Document VdMGGkYw313JdYkaemajKOep

FILE NAME Manville JMA DATE 1962 DOC JMA148 DOCUMENT DESCRIPTION Contract Unit Claim File - Paul J. Greischar APPEALS WORKERS' COMPENSATION BOARD - CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION prior to 1956 APPLICANT PAUL J. GREISCHAR - Asbestos Worker DATE CLAIM FILED INJURY ALLEGED April 24 1962 Asbestosis ALLEGED DATE OF INJURY present _. CASE <OAK 8188 EMPLOYER INSURER Plant Rubber & Asbestos Works et al including M Travelers No apparent Canadian carrier OTHER NOTES Severe pulmonary emphysema asbestosis Dr. Hinshaw report raises the of Oct. 4 possibility of 1965 to State Comp Ins Fund Asbestosis severe pulmonary insufficiency Dr. Eaton report of May 31 1962 to applicant's attorney DATE OF RESOLUTION March 17 1966 RESOLUTION CF Compromise & Release 8,735 settlement apportioned among 1 employer carriers - DOCUMENTS COPIED 1 Compromise & Release # OF PAGE CLAIMANT _ Paul California ... Greischar Workers Compensation Appeals Board CARRIERS INVOLVED The AETNA Casualty & Surety Co. American Automobile Ins Co. American Employers Ins Co. American Motorists Ins Co. oArgonaut Ins Co. oAssociated Indemnity Corp. California Casualty Indemnity Exchange oCalifornia Compensation & Fire Co. oCasualty Ins Co. of California Employers Liability Assurance Corp.Ltd . Employers Mutual Liability Ins Co. of Wisconsin Fidelity & Casualty Co. of New York _ 7 | oFireman's Fund Ins Co. oGeneral Accident Fire & oGlobe Indemnity Co. Co. Life Assurance Corp. Ltd. OGuarantee Insurance Co. oGreat American Ins Co. . oHardware Mutual Casualty Co. Industrial Indemnity Co. Sentry oIndustrial Indemnity Exchange oInsurance Co. of North America Liberty Mutual Ins Co. Ins Co. oLumberman's Mutual Casualty Co. oMaryland Casualty Co. oMichigan Mutual Liability Co. oMission Insurance Co. oNational Automobile & Casualty Ins Co. oNew Amsterdam Casualty Co. oOcean Accident & Guarantee Corp. Ltd. Pacific Employers Ins Co. oPacific Indemnity oReliance Ins Co. oRoyal Indemnity Co. Standard Accident Ins Co. , oSecurity Ins Co. of Hartford U.S. Casualty Ins State Compensation Insurance Fund oTransport Indemnity Co. The Travelers Ins Co. Co. Co. oThe United Pacific Ins Co. oU.S. Fidelity & Guaranty Co. oZenith National Ins Co. oZurich Ins Co. oc0o 17 5/81 mmf , WORKERS COMPENSATION APPEALS BOARD STATE OF CALIFORNIA 3 PAUL J. GREISCHAR 4 CASE No. 62 OAK 8188 5 Applicant 6 VS. . 7 PLANT RUBBER & ASBESTOS WORKS| et al 20 ; | CERTIFICATION ; 9 Defendant 10 11 I hereby certify that the attached documents are true 12 _ and correct copies of the original documents filed in the records 13 of this office in the entitled matter 14 ATTEST my hand and the Seal of the Workers Compensation 15 Appeals Board of the State of California 18 17 18 19 i Workers Board 20 f Compensation Compensation Judge Workers Compensation Appeals Board 21 22 23 24 Dated at San Francisco 25 California this 6 day 26 of April 1981 27 DIA WEAS FORM 115 NEW 1.791 CH TCSP DEPARTMENT OF INDUSTRIAL RELATIONS DIVISION OF INDUSTRIAL ACCIDENTS { f x , , OF THE STATE OF CALIFORNIA OL re ee Nr ee PLANT RUBBER & ASBESTOS WORKS Nw and OTHERS ee Defendants Defendants Ma ACCIDENT 2 Dap FACETV FACETV FACETV FACETV eet a ar on FILE FILE FILE WORKMAN'S COMPE APPEALS RCA BOARD ee hereby submit the following agreed statement of facts 1. Paul J. Greischar claims that he was employed employee herein born September 11 in California and other states whe CLANCY & CALIFORNAPADUCK LAW BuilDING AT 07- Center 12 17 17 PARISH ATORNEYS FINACL OAKLND LUDONIT SMITH July 1 1965. at a variety of places by various employers dur which period he sustained an injury consisting of pulmonary and chest disability the nature and extent of which is more fully forth in the medical reports of record which are hereby incorp ated by reference as if set out in full was During such period employed by certain of employment as described above appli employers whose names or their insuranc carriers during such periods are set forth below 2 The actual weekly wages of the employee at the time of injury were sufficient to entitle him to a maximum weekly compe sation rate employed employed oh: 1 5. The parties hereby agree to settle any and all claims on 2 account of said injury siad sum to be paid by by the payment of the sum of 8,735.00 the following entities and in the amounts 4 stated below 10 Aetna Casualty & Surety Company 6 O28 ' HEEEE HEEEE HEEEE HEEEEHE E HEEEE CLANCY HEEEEHEE 15 15 & CALIFORNALAW BUILDNG FADUCK AT 2.0 16 flISHRNEYS CENTER 12. GLENCOUT H17 *** *** FINACL OAKLND SMITH 1920 American Employer Insurance Company State Compensation Insurance Fund Travelers Insurance Company American Motorist Insurance Company Fidelity & Casualty Company of New York Liberty Mutual Insurance Company California Casualty Casualty Indemnity Exchange Pacific Pacific Employers Insurance Company Employers Mutual Liability Insurance Company of Wisconsin Plant Rubber & Asbestos Works . Industrial Indemnity Company TOTAL The above stated sum of 8,735 is to be paid to the applicant in one lump sum less attorneys fees and litigation costs of 309.25 consisting of the following Dr. J. Lloyd Eaton Palmer Multigraphing 268.00 268.00 * California Inspection Rating Bureau Bureau Social TOTAL of Old Age Survivors Security Records for 5 5 . The amount of medical and hospital expense incurred or paid by the employee is in dispute as is the amount of unpaid bills Unpaid and future medical and hospital expenses are to be Paduci & Clancy 315 Financial Center Building Oakland 12 , attorneys atorneys ataorneys ttorneys fees previously paid if any 0 "fi 9. The reason for compromise compromise is that there is a serious and 3 fi& 5 extent of disability if any caused by the variety variety variety variety of of employments employmentsemployments employments employmentsemployments employments employmentsemployments employments 6 further expense and hazards of litigation by means of the within 7 Compromise and Release agreement 10 It is specifically understood and agreed that this 9 agree ment encompasses all periods of employment by the above mentioned il il 12 1313 CLANCY 1414 1515 & CALIFORNAPADUCKALATW BUILDNG 2-0 1616 CENTER 12. 1717 P'RISH TORNEYSFINACLOAKLND GLENCOURT 181189 SMIT 2020 21 2222 23 2324 employers or not and whether such periods are specifically set forth above includes all employers insured by the above mentionemdentioned insurance companies whether or not previously joined in this actio 11. The undersigned requested this Compromise and Release agreement be approved 12. Upon approval of this Compromise and Release agreement by the Workmen's Compensation Appeals Board a panel thereof a Commissioner or a Referee and payment in accordanceaccordance with the provisions hereof said employee releases and forever discharges said employers and insurance carriers from all claims and causes of action whether now known or ascertained or which may hereafter arise or develop as a result of said injury including any and all liability of said employers and said insurance carriers and each of them to the dependents heirs executors representatives administrators or assigns of said employee 13. It is agreed by all parties hereto that the filing of this document is the filing of an application for adjustment of claim on behalf of the employee and that the Appeals Board may wen o> document and that the Appeals Board may thereafter Release 2 said Compromise Agreement and or disapprove disapprove the same and is 3 Findings and Award after Hearing has been held and the the matter mm regularly submitted for decision 5 DH 7 8 9 10 10 11 11 12 14. For the purpose of determining the lien claim filed herein for the have been paid unemployment compensation disability benefits which under or pursuant to the California Unemployment Insurance Code as aforementioned it is agreed that applicant's Wa permanent disability if any commenced July 1 1965 1965 further that any unemployment July 1 1965 was compensation disability benefits paid out after for a cause and condition unrelated to the the indus- 14 CLANCY 15 & CALIFORNAPADUCK LAW BUILDNG AT 2-0 16 CENTER 12. PARISH TORNEYS FINACL OAKLND GLENCOURT18 PAR ISH 19 SMITH 2020 2 2 this 12 Mark Mark 12 day of Mark ^' cA rs . va a a A os oo Met ca Paul Freischar Freischar a - Attorneys SMITH SMITH PARRISH PADUCK & CLANCY Applicant's Attorneys $ Rfounder COMPANY ty Attorneys by its AttorneEysMPLOYER ee, Rfounder Rfounder STATE COMPCENOSAMTIPONENCSATIONOMPENSATION INSURANCE its Attorneys FUND oy 4 f TRAVELERS J TRAVELERS INSURANCE COMPAITY by Cits Attorneys OER: \ Attorneys Attorneys Vou bo med A AtS Attorneys INSU ra we Bee DHFANY DHFANY DHFANY DHFANY i 22 3 i 10 CLANCY & CALIFORNALAW BUILDNG AT 2-0 PADUCKFORNEYSCENTEN 12. GLENCOURTOAKLAND RISH INCALINICIAL OAKLAND SMITH 19 _ . CALIFORNIA CALIFORNIA CALIFORNIA CALIFORNIA CASUALTY by its Attorneys ---- ----- KR Attorneys . WW PACIFIC EMPLOYERS Attorneys INSURANCE byits EMPLOYERS Attorneys EXCHANGE INDESITY INDESITY ---- ----- - ---- ----- COMPANY - COMPANY EXPLOYEROSF WISCONSIN COMPANY ne MUTUAL on LIABILITY LIABILITY LIABILITY MUTUAL LIABILITYLIABILITY INSURANCE by it Attorneys Attorneys Harum corPpLAoNTration by INDEMNITY Minney Miney Minney Har um RUBBER & ASBESTOS WORKS Harum a > fl fl it AttorneAysttorneys INDUSTRIAL K ICF. om* KIKI INDEMNITY Nh Minney Minney INDUSTRIAL INDEMNITY Attorneys by its COMPANY if its Z a Mb, this On day of , 4, before me , Pr Notary A. D. 1966 Notary and and for the said County oF a Public in dyly State and sworn residing therein commissioned appeared commissioned personally Whose name eee known to me to be the person nameinstrument official Certificate within instrument subscribed to the executed the and acknowledged to me that he unto set my hasnadmeand IanffWiixtendess Whereof I have here- day and year in this my seal the first above written ida an e a ye! f . _ ey 4c? Notary Public in and for Said County and State of California