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FILE NAME: Insulators Workers' Comp Claims (IWC) DATE: 1955 DOC#: IWC016 DOCUMENT DESCRIPTION: Claimant - Cuthbertson, Jack Herbert s. J o hnso n JA M E S E. M IL L E R J O H N J . D A V IS , JR. RAPHAEL SHANNON " IAN B . E M E R S O N LORI A. NORD M C C A R T H Y J O H N S O N & MILLER ATTORNEYS a t law 22 SECO ND STREET, SEVENTH FLOOR SAN FRAN CISCO 9 4 ,0 5 (415) 3 6 2 - 0 7 2 6 June 6, 1984 Dr. Barry Castleman 1722 Linden Avenue Baltimorei Maryland 21217 Re: jgPk . Cuthberi-gnn Dear Barry: P- M eCATHY. involved the Cuthberts^Br^theS *2 * ^ ^ files of Armstrong Cork of them, Bob in connection with a garden CurrentlY/ we represent both regrettably, in connection with a teritnn^l ariet->' asbestosis claim, and Jack extremely rapidly. " 3 mesothelioma, which is prSgresstag Jack's old Workers' C o ^ S s a t S ^ f i i r 10! S l d 1S Bard tas to misplace or your copy, if that San be arrSiali 5? Very m c h like to obtain 7 c ^ reimburse you for copying and postagftipen^ to Say' 1 "" M be happy to aa n k you for your anticipated c a t i o n . Best personal regards. cc: Ken Lynch JACK CUTHBERTSON \ \ PLANT RUBBER AND ASBESTOS WORKS, _ AxMJl'iiONG CONK COMPANY, MJNDBNT CORK CORPORATION, PLANT ASBESTOS COMPANY WESTERN ASBESTOS COuPa NY, J. J. THORPE AND JON, and TRAVELERS INSURANCE COMPANY, INDUSTRIAL INDEMNITY COMPANY, STATE COMPENSATION INSURANCE FUND, PACIFIC EMPLOYERS INSURANCE CO., CALIFORNIA COMPENSATION INSURANCE 00., and STANDARD ACCIDENT INSURANCE COMPANY JOSEPH SHEEHAN, REFEREE San Francisco, Sept. 7, 1955 CLAIm NO., 161-370 Inj. 1944-1954 REPORT OF REFEREE Asbestos worker, 26, claims Injury to lung from breathing substances in the course of work harmful to chest and lungs. FACTS IN CONTROVERSY AS TO STATE C0MPEN3ATJ.Jhi INSURANCE FUND: 1, Occupation 2 a Injury. 3. Medical. 4. Medical expense. 5. Earningso t>. Temporary disability. 7. Notice and prejudice. 3. Statute of limitations. 9. Lien of Department of Employment. 10. Lien of Occidental Life. 11. Costs 12. Estoppel. 13. Jurisdiction. SUMMARY OF TESTIMONY: Applicant testified substantially as follows: While he worked at Western Asbestos his rate of pay was as set forth in the letter of February 14, 1955. His hourly rate was for a 40-hour week. He first worked at Western as a helper. He did work aboard the 3. S. Lurline. This work consisted of packing materials from the dock to tne ship. He worked as a helper for three and a half months. The asbestos that he handled during this period of time was in closed cartons. He worked mostly on the dock. He worked for Western Asbestos on the Standard Oil job as a helper. 'This job consisted of making cork insulation. During the period 1947 to 1950 he handled various materials including ' asbestos, rock wool, fiber glass and asbestos paper. His job was that of a helper and he would pass these materials to tne mechanics. Dome- times the air in which he was forking was dense. Sometimes he would work in enclosed areas. He worked on the Standard Oil job for three and a half months. On that job he had very little contact with tne materials of asbestos and rock wool. He also worked on the Union Oil Company job. * # /. CU THBLiiToOW 2 He worked for Mundet on a job at the Bethlehem yard. This job required him to work mostly on the ships. He also worked at .-joss Landing, While he was working at the Moss Landing job no was v.i asbestos norker. He was also known as a mechanic and he would apply the asbestos to pipes and boilers. On this job his d o m e s were dusty and he noticed that tne inside of his nose was also uasty. In 1953 he went to Dr. Thompson and Dr. Thompson took x-rays. Dr. Thompson in turn sent him to Dr. Crenshaw. Under Dr. Crenshaw he underwent surgery to obtain a diagnosis. At that time he was having pains. He stopped work on September 30, 1953, and was off work for one month because of tne surgery. The doctor found nothing wrong and the doctor told him to ,3o back to work. He continued working until October 19, 1954, when he nua further surgery on his cnest. Dr. Crenshaw performed this surgery. He has been off work ever since October 19, 1954* Ho has not returned to his trade. It was on October 22, 1954, that Dr. Crenshaw advised him tnat nis condition was due to his work. The bill for the first surgery was paid half by himself and half by the Occidental Life. The bill for the second surgery jls to be paid naif by him and half by tne Occidental Life. Dr. Crenshaw has sent him a bill, but he left the bill home. He worked from July 15, 1955, to August 14, 1955. During this time he earned 35^ a week. . At one time in his career he was an able-bodied seaman. He held a card as such for a period of three years, but he v/as not three years on the sea. On October 15, 1954, he gave a work history when he was in the Herrick Memorial Hospital. ' His work on the Luriine was that of a helper. He would transfer the materials from the dock to the shxp. He worked on this job for three or four months. On tne Standard Oil job he would use rock wool and cork. The Luriine job required him to mix wet and dry asbestos. Occasionally he worked aboard ship. His general duties required him to bring the materials aboard. He was just a helper on tne Standard Oil job. He worked about six weeks with tne rock wool. During the last four and a half months he worked for Western he was a journeyman. He does not know whether or not the ships at Bethlehem were new construction. On tnese ships fiber glass was used. He is a journeyman asbestos worker. The job at the ship yard was a rush job and it was Very dusty in the shop at the ship yard, This W mau uhjpeu' f % 4 VJi f GU'fHBEiiTSQN ,,3 required him to work lo hours a day. He w?q t-iroH .,f>ur, ^ - . but he had no other complaints? 7 d ditei ',lls K?re aP;-,;L1f d t0 the ship "Wilson" and irorlnn-- on thi- Ship required him to work in a dusty niace F a / i n 1 p i eight hours a day.- / i - * ior aundet Cork he workeu tuAlSS openj a i r a t b u te-lii0wn Landinf was an o u tsid e jo b . lie worked in the hS h a d \ i w S r L d ^ S i n/ dr M o " SlS n (U n ? Cr0H1P0h f wintl- complaints regarding his cheat wnen he loft eocern Asbestos? After his first surgery he continued under the care of Ur. Crenshaw. foilow!?5haW' Called by thS aPPllcan. testified substantially as Stated his qualifications. The applicant has been under his care since September 22, 1953. Surgery was performed the second time October IB, 1954. ^ " ."s i r .i s : / ; : a s s a y s K f s s ; , " 1" "f leSi^aftieatment?3 "8diCal ob=>enrabi". ba* he does not need any S k a ? irs s b s s s s i t e ^ ? n t 18 e n jo in e d fro m Itta?aL^L5Snts:s8: ^ s ,sirhS;<,i.i :doctor toid the a^iicant wnich ? L eaS!?cIntsS??is! 3ub3tance3 can baa3e tba condition from On September 22, 1953, the applicant was complaining 0 f a m ,ht -idP pleural effusion. His condition was diagnosed as non specificthoraci- c o i d i S l hlS 3Urgery the dCt0r * the serious^Causes of\e * The fibrosis did not show in the x~rays. It was iust orior to nr subsequent to the second surgery that he notified'the applicant of his opinion that the condition was due to the applicants work. Possibly advised1*!he^applicant.a^ter tb3 -- b a- gery that the ^ t o ^ r 17 / f CUTHBBHT3QN -4- The doctor does not believe that the applicant could return to work of a seaman. The doctor believes that a seaman's work requires heavy exertion. That the applicant could do general work, except that the applicant can not do hard work and he must work in a place chat is free from harmful dust. It is reasonable to expect uiat the applicant's capacity to work in the future will be less than it is now. In tne opinion of trie doctor the fibrosis that is present will continue to increase. The doctor came to the conclusion that the work was responsible for the condition because ha found substances of elements used in the woi'k in the lung. There is a possibility that the fiber glass may have caused the disa bility. The present factors of disability in the applicant are shortness of breath and weakness Continued, to be reset on the first available calendar. J3:jr to CUTHBERTSON Claim No. SF 161-870 JOSEPH SHEEHAN, REFEREE Oakland 2/17/55 Injury: 1944 *- 1954 REPORT OF REFEREE ON ORIGINAL HEARING Asbestos worker (date of birth not alleged) claims injury to lungs from '`breathing substances in course of work harmful to chest and lungs" . ISSUES i.s TO INDUSTRIAL INDEMNITY COMPANY .1 Employment. 2 . Occupation. 3. Injury. 4. Insurance. 5. Medical expense. 6 . Medical. .7. Earnings. 8 Temporary disability. 9. Notice and prejudice. 10. Statute of Limitations. 11. Lien of Department of Employment,. 12. Lien of Occidental Life. 13. Costs. ISSUES AS TO TRAVELERS INSURANCE COMPANY 1. 2." 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. Employment. Occupation. Injury. Insurance. Medical expense. Medical. Earnings. Temporary disability. Notice and prejudice. Statute of.Limitations. Lien of Department of Employment. Lien of Occidental Life. Costs. ISSUES AS TO STATE COMPENSATION INSURANCE FUND 1 * 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. Employment. Occupation. Injury. Medical expense. Medical. Earnings. Temporary disability. Notice and prejudice. Statute of Limitations. Lien of Department of Employment. Lien of Occidental Life. Costs. Insurance. SUMMARY OF TESTIMONY APPLICANT testified substantially as follows: He was born May 4, 1928. He is right-handed. , He is an asbestos worker. In 1949 he worked for Westerns Asbestos. He went to work sometime before April, 1949, as a helper. His job was to pack asbestos onto a ship. He worked two or three months. Sometimes he worked below the decks and in the engine room. : ,,r- . .( ^ CTHBEftTSON 2/17A p -2- Claim No. 161-370 ! \ His work reouired him to pack and mix dry asbestos. His earftJLugs were about $46.00 a week. On the Standard Oil job he helped with the supplies. He used rock wool and hot tar on this job. He worked in an enclosed area. There were 20 to 30 men working and the ventilation was poor. He worked with asbestos blocks. He worked for Armstrong in 1950 and stopped work in 1953* He started working for Western Asbestos in 1949 and worked about two years. He worked for Plant Asbestos about nine months beginning in 1950. He worked for Western Asbestos in 1940 and 1950. He worked for Plant Asbestos for one week. He worked for Armstrong Cork in 1951* >[cs|s>;< It appeared to this referee that the proper parties defend ant were not before the Commission at this time and the matter was continued, to be reset. Notice was given to counsel for the applicant that in the event that a proper amended application was not on file within a reasonable time the application filed herein would be ordered dis missed without prejudice. It appeared that the testimony of the applicant should be stricken from the record inasmuch as the proper parties defendant were not before the Commission at this time and the testimony was ordered stricken from the record. The matter was continued, to be reset on the first avail able calendar in the event that a proper amended application was on file herein. JS: S JOSEPH SHEEHAN Referee lAVlV-f r t CUTHBERTSON 2/21/56 -5- Claim No. 161-870 The doctor is of the opinion that the applicant first became afflicted with asbestosis in 1953 when the applicant experienced the pain. The onset of the clinical disease occurred in 1953. The doctor believes that each employment should bear an equal share all the way through. Continued exposure increases asbestosis. ROLAND E. MASTERS, called by the defendant, testified sub stantially as follows: He is the office manager of the San Francisco office and of the Marine Department of J. T. Thorpe and Sons. In 194S and 1949 the company was using asbestos products, which included block insulations, both hot and cold temperatures, pipe coverings and certain cements. He enumerated the content of asbestos in some of the products he used. During those years most of the work was outside work and was new construction. In 194# and 1949 he received no complaints regarding dusty conditions at the job sites. A helper would usually mix the materials used at the job. One of the samples contained 15 pet cent asbestos and another of the samples contained 15 to 20 per cent asbestos. CARL 0. JUST, called by the defendant, testified substan tially as follows: He is a supervisor at Plant Asbestos and has been such for six years. He knows the applicant and knows the employment of the applicant at the plant. The employment consisted of work mostly on new construction. No request was ever made of him for any change in the ven tilation on the job. He received no complaints regarding dust on any job. > ALLAN HOLDEN, called by the applicant, testified substan tially as follows: He is employed by the Occidental Life Insurance.Company and the Occidental Life Insurance Company have filed a lien herein in the sum of 591.37. The following bills make up this item: Bill of Dr. Thompson, 10-9-53, for <30.00; bill of Dr. Crenshaw of IO-9-53 for 220.00; bill of the Blood Bank of 10-16-53 in the sum of 33.25, of which the lien claimant has paid 24.75; the bill of the Herrick Hospital in the sum of 4361.07, dated 10-23-53, of which the lien claimant has paid 4292.12; the bill of the Peralta Hospital for laboratory examination in the sum of ,,>20.00, dated 10-30-53. The lien claimant has paid hospitalization and medical benefits under their accident and sickness policy. They have also paid 15.00 a week for 47-1/7 weeks. This sum was paid beginning April 5, 1955, to 9-14-55 and the witness corrected this period to be 10-20-54 to 9-14-55. The policy does not cover reimbursement of workmen's com- ' pensation benefits. APPLICANT, recalled, testified substantially as follows: He was born May 4, 192$. In 1953 while he was in the hospital special nurses, were hired for eight shifts at 3.00 each and 64.00 was paid by him to the nurses. __ , . In September, 1954, he incurred the bill of 412.50 at the Herrick Hospital. In January, 1955, tHere was a 'charge of 415.OO --for a laboratory cerstT 6n February 20, 1954, there were laboratory tests and X-ray, for which he was billed the sum of 437.50. CTHBERTSON 2/21/56 -6- Claim No. 161-870 DISPOSITION The matter was ordered submitted at the end of 10 days and the case to remain open for said 10 days to permit the filing of the copies of the medical reports of the Department of Employment, together with the hospital record of Herrick Hospital and further medical reports from the applicant; the parties were reouested to submit briefs on all of the issues within 20 days. JS: S JOSEPH SHEEHAN Referee 10 ,itti 1 2 3 4 5 6 7 8 BEFORE THE INDUSTRIAL ACCIDENT COMMISSION 9 OF THE STATE OF CALIFORNIA 10 -- 0-- 11 JACK CUTHBERTSON, 12 1j Applicant, 13 ! 1 vs. 14 i\ WESTERN ASBESTOS COMPANY, PLANT ) ASBESTOS COMPANY, ARMSTRONG CORK 15 COMPANY, J. T. THORPE & SONS, ) 1 STATE COMPENSATION INSURANCE FUND, 16 !; INDUSTRIAL INDEMNITY COMPANY, ) j TRAVELERS INSURANCE COMPANY, 17 jj STANDARD ACCIDENT INSURANCE COMPANY, ) [ and PACIFIC EMPLOYERS INSURANCE 18 r COMPANY, ) CLAIM NO. 161-870 FINDINGS AND AWARD 19 , Defendants. ) 20 ____ ______________________________________ ) 21 Application for Hearing having been filed herein, 22 jj and all parties having appeared or having been duly notified, !* 23 II and the matter having been regularly heard before Referee 24 ji Joseph Sheehan, and submitted for decision, said Referee now 25 || makes his Findings and Award, as follows: 26 j| 27 I FINDINGS OF FACT 28 I 1. Jack Cuthbertson, born May 4, 1928, while em 29 I ployed as an asbestos worker by Western Asbestos Company, 30 I Plant Asbestos Company, Armstrong Cork Company, J^ T. Thorpe I 31 i & Sons, during periods of employment stipulated to by each 32 | of the several defendant employers herein, contracted an occupational disease, to wit, a form of pneumoconiosis, 2 j namely, asbestosis. 3 | 2. The date on which said employee first suffered 4 ! disability from said occupational disease and either knew, |i or in the 5 | <ii 6 that said ii 7 i* ji ployment, !* i* 8 I: exercise of reasonable diligence should have known, disability was caused by his present or prior em was October 23, 1954. 3 . The occupation of the applicant was asbestos worker. | 10 i! MI 4. At the time of said injury the weekly earnings 11 *1 of the employee were maximum. 5. Employee has incurred expenses for diagnostic 12 I treatment beginning October 17, 1954 and thereafter, and 13 i| said treatment was reasonably required to cure or relieve 14 i! 15 | the effects of said disease. A supplemental award for the 16 1 amount of such expenses will be made upon the service and 17 filing of a supplemental petition in the event the parties 18 are unable to adjust such expense to their mutual satisfac 19 20 j 21 22 23 24 25 26 27 28 tion. 6 . Employee is in need of further medical treat ment reasonably required to cure or relieve him from the effects of said disease. 7 . Said disease caused temporary total disability beginning October 17, 1954, to and including July 14, 1955 8 . Employee's condition is not yet permanent. 9. Statutory notice was given by the employee to Plant Asbestos Company. None of the defendants herein on whom liability is Imposed have been prejudiced by the al 29 leged lack of notice. 10. The filing of the Application was timely. 30 11. Department of Employment, State of California, 31 has paid to the employee unemployment compensation disability 32 benefits in the sum of *970.00 during the period of disa il bility found herein. 1 12. Occidental Life Insurance Company paid no sum of money for medical treatment reasonably required to cure or relieve from the effects of the injury found herein. 1 3 . Employee has incurred costs in the sum of $7 0 .0 0 . 8 14. The determination of apportionment or contri bution among the several defendant carriers Is deferred. 9 1 10 I 1 5 . It is not true that employee is estopped to assert the claim made herein. "1 12 il 1 6 . The Commission does have jurisdiction of the 13 IiIl subject matter of said claim and of each of the defendants t upon whom any liability is imposed herein. 1145 j!; 1 7 . Employee*s attorneys, Smith k Parrish, have 16 1 rendered services to the employee in the reasonable value - i of $300.09. 18 j 18. Cork Insulation Company is not a necessary or 19 proper party. 20 1 9 . Plant Rubber & Asbestos Works is not a neces 21 sary or proper party. 20. Mundet Cork Corporation is not a necessary or 22 23 proper party. 24 AWARD 25 26 AWARD IS MADE in favor of Jack Cuthbertson against 27 State Compensation Insurance Fund, Pacific Employers Insur ! 28 ance Company, Standard Accident Insurance Company, Traveler* 29 1 Insurance Company and Industrial Indemnity Company of rei il 30 bursement for the reasonable value of medical treatment ob i 31 tained by the employee on and after October 17, 195^ to and 3,,2 1j! Including July 14, 1955* -3- 3 AWARD IS FURTHER MADE in favor of Jack Cuthbertson against State Compensation Insurance Fund, Pacific Em ployers Insurance Company, Standard Accident Insurance Company, Travelers Insurance Company and Industrial Indem nity Company of temporary total disability indemnity in the SUm of $35.00 a week, beginning October 17* 195^ to and in eluding July 14, 1955* AWARD IS FURTHER MADE in favor of Jack Cuthbert8 50n against State Compensation Insurance Fund, Pacific Em 10 ployers Insurance Company, Standard Accident Insurance Company, Travelers Insurance Company and Industrial Indem 11 nity Company of reimbursement for the reasonable value of 12 costs incurred by said employee in the sum of *70.00, said 13 costs being payable as follows: *35-00 to Dr. A. R. Thomp 14 son, and *35.00 to Dr. Oerald L. Crenshaw. 15 ii AWARD IS FURTHER MADE in favor of Jack Cuthbert16 son against State Compensation Insurance Fund, Pacific Em 1? I ployers Insurance Company, Standard Accident Insurance 18 | company, Travelers Insurance Company and Industrial Indem- j 19 nlty Company of further medical treatment reasonably required 20 21 * 22 | to cure or relieve him from the effects of said disease. | IT IS o r d e r e d that employee's attorneys, Smith & 1 Parrish, be and they hereby are allowed a first lien in the 23 I sum of *300.00 against any compensation unpaid and payable 24 tt 25 | herein. 26 ! IT IS FURTHER ORDERED that Department of Employ ment, State of California, be and it hereby is allowed a 27 | second lien in the sum of *970.00 against any compensation 28 ! 29 unpaid and payable herein. 30 il IT IS FURTHER ORDERED that the request^of the Department of Employment for an additional lien in the sum 31 32 of $179-71 be and it hereby is denied. -4- i: IT IS FURTHER ORDERED that Cork Insulation Company be and it hereby is dismissed. IT IS FURTHER ORDERED that Mundet Cork Corporation be and it hereby is dismissed. IT IS FURTHER ORDERED that Plant Rubber & Asbestos Works be and it hereby is dismissed. IT IS FURTHER ORDERED that jurisdiction be and it 8 hereby is reserved to determine apportionment or equitable 9 subrogation on petition properly filed. 10 IT IS FURTHER ORDERED that this Award shall bear 11 interest pursuant to the provisions of Section 5800 of the 12 Labor Code. 13 14 15 16 JOSEPH SHEEHAN, REFEREE 17 INDUSTRIAL ACCIDENT COMMISSION 18 19 !i 20 liJUN 1 1 1956 FILED AND COPY MAILED TO: (JA) If 21 |j Department of Employment, P 0 Box 1857, Oakland 4 ii Occidental Life Insurance Co., 583 Market St., S.F. 4 22 a Jack Cuthbertson, 2284 Holbrook Drive, Concord I Smith & Parrish, 1616 Financial Center Bldg., Oakland 12 23 !j Leonard, Hanna & Brophy, 100 Bush St., S.F. 4 I; Mullen & Filippi, 315 Montgomery St., S.F. 24 ji Travelers Insurance Company, Latham Square Bldg., Oakland |! Industrial Indemnity Company, 350 Sansome St., S.F. 4 25 State Compensation Insurance Fund, 450 McAllister St., S.F. 1 f; Pacific Employers Insurance Company, 3770 Piedmont Ave,Oakland 26 jj Standard Accident Insurance Company, c/o Leonard, Hanna & | Brophy, 100 Bush St., S.F. 27 | Plant Rubber and Asbestos Works, 5309 Horton St., Emeryville Armstrong Cork Company, 1355 Market St., S.F. 28 Mundet Cork Corporation, 440 Brannan St., S.F. Plant Asbestos Company, 5309 Horton St., Emeryville 29 Western Asbestos Company, 675 Townsend St., S.F. 3 J. T. Thorpe & Sons, Emeryville 30 31 32 -5- CUTHBERTSON Claim No. 3F l6l870 JOSEPH , SHEEHAN REFEREE MAY 14, 1956 REPORT Injury: 1944 - Alleged asbestos worker,^borri inay^4, to lungs from "breathing substance- 1- - ` chest and lungs. The proper no* of the dfwtaW "err in this report, as follows: Western Asbestos Company State Compensation Insurance uk Plant Asbestos Company Industrial Indemnify Company Armstrong Cork Company Travelers Insurance Company Standard Accident Company Occidental Life Insurance ,-0 . Sbttiaafvcvo ouxf California- Doie>paErm-pwleo^ytmen Pacific Employers Insurance Co, j,, T. Thorpe & Sons Mundet Cork Corporacin Cork Insulation Company Plant Rubber & Asbestos Works Vifia r e m f ur..d Plani Industrial Armstrong Tt-ave lare il:,andari. Ooc.lde.niai Department P;l' Thorpe Mandet ':'/S" Pliant ftiVobi L to * the a p p l i c a t i o n is a ^ s - a that > ployed by Mundet, as iollows. "1948 - in Februasry,^Marc.i, ftprli au.d h..y > -41 mately 4 months (4)." . ,,, 4-a-i" ratter. No appearance was Mundet never appeared In 6h * The letter of made for it. No proof of p r o p a ^ ^ Q a 'sl3b?oena of the Commis Mundet of 2-16-56 was t worked for Mundet he used strictly sion. During the time app A o p U cantos counsel has assured cork (Testimony of applicant.) App,, against Mundet the CoffiBtf.ssi.on that we r e (?3nfript D . i6). Mundet should be 1SS5 ***> Employment with Cork Is alleged to have been: Cork made no appearance herein.^ A W ^ a n S r a t transcript submitted no proof ^ rfo?" i8iitfBsal of Cork. Cork should be S i J g i ^ T f S S K t S . 'T S S S 10775 and 107). The Application, filed March 8 , 1955, alleges. a Pinrvt" Rubber ''Original employment, Plant Sh!Tp^matSf3-l/l-,,ths.'' Asbestos Works, 26th to June _ ....... Apparently purported service on this defendant was made . - "Plant Rubber & Aabastos Works, 5309 Horton Street, Emeryville, Calif CUTHBERTSON Claim No. 161-870 -2- 2 -2 0 -5 6 SUMMARY OF TESTIMONY HERBERT E. SIMONS, called by the defendant State Compensa tion Insurance Fund, testified substantially as follows: He is employed as Safety and Transportation Supervisor at the Western Asbestos. The record at the plant shows that the appli cant worked at the plant from April, 1947, to July, 1950. The applicant handled asbestos and other materials used at ,, a list of ingredients of the products used is contained IS the niulaton list S5 r p ? S p ared this list from the samples sub mitted to him by the manufacturers. The same material was used m 1 % 7 and 1948. JACK CUTHBERTSON, recalled, testified substantially as follows: He worked for J. T. Thorpe and Son beginning in August, 1948 to 1949. It was outside work on a power house. He appli asbestos blocks to the boiler. It was quite dusty and windy. The boiler was located in the open. He did not become ill on this 3 He was a mechanic or insulator on this job. All of the men on the job were using the same insulation. It was drv material. The first application would be dry and the second application would be wet. Magnesium blocks were ^ dabout about 8? per cent of the time. He handled dry asbestos blocks about 35 S inor' tilt L oput of the dtime. The magnesium blocks contained magnesiu , 15 Pe? ^ n t After handling the agnesium blocks he would apply a wet coating. This coating material was handled like plaster. He also worked for J. T. Thorpe in 1953, that is, from to going to the hospital he was working for Armstrong Cork. On further ouestioning he said he worked for J. T. Thorpe and Son from May 9, 1952, to June 2, 1952. during this time handled asbestos covering and various asbestos products. While he was working at Hunters Point the boiler was in the open air. You could see particles of asbestos dust. No notice was given to Pacific Employers or to Thorpe and Son. Neither of them have made any promises of compensatio him and neither of them have made any payments of compensate . He went to the hospital in September, 1953, directions of Dr. Crenshaw. Two weeks prior t0.S015? t0 ^ ? sPJ^al he'd b e e f u n d e r Dr. Crenshaw's care. Dr. Crenshaw did not tell him ..v,.. wfl. wronz with him. Dr. Crenshaw has continued to give him treltm" t. When he first saw tootc- I ^ Y a ^ ^ I f u I e . ^ H e ^ S I ^ f o ^ I w o ^ e k s in the hos pital. Hp first learned about his condition about six days after eight years ago when he first took up the trade. He had no cough before the first operation. He had severe doctorl^He^ha^never S S ' M W chant Marine in 1944 to 1946. ^ l e ^ s V I h e Mer He was in asbestos work prior to 1944. He that time. They did not make any X-ray examination of him while he was in the service. _ CUTHBERTSON Claim N o . 161-870 -3- 2/20/56 He drew the maximum amount of benefits from the State. These benefits covered ?r5 Occi- his disability. He ^rew Ty,e tw0 payments together, being Zl% dental en no for each week he was entire a week, were paid to him during tne enci.e He t i m e d tS work on September 18, 1955. period he was off (It was stipulated that Travelers coverage for Armstrong time and that Standard incident h d g ning January 1, 1949, to Decemoer d , fo?'the period begin It was likewise stipu- different periods i S 5 i l i S r . S ^ M i weeksTMeginnfng in September, 1949.) He worked for Armstrong Cork for about two weeks in 1949, that is, from September to October. In this job he usea y board and hot tar. He worked for Armstrong Cork from S^ a m b e r 6 1950, ^ 0^ 1954. He was an insulating mechanic, ^e use WOpiPand cork k f w e ' r f i l s f l l l f " bSllera. He h L no helper and there was heavy dust on the job. He has worked in the asbestos trade for a period of about f i f yeo n n ? h e s O b ? h Se ^ n S r u s e l h e f a m e ^ t f ifll!" While' he worked for Mundet he used strictly cork. Samples which have been introduced w e r e t o that he used while i r k i n g for Armstrong. He used the sa material for Plant Asbestos, J. T. Thorpe ana i o ^ those^ & same union man and most of t e J asbestos or asbestos products. On all materials on the jobs. It is a De f .h iov.s t^e ventilation these jobs he had windy days. . V TM f f n f h e S ? . T h e dust was was poor. On others the different jobs the same exposure occurred.WiSome^ofSthe^Armstrong^ jobs w f r f a l l cork jobs. Generally speaking, the materials used and the amount of dust produced was the same for all his employers. He was hospitalized in September, 1953, and P ^ t o ^ h a t time he made no request for compensation of Armstrong, Standard or Travelers. At the present time he has t | U in the chest, tiredness in the afm s *. *f ^ h f h a f ^ f g o eiVg him sharo pains at f i - T I M S s S o u p ^ e scars h u r t - o r e ^ c o l d w e a t h e r m a n goingWt o^Dr? *Crenshaw?0 H e ^ e e l l better than he did at the time of the last hearing. At night he has a tired feeli"S- It is hard for him to keep his average up while working in tn noon. On July 15, 1955, he V 6"* " " n r S / f f l d i f this job work reouired him to s ove 1955, and thereafter he was off i S i l ' I i ^ r n i f B f s : 1**. I TM i ^ s w o r k up on August 14, 1955, because he did not continue doing e After August 14, 1955, he listed himself as available for work after about two weeks. ffie r'oprards Plant Asbestos, it was stipulated that the e m p j x g e r l f l ^ ^ f f m n a n v tod CUTHBEh TSON 2/20/56 -4- Claim No. 161-70 It was stipulated that the Industrial Indemnity Company had coverage for Plant Asbestos for the period beginning July 1, 1954, to October 17, 1954, and it was also stipulated that appli cant worked at the plant during that period.) While working for Plant Asbestos he used heat and frost insulations. He worked as a mechanic applying these products which were made from asbestos products. From July, 1954, to October, 1954, he did mostly little jobs. He handled asbestos products during this time. They had to mix the products themselves. It was dusty. It was very dusty while they were mixing. The job at Mare Island during this time they had to work in a trench, and the material was on top of the trench. The wind would blow the material at him. On October 17, 1954, he stopped work because he was wheezing and subsequently he went to surgery. The first notice he gave to Plant Asbestos was about a week and a half after leaving the hospital. His attorney told him that he had to notify his employer. Plant Asbestos or Pacific Employers or Industrial Indem nity or any of them have made no promises or payments of compensa tion to him. He has received payments of disability benefits during the entire period he was off. He drew disability from the State for the maximum amount. He received no benefits after leaving the job he had at the foundry. The majority of all his work was new work. He did not receive benefits for all the time he lost from work. A recess was taken in this matter until 9*00 A.M. tomorrow, February 21, 1956. The matter came on regularly for further hearing on February 21 at 9:00 A.M. SUMMARY OF TESTIMONY SIDNEY J. SHIPMAN, M.D., called by the defendants, testi fied substantially as follows: 1955. He saw the applicant on one occasion, that is, on June 15, His diagnosis was asbestosis or pneumoconiosis caused by asbestosis. This results from an exposure to asbestosis dust. As to the degree of disability seen in the applicant on June 15, 1955, he said that his chest was normal to examination. However, an examination at U. C. Hospital showed that the oxygen saturation of the blood was slightly low. The doctor believes that the applicant is able to work at the present time. He cannot give a probable prognosis. He cannot say the condition will become worse or better or remain the same. The applicant should have a periodical check by the doc tor. The applicant is able to resume normal activity. The oxygen saturation test showed that the oxygen was not absorbed by the blood like the oxygen should be absorbed^ m ~ " Bnrafl-- J " ' CUTHBERSON "2- Claita i t o . I h l - o ' f O Ho showing has been made (lit the addrev,; of thin de fendant is at kmeryville. Jurisdiction over this defCUiano Is not shown by the record. Plant Rubber a Asbestow worse an mild be dismissed. (Rule 10775 and 97-'5)- Applicant hm. oleccod not to proceed agelasi this defendant. One or more of the other clefeno ant... h-'vo w:\. of teen Issues herein, These issues aro: ven 1 . Juri sde.tion 2 . .Smplopment 3 . Occupation 4. Injury 5 . Inauranee 6 . Medical expense 7 . Medical 0. Earninga 9. Permanent 10. Temporary 1 1 . Hotice and prejudice 12. Statute of Limi testions 13. Department of Employment lU.-u 14. Occidental Life last:renco do. I..on 1 5 . Coats ' 1 6 . Apportionment 17. Estoppel Only Fund has raised the '.a.ioo o .vo.vvJ . tv, ,ei for Fund has advised that this is one ..a '*! .loro i. .-.ovi. .-vy. r,v. 1 The issue is the name as notice and projubi-.o. ino i---.; doe.., not require the impossible of nn api..l.lurnt. do 1: :.n ar.r v-a.-rrd exists for finding estoppel on the rari- n' two ohl.'.ornt. Industrial has put in is on ru;<3v.yu.cnt *va.. ...i.:w|'x"-in.;e. It has disposed of these issues by ..t.'.pvlnw.vn. In view of the stipulations, no findings on these lar.ve i avo ne ;oy. (inle IO744). ' Industrial and Fund have nut In 1.orco earnings and occu pation. The answer of the Fund admits maximum wages and the oc cupation of asbestos vjorker. , While working for Industrial's assured (Plant) on October 1 7 i 1954 applicant received maximum earningu (stipulated) and his occupation was asbestos worker (stipulated). Fund's assured, Western, paid applicant wages of $100.00 a week. (Applicant's testimony). The entire record compels the finding of asbestos worker as the occupation of the applicant, and maximum earnings. - Fund, Thorpe, Plant, and PE, as to themselves, question the jurisdiction of the Commission. By its nnswer, Fund relies on the defense that maritime injuries are beyond the jurisdiction of the Commission. The evidence fails to support the position taken by these four defendants on this issue. In holding that the Com mission does have jurisdiction, uniformity of the maritime law Is not disturbed. Work done by this employee tas not of maritime ^import since the transaction was of local concern and not prejudicial to uniform application of admiralty law. CUTHBERTSON -4- Olalla No. 16 I-8 7 0 The request filed 4-22-55 is for $1,149.71. This amount consists of two parts: (1) $35 a week from 10-18-54 thru 4-17-55 -- -{>910 plus $60 Hospital benefits, and (2) 130 a week from 9-28-53 thru lh~2l'--53 - $115.71 plus $64 (8 days ho&rvltal benefl ts) A lien for $970 should be allowed 00 the Department and the Department's request for the additional $179.71 should be de nied. 'No recovery can be had for this additional ra/nem;., the same being properly pa:?able to the employee unctor the unemployment in surance code. Applicant's counsel contends thn he is entitled u< co imbursement and payment of medical expon ei-.r.c"* (Loiter ca ~'il' a v.Ci-C. 3-5-56). He argues that Simien case (22 wLfW/ 10) a. ..-.ini rolli n--;. Beginning October 17? 195-1 c.j.: ..loa.nt obtain treatment which was successful and led 10i bi.`0 diarino.;; namely , asbestosis. It follows he Is entitled to reicover,/ of rxch i-eaocn- able expense as was necessary fcc enable hi.-; doctor ;.uk1 the do'0'.odants* doctors to properly diagnose the causo of the dJ sablJ.xty. The evidence as to the exact amount of too expenso xs vague and indefinite. This referee is unable_to hpeculate aa to the true total. Applicant'c counsel sent to the Comm.:,sai 011 `-orne exhibits attached to la letter- of February 29;. 15f6. 'muoex hibits were never properly introduced to evidence. ^Trr.nsciipt, page 86). A determination of the exact amount of mec.ior.l (expense will be made upon the service and filing of a proper petition in the event the parties are unable to ad:iuot this among themselves. The evidence allow*, and standard practice permits, only general finding. $70*00. Applicant has reasonably incurred costs in tne sum of (Exhibit A-2). ' As reflected by this record, applicant's attorneys have rendered services to the employee in the reasonable value of $ 300.0 0 . Apportionment or contribution of a defendant carrier is properly the subject matter of a supplemental petition. FINDINGS QF FACT 1. Jack Cuthbertson, born May 4, 1923, while employed as an asbestos worker by Western, Plant, Armstrong, ihorpe, during periods of emnloyment stipulated to by each of the several defen dant employers herein, contracted an occupational disease, to wit, a form of pneumoconiosis, namely, asbestosis. 2. The date upon which said employee first suffered dis ability from said occupational disease and either knew, or in the exercise of reasonable diligence should have known, that said dis ability was caused by hia present or prior employment, was October 23? 1954. 3 . The occupation of the applicant was asbestos worker. CUTHHERTSON -5- Claim llo. 161-870 4. At the time of said injury the weekly earn_ngs of employee were maximum. 5 . Employee has Incurred expenses for diagnostic treatment beginning October 17* 1954 and thereafter* and said treatment was reasonably required to cure os- relieve the effects of said disease. A supplemental award for the am-.unt of such expenses will be made upon the service and fxl..iv: of a supplemental petition in the vent the parties are un-.ble to " adjust such expense to their mutual satisfaction. 6 . Employee is in need of further mod a cal iron t-cenL reasonably required to cure or relieve fre-m the effects of said disease. 7. Said disease caused temporary total clifrul:.tg beginning October 17* 1954* to and Including tuly it.. Iff ^ 8 . Employee*a condition is not yet porta,1nont. 9. Statutory notice was given by the ce to Plant. Rone of the defendants hore-'<n on wirm! i.aV.-.-.i.ty la Imposed have been prejudiced by the alleged rv.,o c-; 10. The filing of the Application c.lmci/. . 11. Department has pa,id to ei-iplo; eo ; pensation disability benefits in the i.au of period of disability found herein. ;cr.rEv.t.; .so ' 12. Occidental paid no sum er moiicp .ita* hov.. I ^revtment reasonably required to cure or rel'.cve from .,0 o, fa...'., oi injury found herein. . 13. Employee has incurred costs .ui Uie ..cm of 47 >.30. 14. The detex-iiilnation of apportionment or contribution among the several defendant carriers Is deferred. 15. It is not true that employee Is estopped, to assert the claim made herein. 16. The Commission does have jurisdiction of the sub ject matter of said claim and of each of the defendants upon whom any liability is imposed herein, 17. As reflected By this record, employee's attorneys have rendered services to employee in the reasonable value of $ 300.0 0 . 18. Cork Is not a necessary or proper party. 19. Plant Rubber la not a necessary or proper party. 20. Mundet Is not a necessary or proper party. CONCLUSIONS OF LAW Employee is entitled to a joint and several award against Fund, PE, Standard, Travelers, Industrial, of: ' The reasonable value of medical treatment obtained by the employee on and after October 17, 1954 to and including July 14, 1955 and CUTHBERTSON -6- Claim Ho. 161-8TO Temporary total disability indemnity at maximum rate beginning October 17j> 195^ to and Including July 14, 1955, and Costs in the sum of $70.00, said sum being payable $35.00 to Dr. Thompson and $35.00 to Dr. Crenshaw, and . Further medical treatment reasonably requirad to cure or relieve from the effects of said disease. Employee's attorneys are entitled to a first lien in the sum of $300.00. Department Is entitled to a second lien in tne sum of $970.00. Request of Department for additional lien of $17 9 .7 1 should toe denied. Cork, Mandat, Plant Rubber should toe dismissed. Jurisdiction is reserved to determine apportionment or equitable subrogation on petition properly filed. JS: ja JOSEPH SHEEHAN Referee 3. Injury. 4. Insurance. 5. Medical expense. 6 . Medical. 7. Earnings. Temporary disability. -- anA iT.ldjCP I 1 Hailed from Son far.ftcn Office Industrial Acdcbn! Conrdaicrt Stateci C alif." ,, BEFORE THE INDUSTRIAL ACCIDENT COMMISSION 8 9 OF THE STATE OF CALIFORNIA 10 --0- 11 JACK CUTHBERTSON, 12 Applicant, ) ) CLAIM NO. I6I-87O 13 vs. ) 14 WESTERN ASBESTOS COMPANY, PLANT ) ASBESTOS COMPANY, ARMSTRONG CORK 15 !i CSTOAMTPEANCYO,MJPE.NTSA.TITOHONRPIENS&URASNOCNES,FUND, ) 16 INDUSTRIAL INDEMNITY COMPANY, ) TRAVELERS INSURANCE COMPANY, 17 STANDARD ACCIDENT INSURANCECOMPANY, ) and PACIFIC EMPLOYERS INSURANCE 18 COMPANY, ' 19 Defendants. ) ORDER DENYING PETITIONS FOR RECONSIDERATION 20 ___________ _______________________ ) 21 GOOD CAUSE APPEARING THEREFOR: 22 IT IS HEREBY ORDERED that applicant's Petition for 23 Reconsideration, filed herein June 9, 1956, he and it hereby 24 is denied. 25 IT IS FURTHER ORDERED that Pacific Employers In 26 surance Company's Petition for Reconsideration, filed herein 27 July 2, 1956, be and it hereby is denied. 28 I INDUSTRIAL ACCIDENT COMMISSION OF THE STATE OF CALIFORNIA 29 ; F.A.Lawrcno 30 John J,Synon 31 32 Commls si oners JACK CU 'h'.RToON July 2`i , 1.0' v, WESTERN ASBESTOS COIm 'Jm plant asbestos COMPAN- ARMSTRONG CO!-;' CSMPAil:' J, T 'jKOI.PE A. SG'ff I..V COMPENSO?1Oli INOUMANO': FUND ,`fKDUSTR F.AX INDiEN TY COMPANY travllths .timo COMPANY STANDARD AS0 If.ST INSURANCE COM'MK5' i.ri P Cl EMPLOYER'' INS Alici. C -fi'All Claim No. ?.6i-5!7`.) >tEPCylT OF IAGEL ONE The ree": sustain e the Findings am' Ai. -'-`C 111l:; June li... The Peti5ions tor Reconsideration should therefore be denied. INDUSTRIAL ACCIDENT COMICI Sl ON OF THE STATE OF CALIFOEHIA F.A.Lawrence John J.Synon a:k tfornrais'siooer s CUTHBERTSON Claim No. 1 6 1 -8 7 0 JOSEPH SHEEHAN ; Referee JULY 10, 1956 In ju r y : 1944 - 1954 UF REFEREE ON PETITIONS FOR RECONSIDERATION -----i2Hei_Juljr_2 ^ ^ 1 23_J_____ claims inJur^Sto3liiJsCf TM an,asbestos worker, 26 who of work h S n S u I 0^ ; . ^ ^tanoea''in o 2e seventeen issues.m0re f the defendants have raised herein said findings arfScontainedeinnthe1Fi'SH!ieS Presented, and herein June 11, 1956. n the Plndings and Award, filed Petition for ReconfideiatioiheanriPl? r e flled herein his ?htel ln excess of its powers t h e ^ i f f ^ that the CoTMnissio] award?S f fa" ' - treatment procured b ^ S expenseWedica Insurance Company^has*fficrt"vi3 ' ,t0 wlt! Pacific Employers slderatlon. ffi'ca??iir *>" R e ? ! as an Answer to the applicant's to be cnsidered tion for Reconsideration. petition and also as a Peti- liability for temporary disabilit^i direc.ted to the impositioi expense prior to October 2 1 ^odemnlty, and medical 17, 1954. The earriercontends^therp " f l u e n t to Octrter e employee prior to the date o f t h 2 T ? no obH E a t i o n to to be October 23, 1954. 1 of the injury, which was found 1954, and leftethehosDltflfrrtd *;he-hospital on October 17 during this perlol S? h ^ p i t TM l t , i er, ? 4 1954' treatment was successful and resSltS? , a4 the diagnostic asbestosis. a resulted in the diagnosis of who hospltalisld3hi2ef22P a 22o2??SUite!i hls own doctor, fJiied ihle diagnostic t r eatmm? i^s 2??tment ln the sanle ailed to furnish any basis for a diag22si2CCeSSfUl 0nd 32 Commissioners JACK CUTtfBERTSON July 19 56 Vo WESTERN ASBESTOS GOMFaN , PLANT ACIk'iSTOG COMP AN T f ARMSTRONG CORK COMP/ufiT J, T 'THORPE & SOKE, 01 >TE COMPENSATION insurance FUND, INDUSTRIAL INDnMN TY COMPANY, TRAVELERS INGU.-ANGE COMPANY', STANDARD ACCit):.NT INSURANCE COMPaNT uni P. Cl PIC EMPLOYERS IKiJU cAUCL COM'ANir C laim N o , 161 -S? VjE.PCuiT OF PANEL ONE The reeoct sustains the Findings and Aw-rr-d fileo June1 1.1, 1956o The Petitions tor Reconsideration should therefore be deniedo INDUSTRIAL ACCIDENT COMMISSI IN OF THE STATE OF CALIFORNIA F,ALawrence John J.Synon ask 0 oraraiisioEeri CUTHBERTSON C la im No. 161-870 JOSEPH SHEEHAN, Referee JULY 10, 1956 I n ju r y : 1944 - 1954 REPORT OF REFEREE ON PETITIONS FOR RECONSIDERATION _____ i 2 H S i _ J ! L 2 2 i _ 1 2 5 6 U _____ This is the claim of an asbestos worker, 26, who claims injury to lungs from "breathing substances in course of work harmful to chest and lungs." One or more of the defendants have raised herein seventeen issues. Findings were made on all issues presented, and said findings are contained in the Findings and Award, filed herein June 11, 1956. On June 29, 1956 the employee filed herein his Petition for Reconsideration, and alleged that the Commission acted in excess of its powers, the evidence does not justify the findings of fact, and the findings of fact do not support the award. The employee objects to the finding that he first suffered disability on October 23, 195*+, and he contends he is entitled to temporary disability indemnity for approxi mately one month in 1953, together with the expense of medical treatment procured by him in the year 1953. One of the defendants, to wit: Pacific Employers Insurance Company, has filed herein its Petition for Recon sideration. This carrier wants the petition to be considered as an Answer to the applicant's petition and also as a Peti tion for Reconsideration. The carrier's petition is directed to the imposition of liability for temporary disability indemnity, and medical expense prior to October 23, 195*+ and subsequent to October 17, 195*+. The carrier contends there was no obligation to the employee prior to the date of the injury, which was found to be October 23, 195**. The employee entered the hospital on October 17, 195**, and left the hospital on October 23, 195*+. It was during this period of hospitalization that the diagnostic treatment was successful and resulted in the diagnosis of asbestosis. In 1953 the employee consulted his own doctor, who hospitalized him for diagnostic treatment in the same year. This diagnostic treatment was not successful and failed to furnish any basis for a diagnosis. The carrier contends that no liability may be imposed upon it prior to the time that the employee had disability, and either knew or in the exercise of reason able diligence should have known that the disability was caufeed by his work. w . 4 . Thls Referee recommends that applicant's petition De denied, and also that the carrier's petition be denied. Applicant relies upon the Simien case (Simien vs I.A.C., 21 CCC 10) as authority for the imposition of liability on the defendants herein for the diagnostic treat ment which was unsuccessful. The holding in the Simien case is not authority for imposing any liability on a carrier for medical treatment which has been unsuccessful. Simien re ceived medical treatment which successfully relieved and cured from the effects of the injury. ln the instant case the diagnostic treatment secured by the employee in 1953 was unsuccessful, and it was obtained by the employee at his peril. It would be unreasonable to assess liability for this treatment against any of the defen dants herein. The successful diagnostic treatment which was secured by the employee 7 days before he was informed of the work connection of his disability has reasonably resulted in an obligation of the defendants herein. .. , , T5e carrier has also urged other points, such as dismissal of unnecessary parties, and lack of cross-examination 01 some employments not herein specifically involved. . , v. is not true that the defendants, or any of them, have been denied an opportunity to cross-examine the appli cant in any particular. Furthermore, this particular carrier may file a proper petition for contribution or subrogation herein8 Sn aS lt pays more than its ust share of the award ,, . Submitted herewith is appropriate order denying applicant s Petition for Reconsideration. Also submitted herewith is appropriate order deny ing the Pacific Employers Insurance Company's Petition for Reconsideration. JS: Ja JOSEPH SHEEHAN Referee -2- JACK CUTHBERfSON \ \ PLANT RUBBER AND a SBE^TOS WORKS, AiMjrNli CORK COMPANY, MJNDBNT CORK CORPORATION, PLaNT ASBESTJS COmPANY, WESTERN A3BEST0B COmPAiMY, J. 'JE fHOHPS AND SON, and TKAVELEK2 INSURANCE COMPANY, INDUSTRIAL XNDEMNITY COMPANY, 3 TA TE COMPENSATION INBCHANGE FUND, PACIFIC MPL0YHR3 XWJUHANCS 00., CALIFORNIA CJ.iPEN3a n o a INSHa NCE CO., and STANDARD ACCIDENT INSURANCE COMPa WY JOSEPH SHEEHAN, REFEREE San Francisco, Sept. 7, 1955 4 CLAIi-i NO- 161-370 Inj. 1944~19.,4 REPORT OF REFEREE Asbestos worker, 2i>. claims injury to lung from breathing substances in the course of work harmful to chest and lungs. FACTS IN CONTROVERSY AS TO STATE COMPENSA I'JOh INSURANCE FUND: 1. Occupation,, 2 o Injury. 3 . Medical. 4. Medical expense. 5. Earnings. o. Temporary disability. 7. Notice and prejudice. S. Statute of limitations. 9. Lien of Department of Employment. 10. Lien of Occidental Life. 11. Costs. 12. Estoppel. 13. Jurisdiction. SUMMARY OF TESTIMONY: Applicant testified substantially as follows: While he worked at Western Asbestos his rate of pay was as set forth in the letter of February 14, 1955- His hourly rate was for a 40-hour week. He first worked at Western as a helper. He did work aboard ^he 3* Lurline. This work consisted of packing materials from the dock to the ship. He worked as a helper for three and a half months. The asbestos that he handled during this period of time was in closed cartons. He worked mostly on the dock. He worked for Western Asbestos on the Standard Oil job as a helper. This job consisted of making cork insulation. During the period 1947 to 1950 he handled various materials including asbestos, rock wool, fiber glass and asbestos paper. His job was that of a helper and he would pass these materials to tne mechanics, some times the air in which he was working was dense. Sometimes he would work in enclosed areas. He worked on the Standard Oil job for three and a half months. On that job ne had very little contact with tne materials of asbestos and rock wool. He also worked on the Union Oil Couipany job. j. ! i CUrHriiilifJUi'l - 2- He worked for Mundet on a job at tne Bethlehem yard, This ;joo required him to work mostly on the ships. He also v/orked at oss Landing. While he was working at the Moss Landing joo ao wa.,, asbestos worker. He was also known as a mechanic and he would apply the asbestos to pipes and boilers. On this job his clotass were dusty and he noticed tnat t.ie inside of his nose was also easty. In 1953 he went to Dr. Thompson and Dr. Thompson took x-rays. Dr., Thompson in turn sent him to Dr*. Crenshaw. Under Dr. Crenshaw he underwent surgery to obtain a diagnosis. At tnat time he was having pains He stopped work on September 30, 1953, and was off work Lor one month because of tne surgery The doctor found nothing wrong and the doctor told him to _3o bacx to work. He continued working until October 19, 1954, when he nau further surgery on his cnest. Dr. Crenshaw performed this surgery. He has been off worn ever since October 19, 1954 Ho has not returned to his trade. It was on October 22, 1954, that Dr. Crenshaw advised him tnat nis condition was due to his work. The bill for the first surgery was paid half by himself and half by the Occidental Life. The bill for the second surgery is to be paid naif by him and half by tne Occidental Life. Dr. Crenshaw has sent him a bill, but he left the bill home. He worked from July 15, 1955, to August 14, 1955. During this time he earned -353 a week. . At one time in his career he was an able-bodied seaman. He held a card as such for a period of three years, but he v/as not three years on the sea. On October 15, 1954, he gave a work history when he was in the Herrick Memorial Hospital. His work on the Lurline was that of a helper. He would transfer the materials from the dock to tne ship. He worked on this job for three or four months* On tne Standard Oil job he would use rock wool and cork. The Lurline job required him to mix wet and dry asbestos. Occasionally he worked aboard ship. His general duties required him to bring the materials aboard. He was just a helper on tne Standard Oil job. He worked about six weexs with tne rocx wool. During the last four and a half months he worked Lor western he was a journeyman. He does not know whether or not the ships at Bethlehem were new construction. On tnese ships fiber glass was used. He is a jcsmeyioan asbestos worker. The job at the ship yard was a rush job and is was very dusty in the shop at the ship yard. This job CUfHBiSrtXSON required him to work lo hours a day but he had no other complaints. H e w a s t i r e d af ter- this lot v When he worked for Mundet Cork the job was at the Alameda ship yard. On this job he used the tools of an asbestos worker. He worked in a s b e s t o s \nd cork but it w a s m o s t l y cork. fhe m a t e r i a l s w e r e a p p l i e d to the ship 11W i l s o n " and w o r k i n g on this ship r e q u i r e d h i m to w o r k in a d u s t y place. F o r tfundet Cork h e wo r k e d eight hours a day. The j o b at the m o s s L a n d i n g was an o u t s i d e job. lie w o r k e d in the open air, but it was very dusty. There was no control of the wind. H e ha d no d i f f i c u l t y w h i l e w o r k i n g at rloss L anding. He h a d no c o m p l a i n t s r e g a r d i n g h i s c h eat wneri he left /estern Asbestos. A f t e r his first surgery he continued under the care of Dr. Crenshaw. foilow3"ShaW' Called by ths aPPlicant, testified substantially as Stated his qualifications. The applicant has been under his care since Depteiaber 22, 19 5 3 . Surgery was performed the second time October IS, 1954. The doctor is of the opinion that the reasonable period of convalescence from this surgery would be four or five months and thereafter the applicant could return to light work. S , d ? S i r 1 3 f the i?i n ion that the r e a s o n a b l e p e r i o d of c o n v a l e s c e n c e xrOifl this s u r g e r y is six m o n t h s a f t e r t h e s u rgery* fhe d o c t o r is o f the o p i n i o n tnat t h e a p p l i c a n t is 20 p e r c e n t d i s a b l e d at the p r e s e n t t ime and t h a t tne a p p l i c a n t 's c o n d i t i o n w ill get worse. The applicant need3 medical observation, but he does not need any medical treatment. J The applicant could go to work now, but the applicant is enjoined from working in asbestos work or doing heavy labor work. The doctor is of the opinion the applicant suffers from asbestosis, when asked whether or not the applicant also suffered from silicosis the doctor answered yes and no It was only after the second operation that the doctor told the applicant that his condition was connected with his work. Years of exposure to harmful substances can cause the condition from w m c h the applicant suffers. O n S e p t e m b e r 22, 1953, pleural effusion. His Following this surgery condition. the applicant was complaining of a fi-ht side condition was diagnosed as non specific thoracis. the doctor ruled at the serious causes of the The f i b r o s i s did not s h o w i n t h e x*rays. It w a s j u 3t p r i o r to o r subsequent to the second surgery that he notified the applicant of his opinion that the condition was due to the a p p l i c a n t 's work. Possibly it was roughly a week after the second surgery that the doctor so advised the applicant. CUTHBEtiTSGtfi -4 - The doctor does not believe that the applicant could return to work of a seaman. The doctor believes that a seaman*s work requires heavy exertion. That the applicant could do general work, except tnat the applicant can not do hard work and he must work in a place that is free f r o m h a r m f u l dust. It is reasonable to expect tnat the a p p licant's capacity to work in the future will be less than it is now. In tne opinion of tao doctor the fibrosis that is present will continue to increase. The doctor came to the conclusion that the work was responsible for the condition because he found substances of elements used in the work in the lung. There is a possibility that the fiber glass may have caused the disa bility. The present factors of disability in the applicant are shortness of breath and weakness C o n t i n u e d , to be r e s e t on the first a v a i l a b l e calendar. JS:jr 4 ' CUTHBERTSON Clr.im No. SF 161-870 JOSEPH SHEEHAN, REFEREE Oakland 2/17/55 Injury: 1944 - 1954 REPORT OF REFEREE ON ORIGINAL HEARING Asbestos worker (date of birth not alleged) claims injury to lungs from '`breathing substances in course of work harmful to chest and lungs" . ISSUES a S TO INDUSTRIAL INDEMNITY COMPANY 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. Employment. Occupation. Injury. Insurance. Medical expense. Medical. Earnings. Temporary disability. Notice and prejudice. Statute of Limitations. Lien of Department of Employment. Lien of Occidental Life. Costs. ISSUES AS TO TRAVELERS INSURANCE COMPANY 1. 2. - 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13- Employment. Occupation. Injury. Insurance. Medical expense. Medical. Earnings. Temporary disability. Notice and prejudice. Statute o f .Limitations. Lien of Department of Employment. Lien of Occidental Life. Costs. ISSUES AS TO STATE COMPENSATION INSURANCE FUND 1 * Employment. 2. Occupation. 3. Injury. 4 . Medical expense. 5. Medical. 6 . Earnings. 7. Temporary disability. 8. Notice and prejudice. 9. Statute of Limitations. 10. Lien of Department of Employment. 11. Lien of Occidental Life. 12. Costs. 13. Insurance. SUMMARY OF TESTIMONY APPLICANT testified substantially as follows: He was born May 4, 1928. He is right-handed. He is an asbestos worker. In 1949 he worked for n'estem Asbestos. He went to work sometime before April, 1949, as a helper His job was to pack asbestos onto a ship. He worked two or three months. Sometimes he worked below the decks and in the engine room f COTHBERTSON 2 / 1 7 / -2- Claim No. 161-870 \ His work rcouired him to pack and mix dry asbestos. His earplugs were about ^46.00 a week. On the Standard Oil job he helped with the supplies. He used rock wool and hot tar on this job. He worked in an enclosed area. T h e r e w e r e 20 to 30 m e n w o r k i n g and the v e n t i l a t i o n was poor. He worked with asbestos blocks. He worked for Armstrong in 1950 and stopped work in 1953 He started working for Western Asbestos in 1949 and worked about two years. He worked for Plant Asbestos about nine months beginning in 1950. He worked for We s t e r n Asbestos in 1940 and 1950. He worked for Plant Asbestos for one week. He worked for Armstrong Cork in 1951* ifi It appeared to this referee that the proper parties defend ant were not before the Commission at this time and the matter was continued, to be reset. Notice was given to counsel for the applicant that in the event that a proper amended application was not on file within a reasonable time the application filed herein would be ordered di s missed without prejudice. It appeared that the testimony of the applicant should be stricken from the record inasmuch as the proper parties defendant were not before the Commission at this time and the testimony was ordered stricken from the record. able file The calendar herein. matter in the was continued, to be reset on the first event that a proper amended application avail was on JOSEPH SHEEHAN Referee CUTHBERTSON 2/21/56 -5- Claim No. 161-370 The doctor is of the opinion that the applicant first became afflicted with asbestosis in 1953 when the applicant experienced the pain. The onset of the clinical disease occurred in 1953. The doctor' believesthat each employment should bear an equal share all the way through. Continued exposure increases asbestosis. ROLAND E. MASTERS, called by the defendant, testified sub stantially as follows: He is the office manager of the San Francisco office and of the Marine Department of J . T . Thorpe and Sons. In 1943 and 1949 the company was using asbestos products, which included block insulations, both hot and cold temperatures, pipe coverings and certain cements. He enumerated the content of asbestos in some of the products he used. During those years most of the work was outside work and was new construction. In 1943 and 1949 he received no complaints regarding dusty conditions at the job sites. A helper would usually mix the materials used at the job. One of the samples contained 15 per cent asbestos and another of the samples contained 15 to 20 per cent asbestos. CARL 0. JUST, called by the defendant, testified substan tially as follows: He is a supervisor at Plant Asbestos and has been such for six years. He knows the applicant and knows the employment of the applicant at the plant. The employment consisted of work mostly on new construction. No request was ever made of him for any change in the ven tilation on the job. He received no complaints regarding dust on any job. ALLAN HOLDEN, called by the applicant, testified substan tially as follows: He is employed by the Occidental Life Insurance Company and the Occidental Life Insurance Company have filed a lien herein in the sum of $591.37. The following bills make up this item: Bill of Dr. Thompson, 10-9-53, for #30.00; bill of Dr. Crenshaw of 10-9-53 for $220.00; bill of the Blood Bank of 10-16-53 in the sum of #33.25, of which the lien claimant has paid #24.75; the bill of the Herrick Hospital in the sum of 4361.07, dated 10-23-53, of which the lien claimant has paid $292.12; the bill of the Peralta Hospital for laboratory examination in the sum of ,,>20.00, dated 10-30-53. The lien claimant has paid hospitalization and medical benefits under their accident and sickness policy. They have also paid $15.00 a week for 47-1/7 weeks. This sum was paid beginning April 5, 1955, to 9-14-55 and the witness corrected this period to be 10-20-54 to 9-14-55. The policy does not cover reimbursement of workmen's com pensation benefits. . APPLICANT, recalled, testified substantially as follows: He was born May 4, 1923. In 1953 while he was in the hospital special nurses were hired for eight shifts at $3.00 each and $64.00 was paid by him to the nurses. In September, 1954, he incurred the bill of $12.50 at the Herrick Hospital. In January, 1955, there was a charge of #15*00 for oTlaboratory rest. ~"0n February 20, 1954, there were laboratory tests and X-ray, for which he was billed the sum of $37.50. CUTHBERTSON 2/21/56 -6- Claim No. 161-S70 DISPOSITION The matter was ordered submitted at the end of 10 days and the case to remain open for said 10 days to permit the filing of the copies of the medical reports of the Department of Employment, together with the hospital record of Herrick Hospital and further medical reports from the applicant; the parties were requested to s u b m i t b r i e f s on a l l o f the i s s u e s w i t h i n 20 days. JS: S JOSEPH SHEEHAN Referee rsc- > 1 2 3 4 5 6 7 8 BEFORE THE INDUSTRIAL ACCIDENT COMMISSION 9 OF THE STATE OF CALIFORNIA 10 --0- 11 JACK CUTHBERTSON, ) 12 Applicant, ) 13 vs. CLAIM NO. 161-870 14 WESTERN ASBESTOS COMPANY, PLANT ASBESTOS COMPANY, ARMSTRONG CORK 15 COMPANY, J. T. THORPE & SONS, FINDINGS AND AWARD ) STATE COMPENSATION INSURANCE FUND, 16 INDUSTRIAL INDEMNITY COMPANY, ) TRAVELERS INSURANCE COMPANY, 17 STANDARD ACCIDENT INSURANCE COMPANY, ) and PACIFIC EMPLOYERS INSURANCE 18 COMPANY, ) 19 Defendants. ) 20 21 Application for Hearing having been filed herein, 22 and all parties having appeared or having been duly notified, 23 and the matter having been regularly heard before Referee 24 Joseph Sheehan, and submitted for decision, said Referee now 25 makes his Findings and Award, as follows: 26 FINDINGS OF FACT 27 28 1. Jack Cuthbertson, born May 4, 1928, while em 29 ployed as an asbestos worker by Western Asbestos Company, 30 Plant Asbestos Company, Armstrong Cork Company, J. T. Thorpe 31 & Sons, during periods of employment stipulated to by each 32 of the several defendant employers herein, contracted an occupational disease, to wit, a form of pneumoconiosis, namely, asbestosls. 2. The date on which said employee first suffered disability from said occupational disease and either knew, or in the exercise of reasonable diligence should have known, that said disability was caused by his present or prior em ployment, was October 23, 195^* 3 . The occupation of the applicant was asbestos worker. 4. At the time of said injury the weekly earnings of the employee were maximum. 5. Employee has Incurred expenses for diagnostic treatment beginning October 17, 195^ and thereafter, and said treatment was reasonably required to cure or relieve the effects of said disease. A supplemental award for the amount of such expenses will be made upon the service and filing of a supplemental petition in the event the parties are unable to adjust such expense to their mutual satisfac tion . 6 . Employee is in need of further medical treat ment reasonably required to cure or relieve him from the effects of said disease. 7 . Said disease caused temporary total disability beginning October 17, 1952*, to and including July 14, 1955 8 . Employee's condition is not yet permanent. 9. Statutory notice was given by the employee to Plant Asbestos Company. None of the defendants herein on whom liability is imposed have been prejudiced by the al leged lack of notice. 10. The filing of the Application was timely. 11. Department of Employment, State of California, has paid to the employee unemployment compensation disability 11 j # ji * 1 NH I1 benefits in the eum of $970.00 during the period of disa # V ** %b * *\ * j 2 bility found herein. aa 3 12. Occidental Life Insurance Company paid no sum 1S 4 of money for medical treatment reasonably required to cure I 5 itI it or relieve from the effects of the Injury found herein. !S 6 !! 1 3 . Employee has Incurred costs in the sum of 1y a 7 ** $ 7 0 . 0 0 . 8 ii 14. The determination of apportionment or contri aa1 9 :t bution among the several defendant carriers Is deferred. : 10 it 1 5 . It is not true that employee is estopped to tt 5 11 i! assert the claim made herein. 12 a 1 6 . The Commission does have Jurisdiction of the 13 subject matter of said claim and of each of the defendants iiij 14 a upon whom any liability is imposed herein. 15 1 7 . Employee's attorneys* Smith & Parrish* have 16 I ii rendered services to the employee in the reasonable value I 17 of $300.0#. ii 18 a 1 8 . Cork Insulation Company is not a necessary or S 19 y proper party. 1 20 1 9 . Plant Rubber & Asbestos Works is not a neces ii 1 21 sary or proper party. it!t 22 ii 20. Mundet Cork Corporation is not a necessary or 23 a proper party. ! 24 ii AWARD 25 11 26 1 AWARD IS MADE in favor of Jack Cuthbertson against 8 27 State Compensation Insurance Fund* Pacific Employers Insur ?l a 28 ance Company* Standard Accident Insurance Company, Travelers s1 29 st Insurance Company and Industrial Indemnity Company of reim 1 30 tt bursement for the reasonable value of medical treatment ob H 31 i tained by the employee on and after October 17 * 195^ to and it 32 i including July 14, 1955 i -3 - 3 AWARD IS FURTHER MADE in favor of Jack Cuthbertson against State Compensation Insurance Fund, Pacific Em ployers Insurance Company, Standard Accident Insurance Company, Travelers Insurance Company and Industrial Indem nity Company of temporary total disability indemnity in the sum of $35.00 a week, beginning October 17, 1954 to and in cluding July 14, 1955* AWARD IS FURTHER MADE in favor of Jack Cuthbertson against State Compensation Insurance Fund, Pacific Em ployers Insurance Company, Standard Accident Insurance Company, Travelers Insurance Company and Industrial Indem nity Company of reimbursement for the reasonable value of costs incurred by said employee in the sum of $70.00, said costs being payable as follows: $35-00 to Dr. A. R. Thomp son, and $35.00 to Dr. Gerald L. Crenshaw. AWARD IS FURTHER MADE in favor of Jack Cuthbertson against State Compensation Insurance Fund, Pacific Em ployers Insurance Company, Standard Accident Insurance Company, Travelers Insurance Company and Industrial Indem nity Company of further medical treatment reasonably required to cure or relieve him from the effects of said disease. IT IS ORDERED that employee's attorneys, Smith & Parrish, be and they hereby are allowed a first lien in the sum of $300.00 against any compensation unpaid and payable herein. IT IS FURTHER ORDERED that Department of Employ ment, State of California, be and it hereby is allowed a second lien in the sum of $970.00 against any compensation unpaid and payable herein. IT IS FURTHER ORDERED that the request of the Department of Employment for an additional lien in the sum of $179.71 be and it hereby is denied. 1 IT IS FURTHER ORDERED that Cork Insulation Company 2 it u1 be a n d it h e r e b y is d i s m i s s e d . * 31 IT IS FURTHER ORDERED that Mundet Cork Corporation 4 li b e a n d it h e r e b y is d i s m i s s e d . 1 5 i IT IS FURTHER ORDERED that Plant Rubber & Asbestos ii 6 n W o r k s be and it h e r e b y is d i s m i s s e d . 7 iIi* If IT IS FURTHER ORDERED that jurisdiction be and it 8 !i h e r e b y is r e s e r v e d to d e t e r m i n e a p p o r t i o n m e n t o r eq u i t a b l e 1 9 ii s u b r o g a t i o n on p e t i t i o n p r o p e r l y filed. 5 10 ii IT IS FURTHER ORDERED that this Award shall bear 11 j i n t e r e s t p u r s u a n t to the p r o v i s i o n s o f S e c t i o n 5 800 o f the 12 ! L a b o r Code. 13 * S t 14 ;!!! IS i 16 ii ii 17 Ii !:: 18 H 1I 19 Iti!t I 20 JUN 1 1 1956 JOSEPH SHEEHAN, REFEREE INDUSTRIAL ACCIDENT COMMISSION FILED AND COPY MAILED TO: (JA) 21 Department of Employment, P 0 Box 1857* Oakland 4 22 iMi O c c i d e n t a l Lif e I n s u r a n c e Co., 583 M a r k e t St., S.F. 4 a Jack Cuthbertson, 2284 Holbrook Drive, Concord ii S m i t h & Parrish, 16 16 F i n a n c i a l C e n t e r B l d g . , O a k l a n d 12 23 ti L e o n a r d , H a n n a & B r o p h y , 100 B u s h St., S.F. 4 i|* ** M u l l e n & F i l i p p i , 315 M o n t g o m e r y St., S.F. 24 I* T r a v e l e r s I n s u r a n c e C o m p a n y , L a t h a m S q u a r e B l d g . , O a k l a n d 25 i*14i In St d a u t s e t rial Comp e I n n s d a e t m i n o i n t y I n C s o u m r p a any, nce F 350 und, S a 4 n 5 s 0 o m M e c A St., llis t S.F. er S t 4 ., S.F. 1 II*i P a c i f i c E m p l o y e r s I n s u r a n c e C o m p a n y , 3 770 P i e d m o n t A v e , O a k l a n d 26 ;j S t a n d a r d A c c i d e n t I n s u r a n c e C o m p a n y , c/o L e o n a r d , H a n n a & 1 Brophy, 100 Bush St., S.F. 27 1 P l a n t R u b b e r a n d A s b e s t o s W o r k s , 5 3 0 9 H o r t o n St., E m e r y v i l l e 1 Armstrong Cork Company, 1355 Market St., S.F. 28 Mundet Cork Corporation, 440 Brannan St., S.F. 1 Plant Asbestos Company, 5309 Horton St., Emeryville 1 29 Western Asbestos Company, 675 Townsend St., S.F. 3 1:i J. T. Thorpe & Sons, Emeryville 1 30 31 32 Ky -5 - CTJTHBERTSON Claim No. 3F 161-870 Injury: JOSEPH SHEEHAN, REFEREE MAY 14, 1956 REPORT OF REFEREE ON DECISION 1944 * 1954 Alleged asbestos worker, botn May 4, 1928, clajuu injury to lungs from "breathing substances in course of work born ..i to chest and lungs.'1 The proper names of the defendants have beer in this report, as follows; yr' .d Western Asbestos Company State Compensation Insurance Fund Plant Asbestos Company Industrial Indemnity Company Armstrong Cork Company Travelers Insurance Company Standard Accident Company Occidental. Life Insurance Co. State of California, Department of Employment Pacific Employers Insurance Co, J. . Thorne C< Sons Mundet Cork Corporation Pork Insulation Company Plant Rubber & Asbestos Works Vlnsoem F ur.d Plant In'i'.otr.'.uJ ArriK-1traag Travelers Sari rdarc. Ooc.tdeof,al v^part;iK.nt Pi Z !.rvoruli "to.ei, ) .a,vt ftvPb'.'r In the application it is alleged that, applio-.u iss e m ployed by Mundet, as follows: "1948 - in February, March, April and May, ~R-f" mately 4 months (4)." Mundet never appeared in this matter. No appearance was made for it. No proof of proper service was mccte. The letter of Mundet of 2-16-56 was filed In answer to a subpoena oi che commis sion. During the time applicant worked for Kuuaat he ut'-d strictly cork. (Testimony of applicant.) Applicants counsel has assured the Commission that "we are not going to proceed against Mundet Cork or Cork Insulation." (Transcript p. 46). Mundet anov.ld be dismissed forthwith. (Rule 10775 and 10782). Employment with Cork is alleged to have been: "Cork Insulation Co., San Francisco, Cal. 1949 February to April, approximately 2 months. Cork made no appearance herein. Applicants counsel has submitted no proof of proper service. His assurances (transcript p. 46) constitute a request for dismissal of Cork. Cork should be dismissed forthwith. (Rule 10775 and 10782). The Application, filed March 8 , 1955# alleges: "Original employment, Plant Rubber Asbestos Works, San Francisco, Calif. 1944 - February 26th to June 12th, approximately 3-1/2 months." Apparently purported service on .his defendant was made at "Plant Rubber & Asbestos Works, 5309 Horton Street., Emeryville, Calif.1, CU1HBERTS0N "2- No. 161 ' No s a o tfln s h as been made t h a t th e '.der'e;.,; ox' 'oh.-.c d e fe n d a n t i s a t E m e r y v i ll e . J u r i s d i c t i o n o v e r tb ..a oexcnticno xs n o t shoirn by th e r e c o r d . P la n t Rubber A co o sco s uov.>.b u,n m id Se dlaMhiCd. (RvJ.e 10775 and W 5 ' . ' : > 3 > 1 -=.... . q oroceeo a^yr-nsc this deiendano. One or more of the other d es herein. The:;,e issues sr 'Hu-oni, h- .von- 1 . JUIV-uiCii o o,,on 2 . impj.oymenu 3. Occupation 4. Injury 3* Insurance 6 . led!cal expense 7. Kedier.1 8 . Earning:. o Perm anent 10. Temporary 11. Notice and prejudice 12. statute of L im it a t io n s 13. Department of j-mplopms. 14. Occidental L i f e Insv.rai VO. 15. Cos ss 16. hppovtXonmenu 17. Estoppel Only Uniid ho-:- raided the .Vn . Ci X'OC Fund has adviced that tfc.'.e issue ' .1 f `V,. ^ ::.- .1. A-O. COO n u t The issue is the name as notice rue. y< require the impossible ol rn <r;>, .Uu~nw. j- l\ ' i rd exists for flnd^np, estoppel on tns <ru*t. ~x e * ;i. -r fh.. Industrial has put in r:.- em 3 -,,-.cal "ni. cv. c It has disposed of these issue,.. \rj s,..ivvo-.o.--a.^ ;:.n vj *...- ox u j stipulations, no findings on these :s -c . "so iu- .o ..or.. . u- - 10744). - Industrial and Fund have pub ..n '-....e eoitunys c-nc? occu pation. The answer of the Fund admits maximum v.^pe-s and tiie oc cupation of asbestos worker. While workints for Industrial's assured (Plano) on October 17, 1954, applicant received maximum earnings (stipulated) ana his occupation was asbostos worker (stipulated)* a week. Fund's assured, Western, paid applicant wages oi $100.00 (Applicant's testimony). The entire record compels the finding of asbestos worker as the occupation of the applicant, and maximum earnings. . Fund, Thorpe, Plant, and PE, as to xhemselves, question the jurisdiction of the Commission. By its Answer, rund rel.ies on the defense that maritime injuries are beyono. the juxasdyction of S o S e l l o n . The evidence fails to 3ppc.-t the poeieion ta!n by these four defendants on this issue. In nolo^ng chat the Com mission does have jurisdiction, uniformity of the maritime l,.v is not disturbed. - Work done by this employee was not of maritime import since the transaction was of local concern uid not prejuaicxal to uniform application of admiralty law. CUTHBERTSON - 3- Claim No. 161-870 The evidence of Drs. Shipman, Watson Indicates that the applicant d< from an occupational disease, namely, to wit, asbestosis. Thompson, Crenshaw, and have and does suff~er form of pneumoconiosifs a Dr. Shipman testified the p< ployment contributed equally to the dJ disease on October 1'J, 1954. OQ .> 01` SOi-pulavod om.bling c-ufeo fco of the :ti Oil between the disea,se * apyl 1eant 0,c.fi a~js a.i`ter ..1 . cuvet had, anJ xi tiie ex- ?": kn'Ui.eego of .u..-.h oon- Ci<'n.ii'aj )* Dr. Shipman and Dr. Cron.,.hoi: is5 u'x'led tte employee needs Vis,11'i.Jg'-*- iVad. V J.iT. ,v ? of .her rrad' -v.i t .CXt VCLipernr V C..tivC.v ** bill by beginning October XT., 1954, to v .-.aoled .'July 14, I.955. (Testimony of applicant and Dr. Crenslvt:} D r . Shipmon5s testimoiy inciJ.0"to. tno permanent. Applicants counsel has requested de permanent disability be deferred. (Latter of in ndxv.ion r-^x, ratnation of Jiiii.t h . -01. Some evidence indicates fcho employee , i ;. and that his condition will get worse. Cn cho otho5.- neiid Dr. Illnnhaw (5-24-55) advises that there will be no program .i on of the disease, The evidence of Dr. Shipman moves this referee to defer dar-ermna- tlon of this issue. Notice of injury was Dromptly given to plant end Indus trial. (Testimony of applicant), Nona of the defendants have been prejudiced by alleged laclc of notice en October 1?. 1954, or subse quent to October 17, 1954. The evidence does not establish any oblige.cion in the defendants to, in any manner whatsoever, compensate applicant for a disability occurring in 1953 and the diagnostic treatment pro cured by him in 1953 (Record of I-Ierr.-jk Hospital and testimony of applicant). The medical services obtained by the applicant in 1953 were obtained by him at his peril. The filing of the Application was well within the statu tory period of one year of October 23, 1954. Occidental claims a lien in the sum of $591.3?. The sums making this total of $591.87 were paid from 10-9-53 to 10-30-53. Such payments were not made for the reasonable expense incurred by or on behalf of said employee for medical treatment to cure or relieve from the effects of the injury found herein above. Diagnostic thoracotomy in 1953 did not result in a diag nosis so far as the parties herein are concerned. Payments made by this lien claimant cannot be made a basis for recovery by it either from the applicant or the defendants. The Department has lien. One request was filed a duplication of the request missed. filed two requests for allowance of 1-4-55 for $539.71. This request is filed 4-22-55. it should be dis . CUTHBERTSON -4- Claim No. 161-870 The request filed 4-22-55 is for $1,149.71consists of two parts: (1) $35 a week from 10-18-54 thru 4-17-55 $9io plus $60 Hospital benefits, end This amount . (2 ) $30 a week from 9-28-53 thru 10-24-53 . $115.71 plus $64 (8 days hospital benefits) A lien for $970 should be allowed sc the Deparfmcnifc and the Department's request for the add:*.ticnnl $179 71 should to de nied. No recovery can be had for tiv.c aciditxonai mcanth.. aha seme being properly payable to the employee unoor two unefvlo; -'-an'c .in surance code. Applicant's counsel contends LUo). ho ..;. CM,r.iIou u re imbursement and payment of medical expeu-.,e.` ;Lccter of nr. wm.th 3-5-56). He argues that 61mlen cere (21 too l"') : ^ ontreui n.;. Beginnin,;Lv> JV> Lober 17, 1954 uppr '.'U'-iu' OiJ s>L ;'.ued : . : agnostic treatment which wa `3V ess fui and led io o-.o Ci.'-- an>o . U:amei:. , asbestosis. It fon o w s he is entitled tc x :-:>vO:a, f .VCh rennanable expense as was ne cessarjr tc enable .;J. - coi. . and thn aciao - dants' doctors to properly diagnose vke ause of cue .<:sab .J..t, . The evidence as to the exact amount of tre e^peruo j..-; vague and indefinito. ihis votevos is unable to ; to -v. to the true total. An lioasii-'c counsel sent to the Coarmi^i ion exhibits attached to lus letter of February ft,, 15 . Iri'ji.j exhibits were never properly introduced no avid en . ^*j.X'*iIj j/.k f page 86). A d.ot3vii:ia.:t.*-on ex' tu3 e^aoi. Tiuut*nt oi uoc.'.cr 1 will be made upon the service and filing of_ a proper ,;>et.;fJ.on in the event the partie-., are unabli-- to '(Jou-o 'Limn- aiming themselves The evidence allows, and standard prac'-ice permxty. only a general finding. $70.00. Applicant has reasonably incurred costs in tne cum of (Exhibit A-2). As reflected by this recoil, applicant's attorneys have rendered services to the employee in the reasonable value of $300.00. Apportionment or contribution of a defendant carrier is properly the subject matter of a supplemental petition. FINDINGS-OF FACT 1. Jack Outhbertson, born May 4, 1923, while employed as an asbestos worker by Western, Plant, Armstrong, 'ihorpe, during periods of employment stipulated to by each of the several defen dant employers herein, contracted an occupational decease, to wit, a form of pneumoconiosis, namely, asbestosis. 2. The date upon which said employee first suffered dis ability from said occupational disease and either knew, or in the exercise of reasonable diligence should have known, that said dis ability was caused by hl3 present or prior employment, was October 23, 1934. 3. The occupation of the applicant viro asbestos worker. CUTHBERTSON -5- Claim Ho. 161-C70 4. At the time of said injury the weekly earnmigs of employee were maximum. 5 . Employee has incurred expensec for diagnostic treatment beginning October 17, 1954 and chore".iter, and said treatment was reasonably required to cure or relieve the effects of said disease. A supplemental -ward for the aw writ of such expenses will be made upon the service and i-I-.e/. of r. supplemental petition in the event the parties re un-b^e to adjust such expense to their mutual satisfaction. 6 . Employee is in need of further medio"! iregimenl reasonably required to cure or relieve from the e-iVe ;L o f said disease. 7. Said disease caused temperaiy tutal cl".>frv.1 11;. beginning October 17, 1954, to and including July is, 1'1 . S. Employee *s condition :1s not yet, occu/ none. 9. Statutory notice was given L; the om,.>io, co to Plant. None of the defendants here'*n on i;ii.m 1 . a 1,' imposed have been prejudiced by the alleged i r ^ t- ` r. .tea. 10. The filing of the Applierv a.n *. , imoi, . 11. Department has paid to t - m , s c pensation disability benefits in the u ...! period of disability foituu herein. ri- u'.. i./.u,-. .a;err...'*; 1 io 12. Occidenirl paid no sum cf u :s-e. , raent reasonably required to cure or rel eve injury found herein. met i-re.L- l.o o_ fe. . , oi 13. Employee has incurred cost;, .ui die >.tu cc :7 9 30. 14. The determination of apportionment ox* contribution among the several defendant carriers is deferred. 15. It is not true that employee is estopped to assert the claim made herein. 16. The Commission does have jurisdiction of the sub ject matter of said claim and of each of the defendants upon whom any liability is imposed herein. 17. As reflected by this record, employee's attorneys have rendered services to employee in the reasonable value of $ 300.0 0 . 18. Cork Is not a necessary or proper party. 19. Plant Rubber is not a necessary or proper party. 20. Mundet is not a necessary or proper party. CONCLUSIONS OF LAW Employee is entitled to a joint and several award against Fund, PE, Standard, Travelers, Industrial, of; The reasonable value of medical treatment obtained by the employee on and after Octobei' 17, 1554 to and including July 14, 1955, and CUTHBERTSON Claim No. 1 6 1 -8 7 0 Temporary to cal disability Indemnity at maximum rate beginning October 1J, 1954 to and including July 14, 1955, and .^ Costs In the sum of $70.00, said sum being payable $35.00 to Dr. Thompson and $35.00 to Dr. Crenshaw, and Further medical treatment reasonably required to sure or relieve from the effects of said disease. Employee's attorneys are entitled to a first lien in the sum of $300.00. Department is entitled to a second lien in tne sum of $970.00. Request of Department for additional lien of $179.73 should be denied. Cork, I'lundet, Plant Rubber should be dismissed. Jurisdiction is reserved to determine apportionment or equitable subrogation on petition properly filed. JS: Ja JOSEPH SHEEHAN Referee CUTHBERTSON Claim No. SF 161-370 JOSEPH SHEEHAN, REFEREE S.F. 2/20/56 Injury: 1944 - 1954 REPORT OF REFEREE ON CONTINUED HEARING Asbestos worker, 26, claims injury to lungs from "breath i n g s u b s t a n c e s i n c o u r s e o f w o r k h a r m f u l t o c h e s t a n d l u n g s 1234567*9'. ISSUES (as to State Compensation Insurance Fund) 1. 2. 3. 4. 5. 6. 7. 3. 9. 10. 11. 12. 13. Jurisdiction. Occupation. Injury. Medical. Medical expense. Earnings. Temporary disability. Notice and prejudice. Statute of Limitations. Costs. Estoppel. Lien of Department of Employment. Lien of O c cidental Life Insurance Co. I S S U E S (as to J . T. Thorpe and Son and Pacific E m p l o y e r s Insurance Co.) 1. 2. 3. 4. 5. 6. 7. 3. 9. 10. 11. 12. Jurisdiction. Injury. Medical. Medical expense. Temporary disability. Permanent disability. Lien of Department of Employment. Lien of Occidental Life. Notice and prejudice. Statute of Limitations. Costs. Apportionment. I S S U E S (as to Arms t r o n g Cork, Travelers Insurance Co. and S t a n d a r d accident Insurance Co.) 1. 2. 3. 4. 5. 6. 7. 3. 9. 10. Injury. Medical. Medical expense. Temporary disability. Permanent disability. Lien of Department of Employment. L ien of Occidental Life Insurance Co. Notice and prejudice. Statute of Limitations. Costs. ISSUES (as to Plant Asbestos and Pacific Employers) (Same i s s u e s as at i s sue w i t h J. T. T h o r p e a n d Son and Pacific Employers Insurance Company) ISSUES (as to Plant Rubber and Asbestos Works and Industrial I n d e m nity Company) 1. E m p l o y m e n t . 2 . Occupation. 3. Injury. 4. Insurance. 5. M e d i c a l e xpense. 6 . Medical. 7. E a r n i n g s . 3. T e m p o r a r y di s a b i l i t y . 9 . No-M r*o t w o inrH r*ea CUTHBERTSON Claim No. 161-870 -2- 2-20-56 SUMMARY OF TESTIMONY H E R B E R T E. SIMONS, c a l l e d by the d e f e n d a n t State C o m p e n s a tion Insurance Fund, testified substantially as follows: He is em p l o y e d as Safety and T r a n s p o r t a t i o n S u p ervisor at the Western Asbestos. The record at the plant shows that the appli cant worked at the plant f r o m April, 1947, to July, 1950. The applicant h a n d l e d a s b e s t o s and o ther m aterials used at the plant. A list of ingredients of the products used is contained in the insulation list. He prepared this list from the samples sub mitted to him by the manufacturers. 1947 and 1948. The same m a t e r i a l w a s used in follows: JACK CUTHBERTSON, recalled, testified substantially as He w o r k e d f o r J. T. T h o r p e a n d Son b e g i n n i n g in August, 1948 to 1949* It was outside work on a power house. He applied asbestos blocks to the boiler. It was quite dusty and windy. The b o i l e r w a s located in the open. He did not become ill on this job. He w as a mechanic or insulator on this job. All of the men on the job were using the same insulation. It was dry material. The first application would be dry and the second application would be wet. Magnesium blocks were handled a b o u t 85 p e r c e n t of the time. He h a n d l e d d r y a s b e s t o s b l o c k s about 80 per cent of the time. The magnesium blocks contained magnesium, 85 per cent, and asbestos, 15 per cent. After handling the magnesium blocks he would apply a wet coating. This coating material was handled like plaster. He a l s o w o r k e d f o r J. T. T h o r p e in 1953, that is, f rom S e p t e m b e r 1, 1953, to O c t o b e r 23, 1953* B e g i n n i n g S e p t e m b e r 28, 1953, he was off work for a month while he was in the hospital. Just prior to going to the hospital he was working for Armstrong Cork. and Son handled O n f u r t h e r o u e s t i o n i n g he s a i d he w o r k e d for J. T. f r o m M a y 9, 1952, to June 2 , 1952. During th i s time asbestos covering and various asbestos products. Thorpe he While he was working at Hunters Point the boiler was in the open air. You could see particles of asbestos dust. No n o t i c e w a s g i v e n to P a c i f i c E m p l o y e r s o r t o J. T. T h o r p e and Son. Neither of them have made any promises of compensation to him and neither of them have made any payments of compensation. He went to the hospital in September, 1953, following the directions of Dr. Crenshaw. Two weeks prior to going to the hospital h e ?d b e e n u n d e r Dr. C r e n s h a w 's care. Dr. C r e n s h a w d i d n o t t e l l h i m what was wrong with him. Dr. Crenshaw has continued to give him treatment. When he first saw Dr. Crenshaw Dr. Crenshaw could not tell him what was wrong and he believes that the doctors were look ing for cancer at that time. He remained for two weeks in the hos pital . He first learned about his condition about six days after October 6 , 1954. He knew about the theory of asbestos becoming lodged in the lungs. He first learned about this theory seven or eight years ago when he first took up the trade. He had no cough before the first operation. He had severe pains behind his left shoulder and these pains led him to see another doctor. He has never been called by the draft. chant Marine in 1944 to 1946. He was in the M e r He was in asbestos work that time. They did not make any was in the service. prior X-ray to 1944. He was a examination of him helper at while he CUTHBERTSON Claim No. 161-370 -3- 2/20/56 He drew the maximum amount of benefits from the State. These benefits covered all of the time he was off work because of his disability. He drew $35.00 from the State and $15.00 from Occi dental for each week he was off. The two payments together, being ^ 50.00 a week, were paid to hi m during the entire period he was off work. He returned to work on September 13, 1955. (It w as stipulated that Travelers Insurance Company had c o v e r a g e f o r A r m s t r o n g C o r k f r o m J a n u a r y 1, 1952, u n t i l t h e present time and that Standard Accident had coverage for the period begin n i n g J a n u a r y 1, 1949, to D e c e m b e r 31, 1951. It w a s l i k e w i s e s t i p u lated the applicant worked for Armstrong Cork for different periods totaling approximately 191 weeks beginning in September, 1949.) He worked for Armstrong Cork for about two weeks in 1949, that is, froy September to October. In t h i s job he used only cork board and hot tar. He worked for Armstrong Cork from September 6 , 1950, to 1954* He was an insulating mechanic. He used asbestos pipe cover ing, asbestos blocks, various foims of asbestos, rock wool and cork board on the job. The dry asbestos came in hundred pound sacks. It was the job of a helper to mix this dry asbestos. 35 per cent of the time the applicant mixed his own dry asbestos. The asbestos blocks were installed on boilers. He had no helper and there was h eavy dust on the job. He has worked in the asbestos trade for a period of about eight years and during this time has worked for six or seven compa nies. On all these jobs he did not use the same materials. While he worked for Mundet he used strictly cork. Samples which have been introduced were similar to those that he used while working for Armstrong. He used the same type of m a t e r i a l f o r P l a n t A s b estos, J. T. T h o r p e a n d f o r W e s t e r n . He is a union man and most of the jobs are the same. They used the same materials on the jobs. It is asbestos or asbestos products. On all these jobs he had windy days. On some of the jobs the ventilation w a s poor. On others the dust just hung in the air. The dust was worse on windy days. All through the different jobs the same exposure occurred. Some of the Armstrong jobs were all cork jobs. Generally speaking, the materials used and the amount of dust produced was the same for all his employers. He was hospitalized in September, 1953, and prior to that time he made no request for compensation of Armstrong, Standard or Travelers. At the present time he has still complaints regarding pains in t he chest, t i r e d n e s s in the arms. A f t e r a d a y 's w o r k he h a s t o go to bed after dinner. The scars in his chest give him sharp pains at times. The adhesions around the scars hurt more in cold weather than warm weather. It is an effort for him to go up ladders. He is still going to Dr. Crenshaw. He feels better than he did at the time of the last hearing. At night he has a tired feeling. It is an exhausted feeling. It is hard for him to keep his average up while working in the after noon. ,, On July 15, 1955, he went to work for a foundry and this work required him to shovel sand all day long. He worked at this job from July 15, 1955, to August 14, 1955, and thereafter he was off work until September 13, 1955* He gave this work up on August 14., 1955, because he did not continue doing the work. After August 14, 1955, he listed himself as available for work after about two weeks. (As regards Plant Asbestos, it was stipulated that the employer's insuranr.p i'nmnanv had coverfpp fVnm D^triHo-r l toii CUTHBEnTSON 2/20/56 -4- Cl'iim No. 161-B70 iy54, to October 17, 1954, and it was also stipulated that a n n n cant worked at the plant during that period.) PPll" . , . W h i l e w o r k i n g f o r P l a n t A s b e s t o s he u s e d h eat and p ? 0m t a n lc a p p ly ln s th e s e produots which mixStheHprSdSctsdtBmslla P ^ '^ u r in l^ th is timeT^They^ad^o toey Sire S S i i l . emselves- U was dusty' Jt was V V <<* while uii in a trench^anH1^ Mafe is^and during this time they had to work u S 5hi h . i S i ^ r h i . " 8 on to p o f th e t r e n c h ' The wind wheezing & he W3S week and a ^ I l f ^ f L i 0? i'6 -he ave.to f1?* Asbestos was about a SS f f e 1S f l " l rh 0 S p lta l- HiS attoraey to ld h i" nitv or a n ^ ^ t h f m 6^ 08 o r ,Pacific Employers or Industrial Indem- tion to him. f th h made n Promises or Payments of compensa te He b a s ,rceived payments of disability benefits during ^ ir! Period he waa off. He drew disability from the St at! he^hadXainU!nH aT nt; He eceived no benefits after l i v i n g ?he orkh h S dfd ifindry\ Tha.majority of all his work was few work. He did not receive benefits for all the time he lost from #*>!< F,, e .b r u a r y 21A, r 1e9c5e6s.s w a s t a k e n in thi: m a t t e r u n t i l 9 : 0 0 A.M. tomorrow , February SUMMARY OF TESTIMONY n resularly for ^ t h e r hearing on fied s u b s t S S i a i l i ' a f i S s f " ' ' Called by the def . testi- 19 55. He saw the applicant on one occasion, that is, on June 15, a _H i S m ? ^ a g n o s i ? w a a s b e s t o s i s o r p n e u m o c o n i o s i s c a u s e d by asbestosis. This results from an exposure to asbestosis dust? June 15, ^eS^nTM " that the p r e s e n t ^ w Ct L beiieVf S ^hafe the aPPlicant is able to work at say the J 11T glVe a Prbable prognosis. He cannot say the condition will become worse or better or remain the same. ttoorr. TThhPe applicant is aubl?e0Uitod hraevseumea nPoerrmiaoldicaacltivcihteyc.k by the doc absorbed h ^ t n L sabrabin test showed that the oxygen was not si8 th b - -d llke the .oxygen should be absorbed? There is  c *<m h i i ( ) h o r n e cat N O R T H F RN C A L IF O R N IA i t 'll I MT k/f I t A M L N T O C O U N T Y ) 0 (ib M I S S I ijh b Y M E S T San F uamcisco 3 F O R 'A( W \Mf N ro COI N rY O N L Y R o o m 2 0 0 u JI J U r u t f f>A(.l A M C N I O FOR S O U T H E R N C A L IF O R N IA (fri I.ir a A N Ol LC.O C O U N T Y I b o i b rA rC U U U .D IN O Los A n ic l f t 2 F o n fi A N O IC O O C O U N T Y 1C 2 I K o u f l T H V e N U S an D ic c o i ONLY 8T A T K o r C A L I F O R N I A D E P A R T M E N T O F IN V J S T R IAL R E L A T I O N S INDUSTRIAL ACCIDENT COMMISSION APPLICATION FOR HEARING C u e N o . ..101-070 54 SF . Filed 12-21-54 D O N O T W R IT E IN THIS SP A C E E N T E R E D IN D O C K E T B Y _________________________________ Employee' N a m e .... 4A0iC .UUIliiSiaQL.. Social Security N o ..,. Name of Employer 1 . %r&tran.Cork Company &X Travelere Ins-aranc Company ----- 2. -I'lant- s^aiicstaa ..Uoxapaay..... Name of Industrial Indemnity Company Insurance Carrier ............ 3# 'Western Asbestos Company --------iLfcata..Coffl^flnaatiQn.ln&uranfiO Em ploy' Address 224 H olbrook. P rJL e . IT Ml IT ANO N U M M I ....09ncordj...CaTifornIa.. Employer* TOWN o a CITY , , _ . Address.. ..i d .n L r a n s i u c o A l i f Q r n i a . L a t h a a ^ < ^ u ar'5* , , r *,,0 "u', , ` B i d # , O a k l a n d ______ 5 1 0 2 - i i o r t . a n ______ in s u ^ t^ Q B d W i i o l i t . d i m F ^ H n c l a c t f 1' Carrier's Address . ............. ........................... ............ 7 5 T a w n 8o n < J Ti' # t v 4"u**il n F r a n c i s c o f u n d . _______45.Q .J : ^ G f y l _ i l a k < L r ..d i 4 * * _ B y i . F r a n c i s c c Employee's name............. J a c k . C J U . t i l b s r t S O L ............................. _ Employee* date o f birth.................................... ........................................... Date of your injury 1 9 4 9 -- 1 5 5 4 . Employee' occupation ................................ at time of injury____ _____ V f Q ik d iT ............................................... .. ......... Place where injury occurred ............ i a f l F r c U l C i f l C O ........................................ d ' T A N D 1T A T K W hen did you leave work as a result o f this in ju ry__ d e p L e w b e T * 3 0 . 1 9 5 3 O C tO b C T 1 9 , l9 5 4 . .. . H ow did injury occur ._ l l m a t k i n ^ - m i L t a L u n c a a J j i ^ C L O i i c s . f t v i f ^ Q j C k , J d ^ O i L F y l - A q _ J.U P & Q W hat part or parts o f your body were in ju red ____ L u n & a ____ _____ __________________________________ ___ _______________________________________________________________________ _____ __ Full or part time work When did you return to work n J t t i l l d i S U b l C t i .. . and at what w a g e ____ _ _ . _ ............................................................. .. Your >s ag o or salary (before deductions) $ .. Blti.W^wr Four nr y ................................. per week or i ____________________________ perm onth. 11 paid on hourly rate, how many hours did you work per week____ ... ... . ..................- .........................-- ........ -- . . . . Did you receive any o f the follow ing; Board? Yes N o ; Lodging? Yes Q N o Q ; Tips? Yes Q N o Q ; O ther advantages? Yes Q N o Q State their weekly value $ ------------------- ----- . Have you been paid any compensation? Yes Q Date whin last payment was m a d e ........................... N o l~~k H ow much . . . ________________________ ........................ TOTAL AMOUNT , 19______. W eekly rate o f payments $ ._ ................................. 1las the employer or the insurance carrier furnished you with any medical treatment? Yet Q N o f he Date when last treatment w is given . .................. .........................., 1 9 ................. List names of all doctors who have treated you and who were furnished by the employer or insurance carrier...................................................... ..................... U n iv o r a ity o f C a lifo r n ia --- I lave you obtained any medical treatment at your own expense? Yes .............................................................................................................. ................................................ No Q . List names of all doctors who have treated you ac your own expense............... - .....................- ....................- .................................... .................... ...........-- ................ A rc >ou claiming any of the following benefits (Answer Yes or N o ) : (a) Temporary disability paym ent................ T S S ................. ................ (b) Permanent disability payment . (c) Further medical treatment Yo-S- ......... (d) Cost o f your medical expeiue .... I f t a ........... (e) List other benefits claimed and not mentioned above ..................................-- ...................................... .............. .................................................. ........... f lave you ever before filed a claim with this Commission? Yes Q N o c * i f so, when was it file d ........... --------Iblb Financijj^^genttrr -nlai;.--... -.. - xlack Date //.......... S I I N A T U I I 01 A f f L l X A U r - 2 Q 1 9 5 4 ................................ .1 9 L Lcncourt ft-fc.Q,,,, ` " N *)f IH A |lIM , 1 ' i ' t i >h s I;,111 11 n j>ts Keen file I h k (Le IJ aitriI A <<iJem Crimen iturn t),. pirite *11 l*e a m ttiaJ in writing of iha lima tnd pitta v i haari nf Either pa/1 f vtif b* it) '/< linpe.ti I f imuntr vi n '.ii i m D A N S N A i M Iti Irien 1iru < 'i]f t I - l>U in fu * r .il.irt IO d, firr u t *i r t nl 'npv of ihii pplitiiiin, usirtf tl. form iuim tbed l.r (hjt purp<ie 11 dr (nJ ml m pin far li IntueJ tiui i*. limiti. it 1 1 <I t* j ," .t < o' I r Hr ri j!-tj11 n i. imfi n/-i b< |ilid by the h ai i..|(i, tUaf * ill I di na bf iha rirmi i but l/ the inuiinti (an ia? 1 not *B\ed, tLaA tk to.(!.><r il oil n < I 'l.i Im m un nie 11I1y ** Ihr prsi>*t nswii c m fe rilevi. O A I P OF M U N IC H SKJIVICJl ON tnUM 14 I a * * STATE OF CALIFORNIA in d u s tr ia l a c c id e n t c o m m is s io n U SCO M i h i o n S t r e e t , San F r a n c ico 3 4 1 2 H e lm B u i l d i n g . F ue a n o 21 S t a t e B u i l d i n g . L o # A n g e l e # 12 Room 200 . 831 J Street, Sacram ento R M 2 ' 4 ' 100 E 0cEAN a 'v o . L ong B each 2 1821 4 tm A v e n u e , Sa n D ie g o 1 C l a im N o . 5 4 r **>:*.. 1 0 1 - V 0 E l Lacs ..U U j i ',; i .-J A ^ LJK o i J tteA u vU , .-..L*. aT U JllG C.Jiv;-. C-u*'a eU , '.U iiu ii.r C J ;u C C J . C i l ' . , . .a..di a Lae.T ..aAljVw u C.^ a H, i.xaTa M h 2...-3,^70j C '.iT .aA llY , J # i . Xi)\ J J Li.*W t jU Vrf AOU L all J , i i w l i *-*A J ilUl Y -1'V I*'- , ,*- ;5 a I ][ tri; 4l, Defendant & / N o t ic e o f H e a r in g o f A p p lic a t io n For A djustm ent o f C la im You arc hereby notified chit an application to adjust a claim for compensation (a copy o f which is attached hereto) has been filed with the Industrial Accident; Commission o f the State o f California. You arc further notified that said application has been set for hearing at i j t . 2(jo, 1531 i.cusLur OaKlanu, C a lif o r n ia , on vh 2}r< da/ o f Mix/, 1955, t 1:3 o ' c lo c k p .n . A l l v.ta. ami that at sa.d time and place the Industrial Accident Commission o f the State o f California will proceed to hear and cmpose ox the said application in the manner prescribed by law. N . n r : rise P a r tin .re r ip c o r d to iv b n m all m u m in c o n tr o v triy for d e ciu n n at ih n he arin g : t l.t r t io r t , all ne ceu ary witnesses, evidence, documents, m cuieal rep o rt!, p a y r o ll,, ami other t s it .m a l proof m u be availab le and ready for aub m n n on a t the hearing. Dated: vril 25, 1955 IN D U ST R IA L A C C ID E N T COM M ISSION By ItLs J XAuiR a-*, *il# Au*t+9frj Sa rrtary The undesigned certifies that as an employee of the Industrial A ccident G,m m ,salon she served the foregoing notice on the parties hereinafter mentioned, at the time set oppos.tc their respective names, by depositing a copy of said notice attached to a copy oi the application therein mentioned, in a scaled envelope in the United States mail on said day, l t . ^ , California, with the postage thereon fully prepaid, and addressed to the sa.d parties at them last known residence, as follow s, to w it: of'buJin * o ? ' N A M i . b O I 1 P A R I ' l l . S S L R V 1.D u 11:op sutvia: aee u i u c o o d uho<jt f OHM #3 k4 . *4 [ S k .NA I U R L J /t H4*'.UiTt-, II of Employ. ,r.O. uox 18 57, Oakland, Calif. Occidental Life Ina. Co., 300 J.ont^omory Jt., 2f.F. Calif. 4/2 5/ 55 Jack Cuthbertoon, 2284 Holbrook Dr., Concord, Calif, dmith h. rarriah, Fin. Center olaj;., Oakland, Calif, riant Hub^or L asbestos V/orks, 5309 Horton dt., hmeryvillG,Cal. Armstrong Cork Co., 1355 Market dt., G.F., Calif. Mundet Cork Corp., 410 drannan St., d.F. , Calif riant ASbeatoa Co.,, 53s0j9y H-.oArton odvt..., 5309 Horton ft .,Emeryville. keatorn Aaboatos Co., 6 7 5 T o w n s e n d St., S.P., Calif. J . T . Thorpe L don Emeryville, Calif. Travelers Ins. Co.w Latham dquare iildp,., Oakland, Calif. Indu o . Indem. Co., 3 5 0 d a n a o m e dt., d . F '., Calif, dtate Comp. Ina. Fund, Pu njonal service raciflc Employ. Ins. Co., 3770 *iedmont Ave., Oakland, Calif. Calif. Compenuution Ins. Co., 28 Ge^ry dt., G.F., Calif. vwx jtizuuiclaJ_Cfiintdr-.j Aooaiti dlcncourt 2 2000 /-&/- j|i i :_a__________ _________ il N A T U II Of AffLlCAHT Djte .. - r-aren ~4 -.- ------ --- 195..5 -- TILCfMOMI I U I H I N O T E -- M RA R 1Ni 1 Ai<r ihn pplicinna Xu fcxo r<primrd in pinnn, by titornfr. or oikrr c*ni. u h ih* InduUntl Aciidrnt A N S V I Hi 1fi* J i i i n . l i n i 11 1 1 p<. 1<J io AI ia u i < r v i (Ki a 10 .1i r* f u r iru of ind ininf im r 1 i r<p 1 1r mn.r.l in (hr ipplw u<.n. no i m * * f n<rd br bird by mplot <r ikoul.J n ci i i r ih< n r i u i i m m< J ut f! y w> th proper i i u t u c i " b* ltd. Ceauuitiioa tb< ptrtiti ill L ooufitd ia v r i t i s f 0/ th* tun* md pltp* of Xttrloi. F.idur p r<f miy b enpy <.f (Xu ippli. iimn, u i m4 1Ik i m n fiu mil ./J L.r 1lui pu< pmc [- <J<fmli At fmpl nn r It lnmrJ lb* employer, it Kt Hl ba Jon* by 1)1 i t i r i i u buc if tl> imuftnc ci riu r It nnt r\rnJ, the tha D A T E OP S f J t V I C I SLKVIC1 ON i. '1 COMMI S 810 N OFFICI tj- fc J R N O R T H L R n C A L I F O R N I A 0;5vMirs ,s iAoCnRAbMr,i-nN.Ttroc,,uN*l / San FnArc m co 3 FOR SA C R A M E N T O CO U N TY Room 00. 83! J S nillt aA<:nam t n ro ONLY for so u th er n C a lifo r n ia l E X t t l 'T S a n OIEGO COUNTY) 501 S t a t e Q u i l o i n o L o . ANOELts 12 AM FO " S * N( ^ g o C O U N T Y O N u r ^ " 1521 f O U R T M A V C N U C 8 am D ieg o i s t a t e o f CALIFO RN IA M PAHTMENror.Rou.rH.AL.U.AT.ONS INDUSTRIAL a c c id e n t c o m m is s io n a p p l i c a t i o n FOR h e a r i n g - , Ca5e No-55.V- 141 -JVO Filed /mrch J, DO NOT WRITE IN THIS SPACE BY_ e n t e r e d in d o c k e t Employee's N ^ m c N jA C L -^ T .t F T '>T,f Q jj . Social Security N o .. ...... Name of * " Employer l i A U . W U . . L I C I ......................................... Em ploy'. Addrcss - .RId ^ ui. aJIV R ..... 11,117 A** numur Employer' Address... Cocleari!r -cu! ..Xai*uLg. T O W .O .C T , I0,, S T i i i t AMO N U t i m TAT Name of Insurance Carrier . i T''i* i * > , . , . -T.-FF- ,, 1 i - A w W - . ^ 4 - Insurance I0W" * Carrier's Address............ .......... TCCT AHO N U U I t l Employee's _____ ____________ - Date of your injury ... Place where 1 9 W - 1 9 5 4 ...... . 00 1 injury o c c u r r c d -H ^ U - . r O i l C 1 3 , : a I l f . . C U T AHI) I T A T I How did injury occur.. kiPtfrVilify-^haUtwfrG-w^ in W lu t part or parts o f your body were injured____ L y t t js g ..................... .......... _ _ Employee's date o f birth. Employee s occupation - I * , - * * - 92.5........................... at time of injury . . . . A b S t o a V O V k Q P -................................ When did you leave work as a result o f this injury F l a p 1 9 J 5 J UctvLi-r 19, 1954 .... ba*v-^.lua&a, When did you return to work . C i t U 1 4 Pull or part time work and at what wage ______ Your wages or salary .(before deductions) S,_; .. r . per hour or t If paid on h o u r lyr-a-t-e, how many hours did you work per week _ D ,d you receive any o f the follow ing! Board? Y e , N o D : lo d g in g ? Yes D State their weekly Value $ ____ per week or $............................................per m onth. No Q ; Tips? Yes ps? es Q N o ; Other advantages? Yes N o Q Ila ve you been paid any compensation? Yes N o How much $ - W eekly rate o f Date when last payment was made . TOTAL AMOUNT 1 Has the employer or the insurance . . -,19... 1 n , . ,, l carrier furnished you with any medical treatment? Yes I~1 N o I 1 Date when last treatment w as given___________________ ______________ < l_ l in o |s - 7 L i names o f all doctors who have treated you and who were fuTnished by th cmpioycr or ir insurance carrier. payments ' J ..................................... ! isidjy, & i List names o f all doctors who have treated you at yourexopwennseex?peYncs5e 6. d N o - Are you claiming any o f the following b-mefits (Answer Yes or N o ) : (a) Temippooraaryy ddisabbility ppaayymmeenntt___________ ______ ' (c) Further medical treatment__ ____________...................................... (c) List other benefits chimed and not mentioned /Iso , Y Permanent disability payment............................ ^ ^ ^ mCditaI ..............y <8 H.ive you ever before filed a claim with this Commission? Yes Q N o Q I I su, when was it filed X ' l i f U i i i A. F A - . i - . I J i i I I r . l l I N T I T I Y I 01 A T T O I M I Y 101 A E f L I C A N T A O O IIg | Nileracourt, 2 200 T ILIFHO M( R u l l i ' A N S ' ! K h , diftn.I., -h-, .k..M d a t e o r SLAV,C I s .*-- - 5L* VICJ1 ON - -- " ~ Date :,.fM a;... .. (MATUIK Of AFFUCAMT elTTTTT' ^ - ..........- - , 19 . . . ... -- .V .`w ..... n ........ .. j p!*c o( hfiof. Ei(ji*r P, ,, y mtf ^ ; ' r 11 >>..d " " -J. . 1, H* ; JACK CUTHBHT30N IAC ,/ 161-07 L i s t o f caployor3 n a M Rubber k Aabeeto3 Worte, 5309 H o r t o n S t . , L a e r y v i H , calif keatrn ******** s^\%*rancl3C0,Calif. 675 T o w n s e n d St.,**1 j, T. T h o r p b So iiiaoryvilla, Calif Mundet Cork Corp., L40 Brannon Bt, S a n Frr.ncls c o , C a l i f * Cork Insulation C o ^ S o n F r a n c la co , c a l l * Arias t r o n g C o r k Co., . 1355 Markat ut., Jan F r ancir,uo,o a l i l . Plant Aabcstoa Co., 5309 Horton t*. i ^ v i U e , oalif I K 3 U A M C B OOMi'A M W list of Travelers F u r a n e Co., Latham Square Bld6. , Oakland, Calli* I n d u e Indemnity Co., 350 Jansorao ut., JJailni* Fr*a--n-c~isco,Calif State Conponoetion Ins. ^ ,, 0 , Caiii* ,50 K o * l U t r u... uan Pacific 3770 Fiednont tor * C l l f o m l . Coupensatlun Insurance C o.. Calif.  Before the Industrial Accident Commission of the State of Califorma J'.CK, CUTJHUT5, 55 SeFe 161-^70 ClALM No. Applies* f. Notice of Time and Place of Further Hearing cSr *" ><*>. " Sk J'L a n a i lsunalic* 6 0 M I M I M W M * Of. w '.u u t a. w f end n o t ic e t o a l l p a r t ie s You ,, haraby notifiad that further t o , wilf be held in the a^a-entitled anion at t y^ene*aflo l C-TIivrti*) < 965 r,!-3tag 9 Cdt 1****^ U&XXU3UJL a1i f * g r f g ` >S = ' 1>,"J " nrounwrlccir.KNT uawhissn S ,S .'g * ?* NOTE; CONTINUANCES AND FURTHER HEARINGS ARE N OT FAVORED. SERVICE UPON: 12/29/5*-- Sco mttsehti I* fwr serri 7 STATE OF C A LIF O R N IA D EP AR TM E N T OF IN D U S T R IA L R E LA TIO N S IN D U STRIA L A C C ID E N T COM M ISSION JACK CUTiiflEItTSOIf, Claim Nu._ , Applicant...., VI. ' LANT KUBBKR dt^ABBSTpS WORKS I il ' ' SUBPOENA DUCES TECUM Defendant..,, j T h , I?!,pic of the State of California Send Greeting to: ...... .... -- ^ r* o ^ i M " *i.r1 _.ArBtrqng ..Corl^C_<Mj)iiy ' * * * " VOU, T M w w <- ,w , w ^ A INDUSTRIAL ACCIDENT COMMISSION OF THE STATE OF CALIFORNIA Jt 9^5 .Os s 1q i t Lt * 0 t, San Traxiciso, allTg ,, sotti day o f _________ f t b r H a*y ..... ' * . * entitled matter, noW pendio, U fo , r *5iric Employers - - *19 " 1 1 Mo'clatk. P*. M., than and the ,W I nW1ta,al Acur DEN1 CoMMItMON, on the part of ` ' ` m i. " * W W * tjU c h d a f f i d a v i t , ' ' ' iotOj W tri'tiftfi , . ' - j failure to attend you null be deemed am ity o f a contem h! I n u .................. ' '' n , , W ,W .v> aWna I/o,,r/Iet/to,Wne hAunadtudj djol,,lar,tnaddi*tion th'ekrHeto`.,U >*' * '" * * W M M L w n J Vitnen: INDUSTRIAI. ACCIDI-.NT COMMISSION OF' T u r S T A T E O I L A I I U , * N ! A Ihi, . J*. iiTuiiV lt j.r/> .1 ' rUitrvi . . r-t^^ver; *troci ... c t ^ c v t, ''.iMor.il . ' i CUija '!o. i'-i-TTO - Jcc.. rvth>*rl.ori va i'inr.t w.. .. \lu ".o c'iO)>ot>m - 'n.:trorw' Ui; Jor*ny or.", et * : to it mu* t # <-:trj ('r. tini for V \ < ; A 1 'I'v.'jp'a* o' ir.m'-rr.;* (-on; -ocijiary *.-> u < tb-v^rvii d/.Vd ulrwr/ 2, 1? oftiv-. U <* oub;\*r~ ua.i received by .rntrcu.; -or\ <f.-.layy at *r* on i\jr--Ary 1', l'-">t, urr the tn.'omt n> ; ic iVitila n\ t!. : offLut, -t wi.il or r>;_ to h.ivrj t. o > i -fon.ti'-:'. l'rv.i our poi"ov. 1 r'-cor'' nt "t'-r, Fojvt.Irkrio, un* iraui:,a Lio Ilt*; tiivs v.lll t: `.'ort for t.Vn in omit'on to l<o .notai vied. .11 arivi.-,1 you ...,.n tnc tr.'or's.tlou 1;: w l . U 'Is, . i -**y ti*-ly i?oui*;-, \.cs7!rn ecu; y ` Innulatlor. tivlriyr John `"a.'lor ilt/ltrlct !!*PA.;r c: J. Jr,, lavora:.c* . . ! , 'i i ju i '.y , ..-ir. r \r - Lm' o PEFORE THE INDUSTRIAL ACCIDENT COMMISSION OF TIE STAIR OF CALIF CRNIA CLAIM NO. 1 6 W 7 0 3!. JA C K CUTHB&EISOS, I A p p lica n t, ) ) ) ) AFFIDAVIT FOR SUBPOENA DUCES TECUM PLANT RUBBK& A ASBBSTC# VOED t a l, ) * . D efen d an ts, | STATE OF CALIFORNIA ) Y' ) 83. 1-! CITY AND COUNTY OF SAN^PRANCISCO ) . V . H. MTJLLII i beingf i r s t duly sworn, der:se3 and sayst That ho i s tho atto rn ey fo r the defendant P a c i f l O E m p lo y * T9 I n s u r tn.c * Com pany ^ the above e n title d raattor. n V- ! That p e r s o n n e l M a n a g e r , A r m e tr o n g C o r k Com pany has in possession or under HIS o o n tro l the fo llo w in g documents which ii ' i a f f ia n t doeires to have produood a t the t r i a l o f tho above u n title d action, to-w it: A l l reo o rd s o f em ployasnt o f Ja c k C u lb e r t s o n in c lu d in g n atu re o f work d o n * , wage* and p e rio d s o f em ploym ent. j ii ' * !, ll That sa id records contain ovldonce which i s adm issiblo and rr.ntori'i 1 to tho isnuos involved in the nbovo e n title d a c t i o n * d e te r m in e the p e rio d s o f em ploym ent and th *. exp o su re a s a l i a s * on a p p lic a tio n herein# THEREFORE, tho a f f iu n t csko th a t tho sold In d u s tr ia l Accident ! , . a a ,, ,, u P *rso n n *l M anager, Arm strong Commisrion issu o a subpoena d ir o c tin g said o y k C o r p o x * t i o n to appear and attend boforo said In d u s tr ia l A cciden t Commission ,,n Feb ru ary 2 0 , 1956 a t 1*30 p * a , t 965 M issio n f i t i e e t , San F r a n c is c o , C a l i f , ; and to bring with him said docunonta horoinabervo d o scrib cd . __ iri 1 C ubperib' d and oworn to boforo . mo th is 3 1 a t day of J a n u a r y . i 95_6 . H. HULLS ORAM M, N ICiiOLS NOT/AY PUBLIC -, ar.d fo r tho C ity and County of n F ran cisco , Stato of C a lifo r n ia ! :wVi c k U;Gj 12/29/55-- r of Uiloyw*ot, P. 0. iku 1*57, CMkl.nd, e i l f. jccl`.a,i-l Lift In*. Co., >3 Mnrkat ./t., r. J'-oh Uib#r&oon, 22*4, Holbrock jrlTf, vonoi*rt, Culif, ^oith k ikrriah^ 1616 Ptninoial Conttr dl.*., 0, klMul, e lif. .uboor 4. Avboo&o *ork, 5309 Horton *t., cryriilo, .1ii V Cork -o., 13>5 #Urk*t ut., i, ` /vunsiet. werk Corp,, 440 r ^ n z u m 5t, / . <l.nt A*btoo Co., 5309 Horton i/t., anryvtll, 0 f, %t*rn aboto* Co., 675 Towna*nd 't., . ' J. .. rh)rp* k oa, -acryvill*, 0. llf. vtk iu*ul*aion lUxiCJS Urtk1>0.1A . .tiruU.r Aocldont lnnurone e., */o LonArrf,IUnnA Drcphy, 100 't ~ /* . .u*b T r u w U r Ina. Co., U t h * a -.<j\nr* 31d*., 0*kUniJ, C.-lil". InCu*erl*l lad*,Go., 350 JonauMi Cb., J. r`. -t*t* /und, l=r8onl :nr.c / /eitle np. In. -0 ., 3770 ^iodnont >*., O.klun-), c if, i-ioxi-r: ,i**r.nh 4 Jro,hy, XO duak ab., C, /, ;Suii/a k. iilippi, 3l> ^itt;o6ory St., C. > . ) ; ' i fjilurr 0 tttend yo* will bf Jremrd jfntl/y of t contempt and ILble u, p. ) .o i/V pjrtin [flned ,i L u f t tud i uUiHfi! tb.r.hy tnd forjeit ttne hundrtj Jolltrt hi sddilion Ibrtelo. VHnett: INDUS TRIAI ACCIUINT COMMUsU;. , Ihii VD ^ 0 / ?/ Before the Industrial Accident Commission of the State of California ''CK U'HSXATSM, 55 S.F. 16L-S70 C laim N o. Notice of Time Applicant. _ \ vs. I->.'1itT mJ.SK AN*; AiiS/GS VQWLS ARMtfTnOKO CO V w**;i : u , . `y .o -i.T COII& CUrJO/iAVZW l, P U V k B B U X W c ip Kt FUTULX AJJU..T01; G O K A R T . V , T* I W .P K I. . vtlf A fiJ tA\U.Lrti JllU iZ U iiJi. COMPRAY . Xif.iijT! 1 . -av 1.4*I GUMPAk'I S T A U CO.<i : J l fiATIC2t Ift& lk A Y C S [AL :J u *t r . LMl U)TL;ui ia J .'.fJC li COj<rAl &od T . ..x ACUU u/iT I3U /SCS COM?AT, Defendant 4 . and Place of Further Hearing NOTICE TO ALL PARTIES You are hereby notified that further hearing will be held in the above-entitled action at 965 ^laaiss Sc;i C Xlfvrci, on ^ U u I j 4.mi1u o , C - i l f o r n i a , *9V& d <y t ) f Dwcaabur# 1955 % s o n d J 7hc;i. VTr*> INDUSTRIAL ACCIDENT COMMlssk N OITi CONTINUANCES AND FURTHER HEARINGS ARE NOT FAVORED. SERVICE UPON: 12/29/55-- MP ieo attaeh*4 1 xga fo r swrrinn i*' I Jcvc)=- O x - 4 U ^ t r H - S o ^ $6^ JbJodJ -- i1-- TU^yJbJ Cj^ L . ..... ... .. 'a / ^ > / s n /i BALTIMORE NEW YORK CLARKSBURG TULSA ST LOUIS CHICAGO LOS ANGELES ATLANTA PITTSBURGH 5AN FRANCISCO NEW ORLEANS MIAMI & AIX.V.N-D1KK INCORPORATED insurance average adjusters consulting actuaries ` l o * C H ..F STE,T. L T IH O - " TELEPHONE TUXEDO 9-A304 b ell system TELETYPE BA 582 CABLE ADDRESS ALEXBLUE" Mr. William L. Hughes, Manager Insurance Department Armstrong Cork Company Lancaster, Pennsylvania Dear Sirs _ , rub-3386210 Travelers Policy Ho. -- mada 0f the following claims Please note disposition made ot Date of Accidents Claimants Location: Claim No.: Disposition: Abe. July 1^ l-954. jack C u t h b e r t s o n _ San Francisco, California B-7 583239 $468.60 571.76 Comp Expense Remarks: Indicate Whether: Workmen's Comp. x-- Auto. Liability B.I._ P.D. General Liability 3.1.. P.D. s jm Very truly yours, ALEXANDER k ALEXANDER, INC, /JLOSS DEPARTMENT f A' \ \ rT* HT '*J ,N 1: > I law Offices of L eonard. H anna & B rophy EDMUND 0 LEONARD W AR R EN L. H A N N A DONALD R BROPHY 100 B u s h S t r e e t SAN FRANCISCO 4 YUKON 2 *6 0 7 7 WALTER JAKOBSEN IVAN A SCHW AB Mardi V, 19!>b R O B E R T H SC HI ECK R O BE R T N. M A C LE A N \ JOHN A MAC DONALD EDWARD P MC ALEER HER B ER T C. JEN SE N HOWARD H JEWEL EDWARD W. KORAB Armstrong Cork Company 304 Liiav hc*d South Sau F r a n c isc o , C a lifo r n ia Attention Mr. Jonn 3. Taylor Rei JacK w t n b c T t s o n v. ^.t r o n g Cork .. Company, A0'nut..t Insurance 'CTyany, ct ai )6 C 6 H 1 9 3 Dear Mr. Taylo] .V' fl IM Ol MwA-^L.k t.I-- The s u o p c a / ^ r v u / U attrition bv ur. P-Utt of Filippi f*aJ bbeen iorvearutl y v `u , - i u Company. , . -n +vu, 1 ^ote m -nc th StuniaiV. Acciueut insu v i.j in tn(. orooeus Oa material3 ior^ar^'jl criatynr O tne subjt'ot sLijooena < accumulating lanternais Tnis \iil udv-se t ^ t , submitted. Wo vonxdj tuerai jcon aeard and ,y t>nt 70U the subpoena y y >urs HHJieb ect Armstrong Corii Company Lancaster, Pem w -van-a ' A tten tio n Mr. R. C. S c h ie d t, Jr. oc; Standard Accident Insurance Company 417 Montgomery Street San Francisco Attention Mr. L . V. Platt February 21* 195 MtzuUrd Accident I n * * O W J n.7 Montgoaery gare p m al00 Calif1** Om Uwu Atttim * Hr. Jo i* H a llo r * B a b jeo il1 &i* #9 0 62219 \ ie credi Anutron* Cork Oo. J a 2 Z * i Jack H. O cthbert** 5/Ai Qnkaom V r* nolong a iabpoena w o f a l tt r written Ucm Ith Um U l I a; . ^ J r , t t h . f l ,7 pr* * t h ` b , <mr tt.tr lo t * " > , t u f i . . . f U * " * ^ tk F l * i ubbar A Asbesto ont r j s s 'S t : 5 m ! * .t th . h ~ riM . # la Ht. *" * . __________ . f a r i M t l w 0f ^ ` ! ` J T / S S f l* -- * * Tr" t*ry tru ly your*, jj HSTBDS CO COMMIX tft Qolo*aro ,. 8. Tylr, lna.tlo. R. 0. ohiedt, J r . Ineuunmoe Departnent 8 Tv^itco " S S S y r S ^ S i r " s k s San Francisco, sending this ornee w To From Subject .. Jr insurance Department, Lancaster C. Schi6dti , n san Francisco ohn S. Taylor, m o t i o n Dxvxsio , ack Ho C u t h b e r t s o n S. ^72-2U-8568 February l6, 19^6 U3 lease r e f e r ^ " S ^ ST a^ ^ y th is su bject, the la te st 20, 1955. '' 13 na Claim Ho. 161-870, S e a rch ^ ,, . - iMam, " The case is to come ^1 20 and 21, 19$6* It State of California* ^ 5 ested by the r ^ w ^ * probably oar records are req our ^ ,, y a e n t 1 f Plant Rubber dividual as ^Asbestos Co-paW ytbap other concerns Involv a good deal >re exten siv ,, n e s t i n g an exten sion S^To n ^n from Lan caster, inform ation have to supply th is m i s _ a. . and fu r th e r , we w i l l o ^ il - wages fo r 195#* & in i f th is is in order. y / 7 // J / KU Division, San Francisco G. Uurphy, Insulation well as Notice of Hearing . tug subpoena Document as 'ttlTwAr/ l6 p i ,.1 F U U p i ' ` tr-jet, .ci.cc l t 'A lU 'oraU .. i C\ala !o. lal-TTO ite.. ?.'th>-rt.on v Jlar.t rMb|>ona - >n_`-ro;v tori: ;onp*ny ^ , -vn: o v , -- u t rf-'iu* r.*. t-;tv.r '>r. *'tir* :'or thi .va-vn oi tiv- .'v \i%r.*.pta* o ' t.r.-'jvjry.: : C o rk -o t^ A rjr a - y> ..l i . * ', i : *- .-r 'jbr'oTA dJ.t brvir/ 2 1? ~<1 BuVupoarj wa wealved by .r^rcit: vor1'. ' - ^ ' v ftr' on 'o jr - ir - l ' t tl*. iru o r*tt ?.. ' . r,UjJ r.*. ti. : filo. -* wl!-l "f 1 'lUKi le 1.6 ...uy i -rin i v ' v . irvi a-ir par* ofl r"cor'* *t Po^ vt Ir..ria , onr r^a:) vAblft k-~. : ' tin * v.111 `.'*rd for th.'r ir. d :ri\t'on to l>a a la i ^ U d , JJ. *dvif,W jxrj. .,,.n '.U' Lr.:'crs*tiou 1* svilii..la* / rv t r d y yuurv, \:crr!u*r. .1. vy . Inaulatlor. ilvlrlor John -a.'lor P la trie t Man*.;r .cl.i*dtt Jr., L-^-r?r.c**; Dtrt,, ~; *-- 'Jti'.p, ..-ir. r ' L: -e ' l! PEFORE THS INDUSTRIAL ACCIDENT COMMISSION OF TIE STATE OF CALIFCRNIA I aIt ' ! CLAIM NO. 162^870 \ 3 ! JACK CUTHBIXS80X , I Applioaat, ) ) AFFIDAVIT FOR SUBPOENA DUCES TECUM d < 61 PUNT BUBBH * t a l, ABSESTOS WOXU ! ) Befondants, ) If STATE OF CALIFCRnii:a_. v* <, r 1*5 CITY AND COUNTY OF SA^PftANCISCO ) ) S3. ) . ni W. M. HD1LWI being f i r s t dily sworn, dercses and says That he i s the atto rn ey fo r the defendant P a c i f i O E m p lo y *T * 13 Insurance Company in the above e n title d m atter. 1/ ! That personas 1 Manager, Armstrong Cork Company has in possession or vmder HIS c o n tr o l the fo llo w in g documents whioh a ffia n t dosires to have produced a t the t r i a l o f the above e n title d iction , to -u iti A U rooords o f eaployasnt of Jack t - Including naturo o f work dons, vago and perioda o f eaployaent, H '< !. il 1 That sa id records co n tain evidence which ia adm issible and m aterial to tho i3 .auos involved in the abevo e n title d a c t i o n the period* o f eaployaent and the exposure a* a lla g e d application bsrAia, determine on 1 THEREFORE, tho a f f i a n t csks th a t tho said In d u s tr ia l Accident I -L ' Commit ion issu o a subpoena d ir e c tin g sa id Armstrong ^ C o rp o ra tio n ** r to appear and attend bofore said In d u s tr ia l A ccid en t Commission ,1 _n February 2 0 , 1956 a t 1*30 ]>,a . + 965 M ission S t f e e t , San F ra n cisco , C a l i f * and *to brin g w ith him said d o c t n ta hercinabovo doocribcd . n Subscribed and oworn to boforo . mu this 31st day o f Jan u a ry, 195. * , h. nom ar _____________ ORAM M . K IC nO LS NOTARY PUBLIC in ar.d for tho City and County of f/.n Francisco, Statu of California I r-- /6r/rx *o 'a <nu': \ t- <* ? #* d "* ( c* r tr : *i o - 3 >- * c '. IP C S & ir I J^ r ir tn U c- r 4 u* p jr * ST a. 3 r. r K i * tf r- K * f c & ! / .v'- ft' 7 S T A T E or C A L IF O R N IA DEPARTMENT OF IN D U S T R IA L R ELA TIO N S IN D U S T R IA L A C C ID E N T CO M M ISSIO N JACK CUTHBERT3QH Cl * N o ... 1 6 1 -0 7 0 ?LA iT T RUBBER *r\ al A p p lica ti vi. ------- ----- ---- D efm Jsnt SUBPOENA DUCES TECUM T h e People o f the Stale of California Send Greetings to-. F T t-T T i Ff-- ` t*mtt**.S&iLSaSSBL I c,v iM.MAND YOU . Tht all end tin k e r , bjtsinest end txcutes M m; Urf iiJf,>v *pp**' *** *t,enJ t* f0' e ih' INDUSTRIAL A CCID EN T COMMISSION O f T H E STATE OF CALIFO R N IA 965 l a i L E t m * t w I W M .... -.... , 2061 ____ FfbrRRT..-- . .... .. * - "" >ft0lflc Employers *" * - ~ l " * .... -- ..... ; ~ ..... *" j,- um ifrmg with yvu end then *nd thr,, p ,, J . c , ,1 I M c ^ s r<# k/' Smm attached affidavi*#. W. ..... 13iltnd' Z Z V t Z t I.... A, - J /,,./< .1- -- F - XAI, , M M "" F - -- 'J ... . VTiiness: this INDUSTRI AL. ACrjUI N T C O M M U M i ui- mr iutf : l.miikHNia O (d h/ \ . n i `> 5*. C am I V * r/#pv .w **i*F *. H J 6 /'1 % `nn of the State of California Before the Ind,ustria1l AAcccciiddeenntt Commissi0 '1 ot tue 5 5 SF ^ l " g T 0 C laim N o.- N o tice of T im e and PU ce of Further H earin g ~ ~ c. x rUot furNthaer?heCaErinTg0wX iU tt* T You , " * * " * " * - ^ * * " *' .c _..,,u.r,,.-~uu,, - ** **Ujta**--' * * ia.*eiw * M 5a . 9 10 0 tLL Pat * *** - tk. a i t - x Dated at: Mwf*ceild fn t co5hivi`^ [NDUSTWAL ACC1U "3te ^ ^ ,, N C S A M NT VOAtO. N0TEi C O ^ A N C B ano * * " sl;RV1C.E U PO N ! U ,,, / S^ W {or ^ Sat icx h lh'&l ' s i - z,4--srr C\ - IT) - ^ t 1 O - $ - - ^ 2_ ^ I V - " C > Z T M ' -.-1- - S ' o )C K - --3 -S*0 C ) ~K - - i - i - S' ) v5> \. U tA-)p< ~ - --l- / ^ ~ T -' S ) ^ n fr l- A 14 s i. i r * , T o X y^OL^h )L K^O^ i . . iSiMri?* O 1 i ( . ^ U- >/y "1 D C Mj in c lu t 1 2 , 19 55 firmai* 4, Calif#!* Omtlmm Aitanti Nr, Jefe Hallern# SabjM ti Clia ^96 0 622196 mmundi Aautrang Oorfc Oo. Olatemt J a * H. Oothbertma Wto tafeo* ?//*/,U M 'J M n S 7i i ^ r ,! r 0t. in*u*4 5 ** I r H. Cathbertoon, our ?T,*"?**." of " * T r m ~ t t i i ' V T 'J Z t " * L*d M tU iif to Oo l i t t our a m fo o tu rla , o p r i t i * ot South Soto. ^ o u to r M H o t a h b o tr o * ZZ I you uU on .p ir to our Lol om oo m o not IotoI tu So* h. Outhhortoou. Z r t o r V j u S a S S u . ~ tS111V* &* '*L* <i 0Thourt wSith oooaoiaaal orarti#M. L ft." * V tn tai tha ahora M T ,rl 931 <F#ti<m# raiaad in jour lattar o f Ausasi 3, ? y truly your#, A6HHDH0 COX CONFAVI * . 0. Sehiedt, J r , a j? iMurmoa Department 0 M j[ p fl y jQ 6W H Y J R p,.,,a.,,, R H PLATTS /"*. C h ,, m . n o f t h i Bor<J p S BR O W N v,c . p , . . * s -c T .r .,,, L K K IR K V .i.P r . T, J P H A CK ER Vi c * P r . ,, 0 . n( UCJ PAUL W ILSON . v,c. E A W A R N IC A . V.c. P r .,, a. n, p E LAYHON. Vic. P r .,, d .nl nd Cenerei Couneel H A W HITE. V .c P r ..,d.m Standard A ccident Insurance Com pany RO Y W S M IT H Ruicmnt VicC'Pkc.ioint CASUALTY INSURANCE FIDELITY AND SU RETY B O N O S S an Francisco branch Office 17 M O N T G O M E R Y S T Sa n F r a n c is c o 4, C a l if -. PHONC CXNNOOH 2-4030 Armstrong Cork Company Lancaster, Pennsylvania August 3, 1955 Gentlemen: M -i] He: Claim 96 C 622198 Assured; Armstrong Cork Co. Claimant; Jack ._ Cuthbertson D/A unk. .. In connection with the above caDtion#d *>,t ,. , for benefit, under tbe Worsens Ccpenktion llw b e c ^ S ^ o n ^ c t S ^ 80" T i l S i T ^ ClSCT fflce f0r thls " 1 they beve advise which particular office the cLimJjTvorSd f ^ f P for the year January 1. lolio to tahiistv i m c o T j , ' ^ ^ P 01^ of coverage No 107^71 4-v,4- ** January 1, 1950 indicates that by Endorsannt -*-97571 that Armstrong Cork carried WorkmenR t y rseiaeQt 5 ?S S S S S .1 2 . * g? S S f f S 2 V = b" d ~ !t sSSJKS ^ t520855 "blob Pacific Railroad c2i. ' Uiornla> O * 38221 - Work performed for t k T S s E S S .'& g ? ^ 1952 does not apply to Myers Bros.3l*07 Accident Insurance Company J*. Contract 382a ^ r f ^ d f I r ^ i TM ^ i ' !0f.',L0S An6eles' California. * 21699b on the same period of coverage the emni Rallroad* A^-a0 bT endorsement under the Workmens Compensation A ^ a r i ^ n T c ^ ? 'ST*** ? " * " 3 ^ l u t y - at or in direct connectinn vitO I In iu r a n c a C o m p a n y D etro it Page -1- Standard Acndant Insurance Company Detroit Pilot Insurance Company. Toronto Page - 2 - Cuthbertson*s employment with Armstrong Cork came within the reach of the above mentioned endorsements. For this reason I would appeciate your forward! to us a list of the company offices out of which Mr. Cuthbertson worked and also whether or not any of these offices came within the purview of the above mentioned endorsements. Thanking you for your courtesy and cooperation, I am Very truly yours, JH:k c JOHN HALLORAN Claims Representative *1 1 1 0*' V-L. P. SHRIVER AGENCY, General Agent 1801 UNION BANK BLDG. PITTSBURGH 22, PENNSYLVANIA P hM rant 1-7*00 July 21, 195$ r'.r. :t. C. Cchiedt, Jr. Insurance Lepartment ,.r:n?Prong Cork Company Lanc.ibtf'r, Fenn.\>ylv.- nia jear hick: ae : .Jack i . Juthbe rt on Thanks for your letter of the 20th, en closing photostatic copy of the nearing schedule at c:n rr-ncisfo for s<`pterv,er 7, 1955* I have forwarded same to the htsnui;rd Accident irv urance Company "oyeth.-r with the information you p.ve in your letter. Thanking you for senaing this on to us, ana with kindest personal r. pyrds, I am ry truly yours, > Ti-- P , c ri ..fndCY .a. :r-.aw i ver \ 1 J*. . JU ttuiymr 1 ftrlTMr Am u * i f S fe*0 *k Pltt^urh 22, F*; ^ *> 1955 f W Jm * I* rthbwuo JU 1 ultgr #57^u asA i *r*,,lUpB * * U 0-V315299 j L I l^ L L !* * ui fU4 br ob *3 s^ Sv ^ SX S . -- 1 JO. m * s .- JT *y tniy T w n , * C. Shi4t, J r . -- **W idwr 4 lmxmadmr. In* t * m 503 ** ? m l ?U ^ Baltiaor 2, Md Kr. i o * W H * ., 9 t a t e . W * O o *,*, ,, r ,TM * . ,, 04Uf. ( 2) Jo in a . Murphy, Insolation Dlrislan, Sm frtndsoo ft. 0. Sohiodt, Jr , lu a m M Dopnrtaont, L ta u ta r JaMc H. Oathbortoon Social Soon!* # 5 7 M ^ 5 6 t Ju ly 20, 1955 it* m n Oar pretaM* tho folloviag rooord o f ployaont for tho bora nansd utattoi witart 2 vooks 16 vooks 93 woks So vork A9 vooka Duo to strlho Quit 7/U/5A 0a Xxhlbit #1 vo haro llito d 11 tho contrast nuabors on ifcioh Cuthbortson vosfcoA during tho yoor 1955 la addition, vo haro lifto d oaoh f< ,^..1 p ^ xo ii vook Airing vhlsh ho night haro voxkod on* or aoro day Tho Tn- ,i . 4:4 OiTisian iafoma ao that 11 oontrasts voro nagaasia oororlng omopt thooo aaricod otborvioo Exhibit #2 ladiaatos vlth vtaaa vo had tho oontraot md vharo looatod la California tadiiblt #3 lir ta h m o f tho oan vho vorkod vlth Oithbortoon on tho oontraot v bailor your rooord vould ladioato tho aoro ro o i addroaoo o f thooo nan. Although you roquootod lallar iafomatio for a ll of OithbortaonU oaployw ant* tho aboto applios only to tho yoar 1953 ConaLdorablo tlao van inrolrod la obtaining thi 1953 Information, aoot of vhioh hod to bo takon dlrootly fxoa tho payroll. Vo, o f oourao, w ot to supply Trrralor* vlth a ll tho Information aooo--ary to dofond a olaia o f this kind. Hovoror, la tho vrltar'a axporlanoo, vo haro nrror boon aakod to supply tho dotallod ia lb r- roquostod by Mr John Vallaoo Jo la 0. Morphy 2 Jo ly 20, 1953 V hor* notified oor taokor, T. 1 ? Shriror gmqr, roprooontlng Standard A e $ U m \ Inaurano taspooy, regarding thi# loia i* h a U oBPi -, Mr J * Ja n a * , 41 4 Aloxandor, lao, 503 St Paul ?laoo, j Baltlaor* 2, Md fc) Manor n d ln ln D u p lic a to ( w ith e n c lo s u re s ) V, *w ita. aas. mi bl ^ am maa O K tiw t Vo Veok fedlaf Pet V 5/33 6/23 Vl/53 V V?V l 5 3/13 3/29 % V 26 3/24 # 6/U /2 V? e/u V*3 9/6 12A 5 11/22 12/29 12/6 13A 3 12/20 270011 2/22/33 2/3 *A3 2/22 3/3. Va 3/22 V 29 4/L2 3A 7 V7 7/26 fi/16 V 30 9/6 HA iVa 1V 6 W20 1 V 27 B O U W 53 Ooxkboerd 27006ttP 270091 5/2V53 Ccmc OoTorla* V2V33 27010^ VV53 lbre Lea 270117 7AV33 7A9 13/3 WS Armstrong y CO K c O e A Kj V jTohn Q. Murphy, Insulation Division, San Treaciaoo H. c. Schiedt, J r ., Inaurano Department, Lancaster Jack fi* Cuthbertaon Social Security #572- 2V * 56S July 20, 1955 ATM M IT I, Oaanbrofaitloeaswporrokdeur*o the foUoving reeord of aploynant for the bora and 23 5 9/ 27A 9 to 10/5/9 9/ y 50 io 12/ 22/50 W 23/50 to 1 2 / 2 1 / 5 1 Out V3/51 to V / I 1 2 / 22/il to 1 2 / 2 6 /5 2 Out 5/9/52 to 0 / 5 2 1V 27/52 to 1 2 / 24 /53 ut 9/ V 53 to I 0/ 2V 53 12/25/53 to 7/L4/5A 2 veeka 16 veka 50 weeks Io ixfc 19 veeka Du to atrik 15 veeka Sick 29 veeka Quit 7/U/51 On Exhibit #1 v hay Hated a ll the contract nunbera on which Cuthbertaon vozkd during the calendar year 1953. In addition, ve hare Hated each fiacal payroll week during vfaich he night har worked one or acre daya. Ih Inaulation Division informs ua that a ll oontracta were magnesia oorering except thoae narked othervia. Exhibit #2 indicata with whoa v* had th oontract and vhr looated in California* Exhibit #3 Hata some of the nan who worked with Cuthbertaon on the oontracta indicated. Ve beHere your record* would indicate the more reoent addreaaea of theae nan* Although you requaated aln llar infomation for a ll of Cuthbertaon*a enploynant, the above appHea only to the year 1953. Considerable tine waa inwolred in obtaining thia 1953 infomation, noat of which had to be taken direotly from th# payrolla. Ve, of oourae, want to aupply Travelera with a ll the infomation neceaaary to defend a clain of thia kind. However, in the vriter'a experience, ve have never been aaked to aupply the detailed infor mation requested by Mr. John Wallace. John Q. Morphy - 2- Ju ly 20, 1955 Vo hsro notifiod our brokar, Y. L. P. Shrlror Agaaoy, roprooonting Standard Acaidant Inoaranoo Gonpany, ragarding thia claim* AJ? Bialomra* Mr J S fannoo, Alexander 4 Alexander, Ine, 503 St* Paul Place, Baltimore 2, Md* (2) Armstrong CO** C O w< * A K 4 V John 0. Murphy, Insulation Division, San Tranciaoo R. 0* Schiedt, Jr , Insurance Department, Lancaster leak H. Cathbertsoa Soaial Security #572-21-*56R Ju ly 20, 1955 IT U M1TL Otur ill produce tha following record o f employneat for the boro named asbestos worker 9/27/19 to I 0/ 5A 9 9/<y5o to 12/ 22/93 12/23/50 to I2/ 21/ 9I Out i/3/51 to U 23/ 5I 12/ 22/91 to I 2/2V 52 Out 5/9/52 to 0 / 5 2 1^27/52 to 1 V 24/53 Out 9/2/53 to IO/2V 53 1V25/53 to 7/Ui/51 2 weeks 16 weeks 50 weeks Ho work 19 weeks Sue to strike 15 weeks Sick 29 weeks Quit 7/H/54 On Exhibit #1 we hurt liatod a ll tha aontraot numbers on which Outhbartaoa voxkad during tha oalandar year 1953 1 addition, ve hava liatod each fis c a l payroll vaak during which ha might have worked ona or store days Tha Insolation Division informs us that a ll oontracts were magnesia covering except those masked otherwise Exhibit 2 lndieatee with when wa had tha eontract and where located in California Exhibit #3 lis t s some o f tha men who worked with Cuthbertson on the oontrmets indicated* Ve believe tout records would indicate tha s o n reoant addresses o f these men 11though yon requested similar information for a ll of Cuthbertson *s employaant, the above applies only to the year 1953 Considerable time wu involved in obtaining this 1953 information, most of which had to be taken direotly from the payrolls. Ve, of course, want to supply Travelers with a ll the information necessary to defend a el ala of this kind. However, in the writer's axperienoe, ve have never bean asked to supply tha detailed infor mation requested by Mr. Joha. Vallace. John Q. Morphy Ju ly 20, 1955 V here notified our broker, T. L . P. Accident Inaureaee Coapany, regarding this olalm* representing Standard AJP lfadLoaoree Mr. J . S . Pannon, Alexander & Alexander, Baltiaore 2, Md, W lac#, 503 St. Paul Piece, 1/23/53 1/V53 1/25 2/22 Vi Vi 3/15 3 /2 2 4# 4/12 4/19 J/lO 3/L7 itffi 7/3/53 7/U ittZ L VV53 1/U ^6fl8L itiBL ^6079 g w o m , V23/53 V W 5 3 0xn OarnrlMg 1l//1U$/53 i/14/53 a r a o o m gxrui t k x u % V^/53 V2i 2/2/53 2/# 2/15 3/15 3/29 4/5 4/19 V 26 & 5/U fr vu Va */? /23 9/6 11/15 11/22 /29 12/6 12/13 U/30 1/22/53 2/a 2/15 2/2 2 V 3/22 3/29 4A2 3A7 (/7 i i? 1V 6 1 V 20 i*/a? 4/5/53 Ooxfebont 2/2V53 Oork 0&U 2/2/53 yynm 5/3/53 fhr. au 270197 7AV53 7/19 li/ a C o n tra st 44553 46699 497 46321 46951 46979 270031 270005X1 270041 270043 270045 273069X2 270093 273101 270157 OmteMiJtek Jdaas JL FaMo* Cta&Unft J B* FM:r(0B O s., 9 . F . Aadaarwn ft R > w , I& a ., 9 . F . SUiitorf-3ttle a, Ina ., 9 F . RsGlsaabm O s., 8 Katas Broadway Pluablag* 9 . 7 Atlas S a tli| ft V m tlla tlsg 0 ., 8 F . G*&rgm 9 . Blaohols 9* F . Kedae& haa G o ., 9 F . EaCLmdieai G s ., 8. F . C ah ill Bio ju , 8 . F S o a i'ix a j Balzj ^ t u j , 8# F . ^ostaxn PlmMag ft Eoatlsg* 8 F . Jfeat& Tsy Coaaty PltaM ag to , OeftlaaA Colon OU Co. o f C a lif. 8 . F . fcmttsa Bap 8 U t* Sasp ital, lisnln Boa Jr * High School Vallst}# Stats Bapsrtaont, S* F* H offstt fU L if 0 . S* l a p Sim SbuEUfclp Haspltal, Castro Tallsy (Qjiplo School, T allsjs 1 Bomship Hospital, Castro Yallgr Buntars Point Boosing, 8* F . Trcvis H r Ibres Bass, F a irfla l* Srssls Air Ybros Bass, F s lr fls li 8. F . S m ia g Coup., 8 . F* Boariaaas Dairy Dalirory, Oakland Saermnto Vsllsy Trsasaittsr Station, Viatsr V* 8. Assy Air Bass, Casap Baals Union O il Co. o f C a lif ., Olson Raflnaxy, Boiss N*U A&II&I 46771 46553 270043 46699 270041 46fM MLahard 270041 270043 46699 lotart 46699 270043 270093 46699 270041 270045 270100. Hamgr 270043 46699 270041 270069X3 46651 270001 Loyal 81t u 270043 270157 270041 John - - Bl 270157 270043 tattiMi. Mk a u u t m a mam V a / V2 27CXU1 S5/1/53 Vi SA5 V? aA3 3/3* Vj V>9 V26 & 3/2J V U Va V? VU V 23 Vi uA3 13/22 11/ 12/6 12/ 3J lV JCS1 I/2V 33 V* VlS 2/22 JlA V Va V 29 4A 2 3A7 Vr % gTMUI Vs/53 OoritbwwA 88 12/6 iV 12/27 r*rt6QT2 27QQ91 5/ 24/53 Oo* Oerwrl&f 2/22/33 ZZ3M1 3/ V 53 *** H** ZJJZ 7AV53 7V/ W* Castraci - A s u-- 4*553 6699 755 6321 6851 68 270001 270005H 2700. a 270O3 27005 270069X2 270095 270am. 290057 Cn&tract tttk l& m A. F a ll , Oakland J* H. Flckortoo 0 ., 8 . F . i Q a n m 3 Bava, In o ., 8 . 7 3astarfettlss Is a ., 8* 8 KsCLauh O 8ao Katao fefiagr Finitili 8 Y Atlas fie&tlas 8 Vaatilatiag C o ., 8 8. (borge B . Blanhols, 8 . 8 Kodonfthiuv Ga, 8 8 HcCUms&ao O ., 8 . 8* C aM ll Bios 8 . 8 S s iT iia u Ealiy M I t u Xi 8* 8 Vcstasa PlssMag & Rm tlag, 8* 8* Satorsy County FlzsMag 0 o ., Onici m i Calao O U Co. o f C a lif ., 8 . 8 . LggflU Bapa Stata Hospital, lala 8a$n J r . BI42B School, V a llai* Stata A iU tB a t, 8. 8 . f t f f o t t f i a l i , V. 8* ixaff S i a fiR aihlp Baspital, Castro fa lla r OOjaple School, Vallejo Sic fowiufclp Hospital, Castra Vallar Boaters Point Iteming, 8 . 8 . In a i Air toro* Basa, F a lrila ld f r a i s U r Vbroe Basa, F a irfield 8. 8 . Braving Corp., 8 . 8 . Barcassi Dairy alirary, Oakland Sasxmeato Vallar Traosoittar Statico , Vistar V. 8 . i a j ir Basa, Caap Beala Salem O il Go. o f C a lif ., Olese Belnary, Bodas Uli U! --k-c 'i A ' `fSz k un 4- 3 > ^ 3 "'l'L't ,Tli TI ' '. - /:" 'f i s m t ." t 1 .<U f n >* /OVV ^ O i X 'r\ c() * ' -\ -*.. 1 V 7t **- r ~ $ ^ V r r Jp-m , , .1- r j t t 7r U i `v/^LA -w - 5 ( i j *2.h 3 Hw l*-*:--V-t*--'7 i ' 1! I ! . ^ J **) 0\. / t , n i r -n i- t i H V-a /i-tz^lv p A - v y % 2- t-tuc y$-a* A ^ S^,-- ) u//'^<t\ %ry *2,-. . (Aa a ^ u J - <<i' $ 4 T lW < iS'-e U n O (?+4 ^F?A/y 4 j a -r -._ -4 W t /3 T i -^c/7k./t|LA _ ; j r - n f*s c.> t ^ W O - * 3 -jrj 0 2 ^ 1 -4 `C ` ' ) r ' / 4 j UM_ , i V QA^t~ di-i/i-U " 0 `1 ' Js'^)'-l-fj ULiZ' 1 'iq?r'~ HiZ'Z .. tn 4 (. A i cC U * A j /V ^ j T A A *}tiryt--S:ffr (ii A '(k M-j ir . a i 4 >fx A n tc^ A . ftV'U~> ) -AIa iXA'1< +-t ''taA r YfuA. 7))W''l <nd 4 il* ir (5" 5 i- ^ I - . O ..-o 'fr?' fy JC f& V .# * \ i. *.2--^*p>7_ u ? : i f f. UA A A si^ LU^fv' ; ` i t A Uidi ` '' J^'n \Jl~A M ll r'A' A*}*'1 <Z5 ; ^i^ttLZ*ru :w Hl i P v . ' - j r i i ;,% <^5 `!i u, \S i i "ii '~'/.-,"'f;"tV" T I F \'Afr-i?A ' j i \i" fl i. t 2-/ - tCS'V-:.  .(-Tii L .; . ' / ' d Th? * ' /PS3 / vr 'ffi/* ~ / ? & 3 qX' fssocifje McR-tiq. AtJ ffCh'l.tj't /lsPlcP 7 , / g e K . . J l A L eL h ^ C $ N 't R ft f e |i.oy/ I loX.fn 5t7- ?v4 ?3f ll-^- 5 J~(* . i I pflwg"V- t ; ! r ` * 13 -/3 Q-fr-c4 K i/^f n . C|-uc e. WJ- O / r f/l 11- in Uoyf fttin / I 5U7-r- f f 3Sl ll ~5c*f'tfjC-tfj- i 'tlr - 1 12- 31 fXfTT3S- ; 1 ! i - I i ! i ! f * 4 1 T -1 l;l G Before the Industrial A c c id ^ ^ ^ n u n is ^ io h of the State o f California Claim N o. 3.F. 161-70 Applicant. GOiX vs. PLANT RU3*ii AML ASaiSTCS WO.'JW, AHKUTiiCUG I CCXPNT, XUS LET COUX C O H F O H A T lJi, l LAST ;.;B ^ 3 T 0 3 COMPANY, 'SSTa KS ASBESTOS C G M i N , J . T . THOiPL a' , t > SON /> *f an dJ fTlkftit.Vlai-w1 O> .u.1 i*iSa tSU:*ri..M, >i.<A..1 C M ,'ivv v >t U N+ .i Y , IN u.UI o T rO AL X S la X h IT Y C O rANY. ST-T& COM: STATION IN 3U R f NCE FUND, r-AOlPIC sOU-LoYLiiS I liS a a ^ C A C and C LlFOhtlA CWu - S ^ T I C C.ir > , . , j * Defendant Notice of Time and Place of Further Hearing NOTICE TO ALL PARTIES You are hereby notified that further hearing will be held in the above-entitled action at 965 * ia s lo n S t r i c t , San F ra n e ia co , C a lifo r n ia , on the 7th day o f Soptcaoar* 1955* * t 9*00 o 'c lo c k a a , to co n p lo ta the reco rd Dated at: ALL LAX San F ra a cia e o , C a lifo rn ia * t h is 22nd day o f Ju n e* 1955 iN D U ST^A ^A tci5EiR ><t?M fis$l5 N N OTE: CON TIN UAN CES AN D FURTHER HEARINGS ARE N O T FAVORED. SERVICE UPON: A/2i/55-XcP top a r t m eat o f L u p lo y e a c tt* a t a t e o f C a l i f * P 0 Da* 1657* ^ ^ ^ * * * 6 * C a l i f . O c c id e n ta l L if e Ina C o , , >00 Xontg*m ei7 u t , S . F .- - J o h ii a . fta g ra ttd J a c k G n t h b e r t a o a , 22$4 H o lb r e o k O r iv a * oixoord. C a l i f o aitfc 4 f a r r i a h . 1616 F in a n c ia l co n ta r -Ih * , Oakland c a l i f P la n t uubber k b eu ta Worka* 5)09 H o rto a - t * o r y v i l l e , * l i f A n s a tr o A S C o rk C o * 1555 M a rk e t u t , *' leandet ^orkCorp* 440 arm ane > t. * F P l*.n t A sbesto * o , 5307 M orto u t . E r jr v illa * S a l i r . V e s ta r n b e a to # Co* 675 Townaand u t * u r . J U ih erp * 4 Una* i b e r y v i ll e , w a U f Cork In s a la tio * Addreaa unknewn WjP T ravulcrs In a . - e , Lathaa quare l e * ., O akland , U l i f Intta t r i a l XnMUwo* 350 Sansone -t , P* Stato fuad* raraaaA l Servi co , ah P a o i f l e mj> Ina* L o , 3770 r l s d a o a t A v a , 0 k l a n d , L o n a r d danna 4 Jr o p h y * 100 ju - 6 , F P a c i f i c -4!^. In a* S a l l e a 4 l i i p p i * 315 A o n tp am ery U t , # F O ftM 4 0 0 < H V , .S U 1S S 10-14 TOM ^^y-z p t f l -b i - ? 4 3 fr ( r .,i2 v * S-fr '' ? t' l ' tl Y c, ?. 7 p b ' S t T ^ ^ C" ^ ~ .A-, o-*-*" ., i 77..- nn o*77 t11 - ^ ` ^ ? i H 7 ?_ T [ ; M r -)'1 < ^7 *? J? - ^ I ^2 * ^7 Sl,t ^sh\ I3tr { S (?' ^^ i Inter - Office Communication Armstrong Cork Company To Insurance Department, Lancaster July 8, 1955 From John G. Murphy, Insulation Division, San Francisco Subject Jack H. Cuthbertson Social Security #572-24-8568 I.A.C. 161-870 4 k A ^ \-;355 WLM The writer is enclosing our file concerning a current claim by the above listed former employee. Please return these papers together with the information requested below. Mr. John Wallace of the local Travelers Insurance Company today requested a record of employment for the above con struction employee. This list should indicate period of em ployment on each contract, contract number, name of job, and location of job. He would further like to have names and addresses of other employees on each job for the purpose of establishing the working conditions. Mr. Wallace also requested us to send a letter to our insurance carrier for 1951 (with a copy to him) advising them of this claim and asking them to contact the commission for the date of the next hearing and to represent us at the hearing. If this is in order, please advise. MR Enel* A r f) 7 ; tfst*. Form 3377 8-46 } i >3 ) 5 I I i Marsh 23 1953 lhe Traveler* Informe Oeapeny A S Jfaatfoaery Street Sen Tranci00 California OattMi aac-ti Kr Kl K inril SebJacti Tede H* Onthbartaon Sodai Security #573-2V5 IrKTAanLak -- Xor lo ite r o f March 10 Adreaeod te cor S m Frmeieee o ffic e , hao been referred to u fbr wpljr, Specificali/ yea * * ^ * ^ ****"" ? ^ ^ < 1 the dato* o d con diti o f mploynm t ihr the period Nr* (Xithberteoi as ployed by na la onr contract operation. A far aa the condition o f oeployiMKt arc concerned, the/ e ld be the verace type encountered la ladoatrlal insolation oik d th eorkboard cork eeverlac cad r r ^ f 4* pipe ceverlac beine the prlnaiz aaterlali handled. Tor nere spaeifU Information no snccect yon eontaet Mr. Morphy o f our Sen ireaaiaeo o file a . Va are la a podtlon to fe r a l* Mr. Oathbarteoa'e data of anpley neat to a dacrea ifclah should be aatlfactory. Be vae enploycd la 1940 1941 n d 1942 bet the extent o f hie enploynent dorine thaee years is not kaoni batanee oar records have been destroyed. He osne bade to m k la 1949 m A corked sondamos]/, d th the smosptlon e f the fb llo d ne period Za 9/27/49 Ont IO/3/49 Xa 9/9/50 Ont V 2/5I Xa 4/23/51 Ont 3/9/52 Za V 2 /5 2 Ont 9/ V 33 Za 10/2^53 Ont 7/14/54 Tfca Tranralars Iu b h b m Oom pm j 2 Mar* 23 1955 I f you a m A aqr additioaal information, plaass a ll on us. T 7 truly yaws AM8TB0 COK OOMPAfT Inaurano* Dapartaaot Off V d l i M l , fiottarti Assistant Qanaral Mansfsr Copias toi Nr. J . X. faosa laxandar & JLlaxandar, loo. 303 S t. Paul Piaos Baltiaora 2 Md. Mr. J . 0. Murphy, Insulation Dirialn, San franaiaoo To From Insurance & Real Estate Department, Lancaster J . G . Murphy, In su la tio n D iv is io n , San fra n cisco March 17, 1955 Subject Ja ck H. Cuthbertson S . S . #572-2U-8568 Travelers F i l e #B-7585259 d/a 7-1U-5U y Reference i s made to our l e t t e r o f November 8, 195U, to the Travelers Insuranoe C o . (a copy o f which i s a tta c h e d ). As a r e s u lt o f t h is l e t t e r T ravelers advised the w rite r to f i l e an accid en t report w ith p lace o f accid en t ''unknown". This was done on November 10, 195U. Sin ce th a t time various hearings have been held on the su b je ct Under date o f March 10, 1955 we received the fo llo w in g l e t t e r from The T ravelers: "The above captioned case w i l l be se t fo r another hearing befoqfthe In d u s tr ia l A ccident Commission, in the ite r im , we d esire inform ation from your reco rd s. W ill you please give us a complete run down as to the dates o f employment and the co n d ition s o f employment; th a t i s , what m aterials were worked w ith what v e n ta la tio n was o ffe re d e t c . We appreciate th a t Mr. Cuthbertson worked fo r your fo r about three and one h a lf years and th a t our request might e n t a il d i f f i c u l t y in f u l f i l l i n g . _ We appreciate any inform ation you are able to give to th is o ffic e ." (Signed) K.M. Norris Compensation Adjster With reference to co n d ition s o f employment, m a te r ia ls , e t c . , i t would be the average type encountered in In d u s tr ia l Insulation^work I t i s suggested you answer t h is in q u iry d ir e c t w ith a copy fo r our f i l e s . J M ;p fg Form 377 8-4 y! /y? *h / ^ V/vy^/ v A i/rt yyO'^- . Ajf > ( /j> y --< j-f //v /j'V r / ;/^'/ . o~-J *-- <ST\-' ''***/ /9/ A. ^ 1 -- ' l o .(L, \ November 8, 195L The Travelers Insuranoo Co. 315 Hontgcnory St Son Francisco, California Attention* Subject* Claia Dopartiient Jack H. Cuthbertaon .-Jocial Security ^^W iSoB Qentlaaeni - The above nan quit on July 1i;, 195L, after being employed by Armstrong as an Asbestos Workor aoro than two years with pro* weekly earning# of R120.00 per week. Hie wife called this office November U, 19$h, stating that ^ ;.(r. cuthberteon had recently undergone a lung operation caused by "asbestosis". Ho further clarification was given for the call, but the writer is passing along the information in case of any future plain. Very truly yours, JUaSTBOHQ CORK CCUPAT Insulation Division Construction Supt. JGUilffl aiinH r.aov toi Insurance and Real Estate Dept., Lancaster Blind copy to. ^ T>jrl<>r( j n ^ t l o n Division, 3an Franolooo Note to Insurance Dept* .f Reference i s made to correspondence between 4 * ' Siaaann Firraanncciiascov branch, J . W. L--i d---d- e ll, Insuran,, ce ,, and Peal E sta te D e p t., T ravelers Insurance C o . , Standard A cciden t Insurance Company dated ' March 6, 13, 16, 19$3, re H a n y M. Kish who. apparently died from "a sb e sto a is" on March 19, 1952. The w rite r la not fa m ilia r with the outcome of th . a claim, but perhaps the phone c a l l would in d ic a te a rlnin in the future. EMPLOYER' S REPORT OF INDUSTRIAL INJURY STATE OF CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS DIVISION OF LABOR STATISTICS AND RESEARCH Claim Department THE TRAVELERS INSURANCE COM PAN Y 315 Montgomery $f., San Francisco 4, Calif. Ever; question mutt be answered fu ll; to avoid further correspond ence. FAILURE TO FILE IS A MISDEMEANOR SU B JE C T TO M A X IM U M FIN E O F $100. (Labor Cod. Section 6407-64li) P I.... to W 1DUPI.Ic*TE IOut < o.h., ,k, 0 to the Diviaion of Labor Statistics and Reaearch not later than 24 hour after death.---------- EMPLOYER (Give name under which l . Name concern doe* bueineaei .. , , 1^ $ 6" /ty 2. Office addre Street4)"-- - (Manufacturing *hoes. retailing men I f business clothe*, trucking for hire, etc ' INJURED E M P L O S ^ E s ^ ^ ^ ^ ----------- ----------------------------------------DO NOT WRITS Ilf THIS COLUMN Caae No. rSSi: Zmployar No. Industry 6. Age Z ' ( 0 ......... 7. Sex; Check (v0 9. Number of hour* workedjjpr day . 10. Wage: I per hour, oc '7 : , .i ..per day. or I ....... per week. (If earning* at irregular rate, euch . piece work or on comm.wion be, enter actual everaf. weekly m in i for convenient perriloodd jtpu)tt ttoo eexacceeeeddoonme year.) 11. If board, lodging, or other advantage fumiehed In addition to wage, give eetlrmted value day. or t .................................- .........Pr week As Sax ad Marital Statu KT Z l accrdent jjto ------------ ................. " n . On employer' premises No).............................. u - Department.............................. .......................... ....... ..................... J 1 Hour of day ______________.A .M ./P .M . IT. Did Injury reeult In dleabUlty beyond day of 15. Date of accident........................................................... ......... 4W* ' . .. , (Ye* or .. . . . , . _.i__ .... 19. Waa injured paid In full for accident? No) . . . . IS. If ye^ give date laet w orked..-.------ --------------------------------------------------------- thi* rfav? N<!T r 70. H .mured in a mine, check (V ) accident location: Surface................. M IU ......................UnderP ound: ................Shaft, . .- - A ^ S3 E L CAUSE OF ACCIDEN T 22. How long employed by you at this 21. Occupation (job title) .... occupation? Check (s/> Leas than 6 months 6 montha to 2 years................... ; over 1 y e a r i ^ 2 J . What waj em p lo y jlo ln s when accident (Describe briefly, uch as: loading truck, operating ./ ^X...v..M.G* occurred? drill preee, hoveling dirt, walking down lair, etc.)------ ............fe lL .E ? ..fc S a S 3 -.^ ............... 52.U O X i? f % ^ r^ (ully. . ^ * S X Z Z w J!t X S S 5 S S i S S ^ S ^ rr.a ' J * .m o.... the accident happen? `(2 S S 5 co n u iL tin g ^ r \ ^ n D d ^ ^ l X ? . t n . c k , etc ; give ail accident. U . o t h ^ d d . of p o r t for e d d ,t lo d .p .c e > .e ?._l l e . .......... & * m f e u t i H O t ....t-1 K T C - i V h L . r . F '- i . ' i fe e .-u l y QUIT R 25. ^ J^ H n a c fin i! fto f*S LSn fce. o r^jlct^w StSno 7-,1.4 - S i r - FroW .,-s jM I L h t * t r e itP/n t--w, N .mmtethe pecifnic macahiine, tool, appltaac. p ^ i^ u...i..d.....^.....t...c...^... involved) ................-- ....................................................................... .........~...... (Su te if gear*, pulley. 26. If mechanical apparatus or vehicle, what part o* It? fv2*o r . , . Turn 27. Were mechanical guard*, or other safeguard* provided? No) ~ (S^ yh" ........................................................................(Ye* or 23 W *i injured using them? No) ----........... preventive measure* that can be taken by employer and workers 2o. What do you recommend for preventing thte type of accident? o n o t - y ^ T y being more carefui. " Specify what ahouhior diou.d not be done, Waakly Was County Acddaat Data Occupaou Accidant Type Asney Afncy Part Mach. Dfct Unaafa Act 5 1 , Name and addri I of physician... 52. Name and addri I of hopital-- (Ye* i i . Ha employee returned to work? No) .............. 1. If yea, give date... (Ye* or ib . Did iniury reeult in death? No) . . - ..... i7 . If yea, give date.-------iS . In caae of death, give name and addreaa of neareet relative-------------------- iS . At what wage? !.. Proaal Dafact . Natur of Injury Locution Ixtant of Injury 59. Names and address* of witn< 40. la injured related to Employer?.. Signed by C A S H Rev 7 S3 enmito in u s * 1 0 a If *o how?... r Date of thi* report.----- I u m . ..Official p o e iU o n -i^ -lB -.U ^ j:..... ! '' teediiiK W o re the Industrial A n nient Commission. Lalmr Lode. SeiUon 011.1. / 1 t o 1H* f ill'd crfeiry p ro Twstiftnes Carrier Report Lag Coded by EMPLOYER' S REPORT OF INDUSTRIAL INJURY TO STATE OF CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS DIVISION OF LABOR STATISTICS AND RE8EARCH Every question must be tnawered fully to avoid further correspond ence. FAILURE TO FILE IS A MISDEM EANOR SU B JE C T TO M A X IM U M FIN E O F $100. (Labor Code. Sections 6407-6413) Claim Department THE TRAVELERS IN SURAN CE COM PAN Y 315 Montgomery St., San Francisco 4, Calif. ' ____ _ Pteese make thia report in D U PLICATE so that we can file copies with Division of Labor Statistics and arch in yotir behalf. O' Every work injury to an employee which causes disability lasting lomjer than the day of the injury or which requires medical service! lirst aid treatment must be reported within live days after the injury. If the injury reaulta in death, a report muat be made by telephone or telegnrfh directly to the Division of Labor Statistics and Research not later than 24 hours after death. EMPLOYER ,. Armstrong. Cork t e d.135$ Market St 2. Office address (Manufacturing hoe, retailing men' 3. Nature of buaim m clothe, trucking for hire, etc.) C o ..... Industrial ^TownT `^an Insulation.. INJURED EM PLOYEE 4. Name.____ Jack . . C u t h b e r t s . Q n ............................................... -- s . Address s i? ;3 ? d 2 2 0 k H o l b r o o k . M y a ........... ......................?7?-7U-0g68 ............. (City and State) __ConcordCalif. DO NOT W RITS XR T H IS CO L U M N Cas# No. Employer No. Industry 6. A g e ............... 2 ................. 7. Sex: Check ( y0 M a lt X Female--------------------- 8. Check (V) Married......... ^ Single.__________ _JiQ- 9. Number of hour* worked per day......... J& per week.. Number of day worked per week. A|s J..125 .25,kO 10>.. Wage: I . ............. . per hour, 01 $ . .............. . per day. or S.......X .2 7 - Q Q __________per week. (If wmlng* at Irregular rat, tuch aa piece work or on commimfon b a s t enter actual average weekly earning* for convenient period not to exceed one year.) 11. If board, lodging, of other advantage* furmahed in addition to wage*. give eetlmated value per day, or ................................- .........per week Sex and Marital Statu* Unknown.. A C C I D E N T (No. and 12. Place of accident Street) (Ye or 13. On employer' premi No).............................. 14. (City or Departments ________ (County).. Weekly Wage 19. Date of accident.. (Ye or accident ? No) (Ye* or thu day? No) CAUSE OF ACCIDENT 21. Occupation (job tuie) . occupation? Check (vO .............................. ......... 16. Hour of day_________ _____ -A .M ./ P .M . 17. Did Injury result in dlaabUity beyond day of 18. If yea. give date laat w orked--................. -- ........- ..............- ......-- ......................................... 10, W u injured paid in full for 20. If iniured In a mine, check (V ) accident location: Surface .. . Mill............... Underground ................. S h a ft............ Asbestos Worker 22. How long employed by you at thia Lew than 6 month 6 montha to 2 year......... .........; over 2 y e a r a .-X ... 23. What waa em ploy doing when accident County Accident Date Occupation occurred? drill pres, hoveling dirt, walking down taira, etc.)-----I a s u l a t i n g . . . ] ^ . 3 * ^ .......... (D n cu bc fully. Hating whether the iniured peraon fell, w u .truck, etc.; give all i l l * K r i i l v P R U S a d 24. H_o__w___d_i_d___t_h_e___a_c_c_i_d_e__n_thappen? factor* contributing to accident. Uae other ride ol report for eddltional pace) ........ ......... "Aabeatoaia"..duo to..working with ingni.itinn material.-- quit, nyi 7-i)i-gh Tor niffiiur typti of wcLrk with. anQthflr .aaDloyer..------- -- -- Accident Type Agency (Name the specific machine, toot, appliance, 25. What machine, tool, ubetance, or object waa moet cloaely connected with the accident? gas, liquid, etc., involved) ... Agency Part .............. ................... (State if gear, pulley. 26. If mechanical apparatus or vehicle, what part ol it? motor, etc.) (Yea or (Ye or 27. Were mechanical guards, or other safeguard provided? No) ......................................... 28. W ai iniured using them? No) -- ....................................... .. (State the specific preventive measure that can be taken by employer and worker. 29. What do you recommend for preventing thia type of accident? Do not ay. 'By being more careful." Specify what should or should not be done) Mech. Defect Unsafe Act NATURE OF INJURY AND PART OF BODY AFFECTED (Drtcribe in detail the nature ol the injury and the part of the body affected. For example: amputation r tn lm / v a m 10. ol right index finger at aecond joint, fracture of rib*, lead pouonuig. dermacula of left hand, etc.) ------------ J J U & U U n U ... 31. Name and addreaa of phyuclan.......................... 32. Name and addre of hospital-........ (Yea or 33. Has em ploy returned to work? Noj (Ye* or 36. Did injury result in death? No) . .. . . 34. If yea. give date.................... 37. If yea, give date------- ---------- 3. In case of death, give name and addre of nearest relative___________________________ 39. At what wage? I ..... .......... Personal Dafact Nature of Injury Location Extent of Injury 39. Namca and addre of wune 40. U Injured related to Employer? Signed by.. C-4587 K ev 7 S e rf o in u s j If ao how? _ Date of this report___ JLU10=5k... Signature ........Officiai powuon...UpnOtlUCtOn 3upt. . FiJing of thia roport is not *n admisaion ni liahilitv. " Nn rrfxut **f mjurv re(juin*il t<!>* Id<*d ly an in p lm t. r nr an msuriT li\ t his i ii.ipt* r vh.til lx` adtiiissiliU* . h t*vidcti< r in *iny aiivut'-ii y prceetiint liefore th Industriai .Uvidenf ( tmmu^ion " Lui>or t ode. Vrhon 641.. Insurance Carrier Report Lag Coded by November 8, 195U The T ravelers Insurance Co. 315 Montgomery S t . San F ra n cisco , C a lifo r n ia Gentlemen: Attention: Subject: C la in Department Jack H. Cuthbertaon S o c ia l S e c u rity 572-2l+-8568 The above man q u it on Ju ly l b , 1951*, a f t e r being employed by Armstrong as an Asbestos Worker more than two years w ith prox weekly earnings o f $120.00 per week. H is w ife c a lle d t h is o f f i c e November 1*, 195U, s ta tin g th a t U r, Cuthbertaon had re c e n tly undergone a lung operation caused by "a sb e s to iis ". No fu rth e r c l a r i f i c a t i o n was given fo r the c a l l , but the w riter i s passing along the information in case o f any futuro claim . Very tr u ly yours, ARMSTRONG CORK CQUPAMT Insulation Division JGM:MR Johijy. Murphy Construction Supt. Blind copy to: Insurance and Real Estate Dept., Lancaster John S. Taylor, Insulation Division, San Francisco Note to Insurance Dept: ' _ "71 " _ Reference is made to correspondence between San Francisco branch, J. 7T. Liddell, Insurance and Real Estate Dept., Travelers Insurance Co., Standard Accident Insurance Company dated March 6, 13, 16, 1953, re Harry M. Kish who apparently diedfhora "asbestosis" on March 19, 195?. The writer is not familiar with the outcome of this claim, but perhaps the phone call would indicate a similar claim in the future. BEFORE THE INDUSTRIAL ACCIDENT COMMISSION OF THE STATE OF CALIFORNIA ' ' . Notice and Request for Allowance of Lien ; ?; ''`"'SCo San Francisco Office 965 Mission Street San Francisco 3 Sacramento Office 631 " J " Street f l , A TM N o .. Au J.Zj. .L uO 0 U CLtM T s. JA C K 3 C C T I B ^ K E S C B ________________________ , iin o T ti Los Angeles Office 301 State Building Los Angeles 12 San Diego Office 1521 Fourth Avenue $83 itersot i t n e t gflo T ra ic ig o o j ^jJLiXo.r.da AO M UI JK&J. Uolu?cii: jivio <.oaco!t CaLlComiA ilB IU I Anzirsma coe s anona Ss- ---- - th w z^iis iia .>Tain_______________ INSUtANCC C A tR Itt ___ j d A '&('h(f<iC6 ft//T iiiaetai The undersigned hereby requests the Industrial Accident Commission to determine and allow a 1 lien the sum of teax&tu. aiua w.'/XS^o* rmiin (f C7X+C7 -) against any amount now due or which may hereafter become payable as compensation to_________ J a c k :! C u t ^ b a t i f l g B urum on account of injury sustained by him on______1^00^ X9U3______________ > 1 ht * hir'rfspWdatOritiiTli.1~tijtlriTrt)ifry)Tt fauiilfi y The undersigned declares that he delivered or mailed a copy of this lien claim to each of the above named parties on / consent to the requested allowance of a lien against my compensation. ............................ -___ ___________________________ ATTOHNIT fOft KMPLOVfC Form 329 irev tt-s^i A ........................ Dili 1 94 17 900 STATE OF C A LIF O R N IA IN D U S T R IA L A C C ID E N T CO M M ISS 0 6 8 M is s io n a n ts tT . Sa n F r a n c is c o 3 4 1 2 H u s B u il o in o , FRSSNO 21 Roo m 2 0 0 . 63 J St r u t , Sacram rnto Stats B u il o in o . L os A n o slcs 12 r o o m 2 1 4 . too E. O c c a m b l v d ., L o n s S u c h S 18 2 1 4 t h A v s n u s . Sa n D is o o 1 JACK CUTHBERTSON, C l a im N o . . 5 4 SF .161-370 Applicant__ vs. ARMSTRONG CORK COMENT, TRAVELERS IND IdsMCE CGKf.HT, rL-HiT icJULafOS C0.'CLf, INDUSTRIAL IMJKMIUTT CUBANI WEJiiLUi is>3TO3 CUrtf**. a n d JTitTS CUMfLil3ATI0N INSURANCE FUND, Defendant Notice of Hearing of Application For adjustment of Claim You are hereby notified that an application to adjust a claim for compensation (a copy of which is attached hereto) ha* been filed with the Industrial Accident Commission of the State of California. You are further notified that said application has been set for hearing at Ro o m 206, 1531 Webater Street, Oakland, California, on tha 17tb day of February, 1955, 2 *- ALL F.M. and that at said time and place the Industrial Accident Commission of the State of California will proceed to hear and dispose of the said application in the manner prescribed by law. N o t e : The parties are expected to lubm it all isiuea in controverijr for deciiion at this hearing; therefore, all neceaaary witnesses, evidence, documents, medical reports, payrolls, and other essential proof must be available and ready for submission at the hearing. Dated: January 12, 1955 IN D U STRIA L A C CID E N T COMM ISSION By EDMUND J. THOI'AS, JR. A ulitim i Secretary The undersigned certifies that as an employee of the Industrial Accident Commission she served the foregoing notice on the parties hereinafter mentioned, at the time set opposite their respective names, by depositing a copy of said notice attached to a copy of the application therein mentioned, in a sealed envelope in the United States mail on said day, at California, with the postage thereon fully prepaid, and addressed to the said parties at their last known plaicJ of Busidus or residence, as follow, to wit: NAM ES OF PARTIES SERVED DATE OF SERVICE J a c k c u t h 'o o r t a o n , 228/+ Holbrook Dr., Concord, Calif. ..r .L c ii c. . *r i L o r, I d o ''in-r.cial Ju.ter al;^., j.tklund, Calif .ri'-.itron., C o rk lo 1353 :ar':oL -t., an rV-mcisco, ^lif. . 1 t n t b oaL on J o 5309 Horton .at., -moryville, Calif. ..etrLern ..ioc;3t03 Co., 6 7 5 To*nisnJ .t., oan Francisco, C a lif T r a v e le r s i n s . Co ., Leitliaai o^Uiira J l d e;., O a k land, Calif. I n d u s . Indeiun. Co ., 3 50 3u.nsocje ~t., Can Jr.nciaco, Calif, o t u te Corny I n a . fund, r o r a o n a l C e rvic 1/12/55 ! M *1 I 11 vf F o r m 35 <rkv S4 [Sig n a tu r e] 34 UH (+) *FO C C M M I tO N O F F IC E . FOR N O R TH ER N C A L IF O R N IA (EXCEPT 8A C HA M E N TO C O U N TY I 65 M is s io n S t r e e t S a n F r a n c is c o 3 FOR SACR AM ENTO CO UN TY O NLY Ro o m 2 0 0 . 6 3 1 J Sn.feET Sacham ento FOR(ESXOCEUPTTHSEARNN01CEGAOL ICFOOURNTNYI)A 601 State BuitoiNa L o t An g eles 12 FOR SA N D IE G O C O U N TY 1621 Fo u r t h A v en u e Sa n O ie g o 1 O N LY STATE O F C A LIF O R N IA DEPARTMENT OF INDUSTRIAL RELATIONS INDUSTRIAL ACCIDENT COMMISSION APPLICATION FOR HEARING c ^ no. J& lr $ 2 0 54 a r Filed 12-21-54 DO N O T W R IT E IN T H IS SPACE EN TE R E D IN D O C KE T B Y __ ___________________ Employee'! Name.. JA&C CUTHBiSRTaOM - Social Security N o--.......................................................-- .....................-- ...... ......... Name of Employer 1 ^ ......^ y a t t f o n g - C o r k C<a y u iy ................... jtg T r a v e l t r s I n a u r a n e C o n p a n y ____________ ; 1*1Rn i T rfw u M tn y ------------- Name Of I n d u s t r i a l I a s m i t y Coapvaf Insurance Carrier. .............................................................................................. - 3 ' t * r a A b t o C o n ^ a n y _____________________ H t r t t .* r-fM > n a a L l o n n y 11**-*0 0 * Address------- . 2 2 6 4 l i n i b r o o k . - O r la r .. t T i t l t ANO N U B B IN ________ ^mssa^QMJilPmiJL - TOWN 0 CITY STATE ^ f f l J . _ ^ . . r a n s i * s < , , J^14JrorniA ....... q t t r F ,,T *"' l,<l" B i d s , O a k l a n d 5 3 0 0 r if lr t a n a t r -- jyMuaotiLll#.. insure S i M M M a t ,, 3an fiKineiNdF1* Carrier's Address................ . ................................................ T ........................... 6 7 5 T t n m s e n d '# tv |i,u0 M i F r a n c ia e o sa4___ J^...bfiAiJJLft^_JitA^_a^J'raniao ETAT Employee's name-- Date of your injury Place where injury occurred----- . C i i t i i h a > t a r m ___________________ 1 9 4 9 ?* 1 9 5 4 .......................................... .........._ Sa b F r a n c ia o n C ITYT ARNO STATES ____________ Employee's date o f birth..--............. ............................................ - Employee's occupation at time of injury..................M " M W 1 . M y iA ir-- When did you leave work . _ . ____n o * as a result of this i nj ury-- 1. 9 * 3 ----- --- O C tO b W 1 9 | *9 5 4 How did injury occur - m t A l n g u f r U U l C I n O U T -- O f ***** faftr ttf u l t O C a R t a a A l M W What part or parts , of your body were injured-----j When did you return to work i t i l i d i M l l i A Full or part time work and at what wage. Your wage* or salary (before deductions) $ .... :r hour or $----- .per week or I . per month. If paid on hourly rate, how many hours did you work per * r c .----- -------------------- - ............... ; ,v n v n Did you receive any of the following: Board? Yes N o ; Lodging? Yes Q No ; T ip,? Yes N o ; Other advantage,? Y e , N o State their weekly value $--------------------------- H a v e y o u been paid any compensation? Y e s 0 N o Q j How much $ Weekly rate of payments $ TOTAL AMOUNT DafitCew wTThSIeVInS lAa,,sJtV p[ a/yTm*'e1*4n**t w4as m--a--d--e------------ ---- - . 19- ^ ^ Has the employer or the insurance carrier furnished you with any medical treatment? Yes N o [ j | Date when last treatment was given ............... ............................. -- ----....... - .1 9 -- List names of alt doctors who have treated you and who were furnished by the employer or insurance carner.. U ttivrltf oJT CaliTo*U-- ....... --_ ------------------------------ Have you obtained any medical treatment at your own expense? Yes (jfc N o L J. List names of all doctors who have treated you at your own expense--------------------------------------------------- Are you claiming any of the following benefits (Answer Yes or N o) : (a) Temporary disability paym ent----------1 -------------- ----- 0>) Permanent disability payment... (c) Further medical treatment . . . * * * -- - - ............ (d ) <=* f youf me(i A ............* * * (e) L is t other benefits claimed and not mentioned above...................................-- --------------------------------------------- Have you ever before filed a claim with this Commission? Yes N o [ J If so, when was it filed- - - ltdo Flaonci^.^-entei- tTltas. ---- T^k GufritoarLoan //------------tIB N A T U R t OF A F F L ltA N T Date - D -- k l - 2 & f - 1 9 5 4 -- .......................... ' 19 OLancoort jfcftP, IB N O I I i i r A K i N r , ' u 1 ,1 <)... . , . r i , c i . . I . . . k ~ . t i . d * !< k i t . l . a . . u l a . . . a . . . r i k . ll( ftiffin I m pe,*<. I, t.y ,ttr>rnr or 'nr ANSWIH Ik. ...................... |.-i.d .o "I. ....... .<k,. 10 d... .1... of. -r - tu d. Ii U in iu i n ik U '.n. . .f is..j-.r ..; '. *?* ,*,,,,,'J1 .inn t" he s*1i"l',witi "B. '* *' I#rl 1*4 bird by the rust >'. ui 1 r 'br u n m immr-1l*rty ms lbe p r o v i **' e b* *. ili U ditihed in p ..n PT.I.C...,.n m in x the fnrm .11 be d i n * b y t i n m tbit w r i t i n t o i tk U m *4 p l lu rtn ib *d iur th at purpoe*. If c ir n t r i b u i li tk io s r n c, k . E lt k p t f i f *T k > d r f n d t m ployr ii c u r l * i< 0* d , f W th * D A T E OF S1MYICK SKEV1C1 ON F.ihM 14 .hiv -v*s.i 810 4 84 Ml / / y STATE OF C A LIF O R N IA INDUSTRIAL a c c id e n t e ea m iiom sti i t , san faanciico s 412 helm Building, Fm in o 21 com m ission STATI Buildino. Lo i An o il i 12 ROOM 214. too E. OCIAN BLVO., LONG BIACM 2 1S21 4th a v in u i. Ban Oiiao 1 ROOM 200. # 3 1 J tT R IIT . SACRAMENTO C la im No..54*! a.?-A- 161-VO * '' Applicant-- f U k T ..UlLivjt *SU . j*u Cw**~U, .iUi&T L ai Av/* v' , t, * -, a.. ^ -r-,,%Vii~*.ui UfcJ illa^Uh ` m * mV *i, TM-wItV.M T L Defendant. NOTICE OF HEARING OF APPLICATION FOR ADJUSTMENT OF CLAIM ust a claim for compensation (a copy of which is attached hereto) has You are hereby notified that an application to adjof the State of California. You are further notified that said application been filed with the Industrial Accident Commission has been set for hearing at K * . 2o, 1531 *u*tor t . , AA-Una, C a l i f o m L , on ta* 23rd (L/ of 8*7 1953 * t 1 :3 0 o' clock .U. ,nddm,, idd- mdpl.c<d. indu,.TM. AccidcncCm-- dispose of the said application in the manner prescribed by law. - d. So. 1 CdltoMwd. Fd - bmmd N o t e - The partiel are expected to lubm it all muet in controver.y for deci.ion at thu hearing! ` ^ ref " ' n e c e u " y Wltn * medical ,, p o r t , payroll., and other ential proof mutt be available and ready for tubm .m on at the hearing. Dated: * ,ril 25, 1955 IN D U STRIA L A C CID E N T COMMISSION & &J*Alili J. TaOK.a, Jit. Auirhmt Stcrtltry , , The undersigned c e r t SfolL parties herema ter men 10 , residence, as follows^ to wit: , rhA Industriil Accident Commission she served the foregoing notice on the . f i ke their respcctlvc nemos, by depositing a copy of said notice attached to a envelope in the United States mail on said day, at T j^ iU C lA C O Mr'^dd. -d Md-d .0 .b. -a p-- 0, 1 b -.. pi- orb-- .0 VHW I.C p a r t ic i SERVED e lAtUicrved aheat, Form 15 irev 9 54 I [Su.N stu re] 9J49 9 54 IOM CD * P O Dept. o f Em ploy.,P.Q . uox 1857, Oakland, C a l i f . O ccid e n ta l L i f e I n s . C o ., 300 Montgomery S t . , S . P . , C a l i f . Ja ck Cuthbertson, 2284 Holex*ook D r ., Concord, C a l i f . Smith &. P a r r is h , P in . Center n ld g ., Oakland, C a l i f . 4/25/55 " " w r ia n t kub*>er L asb estos Works, 5309 Horton S t . . E m e r y v ille ,C a l. " Armstrong Cork C o ., 1355 Market S t . , S . P . , C a l i f . " Mundet Cork C o r p ., 440 arannan S t . , S . P . , C a l i f . n r ia n t a sb esto s C o . , 5309 Horton S t . . 5309 Horton S t. E m e r y v ille , " Western Asbestos C o . . 675 Townsend S t . , S . P . , C a l i f . " J . T . Thorpe 4 Son, E m e ry v ille , C a l i f . * , T ravelers I n s . C o . , Latham Square ii ld g ., Oakland, C a l i f . " In d u s. Indem. C o . , 350 Sansome S t . , S . F . , C a l i f . S ta te Comp. In s . rund, Pursonal Se rv ice * P a c i f i c Employ. I n s . C o . , 3770 riedmont a v s . , Oakland, C a l i f . " C a l i f . Compensation I n s . C o . , 26 Ge*ry S t . , S . P . , C a l i f . * YW X C O M M ISSIO N O F F IC L3, FOR N O RTHER N C A LIF O R N IA (EXCEPT SACRAMENTO C O U N T Y t 0 6 5 M is s io n S t r e e t S a n F r a n c is c o 3 FOR SA C R AM EN TO C O U N TY O N LY Room 2 0 0 . 631 J Strekt Sa c r a m e n t o FOR S O U TH ER N C A L IF O R N IA sot ( E X C E P T S A N O tE G O C O U N T Y State B u il d in g Los A ngeles i 2 FOR S A N D IE G O C O U N T Y O NLY* 1521 Fo urth A venue S a n D ie g o 1 STATE O F C A LIF O R N IA D EPA R TM EN T O F IN D U ST R IA L R E LA T IO N S INDUSTRIAL ACCIDENT COMMISSION APPLICATION FOR HEARING Filed arch D O N O T W R IT E IN T H IS SP A C E E N T E R E D IN D O C K E T BY___________ Employee's Name^rc iHT-ttr tTtQjl Social Security N o..........._ ................. ........ __ Name of Employer VrYj ^IT I ft 1 ~,TiT Employee'* Address....... 221+. I L L i l d . . aT J l L O R ........ Employer's Address- 43uaeoxtiT..ALarul4--. TOWN O S CITT ZONE Name of Insurance C a r r i e r - ..4 ^ ._ 1t f 3 ^ C i i fcJ . . . Lini-'-- Insurance T0W 01 CITT Carrier's Address.. Employee*, s^ r 6 " 1" 7....... - w _____ Employee's date of b irth ... __ Employee', occupation * - - ....... .......... - ..... ^ * 2 = ^ + * + * * * - ................. ..30.19 ..................................... of your body were injured i_VU1 ^ S _________________ _______________ nf Moe ii -.iawu-al t o^ h a at^A Inna, When did you return to work --SUAl-GisoblaA-.........- fnd` what ...................... ......................................................... Your wages or salary (before deductions) * * * * 9 ^ ...... per hour or t I f paid on hourly rate, how many hours did you work per week________________ ... per week or $. ----- per month. Did ,o u of . fa ll TM , Board? Y m I No Q , U d * s ? Y ^ H N o' t tV ip ,? Y ^ E ' ^ 5 O ^ d v . ^ i , ? State their weekly value $_________________________ Have you been paid any compensation? Yes N o [ J How much $ Weekly rate of payments Date when last payment was made____ TOTAL AMOUNT -, 19- H a , the employer or the insurance carrier furnished you with any medicil treatment? Yes N o . Date when last treatment waj given______ _ _ _______ ________________ ^ 3C List names of all doctors who have treated you and who were furnished by the employer or insurance carrier....... Have you obtained any meefcaf treatm ent^ yoj own N oQ List names of all doctors who have treated you at your own expensT*__________ Are you claiming any of the following benefit, (Answer Yes or N o) : (a) Temporary disability payment_________ (c) Further medical treatment___ _______________ (e) List other benefits claimed and not mentioned a^ H S L (b) Permanent disability payment............................. (d) Cost of your medical expense . . .. Xe Have you ever before filed a claim with chi* Commission? Yes N o Q I f so, when was it file d .-.- Miln A I.MMiaTATIVI 01 ATTOBNIV rot ArrucABT J f l n a r .r t .-i2 Ge t t a r - i l d ^ . , AOOREM JltL-ACurt 2 2G0t) Ul Date _______ cimrsf w,- ; * ___ Ai.aATUAi or ArrucAar --,195-- A fte r tk* ap plication k i U u U d w ith tW tiu liu ] a , , - j . . - represented in P * r B, by " torn ey. or okrr i c u t . C o m m i.n o o tbe p .r t iu w ill be notified in v r itin / the t im . ,,, d p |K , 0 ( W i n . E ltlitr p arty m ay b* DAT* OF SBAVICI 5Lavica ON iTI ' r a .iggSfc. Raj JACK CUTHBERT3QM IAC / I6ld70 List of Ampioyar* P la n t Rubber ft Aabeatoa Works $309 Jtarton S t . , ttaaryvill, C a lif. Western Aabeatoa C o , , 673 Townend S t ,S a n F ra n cia co , C a l i f . J . T . Thorp ft Son, Em eryville, C a lif. Mundet Cork C o r p ., 440 Brannan S t , San F rsn clx co ,C a lif Cork Insulation C o ., 3an F r a n c is c o , C a l i f . Arostrong Cork C o . , 1 3 5 3 Arkat 3 t . , San Francis co, C a lif Flant Asbastoa Co, 5309 Horton Em aryvilla, LIST OF IHSURAKCS 00KPAH1HS Traralar Inaurane Co, Lathaa Square B ld g ., Oakland, C a l i f . In d u stria l Indemnity C o ., 3 5 0 Jansoaa 3t., San Francisc o ,C a lif S ta ta Compensation In a . Fund 450 KeAl l i s t r S t , San F r a n c isc o , C a l i f . P a c ific Employers Insurance C o . , 3770 Piadnont A r e . , O a k la n d ,C a lif. C a lifo r n ia Coapanaatlon Inaurane Co 23 Usary S t , 3an F r a n c is c o ,C a li f . STATE COMPENSATION INSURANCE FUND KXKll TI\K O M -U -tS W. . . . M i A1Ui hi vTtXk wK SMTKRrI.Cr .T1 SAN KKANCISCO l U-+S z5 / 'J. EARL R MOWARO H C M ILLER DONALD GALLAGHER J H LE I M B AC H M O MANAC.&R COMfTHOIKfl Counsel 4i o>cal Dircctor Induatrial Aooldont Cowartoaton 95 Kiaalon atroot San ytinBlw # California SACRAMENTO SAN O ltG O SAN JOSE STOCKTON Juno 1, 1955 inreflv Referto *312235 Jaok Cuthbortaoa (& 3 > O an tleso xxi Rot z a c 161-aro fiTi Wo aro additional mporta aa folict a. Corwin Hinahaw, M.D. Goer A Wstaon, M*D# Way 24, 1955 toy 10, 1955 p Coploa of roporta aro bain aallod today to tho paraona and addroaata ahoun on tfco attacbod ahoot. Vary truly your. PRHxld -nol. FSR R. UCLW1S Attorney Industrial AaoitKiiv evitis!** oot Deut. aC -aapleyaeut, F . i-cx * caitLafid, ,, l l f . ooi o ccid e n ta l -lo l u * . C u ., 300 aontgyaoxv ->t. /rsnalaco, l l f . co* Jaoit Cu th lortao n , 2214 .io llro w . Dr. * Cuneora, C alo .!. c c : 2miU\ s F a r r ls n , i u l F lu . outer lld ti* > u t a a n d , c l i r , oot Fitaalt K utter a A steo tee `n o r**, Horton S t . , uuoryv i l i ^ *al* cot Artestron Cor* J o * , loo-i Karwit u t . , ^ ^ i d i a i s c w , C u lla , 0 0 1 Mundet Corii C o r p ., 440 Lrsnnsn S t . , u*n i?rono*scof u^xr^rTU cot r ia n t A stes to s o . , *i> Horton H t ., or v i l l o , u * li* o r n l COI western AaScatos C o ., Tutsisond S t . , 3sn F r a n c isc o , t * U f . OOI J. T. Ttu>rp Son, itoaryvilli*, C sllfomia ,..W a cot Traveler ina. Co., laUiau Square 14., uucland, o*J.iiQm-.a oot cot inaustriai indou. Pac. liapley. In s. Co., C o ., 3> Sansone Stritt, 3 //O Fisdaoat A v ., uuOand, C a llirsua fn\ vy/ 1 Ezroaz THE IKDOSTRIAi ACCIDENT CQMGSSIOH 2 C9 THE STATS 09 CALITCaXXA 3 CLAIM MO. lCl~8TQ 4 5 rACX CUEBBSHT3C9 6 Applicant 7 8 PLAST KlBER Al ASBESTOS WORKS, 9 IHMSTROM0 COHX COMPANY, RUKDET ittftX CQR90RTI0I, FLAH? ASBESTOS CChPAJCf, 10 KHMEDSTSEOHSH,ASABnEdSTTROASVCECLMEFRASMYI,NSJG.RA?M,,CETMCOOMHPFASNY, 11 INDUSTRIAL INDEMNITY CCMFAMY, at al, 12 Dafandanta a ignita TO AFFJLICATICM 13 14 15 Coste now tha dafandanta ME8TSRM ASBESTOS CO. and STATS C0KPSM3ATICM INSURANCE FUND, and in l o m r to tho application filed in the abavo entitled canee, ada&t, daay and aliaci aa follows* Allas that the correct nane of the demandant Vastest* Aabeatoa Co. la Western Asbestos Co. and aa such at tlamraferred to In paragraph too, I Adnlt that Jack Cuthbertaon m a ployed by Western Asbeatoa Co. for tha perioda, and cnljr for the perioda, aa shown In tha work record attached barato and narked exhibit "A", reference to Which la hereby aada and the acne incorporated herewith aa though aat out in full. II Admit that luring; the period of anpXpynant aa sat forth in paragraph one above, the koat&rn Aabaatoa Co. was fully insured by tha State Cocpeneatlon Insurance Fund agnina* all liability under Woricaca'a Ccaap^maation, Insurance and Safety Laws - 1- ! 1 2 3 0 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 of tim Stata of California. III Bmr that during tha parted ^ ^ ^ <**hW tU n t u d ,, in ju r, ^ ^ eOUrrlni 10 " * oour" * * * - -eUVHmt, and further d , t dafandant. ha. PmcUd to th . W l i a t fc r to . injury ii.g u iy ^ ^ IV m **" * w i a l, aaparata, and i m m u n d-r----- t -W lla *., n n . -- u att<roti th . part four, dlvlalon four> ^ tiw IA flp Colt of t))t Stttw oorf cc*ain4f#onir.oa!*, mora p acifically fiaotlona 5404, 5405, 5406, and 5410. V m *** **" * ^ ta of th . dafandant. haw* twan prajudiaml t , th . A l l * of th . u lo y .. to u Ufi injury n th in th . tin . rmjuirad ty m . VI BW thrt th . toduatrlal Aooldm* CmmlMico o f th . a t . o f C l f t , ha. Jurladlatlon to u t n th rwtwwmm to V ad aU ra m in a mgXagmmxt. VII a .U t a . ah*. u n t t n . H e **, or dniad. u id ndut. d y ^ and lp w M U ji *" " * 4n* t" ' " ^ * " 1* . e U l d ln * ________ *BS8SFCS , the defendants pray fch^t they b d l n fra*, of n U a m tty h u n n 30 31 Copia, of thla lam er od attaahml oahlhit ha. imm 32 - * U - on th . d at. har*of to th . p *cn . * , . d r n * below.. - 2- MMMtOtOtOtOtOONOtOtOI-'-'l-* NMOOO-4Oli^.OJM-JOtOCO-N3 I u> I I-..- I ,t l_ / I !* CDUli^WfOh-'OtOOO'CJCTiCJI^OJMM 1 STATS CF GALIFCRMJA 2 c i t kmd ccuarr cr sam fxamcimcq 3 4 5 6 7 aajrai R* M SMESM, bain* firat duly ancra, dapoaaa and 8 b* la an omoor, to-mt, Aaaiatant Saoratary 9 oT Stata Conponaatlon Xnsuranc Fundj that ha hn rad tha 10 roragolng Anawer to Application and know tha entant tharoofj 11 that. tha aana la trua oi hla cmn knowlad^a axoapt tha nattora 12 13 whioh arm tharoin atatad on loforaatian or taliaf, and a to thuaa aattara ha baliaves lt to hm trua. 14 15 16 17 18 JU. , am - a & 19 20 21 22 SMbaorlbad and aworn to tafora na 23 thij 24 day of Juna> 10^1 . 25 23 Publia in and fer th City and 27 Coucty o f San Tranciaco, Stata of California 28 29 30 31 32 - 4- . '* ;5' DttfftiMtmf 1 . i *> /*** : ; f :' W C 3 l C K N . A 9 D C 9 I U 9 V . U . ' CQ*aMVIM.V '.*$: W W * ^ * * m m * * e e * * k r. . : # * * * * * * W i * * * * e e w * ^ * r ^ ^ ; --------- _ i Kwr IRIM?-' `V: '-' f\ ^ >: UkjMi-ritc> io4Vv^:' - - ' ' - ~mt n n iiiru Miiucf ca,, ' ** DISTIURUTOItS EN GIN EERS CONTRACTORS " ' .. ' .'. - . - , :.tJV > - m iia w 'a*sa*asat*>-:afaa*va caia . a u T .a ^ * '* Sy-1 aai^Miismaa Y -v^S**' aiaiua mf-aaai,ia. ; CNAfcita a. a a c c Q R r; iu k m . a v i a n >> c a a ta u n a ta a a s iir aaartaa * ia ia a ^ v ^ ^ :,,- - aaavietitfca*fiaa'^-; ; - t m i n i i L m a .* .u i i -u m u cim ^;.- *<y . : *iiru*aaA taa ica .Y ' /V W S ' > 'maai>waT<a.caa*a*iiai ar caie^r<v-"'v^' - i 9$ T *am *n d Sim t T ife r * * K b B m U i* 2 > $ 9 6 9 # tJy -r -;. r.- m' w**m m9mw 9 W W -..: ,* J . _ j ' C fttr a ia a u * t c o m m - i -v. - y e # - , * , ; f e ., - laaaiaacft > * I - . * Sa Fra*ou*tCalifornia , . : VMt a. ia a tc tmmumt -y- .{.i ' * , etatif*imUaI M*aIa*!*iaesaa.AtB*-'`;v ^'v'V.. .`.y.,' . '. . , i i a a t r a t f ia m a ~ . '?.1 \ . . v M iti|iiiii|> |iiu itllW . . . r. < 1 ri..v.'v . j : * i; 1 :. y - .' a * i- * ^ w TM , 19SS ; . . ...- r z z a P : Hw* ^ t,, i ***** . - r -' .. Jfc- : . - .< ,'i 4, . .*. * _ . - .. .;* iaaaatauii aaaaac< r^ * . ,, :^r- 3/ * T ^ S. 4 * ...- _. . - . . - y 6 r'* *' " ' > >' !/`v * 'V V > ^ * S^ - ?4* . f-? State CoapMsanUsoartiioTrniTBnuBnianracao.vR.uAiuiiiil '" '. '*' ^ * t''<*;, ^*' , : < , ' U50 N oA lllater S t r w r t r vs> ; ' 'T * " ' i* , 4 San rFrfamnnceiiMcoO, ^CCaalillffoorma ita >' . . , 4 l ^ '\ <\' -.t.Y.. 4, %> v-/-- ' .' ,?J uS. W',' , ` l > ' Jack H. Cuthbartaon | ^ .' 7 W; t','* * "" ' _ jK ^*`<41,I* Y ... .y Qaa*n!tlaaan*. * , , - * t \ + tx* T , $' . ; -n r.. lJilelsc H. iCioStUUbNamrtsoaa''i' uaimpIOiTj iMnntt raooaradjlaa uaa^ ifoo lulawv aht , . -* ^ & .... ^*. H ,w V r ' " \ i > > >, ,' ` . Hlrad A p ril 1 0 ,1 * 7 , , ,< laffc Tbruarjr 3f il* 8 ^ tD l* o h a r a ^ >;% . ` ! - - ' . r e r 3 0 ,,,1 * 8 ' " Ju ly ; 3 0 , W UaiVQ uit v *- ' v >' " Jan . lit ,/ l* 9 . .. * ' r e n . ^ 9 ,t19U9 ^ Q a lt -l . -*" ' , , . ` ' , - /M.Vr \491. 2T,e1li*9 . a~ AlUuu^cgIArnSaWartt^ii 'r,2fc26W6,>>.'i.*1179l*ib7i99r^f^fMLLaUaiWidd WO*f*f 1 t * ,, , _ T ' - * r v r r e h W ,|lS 5 0 ..? V ^ ii ` J o l y ^ 1 9 5 0 " ^ *tar*0 8 **;> ^ _ % i` - , . .- Ja e k .fi. Cathbartaon'i aa,rata - " 1 * 7 * 1 * 2 5 P te*. .. " > r ./ y * ^^ s ' * r - . ' .:- -,T.-,-I" ; t tTr<v-- & i'. t , *4juvf .^ V , ti?,s T-t * i(. a--r i ^ ^ %m*- -, t - * __ .* f la y4," *' -^ f | ^ K<a*.y * *i' * 1 o, ' ,, ^ s n n u i K ^*...' : iV; ' s-ir i " > -Hs ' ' <v| - <31 1- > J- Ot . (HMimii* fc lr ^ t, . ^ .T ra i .- and.SaftxJtaclnaar r ' s> *Vr -i. ` i L * *0jr l , 1955 CJPY FROM; INDUSTRIAL INDEMNITY CO. 350 SANSOME STREET SAN FRANCISCO, CALIFORNIA d a la ft. 2l-^fO KLate BuJabar mod Aabeatea Warta, A w tn n g Cork Ca^any, Hontet Car* Carp*, P late Aabateoa c * ., J . T. rpe M i S M , M ftn o tftte t e m 8, I, ftyw t mot IfcjnrlM Bt f f t p liy it e , P* 0 Bex 157, flak! al O odtental Aim Iaauraao Gonpasgr# 900 thu tip anr/ , ten Iten teso Jack CuttabarteOB, 22flt Iftlhraoir B rtw , Concord ted tk a i P teriah , 11 fin a n cia l ten ter BudJLfttng, Oakland Flank S teter ai Aabaatee wart e , 5309 Barton , EtearjnrULU trate 3aa Pranedaao V eteen Ateantoa Coepaogr, 75 Twmaawl trate m franela S tate raatim ratlar Ztewrano Pund, t50 fte A llla ta r tr e te , San Praoolao traralare Trwaraneo Cnapaay, Latten Bqpar ftiU A lag, Ook land F a d fle BapLoyare Inauraaea Coagan?, 3770 P latete Arattao ' ` ` " Leonard, te""* & Brephy, 100 Bote Stree t , an Frandxce A ttentiont ftm ari T. JaeaU, C O M M I S S I O N O P F IC I St FOR N O R T H C R N C A L IF O R N IA (K X C C M T S A C R A M tN T O C O U N T Y I 0 6 5 Missio n S thcet S an F rancisco 3 8 T A T e OF C A L IF O R N IA DEPARTMENT OF INDUSTRIAL R tLA TIO N S INDUSTRIAL ACCIDENT COMMISSION FOR SA CR A M EN TO C O U N TY Room 0 0 . Q 3I J S trlet SACnAM bN TU O N LY FOR SO U T H E R N C A L IF O R N IA (EXCEPT tA N DIEGO COUNTY) 501 S tate B u il o in o L Q * A NGELfc a 1 2 APPLICATION FOR HEARING A M i-iO h O F O R S A N D I E G O C O U N T Y O N l V ................................. " 1521 F o u r t h A v e n u s San O ieeo 1 O se No. Filed Auroh i& i-JV G 1955 D O N O T W RITE IN THIS SPACE E N T E R E D IN D O C K E T BY____________ Employee's Employee's Address....... 2 f 4 -i l P/K Social Security N o........................................ ...... Name of Employer. Employer's Address- TOWN 0 CUT ftTKCCT ANO MUNSES Name of Insurance C a r r i e r . . . . , - 4- - Insurance TOWN o n citt Carrier's Address. STIKET ANO MUNSE* Employee's n a m e ^ ^ . ^ ^ ^ ^ j ^ ^ ----------------- ----_ Employee's date of birth. .. ......... . Date of your in ju ry ................1 9 4 4 - 1 9 5 4 ..................................................... Place where injury o c c u r r e d . ^ U i . . F i : 4 i a C i 5 . C O , C a l i f * . .............................. Employee's occupation Jt tinie of injury--- - A b < t O t o O WO r 4 ( 0 ? - ............ When did you leave work as a result of this injury J i e c f c f i E l b e r 3 Q . 1 9 5 3 . .. O cto b e r How did injury occur.. I g a a t > f t l f i ^ -W & b t s r t0 u 3 - l a -J i H i r a O -t What part or parts of your body were injured________________________________________________ _________________________ ___________ 19, 1954 When did you return to work . . l t i l l - 1 ................. Full or part time work and at what w age_____ Your wages or salary (before deductions) ^ C r X i i i U f t l ...... P*-,r hour or * ---------------- ------- per week or $................ ....................... .. per month. If paid on hourly rate, how many hours did you work per week............................................................................................. _ _ ___ Did you receive any of the following: Board? Yes No ; I.odging? Yes No ; Tips? Yes No Q Other advantages? Yes N o State their weekly Value $ __________ _______________ _ Have you been paid any compensation? Y c s Q N o [ 1 How much $ . ,, Uate . when . last payment was m a d e _____________________________________________ 1 j _ TOTAL _ . AMOUNT Weekly rate of payments Has the employer or the insurance carrier furnished you with any medical treatment? Yes N o Q . Date when last treatment was given________________________________________ __ 1 9 _____ _ * List names of all doctors who have treated you and who were furnished by the employer or insurance carrier. $.......... ............. ~if,nlvarsity c f -CTrtlfornlar rlave you obtained any medical treatment at your own expense? Y cs jH No Q . List names of all doctors who have treated you at your own expense...................... Are you claiming any of the following benefits (Answer Yes or N o ) : (a) Temporary disability payment________ (c) Further medical treatment____ JW (b) Permanent disability payment, (d) Cost of your medical expense... (e) List other benefits claimed and not mentioned abd^e!?-_____ yes Have you ever before filed a claim with this Commission? Yes N o . I f so, when was it filed__________ IMMINTATIVI OR ATTOANST TO AFFLICANT jtlnr.ncl.il C a n t , . ADOSESS UleiiCurt 2 2000 ;,n<* /V-AJi4SK uOTlRii T ! rf lNATUa( or ArrLtCAMT Date -, 19...JJ. TELEPHONE SUNSII N O T E --- M E A R I N f s i A f t e r t hi s a p p l i c a n o Km been f il ed w i t h th i n d u s t r i e l A c c i d e n t C o m u m n o o represented rn person, by H o r a r y , or oth er age nt . t b t pa rt ie l l i t be notified ia w r i t i n g / the t i n e and place o f h t a r io g . Eit h e r pa rt y m a y he A N S W I ! Th e d e f e n d a n t n M a t t e d l o file s a a ns we r w i t h . a 10 d t p a f t e r l e M t c e o f c o p y , . f this a n n l u a t i n n u n n i the f . , , m f t . , , , , 1 , 1 ( , ,1 hat pur pore I f a defend ant em ploye r If Inauretf T J r L i oe t '; z z 's!* fcM .. .- - X i ' the lo iu r a a c e e a r n e r ia o o i n a m e d , th e e the O A T S O F S E JLV IC I SJbJIVIC B O N r - .<" "> 1 of nvloy.it'.Q, O O X 1 6 5 7 , Oakland, Calif. 4 / 2 5 / 5 ") Oeeidantal U f a Ina. Co., 3 0 0 IConi^omory dt., 3.P. Calif. * Jack Cuthbartoon, 2 2 6 4 Holorook Dr., Concord, Calif. bmith & rarrlah, Fin. Canter ula*;., Oakland, Calif. rlunt Kubier L asbestos horks, 5309 Horton dt., Kmeryville Cal ** Armstrong Cork Co., 1355 Kurket dt., 3 .F., Calif. * * * Mundet bork Corp., 440 uranium St., 3.P., Calif. * b*toa Co., 5 3 0 9 Horton 3t., 5 3 0 9 Horton 3t .Kaeryville, " i8Jar5v.'Aabeatoa Co., 675 Townsand 3t., 3.F., Calif. * J. f. lhorpe 4 Son, Emeryville, Calif. n Travelara Ins. Co., Latham Square Hldg., Oakland, Calif. * Indus. Indem. Co,f 350 Sansoma 3t., 3.F., Calif. * State borap. Ina. Fund, Purnonal service *!?< Ins* o 3770 iiedmont Ava., Oakland, Calif. " Calif. Compensation Ins. Co., 26 Geary St., G.P., Callf. vwx (|i 1 BEFORE THE INDUSTRIAL ACCIDENT COMMISSION OF THE STATE OF CALIFORNIA 2 Claim No. 161-870 3 | JACK CUTHERBERTSON, ) '4 j Applicant ) 5 V8. ) 6 7 8 ,J 9 ! 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 j 27 j 28 | 29 30 PLANT RUBBER AND ASBESTOS WORKS, ) ARMSTRONG CORK COMPANY, MUNDET CORK ) CORPORATION, PLANT ASBESTOS COMPANY, ) WESTERN ASBESTOS COMPANY, J . T. THORPE ) AND SONS, AND TRAVELERS INSURANCE COMPANY, ) INDUSTRIAL INDEMNITY COMPANY, ETAL, j ANSWER TO APPLICATION Defendants ) Comes nov the defendants, PLANT ASBESTOS COMPANY, AND INDUSTRIAL INDQOUTY COMPANY, and in answer to the application file d in the above entitled cause, admit, deny and allege as follows: > ' I Admit that Jack Cuthbertson was employed by Plant Asbestos Qnupary for the periods, and only for the periods, as shown in the work record attached hereto and marked exhibit "A", reference to which is hereby /i And the same incorporated herewith as those set out in fu ll. II Admit that during the period of employment as set forth in Paragraph I above, the KLant Asbestos Company was fu lly insured by the Industrial Indemnity Company against a ll lia b ility under Workmen's Compensation insurance and safety laws of the State of California. Ill Deny that during the said period above mentioned said Jack Cuthbertson sustained any injury arising out of and occurring in the course of the employment; and further deny that the defendants have provided compensation benefits to the applicant for the alleged injuries sustained by the applicant or furnished medical treatment therefore. 31 32 Syoniy h H ayw ooo 00 ATT U I N ( T A T a oi r i 7 AN FRANCISCO 4 -2 Q O O IV. " "p,01`a ' -- a m ^ i r . * ., . ^ *" * W o o t 'i clam herein 1. barrel 4 hce i, ia e.aco>PnPee<di fri-TMam. presenting any end ala ,, e r e ereader by reaeona * the prorialona of Chapter ' DiTisioa IV, Of tile Labor Code of the State of California, sore specifically Section $4o4, 5405, 5406 ^ 5^ V. AU' e" " " risilt f ** " t . here been prejudiced ^ n r . OX a . p l o y to MUoe ,, ^ ^ ^ ^ ^ tiae required by law. 2*cept as above admittteeda, aalllle!ge*d* or dneni.ed. said defendants dmy " * - " *. * and erery, all and alng^r, the allegation* contained In the eald application. "" "TORE, theae defandant. pray that they be dlamlwed m declared free fro. all liability herein. ' Cople. of thl. anaver and the attached exhibit her. been 17 -1 1 on the date reef to the p-eona uddrea... ^ ^ 18 19 20 Dated: July 1 , 1955 21 San Francisco, California 22 ijj.ea wo i 23 s/ SYDNEY H. HAYWOOD Sidney h . kAYVOOD-- -----ATTORNEY FOR DEFENMNTS PLANT ASBESTOS and INDUSTRIAL INDEMNITY CO 24 25 EUnt Rubber and 4 s t o e ^ k Oakland, Calif W r o n g Cork C c ^ ^ & ??,vU4'. Calif. 26 Rnndet.Cork ConpehyTUo S o ^ ^ 0allf- 27 ..tarfS.'.r ?" * " Uora4 M t ` 0",I'`ay' ^ 5 Tovnsend Street, fcn Prancl.co, 28 State Compensation Insurance Fund 450 ne a ih 4. Travelers Insurance Company LathL, S , ? 3.7. 29 Pacific Beployers IneurSiSi' c S ^ ^ T O 2 ^ ! "'`" and. Cal: Leonard, Hanna & Brophy, loo BushStr-^U Avenue, Oaklanc 30 Attn; Howard T. Jewell Street, San Francisco, C a lif. 31 i! 32 j HOD j Page Two CT I 4 STATE OF CALIFORNIA IN D U ST R IA L 968 MiftsiON STRIKT. San Francisco 3 412 Hilm Builoino. Frksno 21 Room 200. 691 J S t r u t , Sacramento A CCID EN T CO M M ISS 2 Stati Builoino, Los Anoklks 12 Room 214, io o e. ockan blvo., lono bkach 102! 4th Avin u s. San Oiio o ! ' JACK UUTilLUtTJON, C laim N o ..5L 3F..X61-70 Applicant.... vs. ULlTUi.'G CORK CO-LV.NY, TP.VKLKRS IiLiUU N CL COMrUJY, rLvI'T s.Jur.JTlKS C O .C .. . , Ihi/JV.a.L IHKMIilTY COMPANY WJ'JLu .LBITQl CO.'if'i.n , und JTnTIS CUMrUl L TIQN INSURANCE FUND, Defendant Notice of Hearing of Application For Adjustment of Claim Y o u are hereby nocified that an application to adjust a claim for compensation (a copy o f which is attached hereto) has been filed with the Industrial A ccident Commission o f the State o f California. Y ou are further notified that said application has been set for hearing at Room 206, 1531 Webster o tr e e t, Oakland, C a lifo r n ia , on the 17th day o f February, 1955, a t 2:00 r.i-1. ALL if1#M. . and that at said time and place the Industrial A ccident Commission o f the State o f California will proceed to hear and dispose o f the said application in the manner prescribed by law. N o t i : The panics are expected to submit al! issues in controversy for decision at this hearing; therefore, all necessary witnesses, evidence, documents, medical reports, payrolls, and other essential proof must be available and ready for submission at the hearing. Dated: January 12, 1955 in d u s t r ia l a c c id e n t c o m m is s io n By EDMJMU J. THOMAS, JU. Anhtiint StcrtUry The undersigned certifies that as an employee of the Industrial A ccident Commission she served the foregoing notice on the parties hereinafter mentioned, at the time set opposite their respective names, by depositing a copy o f said notice attached to a copy o f the application therein mentioned, in a sealed envelope in the United States mail on said day, at ^ c l CO California, with the postage thereon fu lly prepaid, and addressed to the said parties at their last known plaSfl o f iu su }* o*T residence, as follow, to w it: NAM ES OF PARTIES SERVED DATE OF SERVICE J.ick Cuthoortson, 228/, Holbrook Ur., Concord, Calif*. 1/12/55 .,:.Uii c. ..iri Ljn, I d o /ir.-ncial Cti.Ler u l r . , Calif. '* .rr/aron., Cork .0., 1155 !arkot ..I., -.ai'Y.tncisco, Calif. " .lair, aabitjkoa Co.,5309 Horton, .at,.,'.jmiryvillu, Calif.^ ..fcs'uuni ..ajuC3to3 Co., o7 5 Co viiiatinJ. ..M*n !r.*.ncisco , culif. ' irave lera Ins. Co., Latliaa; o tuciru Jldc;., Oakland, Calif. n Indaa. ludeum. Co., 350 .Yuiaocio ..t., o.m Francisco, Calif. * abate Corat*. lna. Fund, roroonal Cervice " vf Fn# ", . fifV t *4I [Sir,NATURL J 14 1 14 <- f*) Fl COMMISSION OPPK JBi Fu r n o r t h t r n C a l i f o r n i a I f > l I PT SAf H A M tN T O C O U N TY I 0b MISSION S t r e e t S an F rancisco 3 FOV;Ar'!,^'Nro 001Nrv only R c-<j m * . 0 0 . 0 3 1 J S n . L t r 6 a <j A ME N 1 O FOR SOUTHERN CA LIFORNIA iet( LPT SA N Oil.GO COUNTY & O I S TA f t O U l L O I N a L o s A n g e le s 12 F R.F6-.A,N r DIE<' ' 0 C O U N T Y O N L Y 1S21 Fourth Avenue 8 an D iego i 8TATK o r CALIFORNIA d e p a r t m e n t or INDUSTRIAL r e l a t io n * INDUSTRIAL ACCIOENT COMMISSION a p p l ic a t io n fo r h e a r in g CueN o. JL 6 1 - 7 0 54 3F Filed 12 -21-54 DO N O T W RITE IN THIS SPACE E N T E R E D IN D O C K E T B Y ____________________ Employee's Name. JACK CUZLjLQR Social Security No.......... _ _ Name of Employer l . .. ^redtron^ U a r k . C O D G M U iy . . &x Travelers Inaurane Coapany --------------2 * -- I ' l a a C - -tu flia e r . n r (lompuA n y ....................... Name of Induatrial Indemnity Company Insurance Carrier . ' 3* Western Asbestos Co*/sny... ------------------------- lLLoLLQ . C o m ^ o n f l ^ t i n n JL llS L U JC tiJM te E m p lo ye e ' Address.........2 2 4 i i o l k r o o k . P r i v e ....................... .................. T a t t i ANO NU C ----------------------------------- k m c r d ^ _ C a J i j r i j i r n i a Employer*. T0W,,0,` '" m . ............ Address.. . - - ^ a J r . r a . n s i a c o , a l i f r a l a L a t h a n S q u a r e * '" *- B l d g , O o k la a d -- 5 3 Q 9 - J i o g t Q n a t r e e t ^ ^ j c y y j . l i __________ i n s u ^ O V & W S i t . . a n F P S L n c i a c t P 7" Carric/'s Address ................. ............. o ? 5 T o v m s n i T# t v 4 " ut 4 e n F r a n c i s c o ' u n d .-- 4 5 0 ..L ifiA .llia k r _ i> t * ^ C,TT MR . >>a n c is c o TATI ' Employee's nam .Jack e............. * . uCmutahubisexr ri BtaOona. Date of your injury Place where 1 9 4 9 - 1 9 5 4 ................ Employee's date o f birth.................................................................... ... Employee's occupation at time of injury al K b e a t o a w o r k e r _______ . ' W * -- - ...* * ft-pacl....... -.. <:', ', ` '`0`T*T, H ow dad injury occur - l i r a a t h l i y * a m i a L a n c e n l n ^ g a u r a e W hat part or parts . o f your body were injured_____L u n y a ........... ............................................ ............ i S Ti5_ ^ L N b r 10 1 9 October 19 t954 ...... o f , work h a m f u l t n ' When did you return to work S t i l l diOAblcd ...... fn d a T whait^ g e ^ ^ _____ _ Your m Ku or salary (before deductions) $ ... B a x i m U f f ^ e r hour or I f paid on hourly rate, how many hours did you work per w eek___ ---- per week or $___________ -- per month. Did you receive any o f the follow ing: Board? Y e , N o ; Lodging? Y e , N o ; T.ps? Y e , Q No'Bo'thcradvantages? Y e . D N o State their weekly \ralue $_________________________ _ Have you been paid any compensation? Yes N o C i H ow much $ W eekly rate o f payments $ Date when last payment was n u d e ........................ ... ..................................... TOTAL AMOUNT , 19------- Has the employer or the insurance carrier furnished you w ith any medical treatment? Yes N o Q t D.itcwhen lasttreatment wasgiven....... . __ ]9 List name, of all doctors who have treated you and who were furnished by the employer or insurance carrier U n iv e rsity o i" C a lifo r n ia ..... .......... --............................... ......... Have you obtained any medical treatment at your own expense? Yes Qjfc N o Q List names o f all doctors who have treated you at your own expense....................................... ................... _ ___ Arc you claim ing any o f the following benefits (Answ er Yes or N o ) : (a) Temporary disability p aym ent.................X e S ...................................... (c) hurtherm cdic.il trearment . T en - ................... (e) List other benefits claimed and not mentioned above............................ (b) Permanent disability payment (d) Cost o f your medical expense... X ** H ave you ever before filed a claim with this Commission? Yes N o I f so, when wa, t filed . 1910 rinoncliii.genVor- lag.- Jack GtitHWrtemv // tSRATUSI Of ARUffclR/ G Loncourt N> ) I H J ' A K IN' f, f i ,, >|,1# ( i| Imp<,,< IIiiaimrtsi Hunt j A N S\A'1 1 11 | / i , ,, ant .< , I' .1 , J I n . Ir !., L>AIP ItVsiUvu.K HANF FU RAI M#nl I... u iw -I.W ,u us........I '`hi *i#iy so d, pntwf l o ie ir cm hs MM . S K J tV IC I O N A ..,a ... Date r . ,, m,...... ,u . ' -Leeeetber ? 0 k 19$ 4 ...... , 195. --------- - u ,K. ,,m. fcttfi|(i E|lk. r ^ ^ ^ n 'V-'? ... *(*.w......... .... < h d< n bf th (rrifri but i/ th miu/tnc* ctsiier ii not ataud, i Ima iKa I "I'M 1 4 IIII V r* "II 5 e ii u i') n u STATE OF CALIFORNIA A/ tu < X L 8B M im io h industrial S t i i t , S a n F r a n c is c o 3 4 1 2 H e l m a u iL o iN c . F u c in o 21 Ro o m 2 0 0 . 83 J Street. Sacram ento accident commission 8 tate B u il o in g , L n a A n s c l c 12 R o o m 2 1 4 , 1 0 O E . O c e a n B u v o .. L o n g B e a c h 2 1 8 2 1 4 tm A v e n u e . S a n D ie g o 1 C laim N o. ILcU i ..Ulidiji aviiJ agJEjTiJ> riULK L.LUV U>Jkaasili, 'lUitJT UjitA (JJ. /Vi ***sfi . cgaL u vve C u M l'A ti Z , iiC .uY;sfU * . v ' a A M j J . i . Y n O iU E .a J . L S , trv lisoU UAkAtCi C JLJUaIY.LL. illu U-iu'vEY, e t il, K * MYY D efendant Notice of Hearing of Application For Adjustment of Claim Y ou re hereby notified that an application to adjust a claim for compensation (a copy o f which is attached hereto) has Comnu"i" of,lcs"" ofCili,omb-Y" " ^ *ppcL . hjt, 2(Jo, 1531 .ustor .t*, viaKJuinu, California, on iiie 23rd da/ of Hay, 1955, -t 1:30 o 'clock p.. A U *.*. and that at said time and place the Industrial Accident Commission o f the State o f California will proceed to hear and dispose o f the said application in the manner prescribed by law. N o t e : The p arti are r x p tc d to .ubm it all m u in co n tro vm y for decision at t h ,, hearing; therefore, all necessary witnesses, evidence, documents, m e d ial reports, payrolls, and other essential proof mmt be avadable and ready for submtssion at tlie heanng. Dated: vril 25, 1955 IN D U ST R IA L A C C ID E N T COM M ISSION A 8/1 I V I I W A ut+vrrJ St{ reia ry T part, P CBrt`/,e*thataiTM '"P1^ " of ^ IndustrialAccidentCommission sheserved theforegoingnoticeon the coov ofh r ,nal|Cr ment`t nCd' " t,m 7 Ct PP Slte tHdr resPcctivc naTM . by depositing a copy o f said notice attached to a copy o f the application therein mentioned, in a scaled envelope in the United States mail on said day at - ,, `"Uy*** " a M n m * " * * -* * * '>* p c s r a ^ s *.?"0 n am es of parties slrvld U AIT. OF SERVILE see ati.4tc.ird aheot F o h m 8 5 M . 9 54 , [Sk.n a t u r e ] ^ *" **-*. He; JACK CUTOBSHT30N IAC / 161-570 L is t of Employers riant Lubber k Asbestos Works, 5309 Horton St# xuaaryvlLIa, Calif. Western Asbestos Co,, 67$ Townsend St.,San Francisco,Calif J. T. Thorps fc Son, iyacryvilla, Calif. Hundet Cork Corp., 440 brapnon St., San Frr.nclsco,Calif. Cork Insulation Co., Son Francisco, Calif. Armstrong Cork Co., 1355 Wariest St., San Francis0 0 ,Calif Plant Asbestos Co., 5309 Horton oryville, LIST OF INSbliANCB CUMFANILS Travelers Insurance Co., Latham Square Bldg., Oakland, Calif. Industrial Indemnity Co., 350 Janaoma 3t., San Francisco,Calif. State Compensation Ins. Fund 450 KcAllister St., San Francisco, Calif.