* *x* onti'i M E T C A L r l *e *H v ** 1 1 NORTH N i l fcTM IT F l M t t R l T T-OtilV May Twenty Fourth Nineteen Hundred Sixty Two ^ f. .. __ l*. .;i-.- Industrial Accident Commission 236 East Third Street Long Beach, California Re: John D. Staples vs. Plant Asbestos, et al Gentlemen: Enclosed please find original and approximately 27 copies of application in the above captioned matter. Copy of said application together with copy of the attached employment record has been served on each of the employers named. We are now attempting to ascertain the identity of the workmen's compensation insurance carriers and pending determination of such information, it is requested that the matter be taken off-Calendar. Very truly yours, s i lv e r , McW illiams & sherman RLMCtll end. / STATE OF CALIFO RN IA INDUSTRIAL ACCIDENT COMMISSION '-AU APPLICATION A' ,, J -- * .a _ r ' H U SIGN ED O R IG IN A L AN D SEE COPIES (PLEASE PRINT OR TYPE RAMES AND ADDRESSES) <$?/ CASE N O . < 3 19396 JOHN D. STAPLES________ ______ applicant-- __ 10634 Ceres__ . % _____ A P P L IC A N T 'S A 0 P B C S O . W hittier,..C a lifo rn ia . Social Security No.--- 437*12*2206.. SEE L IS T ING ATTACHED I0PIOTKB EM PLO TEAS ADDRESS UNKNOWN AT THIS TIKE U H A T I I I 1*0BAICI CABItU INSURANCE CABBICB ABOBSBB Between 1953 and I. John P. S.a.tr.a.copal.i.iensom,.. ________ .b"at2i4Of"H2I.T5. , alleges that while employed on------ MaMrUcOhflJ7rr,--- 1^62-- ...heat & frost insulator____al KwvCe.Ir.N.a..TiiIOw"I AttintO*P. -.U----r--t--i-.!- I^s Angeles County &.vicinity______,California,by ctTTi y g w a 0 1 .LACK W H KR I lJK T OCCUKKKD ____ I I P i n g f r t - a p h ^ d _____ * _____he sustained injury arising out of and in the course of the employment, as follows: a*at or laruma . __ fixpoppre to asbestos d u s t ...fiberglass.,_&...Q.ther...irrItants------ resultingin KKPLAIM M O * la jU W AS C IIV IO Lungs and r e sSpTATiIrWaMAtToPArATyAOfSsOOyTs(tIIeImI.JUAIDAMDIMMIOUIMTHIUITS 2. ..Unknown. was the employer's insurance carrier on date of injury. bab i or iBiuKABci cobpabt oi, if lartoTii was aoT laswaio, statk w h i t m u mr-iaiuaio 0 uaiasuaio J ________ 5 1 n c e J t o .T c h .7 a ._ 1 9 6 2 ------------------------------------------------------------------------------- - rtiioM opr wo oos to tbs ibjubt injvkkb kitv to WOAK M t t LAST B ED IC A L P N 1 S *E B 4. Was compensation paid?-------NO-- ------- $----------------------------- $ flf OB BO TOTAL PA10 VIULT BATI OATS OP LAST P A T M B T * Earnings at time of injury I ---------M f lX r ------@ ---------------------------------- ^ ''" " am t . Was medical treatment needed?. Yes nsOBM ... Who furnished treatment?- Dr. George Fralick. anaaasorkctoh waoTtTaTatibjbbtabbstatkwaorttwkiiaiua 7. This application is filed to determine liability for: a. Temporary d isab iU ty_y^ S b. Permanent d is a b ility -y e a . c. Medical treatment y e S --- <L Medical - HI 00 YES OB 0 0 TES OB HO c. litigationexpense--TUXM-M- t. AJOB I. usr cam ava or at othia appiication nui* W H ER EF OR E, it it requeued that * thru and place be fixed fo r bearing and that an award be made granting n e b relief at m ay be *n p " *," W ` C em pm uiion * 0 ^ f'^ h n d n g t o n ______ clifomi., May 17. 1962 MTt Hearing requested at-- ,-- Number of witncsset. ------- ----cm - - unknown [N T 'S S IS N A T U B I Eitimated time of triaL J lA sx~ APPLIC AN T S A T T O IN tf 305^ North Avalon Boulevard Wilmingt o n r C alifornia TE 4-2515. R t , ___ p l a u a u n U . I c m w m * M r - r T a m u m u m m l v m n c m m m m u co m aw w r c m . W a m a i u w a v a v o m o b u pv c tu M u u a . MM M A T T ' IP - * in i P M M A P M M M '- .A U > A i K H U l M U l | U H I A C A U H U A a A C M -- c n n m r a w . i m w u n n a C a u i .a a i m . u k i * aatatt u i t. a i m u n . u p m i at. p. t . a m . a a . l a u a i i m i m c c m m fAM TM TCArr. * " * * m ,, 1 , , . J , w , n i , . A . M M i K .t t t It A l l ! A t f i t l A A I M M B A U M t . I . A A.AAAT O ffiC A OP T .A I.PU A TA.A L A C C I M .t C O ..IA A IO V I T .M T AKLAT. M t t WIAA ' " " ' t u M K , n r i a l I I I A K A OP P C .A I M K lT M A MATT BAA M V A PA tA M T A . I . PA A A M . A t A T T O ..At M .TO SA A .A .T . *OKM 34 (WKV. # .sn 4M A 1 S M I T7AM X M O 'W ' JOHN Dt STAPLES 1953 Oct. Oct. Kov. Dee. B rker P*riiins 1000 Hess Ave. Saginaw Michigan 56 hour . T. ion. 360 n 91)8 E. 2nd St. Lo Angeles caiir* 195*1 Jen. Feb. Mar. Apr. Hey June July Aug. Sept Sept. Oct. J.T. horp 939 f! If ft It If c. F. Braun 288 10C0 Fremont St. Alhambra , if CoiiSt insulating 88 2 6 c 4 L a c y St. ^ Loa Angel* 31* * J, T. `i-arpe 1* nil Field Constr* 82 t, % r - n v of.? Baseraiu s wa^ix. it Bov. Oil n . J d C o n t t r . M R December J.t. horp* 3 1955 fix# matron?: Contr* UiCO E. Land Ini 299 Loa Angel*** Callr* R tr! J*T. Ihorp* 19|| fl , >ril A m a t r o n s Contr. fofos ' *lit m . ' ' U 1 ' h \I i } April May Jun* July Aug. Sept. Oct. Hov. Dec. Oct. 19$6 Fibergle Engineering 11)091 hrs 5933 Telegraph Ed. Loa Angele 22, Calif. M h - - ' lift . i s : 'v' M/nsi* j " . tri.' ___ ___ -- L;_;r___ p k .___ w ------ -- . ifU n Reece Insulation 56 ll563 Valley Blvd. Los Angeles 32* Calif. Jan. Feb* Mar* Apr* Me y June July Aug. Sept* Oct. Kov* Dec. Jen. Feb. March Apr. Key June* July Aug. Sent. Oct. Mov. Dec. 1957 Piber^l* Engineering R Armstrong Contr. R R Rece**In8ultion Co. B M . m 195 Reece Insulation 3m T.Thorpe R R R M R R, T. Dninwiddle M 6814 " m " 809 219 11U9 i486 ) ff t Jan* Feb. Kar, Apr, July Aug. Sept. Oct. DKoeve*. 1959 R. T. Dinwiddle 862? So. Atlantic South Grt*. Calif. 657 hr. Fiberglas Engineering H Reeceft Insulation n R 386 592* Jan. Feb. Feb. Mar. g : J tw'-.'r f ; "V sI-*C^iUjrtb'On^C i":: 1962 lAi,,f,f~ ' * -- ..SlfLW Plant Asbffestoa Company Coast Insulating Armstrong Contr. I72i hr; 30 * [0 * Jan. Mar. April May June July Aug. Sept. Oct. KDoevc*. Jan. Feb. Her. Apr. May June Aug. Sept. Oct. N ov , De c. I960 Reece Insulation K?i.0rc, heBroxAs6b6e5s?toa Phoenix, Arizona Los Angeles Cork iflSO 2 . Vathington i3|03 I II 17? 1 oa Anngeles 23* Plant Asbestoa 1206 I5 I4O V. 9th St. long Beech. Calif. K - " 1961 Plant nAsbeato * H Mundet Cork Corp. 6116 Welker Ave. MCaalywoEotadt,CfCtolmipfa.ny 'r a 872 102 ' 32 If Xioe r xe& ^0 0el if. i-ibarrj.fi* engineering Plant Aebesioa Co. 10 3C6 4 6 LONS B FAC H LONG BUCH 1 , <, A O RNIA G M F U C D 4 0411 industrial indemnity c o m p a n y January 16, 1963 Industrial Accident Commission 236 East Third Street Long Beach, California rrV"J*** fir- -, I^ , *; ,. jArj 1 7 i^ 11^.,,. ______ 1I__. i. I.A.C.N.: 62 LB 19396 Claimant: John D. Staples Employer: Plant Asbestos Co. Claim No: C62-43*09355 Gentlemen: A fully executed copy of the Compromise and Release Agreedate to the Carriers listed ment is being served on this below. Th# oriainal of this agreement has been submitted to the C o m m ?ssfor^bythe off ice of St.phenJ G r o g a n a n d a c o p y retained hbwy MMrr-. GGrroogaaann as well as the office or Oliver, McWi11iams & Sherman. Aetna Casualty and Surety, 81 0 South Spring, Los Angeles American Motorist Ins. Co., 35^5 Wilshire, Los Angeles American Employers Ins. Co., 39 S. New Ha,mpshire, Los Angeles, Argonaut Insurance Co., 1001 Wilshire Blvd., Lcs Angeles Casualty Ins. Co. of Calif, 810 South Spring. Los Angeles National Automobile and Casualty, 639 South Spring, Los Angeles Pacific Employers Ins. Co., Zhbk 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 y .-Sr*-* ti `Sfef/y.-j^jas^rM^g; TEAM EN J. OAOOAN M A U A IC E A, H O O A N , J A , J A M E S A. M E L L O N (/ iaw opricct STEPH EN J. G R O G A N ^ ; I* SOUTH WCfTMORFiANO Avjiu' 1 'A ` LOS ANGELES ' ' ,:"l# OUAA,AA.,,., X1- t -- i'Ci ma January 10,1963. Industrial Accident Commission 236 East Third Long Beach, California Gentlemen: Enclosed for approval you will find executed Compromise and Release in the above case. Very truly yours, SJG.-as Enclosure cc Attvs. Silver, McWilliams Sherman 303# North Avalon Boulevard Wilmington, California * IDWIN SILVER Rich a r d l McWil l ia m s ARTHUR SHERMAN LOUIS BERSON LAWRENCE WETIZKR LAW OFFICES silver, McWilliams & sherman JOSH NORTH AVALON BOULEVARD WILMINGTON, CALIFORNIA TERMINAL 4-3S99 8PRUCI S-S13 u m im omci MITCALH t>e IILVIR U l f OUT* MAIN 4TRIIT I U H U I T -O .II 6 l> November Sixth Nineteen Hundred Sixty Two Industrial Accident Commission 236 East Third Street Long Beach, California CCH: ;-\lH N'J'I & i-rii AMI htii) ^ -- E j j ___ 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. F Medical expenses to date are $451.00, consisting of $166.00 to Dr. George Fralick, $145.00 to LaMirada Hospital and $140.00 tor X-rays and laboratory tests, or, in round figures. $450.00. leaving a balance of $8,800.00. Due to the nature of the applicant's condition, the sum of $1,000.00 is allocated to future medical treatment and/or observation, leaving a balance of $7,800.00 for temporary and permanent disability. The period of temporary disability involved is March 7 1962 to October 1, 1962, or, for purposes hereof, $2,100.00! * Based upon the nature and extent of the applicant's con- drtion as reflected in the medical file and also because he u ^ Una?le to reCurn to his ^ a d e , the potential permanent iS-r'estimated at 60 to 65%, or for purposes hereof, $13,000.00. Total potential liability is therefore $15,000.00, ana, consequently, that portion of the balance of the proceeds which may be deemed based on liability for temporary disability is represented by the fraction 21/151 or $1,084.00. For the * period of temporary disability involved, compensation is Payable under the terms of the settlement at the rate of 5.21 per day; and inasmuch as the Department's lien covers of 182 day B * they would be entitled to the sum of vJdd.22 plus $48.00 expended ior hospitalization benefits or a total of $996.22. Page 2 said^sum^is S L i d e r f ^ f L ? TM 1 ircu? stances of the case, as the ^ Yours very truly, s i l v e r , M cW i l l i a m s & s h e r m a n _ a* o/' ~~<-Jlj4L _ P i c k a r d x . M cW i l l i a m s RLMcW:bc cc: C l o p t o n ^ ^ e n n y 1^ 10^111611*"* P **Box 1466 > Santa A n a Travelers^Long^each8 * Aetna Cas & Surety t a " *' Herlihy & Herlihy, Long Beach NNaattiioonnaall'3A]'uto & Cas Long Beach Murray Roberts(Attn: Mr. Thomason) Michigan Mutual Liab. ^ American Motorists * American Employers Pacific Employers, Long Beach EDWIN SILVER r ich a r d l McWillia m s ARTHUR SHERMAN LOUIS PERSON LAWRENCE WITTIER u LAW OFFICES silver, McWilliams & sherman J03W NORTH AVALON BOULEVARD WILMINGTON, CALIFORNIA TERMINAL 4-2993 SFRUC* S-31M AHTA ANA OmCt MITCALFR AN ILVIR t ilt NORTH MAIN (TtttT UNMUT -001I November Seventh Nineteen Hundred Sixty Two *H2 hifa - Industrial Accident Commission 236 E. Third Street Long Beach, California Re: John D. Staples v. Plant Asbestos, et al, 62 LB 19396 Gentlemen: Line 7 of paragraph 3, page 1, of my letter dated November 6, 1962, should read $15,100.00 instead of $15,000.00 as the amount of total potential liability* Thank you Very truly yours, silver, mcwilliahs & sherman RLMcW:bc cc: Department of Employment, P.0. Box 1466, Santa Ana O k4b InitiaiiViii>i^MMiaiiaa^jiiM^^ .L iHMk \ CLOPTON & PENNY h'- r ' Attorneys at Law V, 4 639 South Spring Street Los Angeles 14, California 'JG O- 1 '-'H MAdlson 7*156 6 iy& INDUSTRIAL ACCIDENT COMMISSION Long Beaeh, C a lifo r n ia August f l , 1962 ' -'.7 RE: John Stap les v s . Coast In s u la tin g , e t a l Gentlemen : Case No. 62 LB 19396 Hearing Date O ct. 5 , 1962 Our Pile # 19963 and A Your attention is respectfully invited to the following: I ( ) Attached please find duly executed Compromise & Release 1 for your approval. | ( ) Request is hereby made for further hearing to permit cross examination of * and presentation of rebuttal evidence. ---- ' ( X ) Please notify us of any hearings or other proceedings +.U*16 a^ ove matter. We anticipate making an appearance, either special or general, on behalf of P a c ific -- g*r<,ra *n s * ______ 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: WHKtkb Copies sent to: S i l v e r , McWilliams & Sherman Pac. Bmp. - L .A . 71 PC 7361*3 * 736^1 Very truly yours, 3PT0N & PENNY '//J, WILLIAM H. KENNEDY Office Manager CALC AO O*M HtHANDM ** iy HERLIHY & HERLIHY a T T O U N C Y * A T I.AW .U .T ...A A A A C W AA`- - U'l-0,Ma I I I I T !** T " T _______* a 14. C A U rO H M I* August 22, 1962 t*-> . UJNO SACH O ffIC I OCEAN CENTER U lLD IH a ,,o W il t Oc c am auvo. UONO EACH *. C A L.rO A N .A TELEPH O NE H I K L .1 4 A * A'if;?. ?'0 .iffly-'r* 1 I n d u s t r ia l Accident Commission 236 East Third Street Long Beach. California __ .um a s b e s t o s Re. JOHN D. f f ^ ^ T ^ U R A N C E COMPANY EMPLOYERS LIABILII*__K _ iq62 - 9-00 * Dear Sirs* record in th0 please enter cur "P f " " "n e ^ e f e n d ^ i n s u r a n c e carrier. ^ y ^ B I L I T Y ASSURANCE.* * the Please serve u s ' request^that^ applicant *^ nt.r serve upon the d e f e n d ^ ^ ^ * * h e r m h y * SSSL1' $ h z By Attorneys'Vor* A W & n t a . KTJ/mhh 0C! SILVER, MC WILLIAMS & SHERMAN ATTORNEYS a t l aw 305J North Avalon Blva. Wilmington, Calif \\ /6 DOUOUA* K, WALLACE W. Q C R A k O B R O W N 0 W a l l a c e 8c B r o w n - A TTO R N EYS AT LAW 3 0 0 W C S r C O A S T H *O H WAV NEW PORT BEACH, CALIFO RN IA August 8, 1962 TCLKRHONE MIDWAY 6 * 4 4 0 0 r In d u s tr ia l Accident Commission 236 East Third S tre e t Long Beach, C a lifo r n ia Subject: John B. Staples vs. Baker-Perkins, et a l l . A . C . No. 62 LB 19396 Gentlemen: This o f f i c e represents the Aetna Casualty and Surety Company c a r r ie r fo r defendant Kundet Cork Corp. , in the above t it le d siatter. Defendant submits no medical reports a t t h is time as none are in i t s possession. By carbon copy of th is letter attorneys fo r the a p p li cant are asked to submit copies o f a l l medical reports in th eir possession to th is o ffic e . Very tru ly yours W. Gerald Brown WGBrsr CC: S ilv e r McWilliams & Sherman Attorneys a t Law 305% North Avalon Wilmington, C alifo rn ia HR'IP) Kill .UIl il 'P H;-*-MS>i*Y*** * - " r r o D. s h o w n StKKftAi. MANASE* SAN ri o orne CO. CALIFORNIA i_,. v a a d t v RANDY F. MOWOMTH M A N A !. A O U T H A A ^ ^ K 'OANtA BROWN BROTHERS ADJUSTERS FOUNDED H U BY ARTHUR * BROW N I , t tK k c a ii a d o r i r i f l y t o >917 W E I T SIXTH S T R IC T LO ANOCLCS 9. CALIFORNIA R A N D Y F. H O W O R T H MANARAN July 27, 1962 F H O N C D U NKINK 7 - J I In Youn Reply PLKAIKOtVAOUN NILENO.LA 28717 C /R NO. jrTF/rn intv? ".'.L Arci^Ri COMMISSION -- iU;C BUCH Department of Industrial Relations 236 Cast 3rd Street, Room 237 Long Beach 12, California Attention: Lenore M. Kruger, Clerk Industrial Accident Commission JIA3 01M6J U j F".:,| ........ _ __Uvili... Re: Case Ho. 62 LB 19396 JOHN D. STAPLES -vsC. F. BRAUN, ET AL Gentlemen: This will acknowledge your letter of May 29, 1962 addressed to BakerPerkins in Saginaw, Michigan. Please be advised that Baker-Perkins, Inc. is insured for Workmen's Compensation with the Michigan Mutual Liability Company and that this insurance company is represented by the undersigned. Kindly show copies of future correspondence to the Michigan Mutual Liability Company care of this office. Your kind attention to this matter will be appreciated. Very jtrtrty-*yours , BRpWN BROTHERS ADJUSTERS CA LrO N N lA o f f i c i SAf1RF'Si l* *44* J LINQONUUWROEAOCOH IL CZHTIO t L?h* * A LOS ANGELE WiRTtVILU f ? tiNrt WAR WAR* MK'rSTO MONTEREY OAKLAND PALM FRINII FASAT'f NA FREOT.' >MNAa REDWOOD CITY 43 ADJUSTING OFFICES--- EAACLIRNAAMSSNTO RAANN R.'iHRuNOAROINO RRAANN JM-IA`ENOICO SAN LU' OR!*RO SsAaNn:RaA*ANIAL SANIA RAARARA SANIA MANIA 41.1* M'V* TTUOLCARAETON VAL LIJO VVAENNTUURATI ARIZONA r r t e t * FTMUOCfScONNIS N EVADA O FFICE # LAI VtAR M *0 ORTGON OFFICES FI lOkR*iHnAcND WAMBiNllI N a r O N O F F I C E # FOKANl , =3S=- j-sC. - ' ---'*>' r r Page 2 <-l2. t/13. / Cl5. 16. 17. 18. 19. . 20 21. 22. J. T. Thorpe by A m e r i c a Motorists Ins. Co., prii-fov No SCM-4J1898, 1--1-- jo/ _ , R T ^Dinwiddle b y State, Compensation Ins. Fund, lilliv N?: P-W027-58, 7-1-58/59 Fiberglas Engineer!^ by Aetna Cas. & Surety, Pollcv No. 31C-926-RR, 9-1-58/59 _ ,, r_ Reece^Insulation by National Auto & Cas. Ins. Co., Klrcher^Asbescos - - No record of coverage. PlanAs b e s t o s by industrial Indemnity, Policy No. CC-600091, Y Y ^ t v i * Policv No. CC-611154, 1-1-61/oZ Mundet Cork C o r p ., * i S a s E | J r I n g b? A e g ^ c S l S S * . 23. It t % rer : f o L t f 5 e e n d S f h S l i i eUi p y ^ t S " be joined as patty e a COT)V Qf medical reports heretofore0filed uithW the C o n J L l o n is being served con currently on each of the carriers named. .. -psnectfully requested that the matter be restored " calendar a S aet for a one-day hearing. s i l v e r , M cW i l l i a m s & s h e r m a n / 'j.t/vfi A / t *-- v r i c h a r d l . M cW i l l i a m s RLMcW :bc cc: (with enclosures) all carriers listed i D O U O L A 8 Hi W ALLACE W. O CH A LD SHOW N W a l l a c e : 6c B r o w n A T T O R N C V S AT LAW l o o W EST COAST HIGHWAY KBW POBT BEACH, C A LiroU N JA Jun 14, 1862 In d u stria l Accident Commission 236 East Third S tr e e t, Room 237 Long Beach, C a lifo r n ia telephone MIDWAY 0 * 4 4 5 8 cr.ivT* tNDilVM MClOfKi COMMiiSIGrt -- LGf u KACH JUN 181962 *kD f'i.rp__________ -______ __ _______ CA2i:D--___________ __iuUS Subject: Gentlemen: John D. Staples v s. C. F . Braun, et a l I . A . C . No. 62 LB 19396 This o f f i c e represents the Aetna Casualty and Surety Company, c a r r ie r fo r defendant Fib erglas Engineering Company, in the above t i t l e d m atter. Defendant submits no stadial reports a t th is time a t none are in defendant' s possession. By carbon copy o f t h is l e t t e r , attorneys fo r the a p p li cant are asked to subsiit copies of a l l stadic a l reports in their possession to th is o ffic e . Very tru ly yours W. Gerald Brown WGB:sr CC: S ilv e r 4 McWilliams Attorneys a t Law . 305% North Avalon Boulevard Wilmington, Californka MOM "Automobile and Casualty' Insurance Co. h o m i orrici-t.0 a n o i l i b a* I Q U T H I M I N O S T R I C T M AIL A O D B C B B -B O X 7 * 0 , M ITRO . STATION LO B A N O IL C B BB, O A Lir. M AD ISO N B-B B B 3 3S05ekI*fic#orth Avalon B*lvSd.tarata WXIttinfiton, California *?* Cl; 7 J i u m 12, l<j62 1ST .rr/m toMM:SSnJ`v '"^ry, """ A > iSBi uQ ' . , ' tic, ' Gentlemens Damata la ha all medical importa or under hia Ipplici&tu attorney for 't a t t e r la hla paaaaaaloa z*7Tf Itruly yours* *+*. HCummin* " C om pensation C la im ac* Indue t r i a l Aeoldent 236 East Third ^ on Beach, C a U f o r n U risi a m d c a s u a l t y NSUSAMCt riOlLITY AND BUSIT SONO D IV IflO N O F ADMINISTRATION MARRARCV RITCHII. MISS CONCILIATION RtltVJCC LIM N ROW S, RUMTIVitOR DIVISION o r ARRMENTICCRMIR STANDARDS CMARLIR r, MAMMA. AMISS ' DIVISION o r MOUSINO LOW RAL N IH O N , CHIIF OIVISION o r INDUSTRIAL ACCIDENTS S. W. NACOONALR. CHAIRMAN xP STATE OF CALIFORNIA Y ' J , `i DIVISION o r INDUSTRIAL. SA rffTY IDMUND 0 . tROWN JOHN l HINNINO Dlrscfor DIVISION o r INDUSTRIAL WKLFARC Fl o r e n c e . cu r r e * , CMtsr DIVISION o r LASOR LAW ENFORCEMENT CtRMWNO ARTWITI, CHIEF d iv isio n o r la b o r sta tistic s a n o r is s a r c i MAURICI I. TNRON, MIRI DEPARTMENT OF INDUSTRIAL RELATIONS HEADQUARTERS' 9AJ MISSION STREET, SAN FRANCISCO 3 __ ______ __ STATI COMPENSATION INSURANCE FUND "" " ' ADDRESS REPLY TOi . i f Mav 29, 1962 236 D. Third Street, Room 237 Long Beach 12, California HEmlock 5-8367 . Baker Perkins 10n0 Hess Ave. Saginaw, Michigan 62 LB 19396 m>c o^ no CO } * runo *T *T\ On May 2tf, 1962 Claim was filed by an Application for Adjustmer t oft j 0hn D. Staples lldgirig* injury pp between 1952 to March 7, 1962 The application does not show the name of your workmen's compensation insurance carrier. M i l you please give us J . information in the space provided below. If you are not insured, please state the reason. Since the Commission joins ^he insurance carrier as defendant in these cases, your carrier should be notified t iat the above application has been filed. You will receive Notice of Hearing as socn as the claim has been p U c S l n " hS Sllelar. If you sr. neither eelf-lneured nor have a workmen's compensation insurance policy, you should attend the hearing for your own protection. The prompt return of this form will be very much appreciated. Yours very truly . Lenore M. Kruger ' Clerk INDUSTRIAL ACCIDENT COMMISSION ,, __ . nw 3TTT q a t t o n Michiqan Mutual Liability Comp a n y N A S S e?n/ EI;SATl0N 102 Chamber of C o m m e r c e Bldg. INSURANCE COi TAI Y. ------------- Sagtn3W7 Mirhtgan -- -- 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. MO*- STATE OF CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION Mundet Cork Corporation 6ll6 Walker Avenue Maywood, California May 29, 1962 236 E. Third Street, Room 23f Long Beach 2, California Hemlock 50367 *,v! iMMi; ft ' 62 LB 1939 JUN 1 1196? m On May 1962 an Application for Adjustment of Claim was filed by John D# staples alleging injury np/ between 1953 and March 7, 1962 The application does not shew the name of your workmen's compensation insurance carrier. Will you please give us this information in t he space provided below. If you are not insured, please state the reason. * Since the Commission joins the insurance carrier as defendant in these cases, your carrier should be notified that, the above application has been filed. Tou will receive Notice of Hearing as soon as the claim has been placed on the calendar. If you are neither self-insured nor have a workmen*s compensation insurance policy, you should attend the hearing for your own protection. The prompt return of this form will be very much appreciated. Yours very truly Lenore M. Kruger Clerk INDUSTRIAL ACCIDENT COMMISSION NAME OF W O R KMEN'S COMPENSATION INSURANCE COMPANY: AETmNmA**CmAm-SmUm>AmLmTmYmm&m mSmUmRmETYmmCmOmMmPmAMN*Y NOTICE: The law provides that failure on the part of the employer, for a period of ten days to furnish this information constitutes prima facie evidence that the employer has failed or neglected to secure the payment of compensation. The law further provides that failure to secure the payment of compensation is a misdemeanor. STATE OF CALIFORNIA INDUSTRIAL ACCIDENT CmvssiOti pffTf/rtj tOmkS!! ^ 819G2 Ako niro -- IbUkli. sctis& Reece Insulation 4563 Valley Blvd. Los Angeles 32, California 236 E. Third Street, Room 237 Hem?ocBr & 3V alif TM la 62 LB 19396 was filed hv^ 2gi i96n o an APPlication for Adjustment of Claim iinnijuuirvy on bi19Q5,,3 ftoohMP,arDc*h S7t,ap1l9e6s2 'm .. J a l l e g^i n^g The application does net show the name of veur workmens i n S ^ 3??10"183^ 91100 carrier* w i H you please give us this oplxeesaasfet^sttaatte1tfhhteh ereasspoanc.e P r o d d e d below. If you are not insured, X ? ? he Coramission Joi" 8 th insurance carrier as defendant in ??e9* J 0WL carri?r should be notified that the above - application has been filed. ^ c e i v e Notice L KearlnS a soon as the claim has been placed on the calendar. If you are neither self-insured nor have /San2rime; 8 comPensation insurance policy, you should attend the 'nearing for your own protection. The prompt return of this form will be very much appreciated. NA OF WORKMEN3 COMPENSATION INSURANCE COMPANY? _ Yours very truly JL. wj* ... > . r M l I.nore M. Kruger * Clerk INDUSTRIAL ACCIDENT COMMISSION t v * t v s's*/_< V 7?_ Z g lfTL 6 ^ NOTICE? The law provides that failure on the part of the employer, for a period of ten day9 to furnish this Information constitutes prima facie evidence that the employer has iailed or neglected to secure the payment of compensation. The law further provides that failure to secure the payment of compensation is a misdemeanor. STATE CF CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION Armstrong Contractor UUOO East Bandini Los Angeles, California May 2tf, 1^62 236 E. Third Street, Room 237 Long Beach 12, California Hemlock 5-B367 (?r.;rp/o) 62 LB 19396 M 61962 0n m ,,v 28, 1Q62 an Application for Adjustment of^leim was filed by John D. Staples injury 'Vy between 1953 and March 7, 1962 The application dees not show thew Je p l ^ s ^ g i ^ r u s this i S TM l u o S n iint " c e ^ " i e d below. If you are not insured, please state the reason, . sss 1B application has been filed. You will receive Notice of Hearing ther^elf-insured nor have placed on the calendar. " ^ c y you should attend the a workmen's compensation insurance policy, y hearing for your own protection. The prompt return o f t h i s form w i ll b . ary much appreciated. Yours very tru ly Ienore M. Kruger Clerk INDUSTRIAL ACCIDENT COMMISSION m amt fF W O R K M E N 'S COMPENSATION I n s u r a n c e c o m p a n , _________________ ---------------------------------------------------------------------------------- NOTICEi , a j e.w-4- r . n u r e on the part of the employer, The law provides that f a i l ^ burnish this information for a period of that the employer has constitutes J a? i % * c u r e the payment of compensation, failed or neglected to s failure to secure the The law further provides that laixure payment of compensation is a mis > - P L A N T A S B E S T O S C O M P A N Y * m M M m E N G___I_N___E_,,E,,R,,S ,, rCnOMNT Tl lR AACCTTOO RR SS u ik tT U K T EM EKYVIILE I . CALIFORN IA 1S40 - WEST HE STBEET LONG BEACH. CALIFORNIA OL 3-8371 HE 7-0443 Juno 1, 1962 State of California Industrial Accident Coission 236 E. Third Street, Room 237 Long Beach 2, California Atta n tion: Lanora K. Kruger, Clark Subject: 62 LB 19396 John P. Staples Gentlemen: M t h r..r.M. t^your v) rrir-.f COMMISSIONI' il'VC9 \HJN 6 m V**i 41;iD .. . -- ..r.v.,u .. ------------- aEt r J y w n Cf.ni1e,i53 Y"OdU ,htaovrechre7q-uested the name o'tf our^Workaen's Comp*tion Insurance Carrier which Is as follows: Aswriean Employers Insurance Co. 639 South New Hampshire Straat Los Angelas, C aliforn ia . ..... S t Boiicy Bo. A-19-8102-001 Expiras 1/1/63 Should there be any further information which you - y d e s ir e , please le t us know. Vary tr u ly yours. PLANT asbestos company 0* Paul 6. Nieto Vice President PGN:bw _ cc: American Employers Insurance Co. j ,> t l B 1 H 1 A i . cH 1r*1 I*CkI ' STATE o f c a l i f o k n i a INDUSTRIAL ACCIDENT COMMISSION Kircher Asbestos Post Office Box 6652 Phoenix, Arizona May 2 $ , 1962 I-ons Beach 2 California"' Hemlock 5-367 pfCtvrj 62 LB 1939% wwiww irm'Ri coKMisyr,. - 4 W ils Afct. -- 1. Win Hi I, I On May 28, 1 9 6 2 an Application for Adjustment of Claim was filed by John D, Staples alleging injury/jn between 1953 and March 7, 1962 The application does not show the name of your workmens compensation insurance carrier. Will you please give us this information in the spae "provided below. If you are not insured, please state the r eason j' K Since the Commission joins the insurance carrier as defendant in these cases, your carrier should be notified that the above application has been filed. You will receive Notice of Hearing as soon as the claim has been placed on the calendar. If you are neither self-insured nor have a workmens compensation insurance policy, you should attend the hearing for your own protection. The prompt return of this form will be very much appreciated. lours very truly NAME OF WORKMENS CO INSURANCE COMPANYt Lenore'M. Kruger9 Clerk INDUSTRIAL ACCIDENT COMMISSION pj* JvffVj 0 NOTICE* The law provides that railinre 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. II w STATE OF CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION . M W * ; : .. <4 ^ 4 962 4W) (["n -- j'iiiJ-- r Fiberglass Engineering 5Q33 Telegranh Road Los Angele s 22, California , f'0 May 2ft, 19621 ^ 236 E. Third Street. Room 237 Long Beach 2, California HEmlock 5-ft^o7 62 LB 19396 0n Kav 28, 1062 an Application for Adjustment o^Clai i n j u ^ # f t t ^ l f o W S S h 7, 162 The application daes "e* ? ! j ^ p l e a s e | i v e "us this compensation insurance * dW ieloi! If you are not insured, information, in t he space provided below, xx y please state the reason. these cases^'your'carrier^should^i^'notified^ha^th^abova11^ " application has been filed. You will receive Notice of Hearing 48 f J J ^ s e l f - i n s u r ^ u o r have p S c S o n l h e calendar. If yu n^ e^ S c 5 you ahoS!^attend the l workmen's compensation insurance policy, you a hearing for your own protection. The prompt return o f t h is fore, w i l l be very much appreciate . Tours very truly Lenore M. Kruger INDUSTRIAL ACCIDENT COMMISSION NAU*MiEf OviF WnvO*RK*MEN'S COMPENSATION AtzTfl/A L,fB ^ 2 ? - - INSURANCE COMPANaY,)v . --------------------_ ----------------/L - - - - 7^7 ~ . NOTICE: The law d a y s ^ o fSrnishPthisinformation constitutes prima facie evid*n^payment ^compensation, failed or neglected to secure Pjjnent^ Thr law further provides that laxxu Ivn..n? of compensation is a misdemeanor. I STATE INDUSTRIAL OF CALIFORNIA ACCIDENT COMMISSION May ?S, 1962 RFfrVR COMMi'CN- H'lGGE4CH JUN 41962 A U fit.!?) _______________ ,, __ &U..S1T___ CicO___ -- -- T- ----------- - IE U-.* R. T. Dinwiddie $627 South Atlantic Avenue South Gate, California 216 E. Third Street, Room 237 Lonff Beach 2, California Hemlock 5-3367 62 LB 1939% On May 23, 1962 an Application for Adjustment of Claim was filed by John D. Staples alleging injury oty between 1^53 and March 7, 1962 The application does not shew the name of your workmen*3 compensation insurance carrier. Will you please give us this information in the space provided below. If you are not insured, please state the reason. Since the Commission joins the insurance carrier as defendant in these cases, your carrier should be notified that the above application has been filed. You will receive Notice of Hearing as soon as the claim has been placed on the calendar. If you are neither self-insured nor have a workmen*s compensation insurance policy, you should attend the hearing for your own protection. The prompt return of this form will be very much appreciated. Yours very tru^Ly Lenore M. Kruper * Clerk INDUSTRIAL ACCIDENT COMMISSION NAME OF WORKMENS COMPENS INSURANCE COMPANY: NOTICE: The law provides that failure on the part of the employer, for a period of ten days to furnish tnis information constitutes prima facie evidence that the employer has failed or neglected to secure the payment of compensation. The law further provides that failure to secure the payment of compensation is a misdemeanor. STATE OF CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION Cal State Company S23 Mettler Street Los Angeles 3, California 0n May 2, 1962 May 29, 1962 236 E. Third Street, Room 237 Long Beach 2, California 'JUN 41962 AW fHH> .. --- __ Eiiiaa___ o.si - _________________ ____ ILffcaOE an Application for Adjustment of Claim alleging The application does not show the name of your workmen s compensation insurance carrier. Will you please give us this information in t he space provided below. If you are not insured, please state the reason. Since the Commission joins the insurance carrier as defendant in these cases, your carrier should be notified that the above application has been filed. You will receive Notice of Hearing as soon as the claim has been placed on the calendar. If you are neither self-insured nor have a workmen*s compensation insurance policy, you should attend the hearing for your own protection. The prompt return of this form will be very much appreciated. Tours very truly \ NAME OF WORKMEN'S COMPENSATION INSURANCE COMPANY! _ Lenore M. Kruger, Clerk INDUSTRIAL ACCIDENT COMMISSION A rgo n au t Insurance Co. 1001 VilBhire_Blvd^ Jx>s_ Angeles ^17^ alif NOTICEj The law f. or a provides that p* eri_ od- of ten failure d. ays t. o on the part fA u. rnii s_ hL* ^thU i4 s< i4 nn ftohervtmm aetmip4loonyer, constitutes prima facie evidence that the employer has failed or neglected to secure the payment of compensation. The law further provides that failure to oecure the payment of compensation is a misdemeanor. w cfAlF Of CAllfORNfA ft **T* . C H C M , *r*'M''e -1 UTJWOIPE* . V '`to-tiM* y'-y^y *N (y ` IOHN HIM'. f.'O '. null' '11111M * l * P l H " * * 1**' ,,..u r >` 1 ** / ^ CiV. ,, o n o k r M i h ' i t . " 1' 1 / <** +*?*' f (N<4i * a n *. o tv i.to n o r t* t A T .r T I C * * Bikui|i(. . ............. ** c" " DIVISIONAPd lHiOAUU*lfik*S .ONILI. m%t.9on, CHIA* OIVI*IO o r IN0U1T!. e cu . CCCC . ro rlN . T > o m .u . c roNO B ' tA^t - ,,TilfW T O F INDUSTRIAL RELATIONS t ...r. -- -- ........ . :NtNO. .*J:' 'DEPARTMENT u r ,*n c isc o s A C f- - ,,^DOUAHTWS: M5 MISSION STET. SAN A0MfS1 ,m t TO, P wr -V-'ivVK ' -15ft]) f;`av 2 " 1 l i t > 2 Room 237 2 3 6 D. Third S - ^ ^ o r n i a LHoLnngloBcka 5h-<8^36dtA .1. T. Thorne ,, Ao u1R0 Vc.. .S"^eCcOnTi'Ad Strre,,e;t-if-rt,na Los ^-nreies >* f . i.ri V*.*> y - ' * tA' 8B Application for W i * nlalm wa3?filei ty ''hn in3ury * c h o ^ e of y e - ^ below- I f you are S S T * * " 330n; 3 * . t r a n c e carrier Since the ^ " ^ f ^ r r i ' r should he notified application has been file1' && scon as You will receive iotlc of ? yQU are neither^el f^ " &ttend t e a^worVnen1sh cora''iensa ^ c t ioru ? * utad. hearing for your ^ i# fonn win be very much appre, The prompt return 0 vcry truly N \ s*\-rk &<** * ? i r ST w f i s s i o IlfPuD'hSTrJ-k--L * OP ; TtvghRANCB C/t'/Wt^1 T.- rYhaX failure on tn- pJa r t tvh-i'orLmtattoionn , n n'-ovi i 5 to furnish tm* clover has - t:,TICE, T h e ^ poi.l0ll c ^ n ^ y e etidc t h e t ^ ^,,^cneaticn. , r " ? H tfr'r,eh^ted ,t recur. ^ ctJC tee i;:; ^ :i 0p is n r i * STATE OF CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION t'frrtvrc COMMr.StN... m> ftfu JUN 11983 4*:i' ri p May 2d, 1962 - L J ; .. Vrf,7F 236 R. Third Street, Room 23$ Long Reach 2. California Hamlnrk Los Angeles Cork AlSO East Washington Los Angeles 22, California 62 LB 1939^ 0 n May 28, 1962 an Application for Adjustment of Claim was filed by John D. Staoles alleging injury fyl/ between 1953 and March 7, 1962 The application dees not shew the name of your workmen's compensation insurance carrier. Will you please give us this information in t he space provided below. If you are not insured, please state the reason* Since the Commission joins the insurance carrier as defendant in these cases, your carrier should be notified that the above application has been filed. You will receive Notice of Hearing aa aoon as the claim has been placed on the calendar. If you are neither self-insured nor nave 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 Lenoro M. Kruger * Clerk INDUSTRIAL ACCIDENT COMMISSION NAME OF W O R K M E N 'S COMPENSATION INSURANCE COMPANY* ]ji^ance_ Conpapi_________ 4465 wilshire Blvd, Los Angeles 5 Cal. 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 1allure to secure the payment of compensation is a misdemeanor. STATE OF CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION KflWl JUN 11G2 Oil Field Construction Post Office Box 947 Bakersfield, California May 29, 1962 236 East Third Street, Room 237 Long Beach 1 2 , California 62 LB 19396 On Mav 2#, 1962 an Application for Adjustment of Claim was filed by John D. Starles alleging injury H'd between 1953 and i*arch 7, 1Q62 The application does not shew the name of your workmens compensation insurance carrier. Will you please give us this information in t he space provided below. If you are not insured, please state the reason. Since the Commission joins the insurance carrier as defendant in these cases, your carrier should be notified that the above application has been filed. Tou will receive Notice of Hearing as soon as the claim has been placed on the calendar. If you are neither s e l f - i n s ^ e d nor a workmens 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. Krurrer^ Clerk NAME O F WORKMEN *S COMPENSATION Casualty Ine. 1953 thru 1957 INSURANCE COMPANYt _ jSttfiruCcaBpiiis^on--Insunane^-Bund *15^-thru .196 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. "et , . S r* " DIVISION O F ADMINISTRATION MAMSAAIT S. N tTC N tl CHIIP STATE OF CALIFORNIA DIVISION O f INDUSTRIAI. f A F f T t YM O M At N. IA U N S IS S . SM1IF CONCILIATION KRVIC S U N N I O W I R I , SURSftVISOJt DIVISIO N o r A P T R IM T IC C S H ir STAND ARD S CM A N C IA r , M AN NA, C N IIF EDMUND 0. MOWN O svsm sf JOHN f . HENNtNO Dirsetsr DIVISION or INDUSTNIAL W 1LFA N I rL O S IN C I S . C U F T S N . fc V ltF DIVISION or LABON LAW N ro N C S M tN T SISM UNO A S Y R IV t. M IF DIVISIO N O F NO U SIN S LS W IL L NILSON, C N lS r DIVISION or IN D USTNIAL ACCI D IN T * W. MACDONALD. CMAIVMAN DIVISION or LASON STATISTICS AND NSSCANCH t fA U S IC I I. S C S I N IN I O N . C M IIF DEPARTMENT OF INDUSTRIAL RELATIONS HEADQUARTERS' 963 MISSION STREET, SAN FRANCISCO 3 ADDRESS REFIT TO. May 29, 1962 C. F. Braun 1000 Fremount Street Alhambra, California 236 E. Third Street, Room 237 Long Beach 12, California HEmlock 5-6367 62 LB 19396 0n Mav 2S, 1962 an Application for Adjustment of Claim was filed by John D Staples alleging injury li between 1953 to i-iarch 7, 1962 The application does not show the name of your workmen's compensation insurance carrier. Will you please give us t is information in the space provided below. If you are not insured, please state the reason. Since the Commission joins the insurance carrier as defendant in these cases, your carrier should be notified t .at the above application has been filed. You will receive Notice of Hearing as soon as the claim has been placed on the calendar. If you are neither self-insured nor have a w o rkmen's compensation insurance policy, you should atte hearing for your own protection. The prompt return of this form will be very much appreciated. Yours very tru^y Clerk *0 s t a t e o f CALIFORNIA I" D U S n u 'a coMnssiar , to. Angeles 3 ? * ! ! , . -r J.yo4 P 6 E - H a r d Streak *&o% ^ 62 IB 193J96 M J m S d V 3' 1962, an Application c JUry 7) h.t 0hB Staple? The " "1 a p p l i c a t i o n ' d M ^ t i!arch 7- 62 Adjustment of eiai atlegln s - -'--a please state the r e a ^ n f Pronded brto. this Since the Commission loi ns"red, app Tou licat will ion'h a s receive t e n 1? ! l f d ^ P P t ^ t a ^ ' n o t i f i e d ^ h a ^ t h e ^ b ovVf013* *- S T hc o ; - - a i m has h..a r i n g for your owo prot^ u r a n c , policy. you a ^ T a l t ^ J thhaVe The prompt return of this fopm ^ ,, ` f0r WU1 b* - T - c h appreciated.' ours very truly t o t S S S w oogss. I NS UHA N C ATI 0N r-' wUtRUiMfciiii * iirHnHI-wa-frU., ^ ' APPLICANT: John D. Staines ATTY. FOR AAppr . Sql4iv2er &. M.C W i l H ams> I.WK CLAIMANT: ' 1063A Ceres, W h i t t i e r ^ 3051 N. Avalon Blvd., Wilmington^ DEFENDANTS: 1. Bak-er p0rkln8 J T # Thorpe J-C. -F, Braun Coast Insulating 5>. Oil Field Construction &, Armstrong Contractor 1-Fiberglass Engineering ?v Reece Insulation R. T; Dinwiddle 10- Kircher Asbestos U los`Angeles Cr>rk f** ^Plant Asbestos 1 3 Muhdet Cork Corn. Cal State Companv. ATTY. FOR DEFENDnNT 1000 Hess Ave. Saginaw, Michigan-/ E. 2nd St., Los Angeles 1& 1000 Fremont St., *lhambra v/ 26?^ Lac/ St., L03 Angeles 3 1 1 P.O. Box QA7, Bakersfield J AAO0 E. Bandini, Los A n g e l e s ^ , 5033 Telegraph Rd., Los Angeles 22l,y 4563 Valiev Blvd., Log Angeles 32^ --*63X^1. Atlantic , ,Su uth P.0. Box 6652 Phoenix, ArizonaJ 43.^0 E. Washington, Los Angeles 2 3 / 15A0 W. Qth St.. Long Beach ,, 6116 V/alker Ave., Maywood ^ **23 Mettier St., Los Anreles 3 INSURANCE CO. , a American Motorists Ins. Co. Casualty Insurance Co.H e<aJJL 9 State Compensation Ins. Fund Zurich Insurance Co. 3-Pacific Employers Ins. Co. Argonaut insurance Co. American Employers Ins. Co. % TM lers Insurance Co. ^nNKatZi-o-n~al Auto oScc oGaass.. uCo. i ' f t Casualty & Surety Co, 1 Michigan Mutual Liab. 5, a lio5qW 1SsPSrhiirneS Stl.v,dvLA 3629 Atlantic Ave., LB^ S,5, ^203, Terminal Annpx, LA 54 ' 24*4 Pacific Ave., LB ^ 1001 Wilshire Blvd,, LA ^ n S * New Hampshire, LA 5V Ocean Center Bldg.. LB 2 * Box 57*0, LA 55 V " , *10 S. Spring St., LA 14 c/o Brown Bros. Adjusters,^ 3517 West 6th St., A 5 V f*. c .< X fa a j~/v ' INSURANCE CO. ATTT. I 1 *7,WXXall__a__cfc.e____St Brown McCartney, Ryan, Trout & Dally 1 Murray Roberts 7 Herlihy & Herlihy J 630 s* 2.?* Hcy ' Newport Beach S22 " sPrin5 St., LA 14 ~ nOcneLaBnrrCaedn*tAevreTMBledg.W, iLlmB in2gt^on*^ ..... !* ( `,W ^ -- CLOPTON & PENNY il ? 3. SPWHQ 40S ANGELES 14, CAUPORNI4 . w * ^ Xcv/Co NATIONAL .Automobile and Casualty Insurance Co. h o m b o rn e s - l o . An g e le s .......... .............. November 30, 1972 63 S O U T H SPRING STREET MAIL A D D R E S S -- BOX S780 METRO. STATION LO S A N G E LE S . C A L If. 0095 2-959 Workmen's Compensation Appeals Board 107 South Broadway Los Angeles, California 90012 WCAB NO: 72 SO 31086 Arthur L. Hauk vs. Various Employers Cur File: 20815 Gentlemen : Would you kindly pull WCAB NO: 62 LB 19396. John Stapples vs. Various Employers, and advise this office whn 1t is available for review. Thanking you for your courtesy, we remain. Very truly yours, KC:an Marjorie Cummings, / Compensation Claims Examiner ? i #i M ARINE AND c A U A i ** IN S U R A N C E r i D I l I T A N D <; II f H HONOR /V -- I l -.. -ii.rt.l * ,, . . . . . i . . . im r I 'll I x-\ V 1 BEFORE THE INDUSTRIAL ACCIDENT COMMISSION OF THE STATE OF CALIFORNIA 2 CASE NO. 62 LB 19396 3 4 JOHN D. STAPLES, 5 ) Applicant ) 6 -vs - ) 7 BAKER PERKINS; J. T. THORPE; ) C. F. BRAUN; COAST INSULATING; 8 OIL FIELD CONSTRUCTION; ) ARMSTRONG CONTRACTOR; 9 ihjj h xwaETTT.. _ ___R_E_E_CE ) In s u l a t i o n ; r . t ". d i n w i d d i e ; 10 KIRCHER ASBESTOS; MUNDET CORK CORP.: ) LOS ANGELES CORK; T!a L STA'i' COMPANY; 11 PLANT ASBESTOS; ) AMERICAN MOTORISTS INSURANCE CO.; 12 CASUALTY INS. CO. OF CALIFORNIA; ) STATE COMPENSATION INS. FUND; 13 ZURICH INSURANCE COMPANY; ) PACIFIC EMPLOYERS INSURANCE CO.; 14 ARGONAUT INSURANCE COMPANY; TRAVELERS INSURANCE COMPANY; 15 NATIONAL AUTO 4 CASUALTY COMPANY; AETNA CASUALTY & SURETY COMPANY; 16 MICHIGAN MUTUAL LIABILITY COMPANY; INDUSTRIAL INDEMNITY COMPANY; 17 AMERICAN EMPLOYERS INSURANCE CO., ) 18 Defendants ) 19 ORDER APPROVING COMPROMISE AND RELEASE 20 The parties to the above entitled action having filed a C o m 21 promise and Release herein, on January 11, 19 6 3 , settling the above 22 case for $9 *250,00 in addition to all sums which may have been paid 23 previously, and requesting that it be approved; and this Commission 24 having considered the entire record, including said Compromise and 25 Release, now finds that it should be approved; and, 26 GOOD CAUSE APPEARING THEREFOR: IT IS ORDERED that said C om 27 promise and Release be, and it is hereby approved, payable as follows: 28 (a) B y Industrial Indemnity Company: $2,221.95 ^ To: Dept, of Employment, lien claimant 29 Silver, McWilliams 4 Sherman, lien claimants $996.22 5 0 .0 0 30 John D. Staples, applicant 1175.73 -1 - - FOJ4 3 3 9 i -C 3 I t lJ M 35 I' M wmtmrnmm PPS i 1 S' Casualty ft Surety Co. *1Q1o 2 * 0iJ?o;lhJnV6DJ.* MStcaWpillelsi,amsappftliSchaenrtman as a t6^t ro nr en ye ys s ' ffeeee *7 $750.00 1168.70 3 designated:"* ^ * " * b* Paid t0 PP11'" * by carriers as 4 Pacific Employers Ins. Co. American Motorists In. Co. $1,415.05 5 Travelers Insurance Co. 1,005.90 State Compensation Insurance Fund 6 National Automobile ft Casualty Ins, Co, American Employers Ins. Co. 821.80 800.00 703.85 7 Zurich Insurance Company 120.75 Casualty Ins. Co. of California 8 Michigan Mutual Liability 120.40 57.40 39.20 9 Total 9,25205..0000 10 11 12 INDUSTRIAL ACCIDENT COMMISSION 13 GWica 1.31.63 14 62 LB 19396 15 DATE FEB 1 - 1963 ^ Names and Address of Persons Served: 16 - John D. Staples, 10634 Ceres, Whittier 17 - ^Deiptr, roAf/ E^mpiliolyiamienn3tfc,& PG.her0m.anB,ox 1477,N *SAavnatlaonA,na Wilmin*gton 18 - .Armstrong canntnn+ATM 4400 E. Bandini, C . F . Braun, JW0 Fremont St., Alhambra Los Angeles g 19 - 20 - MH* Cal State Company, 8823 Mettler St., Los Angeles 5R;0a.TJ f'c Dinwiddle, 8627 So. AtlSatn"ticL,os SAonugtehleGsate Fibergiass Engineering, 5933 Telegraph Rd., Los Angeles 31 -- KKiirrcchher5eAAqshbesCt?o^sk,, Bolx806J;6*5o2^W,aPshhoienngitxo,n, ALroiszonAangeles g Mundet Cork. C o m .. fing Walker, Maywood 22 - Si f 1! 1? Construction. Box 947, Bakersfield 23 - Plant Baker Asbestos Perkins, Co., 1000 1540 W. 9th, Long Beach Hess, Saginaw, Michigan HH 24 f.r. vaiiey B i a d - Los Ang-el-es 25 26 g g s g s s s a ; s a i Casualty Ins. Co. of Calif., 8l0 South Spring, L o ^ A n ^ l e s j Industrial Indemnity Co., 3745 Long Beach Blvd., LonS Belch ! 3629 UUaI Llabillty c/o Brown Bros. Adjustors, 3517 w 6th L A 1 S i } ? ? 111!!" ?0 * Casualty C o . , 639 S. Spring St., Los nglles Pacific Employers Ins. Co., 2484 Pacific A?e., Long Beafh !TrSaiv!elie2r2s P?Inns#uartaln0cne ISCo8.*, POucneda*n CenteAtrlBalndtgi.c, ALvoen.g,flLBoenagchBeach j! Zurich Insurance Company, Box 3203, Tenniral AnSfx, l Ss Angeles j Mown 339 9 i * j 11 t* 10M i p -: - 2Dated at tong Beach California FEB 1 - 1963 * 4 $ / ''N N 0* CASE NO. 62 LB 19396 JOHN D. STAPLES BAKER PERKINS; J. T. THORPE; C. F. BRAUN; COAST INSULATING; OIL FIELD CONSTRUCTION; ARMSTRONG CONTRACTOR; FIBERGLASS ENGINEERING; REECE INSULATION; R. T. DINWIDDIE; PLANT ASBESTOS; MUNDET CORK CORP.; LOS ANOELES CORK; KIRCHER ASBESTOS CAL STATE COMPANY; AMERICAN MOTORISTS INS. CO.; CASUALTY INS. CO. OF CALIFORNIA; STATE COMPENSATION INS. FUND; ZURICH INSURANCE COMPANY; PACIFIC EMPLOYERS INSURANCE CO.; ARGONAUT INSURANCE COMPANY; TRAVELERS INSURANCE COMPANY; NATIONAL AUTO & CASUALTY CO.; AETNA CASUALTY & SURETY CO.; MICHIGAN MUTUAL LIABILITY CO.; INDUSTRIAL INDEMNITY COMPANY AMERICAN EMPLOYERS INS. CO. Referee: GEORGE WESTWICK Dictated: January 3 1 , 1963 Injury: Between 1953 and March 7, 1962 Sliver, McWilliams & Sherman, by Richard McWilliams _ attorneys for applicant nai?; representative for American Motorists Herllhy & Herlihy, by Kennls Jones, attorneys for Argonaut . . w . 1x13 Co* and American Snployers u ^ ory, representative for Travelers Insurance Co. r w L t Roberts, by James Thomason, attorneys for Zurich Ins. Euffeie Si 4 Robert Wills, attorneys for Pacific Employers i attorney for Industrial Indemnity ur?i lein afctorney for State Comp. Insurance Fund waiiace & Brown, by Gerald Brown, attorneys for Aetna Casualty ,, . and Surety Company nauxy Be Schuyler, by Rob R. Schuyler, attorneys for Michigan .. . ,, __ Mutual Liability Company LicKer Be McClure, by Robert Licker, attorneys for National Auto & Casualty Company ftgpoRT OF REFEREE ON ORDER APPROVING COMPROMISE AND .......... *............... ................... 1 as adequate?Pn the recopd the~prpsed settlement will be approved extent^? DJ?rt!|lent of Employment will be allowed to the f u *22*^ P 1*3 ia Pursuant to allocation proposed by the i?tention to allow said lien in said amount was issued, and no objection was received during the time provided. r 4 Sherman are entitled to a lien in the sum of 150.00 for living expenses advanced. Both of the above liens are payable by Industrial Indemnity Company -1 - % JOHN D. STAPLES CASE NO. 62 LB 19396 from the amount designated to be paid by them. s :.:S r E !r ;H r s "" QW:ca 2- ftryfifc O ik * * INDUSTRIAL ACCIDENT COMMISSION STATE OF CALIFORNIA x JOHN D. STAPLES, \ Case No.. 62 19396 Applicant 1 s. V i 2 S ? R0N0 CONSTRUCTION, et all ( AETNA CASUALTY AND SURETY COMPANY, et al, l NOTICE OF INTENTION TO ALLOW LIEN CLAIM OP DEPARTMENT OP EMPLOYMENT TO THE EXTENT OP $996.22 Defendant ./ IT A P P E A R I N G T H A T pursuant to allocation proposed by the parties N O T I C E IS H E R E B Y G I V E N that H e n claim of the Department of Employment ill be allowed to the extent of *996.28, and Compromise and Release will be approved within seven days alter r o c , heof uni. Good Caere to the contrary ia shown in writing width, said time . GW:ca 1.17.63 Name and Addm* of Persons Served ^ ^ i ____ _ *rfM Department of Employment p n Rnv 7 Silver, MctfllliaSs r a e m l A , 30f t 5??'? ,, Aetna Casualty 4 Surety cS!? 810 s / s p r l r n " t Wiim Jn8ton American American Motorist Insurance Employers Ins. Co C6o.^,0 35h5 ^ wu'Shire'sHd" . ,a i v d s I a L-A. g s i i i V t o S ^ c S ^ f ^ c S S ^ S i o t nt l k n l s l ^ r t L,Bb 2 SSS^ M FO*M 4 ! 0 <*rv. 4 J I | Mill M l 1IM tfPO i S y y. ' c/o Brown Bros. A3d?ju^sters, 3517 W. 6th, L.A. -- ---------------Can Anrtr>.?ftr>n * (Signature of Penoa Serving Notice) * CONTINUED SERVED: 1-17-63 National Auto Ss Casualty Co. Box 5780, Loa Angeles 55 Clopton & Penny, 639 South Spring St., Loa Angeles State Comp. In3 . Fund, 3629 Atlantic Ave., Long Beach Travelers Insurance Co., 110 W. Ocean Blvd., Long Beach 2 Zurich Ins. Co., by Jas. Thomason, 750 Broad Ave., Wilmington *- -2 -