Document jm6M3akrpveNjb7Bg0294bmm9

BARBARA R. ADAMS, ESQ. law orricES or 1 Fisher 8 Hurst A PARTNERSHIP INCLUDlNO PROFESSIONAL CORPORATIONS 2 FOUR CMBARCADCRO CENTER SAN FRANCISCO. CALIFORNIA 94111 TELEPHONE (419) 059-6000 3 4 5 ATTORNEYS FOR Defendant RAYMARK INDUSTRIES, INC. 6 7 8 IN THE SUPERIOR COURT OF THE STATE OF CALIFORNIA 9 IN AND FOR THE CITY AND COUNTY OF SAN FRANCISCO 10 11 JAMES R.FUNSETH, et al., ) No. 823834 ) 12 Plaintiff, ) ) STIPULATION AS TO 13 v. ) WORKERS COMPENSATION 14 FIBREBOARDCORPORATION, ) FILES ) et al., 15 ) ) Defendants. ) 16 ,) 17 Defendant RAYMARK INDUSTRIES, INC., formerly known as 18 RAYBESTOS-MANHATTAN, INC., stipulates as follows: 19 That those workers compensation files and the documents 20 contained therein produced by counsel for RAYMARK INDUSTRIES, 21 INC. at the deposition of William Ambrose on August 23, 1984 22 are true and correct copies of business records of Raymark 23 Industries, Inc., with the exception of: 24 1) the files for employees of the Bridgeport 25 facility, which were obtained from records of the State of 26 Connecticut and which documents have been maintained by 1 Raymark Industries, Inc. since that time; 2 2) medical records and physicians reports contained 3 in the files. Such documents are stipulated to have been 4 received by this defendant shortly after the date of 5 authorship indicated thereon, and have been maintained by 6 Raymark Industries, Inc. as a part of the workers 7 compensation files since that time. 8 It is understood between the parties to this 9 stipulation that by entering into this agreement Raymark 10 Industries, Inc. is not conceding or stipulating to the 11 relevance of these documents in any trial or other judicial 12 proceeding. 13 14 FISHER & HURST 15 16 17 18 19 DATED: /o 20 - By BARBARA R. ADAMS Attorneys for Defendant RAYMARK INDUSTRIES, INC. 21 22 By: 'EVEN B. STEIN 23 Attorney for Plaintiff 24 25 26 -2- SUPERIOR COURT OF THE STATE OF CALIFORNIA COUNTY OF SAN FRANCISCO ------------------------------------- - -------------------------------- - - - X JAMES R. FUNSETH, et al, : Plaintiffs, : - against - : FIBREBOARD CORPORATION, et al, : Defendants. : X August 23, 1984 1:45 o'clock P.M. No.823834 EXAMINATION BEFORE TRIAL of RAYMARK, INC., by WILLIAM HENRY AMBROSE, pursuant to Notice dated August 8, 1984, held at the offices of Norman Landau, Esq., 233 Broadway, New York, New York 10279, on August 23, 1984, at 1:45 o'clock P.M., before a Notary Public of the State of New York. aaier REPORTING SERVICE STENOTYPE REPORTERS 15 PARK ROW/NEW YORK, N.Y. 1003B/C212)267-33A3, 3339/NIGHT 233-3151 mjd/cjd 1 2 3 4 5 6 7 8 9 10 12 ^3 14 APPEARANCES : 2 NORMAN J. LANDAU, ESQ. Attorney for Plaintiffs 233 Broadway New York, New York 10279 - and - STEVEN B. STEIN, P.C. Attorney for Plaintiffs One Embarcadero Center Suite 2112 San Francisco, California 94111 MORGAN, MEHUISH, MONAGHAN, MEYER, ARVIDSON, ABRUTYN & LISOWSKI, ESQS. Attorneys for Defendant, Raymark, Inc. 50 Broadway New York, New York BY: KATHLEEN F. MORAN, ESQ., of Counsel LESTER, SCHWAB, KATZ & DWYER, ESQS. Attorneys for Defendant Fibreboard Corporation 120 Broadway New York, New York 10271 BY: CYNTHIA E. WEISS, ESQ., of Counsel FRANK BONDONNO, ESQ. Attorney for Defendant Owens-Corning Fiberglass Corp. BY: JAVITS, HINCKLEY, RABIN & ENGLER, ESQS. 1345 Avenue of the Americas New York, New York 10105 BY: MICHAEL B. SENA, ESQ., of Counsel 22 WILLIAM HENRY AMBROSE, having been first duly sworn by a Notary Public, was examined and testified as follows: 25 EXAMINATION BY MR. STEIN: \ x 1 Ambrose 3 2 Q Please state your name for the record. 3 A William Henry Ambrose. 4 Q Where do you reside? 5 A 195 Margaret Lane, Orange, Connecticut. 6 Q With whom are you employed, sir? 7 A Raymark, Stratford, Connecticut. 8 Q Would you give me the exact address 9 of where your office is? 10 A 75 East 20th Street, Stratford. 11 Q When did you start with Raymark? 12 A September 25, 1951. 13 Q When you started with them, what was 14 your job title or position? 15 A EAM trainee, electronic accounting machine 16 trainee. 17 Q Would you trace for me, briefly, each 18 of the positions you held with Raymark from the 19 time you started to the present? 20 A From September of '51 -- I honestly don't 21 know the date, a year or two later I formed a Pay 22 roll Department and became payroll supervisor. I probably stayed in that job for four or five years. 23 24 And then became administrative assistant 25 to the office manager and did all sorts of office \ 1 Ambrose 4 2 services, administrative services. 3 Then I was involved, again, four or 4 five years later, in data processing, now known 5 as management information systems, for a period 6 of probably three or four years. 7 I was involved with budget acocunting. 8 Before, when I was assisting the office manager, 9 the office manager subseguently left and I was ap 10 pointed the office manager, manager of administra 11 tive services for a period of three or four years. 12 Then I was involved in data processing for a couple 13 of years, then I went into budget acocunting. 14 About ten years ago I became involved with 15 personnel in the management of employee benefits. 16 Q Have you had the same job title for 17 the past ten years? 18 A Yes. 19 Q What specifically is that title? 20 A Manager of Employee Benefits, Stratford. 21 Q Within which department are you assigned? A Personnel, human resources is the termin 22 23 ology today. 24 Q To whom do youreport? 25 A Walter Pratt. 1 Ambrose 5 2 Q What is his position with Raymark? 3 A Manager of human resources. 4 Q Is he also an officer of Raymark? 5 A No. 6 Q To whom does Mr. Pratt report? 7 A The director of human resources, who 8 is William Bilatti. 9 Q Is Mr. Bilatti an officer of the corpora 10 tion? 11 A No, he is not, not to my knowledge. 12 Q To whom does Mr. Bilatti report? 13 A Robert Ford, who is the director of 14 human resources for the corporation. He is an 15 assistant secretary, so he is an officer of the 16 corporation. 17 Q What is your specific function in your 18 position at Raymark? 19 A Manage the employee benefits, part of 20 which is worker's compensation. 21 Q What does one do as a manager of the 22 employee benefits? What typ^ of problems do you 23 solve? What type of situations do you handle 24 for the employees? 25 A You have to describe and discuss the 1 Ambrose 6 2 employee benefits that are available to prospec 3 tive employees, enroll them in the various programs 4 and see that if they have applied for a benefit 5 from that program that it is properly safe. 6 Q Is worker's compensation benefits one 7 of the benefits that you personally handle for 8 Raymark employees at the Stratford plant? 9 A Yes. 10 Q Is your work limited solely to employees 11 of the Startford plant? 12 A Yes. 13 Q Does Raymark have more than one plant 14 presently where workers are protected or covered 15 by worker's compensation programs? 16 A To my knowledge, yes. 17 Q At the present time, does each plant handle 18 its own worker's compensation situations? 19 A Not at the present time. 20 Q How is it handled at the present time? 21 A It's handled via Alexis, which is a 22 subsidiary of Alexander & Alexander. 23 Q Is that an outside company that has 24 been retained by Raymark for the purpose of handling 25 its national Worker's Compensation Program? 1 Ambrose 7 2 A Yes, they are located in Melville, Long 3 Island. 4 Q How long has Raymark used the Alexis 5 Company? 6 A January 1, 1983. 7 Q Prior to January 1, 1983 did each plant 8 handle its own worker's compensation? 9 A No. Stratford did. The other plants 10 were handled by Zurich American. 11 Q Is Zurich American an insurance company? 12 A Yes. 13 Q Did they provide a management service? 14 A To my knowledge, yes. 15 Q To the other plants? 16 A To my knowledge, yes. 17 Q When I say "the other plants," that 18 is other than the Stratford plant. 19 A Yes, other. 20 Q For how long had that company been handling 21 worker's compensation claims prior to Alexis taking 22 over? 23 A I don't know. 24 Q Did the Zurich Insurance Company ever 25 handle the Stratford worker's compensation claims? 1 Ambrose 8 2 A Not from first dollar. I understand 3 they carried an override or something along that 4 line, like a million deductible, a quarter of 5 a million dollar deductible. 6 Q When we talk about management of a 7 worker's compensation claim, what do you understand 8 that to be? 9 A The first report of accident is given 10 to them and from that they generate whatever paperwork 11 is necessary to pay the providers, pay the claimant 12 and hire representation at worker's compensation 13 hearings. 14 Q Let's talk about the Stratford plant 15 alone. 16 If a worker wished to make a worker's 17 compensation claim at the Stratford plant, what 18 would be the first thing that the worker would 19 do? 20 MS. MORAN: Is that today? 21 MR. STEIN: Yes, at present. 22 MS. MORAN: I will let the witness 23 answer but I will just note that that is 24 outside the scope of the deposition notice. 25 MR. STEIN: What I am going to Ambrose 9 1 2 do, so that the record is clear and to explain 3 it, find out how it is handled today and 4 then go back as far in time with this witness, 5 as to how these matters were handled. 6 MS. MORAN: That is outside the 7 scope, but as long as the questioning is 8 brief, I will let the witness answer. 9 A The employees are instructed, if they 10 are injured, to report to the Medical Department. 11 From there, the Medical Department notifies myself, 12 if I were involved in it at that time. If it 13 requires, under the OSHA regulations, treatment 14 outside of the plant, or if there's permanent IS disfigurement or loss of time or restricted duty, 16 if you are familiar with the OSHA requirement, 17 then the first report of the accident is written 18 up and filed in the medical folder. 19 Q Each employee has his own medical folder? 20 A That's correct. 21 Q Is that part of hispersonnelfolder 22 or a separate document? 23 A Separate. 24 Q Was the same procedure used in plants 25 other than Stratford? 1 Ambrose 10 2 A I don11 know. 3 Q Do you have any knowledge of how prior 4 to 1983 worker's compensation claims in plants 5 other than the Stratford plant were handled? 6 A No. 7 Q How many plants, from 1938 to 1952, 8 did Raybestos-Manhattan or Raymark have? 9 A I can't give you an exact answer. I 10 can speculate, if you want me to do that. 11 Q I don't want you to speculate but what I 12 would like you to do is name a plant, name where 13 it's located and see how big a list we come up 14 with. 15 MS. MORAN: You ae talking about 16 plants that were owned by Raymark from 1938 17 to 1952? 18 MR. STEIN: That's correct. 19 A I am aware of the Stratford plant. I'm 20 aware of the Passaic plant, I'm aware of the Manheim, 21 Pennsylvania plant. 22 Q To your knowledge, did Raybestos-Manhattan, 23 and instead of calling it Raybestos-Manhattan 24 we will call it Raymark, for the period 1938 to 25 1952, do you know if there were any other plants 1 Ambrose 11 2 operated or controlled by Raymark? 3 A In the inquiries that I made regarding 4 worker's comp, records, I understand that the 5 Profitville, Indiaia plant was established 1952. 6 Q During that period of time were there 7 any plants that were operated in the southern 8 part of the United States? 9 A I don't know. 10 Q Can you tell me whether at any of the 11 four plants that you have named textile products 12 were produced at those plants? 13 A No, I can't. 14 Q Can you tell me where, if at any location 15 from 1938 to 1952 asbestos products were pro 16 duced to be sold under the Raymark label? 17 MS. MORAN: Excuse me. Would 18 you read the question. 19 A Asbestos or textile? 20 (Record read.) 21 Q When I say "Raymark label," I mean as 22 part of Raymark's business. 23 A No, I can't. 24 MS. MORAN: I believe the witness 25 already answered that question by listing 1 Ambrose 12 2 four plants for you. Were you asking some 3 thing different? 4 THE WITNESS: Yes, he was. 5 MR. STEIN: I was asking simply 6 the names of the plant or where they were 7 located and now I will find out specifically 8 what was being done at those plants, if he 9 knows. 10 Q Sir, from 1938 to 1952, did any of the 11 four plants that you have named produce asbestos 12 textile products? 13 A I am not aware of it, no. I don't know. 14 Q Is it your understanding that they pro 15 duced, that those four plants produced other than 16 asbestos textile products during that period of 17 time? 18 A They produced brake linings, automatic 19 transmission parts, but I am not familiar with 20 the formula of what went into that product. 21 Q At any of those plants were textile, 22 asbestos textile products with foreseeable use 23 in shipbuilding produced? 24 A I don't know. 25 Q When you say, "I don't know," is it 1 Ambrose 13 2 they might have been, they might not have been, or 3 you simply do not know? 4 A I simply do not know. 5 Q Do you know, sir, during the period 6 of time that you worked at the Stratford, 7 Connecticut plant whether or not asbestos textile 8 products were produced? 9 A No, I don't. 10 Q Did Raymark have a plant in Bridgeport, 11 Connecticut during the period '38 to '52? 12 A I don't know when it was in Bridgeport, 13 but I have heard people say that there was a 14 Bridgeport plant. 15 Q Is that Bridgeport plant no longer in 16 existence? 17 A That's correct. 18 Q Do you know the period of time a 19 Bridgeport plant was in existence? 20 A No, I don't. 21 Q Do you have any knowledge whatsoever 22 as to whether or not it was in existence between 23 1938 and '52? 24 A No, I don't know. 25 Q Do you know what was produced at the 1 Ambrose 14 2 Bridgeport plant? 3 A No, I don't. 4 Q Are there any other plants that were 5 in existence between '38 and '52 that are no longer 6 in existence today? 7 A Passaic is no longer in existence. 8 Q Is it your understanding that brake 9 parts were produced at the Passaic plant? 10 A No, that is not my understanding. 11 Q What is your understanding of what was 12 produced at the Passaic plant? 13 A Bowling balls, I know that was produced 14 at Passaic. I understood they had five product 15 lines but I don't know. 16 Q Can you tell me, sir, between 1938 and 17 1952, to your knowledge, did Raymark produce asbestos 18 tile products? 19 A No, I can't. 20 Q Can you tell me, sir, if you are aware 21 from any other knowledge other than your own personal 22 knowledge if between that period of time Raymark 23 produced asbestos textile products from any of 24 its plants? 25 A No. 1 Ambrose 15 2 MR. STEIN: Let's have this docu 3 ment marked for identification. 4 (Two-page document was marked as 5 Plaintiffs' Exhibit 1 for identification, 6 as of this date.) 7 Q Sir, would you glance at the document 8 that's been marked Plaintiffs' Exhibit 1 for iden 9 tification for a moment (handing). 10 Would you notice on the left side of 11 that document there's a series of names of products. 12 A Yes. 13 Q It's titled "Raybestos-Manhattan Textile 14 Products and Tradenames." Do you see that? 15 A Yes, I do. 16 Q Can you tell me, sir, whether you have 17 any knowledge whatsoever as to whether any of 18 the products that are named here were in fact 19 produced by Raybestos-Manhattan during the period 20 1938 to 1952? 21 A No. 22 Q Can you tell me, sir, if you have any 23 knowledge with respect to which factory, if any, 24 produced any of the products that are listed on 25 this exhibit? 1 Ambrose 16 2 A No. 3 Q You indicated that there was a gentleman 4 who was an assistant secretary of the corporation 5 who was presently in charge of all of the worker's 6 compensation claims or benefits for all of the 7 factories of Raybestos-Manhattan; is that correct, 8 sir? 9 A No. I indicated a gentleman, Robert 10 Ford, by name, who was director of human resources 11 for the corporation; nothing to do with worker's 12 compensation. 13 Q Is that one of his responsibilities, 14 that area? 15 A I'm not sure that it is. The treasurer 16 is the one that worker's compensation comes under, 17 as far as I know. 18 Q You are familiar with the worker's 19 compensation claims of the plant that you have 20 been assigned to and worked out of for the past 21 25 years, Stratford, Connecticut? 22 A Yes. 23 Q What I am asking is: Is there anybody 24 above you who was familiar with the claims not 25 only from the Stratford plant but worker's 1 Ambrose 17 2 compensation for other plants? 3 MS. MORAN: During what period 4 of time? 5 Q 1938 to 1952. 6 A No. 7 Q What about presently? 8 A No, there is nobody presently, as far 9 as I know. 10 Q Other than the treasurer of the company? 11 A No, he has knowledge of it now, 1984, 12 but he did not have knowledge of '38 to '52. He 13 wasn't even employed. He wasn't even born, I 14 don't think. 15 Q You indicated, sir, that part of the 16 process of filing of a worker's compensation claim 17 in the Stratford plant included an employee report 18 ing to the Medical Department at that plant? 19 A Yes. 20 Q Is that correct? 21 A Yes. 22 Q Can you tell me if any of the other 23 plants presently have a Medical Department? 24 A ' No, I can't. 25 Q Can you tell me if the Stratford plant 1 Ambrose 18 2 had a Medical Department from the period 1938 3 through 1952? 4 A No, I can't. 5 Q Can you tell me if in the period 1938 6 to 1952 the Medical Department of the Stratford 7 plant was in any way involved in the handling 8 or precessing of worker's compensation cases? 9 A No, I can't. 10 MS. MORAN: Objection to the form of 11 the question. I believe the witness said he 12 didn't know if there was a medical director 13 at that time. 14 Q Can you tell me, sir, the names, if 15 you know, of the insurers, if any, providing 16 worker's compensation coverage for the Stratford 17 plant between the period 1938 to 1952? 18 A No, I can't. 19 Q Do you know, sir, if during that period 20 worker's compensation claims from the Stratford 21 plant were handled in-house, meaning that they 22 were self-insured? 23 A The only thing I remember was that there 24 was an Investors Mortgage Company that handled 25 worker's comp., and they're the ones who were 1 Ambrose 19 2 charged with the responsibility of placing the 3 insurance with the carriers. They handled worker's 4 compensation. 5 Q Was that a group of investors of Raybestos- 6 Manhattan or some outside company? 7 A It was an outside company. It was like 8 Alexis, akin to Alexis. 9 Q Did you ever personally have any dealings 10 with that organization? 11 A Not in '38 to '52. 12 Q To your knowledge, even if you didn't 13 have any personal work, with them, how did that 14 organization fit itself in with respect to handling 15 of a worker's compensation claim at the Stratford 16 plant from 1938 to 1952? 17 A I don't know. All I know is they were 18 in existence. 19 Q Do you know if that organization prepared 20 or maintained any records reflecting worker's 21 compensation claims during that period? 22 A No, I don't. 23 Q Did you make any efforts to find out 24 that information prior to your coming here today? 25 A I contacted the various plants, Profitville, 1 Ambrose 20 2 Manheim and North Charleston and spoke with them 3 and asked them if they had any knowledge of the 4 way the records were maintained between 1938 and 5 1952 and I got negative responses from all three 6 locations. 7 Q Did you, in your communication with 8 those plants, ask them if they had in their docu 9 ment files or file cabinets records of worker's 10 compensation claims during that period? 11 A Yes. 12 Q What did they tell you? 13 A No, they did not. 14 Q You just added another plant. You added 15 the North Charleston plant and I asked you for 16 the name of all the plants that to your knowledge 17 were in existence in '38 to '52 and you didn't 18 include North Charleston. 19 A I don't know when that became in exis 20 tence, when it started. I have no idea when that 21 plant started. It's no longer a part of Raymark. 22 That was spun off a couple of years ago. 23 Q Do you have any information or knowledge 24 as to whether or not that plant was in any way 25 involved with the production of asbestos textile 1 Ambrose 21 2 products? 3 A No. 4 Q You said you communicated with the North 5 Charleston plant. Who did you speak to? 6 A I just don't know offhand. Wait just 7 a minute and I will look in my briefcase. 8 MR. STEIN: Off the record. 9 (Discussion off the record.) 10 A (Continuing) At North Charleston I 11 spoke to Al Tiedeman, T-i-e-d-e-m-a-n, who indi 12 cated -- I asked him: Were you around when the 13 records were created '38 to '52? The answer was 14 no. Any knowledge of how the records were kept, 15 the answer was no. Anyone in the company with 16 knowledge of how the records were maintained, 17 and the answer was no. 18 Q Did you ask him if there were any records 19 there at the time you were speaking to him? 20 A No. 21 Q You did not ask him that question? 22 A No, I didn't. 23 Q Did you ask that question to any of 24 the other plant managers or plant people? 25 A Yes, I did. Ambrose 22 1 2 Q That you spoke to ? 3 A Yes, I did. 4 Q Was there some reason you didn't ask 5 the individual at North Charleston the same question? 6 A No. I asked all of the people that 7 I spoke with, I asked them the same three ques 8 tions that I just read off to you. All the people 9 that I spoke with at the various plants, I asked 10 them the same three questions: Were you around 11 when the records were created, any knowledge of 12 how the records were kept, is there anyone in 13 the company now with knowledge of how the records 14 were maintained? Those three questions are what 15 I asked. 16 Q I just want to make it clear. Did you 17 ask anyone if at the present time in any of the 18 business records or storage records or whatever, 19 whether there were worker's compensation records 20 for that period of time presently in their posses 21 sion? 22 A No, I did not. 23 Q Sir, prior to coming here today, other 24 than what you have just told us, did you make 25 any effort to ascertain the existence of worker's 1 Ambrose 23 2 compensation records reflecting claims filed by 3 employees of Raybestos-Manhattan during the period 4 1938 to 1952 which alleged injury or sickness 5 arising from asbestos exposure? 6 MS. MORAN: Mr. Stein, the response 7 to your document demand was done by counsel 8 for Raymark. As you know, I have provided 9 you with the result of that effort. 10 MR. STEIN: I would like the 11 witness to answer the question. 12 A The answer is no. 13 Q Sir, prior to coming here today did 14 you make any attempts to establish where worker's 15 compensation claims filed by employees of Raybestos16 Manhattan during the period 1938 to 1952, which 17 alleged injury or sickness arising from asbestos 18 exposure were stored? 19 A No. 20 Q Prior to coming here today, sir, did 21 you make any effort to ascertain the location 22 of worker's compensation claims filed by employees 23 of Raybestos-Manhattan during the period 1938 24 to 1952 alleging injury or sickness arising from 25 asbestos exposure? 1 Ambrose 24 2 A No. 3 Q Sir, did you bring with you today any 4 worker's compensation records or files reflecting 5 claims by Raybestos-Manhattan employees during 6 the period 1938 to 1952 which alleged injury or 7 sickness arising from asbestos exposure? 8 A Yes. 9 Q Would you produce them for us now? 10 MS. MORAN: Mr. Stein, the witness 11 has copies of what I have already produced 12 for you. As I understand, it is our obliga 13 tion under California law to provide you 14 with copies of the documents and I have already 15 provided you with copies of documents which 16 are responsive to your document demand, which 17 is part of your notice of deposition. 18 The witness himself has copies 19 of identical documents which were sent to 20 him by counsel for Raymark. 21 MR. STEIN: Off the record. 22 (Discussion off the record.) 23 MR. STEIN: Let's mark for iden 24 tification purposes of this deposition, those 25 documents which have just been produced by 1 Ambrose 25 2 the witness himself as opposed to the docu 3 ments that were produced by the attorney 4 prior to the deposition questioning. 5 Let the record indicate that the 6 witness has produced a large number of docu 7 ments , on the top of which was the notice 8 that I served on the attorneys for Raymark. 9 I would like that notice marked 10 Exhibit 2 for identification; and that there 11 are three additional sets which were differ 12 entiated by rubber bands and with face pages. 13 The first one says "Rider A," the second 14 one says "Stratford," and the third face 15 page says "Manheim." 16 I will ask that they be marked 17 2-A, 2-B and 2-C. 18 We will put a marking on the face 19 page and put rubber bands back around the 20 three sets. 21 (Above described documents were 22 marked as Plaintiffs* Exhibits 2-A, 2-B and 23 2-C for identification, as of this date.) 24 MS. MORAN: Before the deposition continues 25 I would like the record to note that I was 1 Ambrose 26 2 advised that two files that may have been 3 responsive to your request were temporarily 4 misplaced and I was unable to determine, ' 5 in the course of the last two days, why that 6 happened or what those files were. 7 But I believe they involved worker 8 compensation claims arising out of the North 9 Charleston plant. 10 When the person who was involved 11 in compiling these documents returns from 12 vacation, I will make every effort to have 13 them provided to you promptly. 14 MR. STEIN: Can we agree via 15 a date that is convenient to you, a letter 16 will be sent to me reflecting the results 17 of your search, can we do that? 18 MS. MORAN: Yes. 19 MR. STEIN: What is a date that 20 would be convenient to you? Would 20 days 21 be sufficient? 22 MS. MORAN: September 15th will 23 be fine. 24 Q Sir, you produced a number of documents 25 from your briefcase just now. Can you tell me Ambrose 27 where you obtained those documents? A They were provided by counsel for Pitney. Q What was the name of the attorney who provided it to you? What was the name of the law firm? A Pitney, Hardin, Kip and Such. Q Don't tell me about any conversations. Just tell me, did it come by hand-delivery, did it come by mail? A Parcel post, mail. Q Was there a cover letter included with the package of documents? A Yes. Q Will you show the letter to your counsel first? A Yes (handing). t MR. STEIN: May I see that letter? MS. MORAN: I don't think corres pondence between counsel and the witness is appropriate for production. I believe that it is protected by the attorney/client privilege. If you can suggest to me some reason why it is important, I would be happy to 1 Ambrose 28 2 reconsider. 3 Q Sir, do you have any knowledge with 4 respect to these records other than the information 5 that is contained in the letter that was sent 6 to you? 7 MS. MORAN: I object to the form 8 of the question. I don't know what you mean 9 by "knowledge." 10 The witness has testified extensively 11 regarding his efforts to find someone in 12 the company who has personal knowledge about 13 this period of time. 14 A No, I don't. 15 Q Without telling us what was said, did 16 you have any personal conversations with any repre 17 sentative of the Pitney, Hardin law firm with 18 respect to these records? 19 A No, other than that they were being 20 shipped to me. 21 Q Was that a communication from a secretary 22 or paralegal? 23 A By one of the attorneys. 24 Q Sir, did you endeavor to find out where 25 the originals of the records that you produced 1 Ambrose 29 2 are presently located? 3 THE WITNESS: Can we go off the 4 record? 5 MS. MORAN: No. Just answer 6 the question on the record. 7 A No, I didn't. 8 Q Whether you endeavored to find out or 9 not, do you have any knowledge as to where the 10 originals are? 11 A Yes. 12 Q Where are they? 13 A For Stratford I did see the documents 14 in the Bridgeport Worker's Compensation Commis 15 sioner's Office a few years ago. Whether they 16 are all here or not, I can't say. 17 I recognize some of the names. 18 Q When you say the commissioner's office, 19 is that a state agency office or is that part 20 of Raymark? 21 A State agency, public record. 22 Q What were the circumstances surrounding 23 your going to look at those records? 24 A I was told to go there by someone at 25 the corporate headquarters, after knowledge that Ambrose 30 1 2 came to their knowledge. 3 Q Who was the person that gave you that 4 direction, sir? 5 A I think it was John Marsh, but I am 6 not positive. 7 Q What was Mr. Marsh's relationship to 8 the company? 9 A He's director of environmental for Raymark 10 Q Is he still with the company? 11 A Yes, he is. 12 Q What is his present title? 13 A I'm not sure if it's the same but as 14 far as I know he is doing the same thing. 15 Q Where is his office located? 16 A Trumbull, Connecticut. 17 Q He is an officer of the company? 18 A Not to my knowledge. 19 Q What is it that Mr. Marsh told you to 20 do, to the best of your recollection? 21 A To look up the records, write down the 22 names, the settlement dates and the amounts. 23 Q Did you do that? 24 A Yes, I did. 25 Q Did he also direct you to order copies 1 Ambrose 31 2 of the records? 3 A No. 4 Q To your knowledge, did anyone from Raymark 5 subsequent to your looking at the records order 6 copies of them? 7 A No, not to my knowledge. Obviously, 8 somebody did but not to my knowledge. 9 Q Do you have any idea why the requst 10 was made of you? 11 A The instructions I got were, there were 12 some cases that had come to light that apparently 13 either the company was not aware of or hadn't 14 heard about or had forgotten about, and I was 15 not aware of them and he just asked me to go down 16 there and look in these records before they were 17 put back into the archives. 18 Q Do you know, sir, if Mr. Marsh has greater 19 knowledge than you with respect to the existence 20 of the worker's compensation records? 21 A No. 22 MS. MORAN: Objection to the 23 form. Are we talking about records from 24 1938 to 1952? 25 MR. STEIN: Yes. 1 Ambrose 32 2 A My understanding. 3 Q Your understanding is what? 4 A That the time frame is '38 to '52. 5 Q Where did that understanding come from? 6 A That's the reason I am here, to discuss 7 the '38 to '52 records. 8 Q That was based upon information you 9 obtained from the attorneys? 10 A From counsel, yes. 11 Q Have you, sir, seen the copies that 12 were obtained by Raymark from which the documents 13 you have produced were made? 14 A Only Stratford. 15 Q You have seen them recently, sir? 16 A A few years ago; 1978 or *9. 17 Q Are the copies of what was obtained 18 from the commissioner's office presently located 19 at the Stratford plant? 20 A No, not to my knowledge. 21 Q Where are they presently located? 22 A In the commissioner's office. 23 Q The commissioner's office has the original 24 documents; isn't that right, sir? 25 A Yes. 1 Ambrose 33 2 Q At some point in time Raymark ordered 3 or requested the copies of the original docu 4 ments of the commissioner's office be produced 5 or provided to the Stratford office of Raymark; 6 is that correct? 7 A No, I don't know. Not to my knowledge, 8 no. 9 Q You have never seen these documents 10 at the Stratford plant? 11 A That's right, until Monday. 12 Q You have never seen any worker's 13 compensation records from 1938 to 1952 at the 14 Stratford plant? 15 A No, I have not. 16 Q The only information you have with respect 17 to these records is information that was provided 18 to you by the attorneys, the Pitney, Hardin law 19 firm? 20 A Yes. 21 Q That information came to you within the 22 last few days? 23 A Yes, Monday. 24 Q Other than that information, you have 25 no other information with respect to these documents? 1 Ambfcose 34 2 A No. 3 Q You have no other knowledge with respect 4 to these documents? 5 A No. 6 Q You attempted to get knowledge such 7 as existed from other factories and you made the 8 phone calls and communications you previously 9 described to us? 10 A Yes. 11 Q Did you have any additional meetings or 12 discussions with the attorneys for Raymark as 13 to these documents? 14 A No. 15 MR. STEIN: Do you wish to enter 16 into any stipulations with respect to these 17 documents, where they come from, how they 18 were collected, anything that we can rely 19 on so as not to pursue the issue further 20 with this witness? 21 MS. MORAN: Yes. I would like 22 the record to note that apparently yesterday 23 you were at the Pitney, Hardin, Kip- and Such 24 offices in New Jersey, and the documents 25 from which Exhibits 2-A, B and C were copied 1 Ambrose 35 2 were made available to you and you were advised 3 that those were the originals that Raymark's 4 counsel had at that time. 5 MR. STEIN: Let me interrupt 6 you. There's a court order that discusses 7 these originals. I was shown xerox copies 8 that were obtained from the Pitney, Hardin 9 law office. 10 It was made very clear that these 11 were not the originals. I was not shown 12 the originals. I was not shown anything 13 like that. 14 I was shown exactly what was produced 15 today. The order covering this deposition 16 provides that the originals be shown to me 17 and they were not. 18 The record that you are making, 19 not only is inaccurate, but it is not responsive 20 to what I asked. 21 If you can make some stipulation 22 with respect to what is produced, that would 23 be fine. To state on the record that I was 24 shown something I was not is inaccurate and 25 does not conform to what I requested. 1 Ambrose 36 2 I will keep asking this witness 3 questions if you would like. 4 MS. MORAN: You asked me if I 5 would like to make a statement and I would. 6 MR. STEIN: A stipulation is 7 what I asked. 8 MS. MORAN: I wasn't there yes 9 terday, so I can't state from personal knowl 10 edge. But I am familiar with the court order 11 and I do understand that either we must pro 12 vide originals to you for your review within 13 20 days or an explanation as to why Raymark 14 is not in possession or does not have the 15 originals. 16 That will be complied with. 17 With respect to the documents -- 18 MR. STEIN: You withdraw your 19 statement that I was shown originals yester 20 day? 21 MS. MORAN: I don't withdraw 22 the statement that was made before. My state 23 ment was accurate. 24 I was advised, I was not there, 25 that you were shown the documents from which 1 Ambrose 37 2 Plaintiffs' Exhibits 2-A, B and C were photo 3 copied. Whether you want to call them orig 4 inals or photocopies, you can call them what 5 ever you would like. I wasn't there. 6 But in any event, these documents 7 that have been produced today are true and 8 complete copies of those documents in the 9 possession of Raymark which are responsive 10 to your document demand in connection with 11 today's deposition. 12 That's the stipulation that I would 13 make. 14 MR. STEIN: Would you read back 15 the last sentence? 16 (Record read.) 17 MS. MORAN: With the proviso 18 that I was advised that apparently two files 19 have been temporarily misplaced, and I will 20 let you know by September 15th whether or 21 not I can produce those files. 22 If I can, I will produce them before 23 September 15th, if they are located. 24 MR. STEIN: Do you wish to enter 25 into any stipulation as to how these documents 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 V. 22 23 24 25 Ambrose 38 were prepared, maintained, stored, et cetera? MS. MORAN: No, I don't. I think that the witness has indicated that he has attempted to find out that information and that his search has not proved to be fruitful. But if anything else is required under California law, I would be happy to try to get further information for you. MR. STEIN: This record will go to a commissioner for review. He did not attempt to ascertain where the records were stored; he did not attempt to ascertain their location. He did attempt to ascertain how they were prepared. He read to us the three questions. Now, I am asking you if you would like to enter into any stipulation which sets forth the manner in which these documents were stored, gathered and now copies of which are produced today. If you don't, that's fine. If you do, that's fine, too. MS. MORAN: The witness testified 1 Ambrose 39 2 that he was unable to find any information 3 regarding how these documents came into exis 4 tence, were prepared, were received, were 5 maintained, were stored or were located from 6 1938 through 1952. 7 I think the witness has covered 8 that adequately. I have no information regard 9 ing anything that happened subsequent to 10 1952 and so I can't enter into a stipulation 11 at this time. 12 MR. STEIN: Counsel, can you 13 stipulate that these documents were gathered 14 from the Raymark files by the attorneys for 15 Raymark for the purpose of this production? 16 MS. MORAN: Yes, counsel for 17 Raymark received your document demand and 18 copied those documents which were responsive 19 to it. Response was made by counsel, that's 20 correct, and I'll stipulate to that. 21 MR. STEIN: Will you furhter 22 stipulate that they were produced from the 23 business records of Raymark, that counsel 24 found them and produced them from Raymark's. 25 business records? 1 Ambrose 40 2 MS. MORAN: I don't personally 3 know the answer to that. I imagine that 4 it is so, but it appears, for example, that 5 some of the documents that you have were 6 copied from court files. Since I, myself, 7 did not participate in obtaining those docu 8 ments, I don't know the source from which 9 they came. 10 MR. STEIN: You are counsel for 11 Raymark, though? 12 MS. MORAN: That's correct. 13 MR. STEIN: But you're from a 14 different attorney's office than the office 15 that actually gathered these up; is that 16 correct? 17 MS. MORAN: That's correct. 18 MR. STEIN: The attorney that 19 gathered these up is someone from the law 20 firm of Pitney, Hardin, Kip and Such. 21 MS. MORAN: That's correct. 22 MR. STEIN: If they did anything 23 with respect to Raymark records and gathered 24 them up we would have to ask them, wouldn't 25 we? 1 Ambrose 41 2 MS. MORAN: That's correct. 3 MR. STEIN: Will you permit this 4 witness to testify as to any conversations 5 that he had with the attorneys from Pitney, 6 Hardin, Kip and Such as to the manner in 7 which these documents were gathered to be 8 produced here today? Or do you assert that 9 as privileged communications? 10 MS. MORAN: I will permit you 11 to ask the witness whether or not there were 12 such conversations. I don't know the answer 13 to that. 14 MR. STEIN: I include in conversa 15 tions writings. I am aware he did have a 16 letter from attorneys and I have asked if 17 I could review that letter and you have declined 18 based on attorney/client privilege. 19 I don't know what is in it. It 20 may be relevant to that issue. I just don't 21 know. 22 MS. MORAN: Why don't you direct 23 the preliminary question to the witness, 24 for a yes or no answer. Because to my under 25 standing there were no conversations with 1 Ambrose 42 2 this witness regarding how the documents 3 were prepared. 4 MR. STEIN: Also, written communica 5 tions? 6 MS. MORAN: As I understand there 7 are no written communications regarding that 8 subject either. 9 Q Mr. Ambrose, did you obtain any informa 10 tion from the Pitney, Hardin law firm as to where 11 the documents you produced today were gathered 12 from? 13 A No, I did not. 14 Q That information was not included in 15 the cover letter that was sent to you? 16 A Not to my knowledge. 17 Q Did any of the Pitney, Hardin attorneys 18 provide you with any information with respect 19 to the manner in which these documents were prepared? 20 A No, they did not. 21 Q Did they provide you with any information 22 as to where the originals of them are presently 23 located? 24 A No, they did not. 25 Q Did they provide you with any information 1 Ambrose 43 2 as to how they were received? 3 A No, they did not. 4 MR. STEIN: I have no further 5 questions. 6 MR. SENA: On behalf of Owens 7 Corning, I would also request that we be 8 advised as to the production of documents 9 for the two plants that have been temporarily 10 mislaid and that if such documents are located 11 and produced we be given copies. 12 MS. MORAN: I don't believe it's 13 two plants. I believe that there may have 14 been two files that are temporarily mislaid, 15 but I will send you a copy of my corres 16 pondence to counsel for plaintiff. I will 17 send a copy to everyone who is present at 18 the deposition. 19 FURTHER EXAMINATION 20 BY MR. STEIN: Q Sir, Exhibit 2 that you had in your 21 briefcase was the legal notice of oral deposi 22 tion of Raymark and attached to it was a series 23 24 of documents which were titled "Exhibit A" and 25 there are certain check marks next to certain 1 Ambrose 44 2 of the dates. 3 Can you tell me, sir, if you made any 4 effort to compare the information set forth next 5 to the check marks with the documents that were 6 produced today? 7 A No, I did not. 8 Q Did you have occasion to read Exhibit 9 A? 10 A Yes, I asked and answered it. 11 Q Can you tell me if you recognized any 12 of the worker's compensation claim names that 13 were on that exhibit? 14 A Yes, I did. 15 Q Were those the ones that you looked 16 at when you went to the commissioner's office around 17 1979? 18 A Yes. 19 MR. STEIN: Counsel, can you 20 make a representation as to what was produced 21 in response to item D of plaintiffs' notice 22 which limited for purposes of this deposition 23 to those items which refer to worker's 24 compensation claims? 25 MS. MORAN: Yes. To clarify 1 Ambrose 45 2 the record, I think that there are some docu 3 ments checked on Exhibit A which do not refer 4 to worker's compensation claims. But as 5 I said before on the record, the documents 6 provided to you today are copies of the records 7 of Raymark which are responsive to your request 8 contained in the notice of deposition, and 9 that includes those documents which you speci 10 fied by checking on Exhibit A. 11 MR. STEIN: Thank you very much. 12 MS. MORAN: With the proviso 13 that I said, the two files that were tempor- 14 arily misplaced. 15 MR. STEIN: Thank you. 16 (Time noted: 3:00 o'clock P.M.) 17 -oOo- 18 W. H. AMBROSE 19 Subscribed and sworn to 20 before me, this day 21 of , 1984. 22 23 24 -oOo- 25 August 8, 1984 EXHIBITS PLAINTIFFS' FOR IDENTIFICATION 1 2-page document 2-A Set of documents, "Rider A" 2-B Set of documents, "Stratford" 2-C Set of documents, "Manheim" -oOo- INFORMATION REQUESTED 46 PAGE 15 25 25 25 1 47 2 3 STATE OF NEW YORK ) : SS. : 4 COUNTY OF NEW YORK ) 5 6 I, Michael J. D'Amato, a shorthand 7 reporter and notary public within and for 8 the State of New York, do hereby certify: 9 That WILLIAM HENRY AMBROSE, the 10 witness whose examination is hereinbefore 11 set forth, was duly sworn by me and that 12 this transcript of such examination is a 13 true record of the testimony given by such 14 witness. 15 I further certify that I am not 16 related to any of the parties to this action 17 by blood or marriage and that I am in no 18 way interested in the outcome of this matter. 19 IN WITNESS WHEREOF, I have hereunto 20 set my hand this - day of_ / " * 1984. 21 22 23 MICHAEL Jy D'AMATO 24 25 Pit; Uk r EXHIBIT B RAYBESTOS-MANHATTAN TEXTILE PRODUCTS ASP TRADE NAMES - I. Chrysotile Products Product Approx. Date First Sold Approx. Max Asbestos % Asoearances Intended Use Lap 1935 Roving 1910 Cable filler 1938 Glassbestos 1940 Yarn 1910 Novatex 1972 Sealsafe 1975 /Rope 1910 Vick 1910 Cloth 1910 Glassbestos 1940 Rhinobestos 1946 Polybestos 1955 Silvabestos 1959 Novatex 1967 Speedlag* 1969 Eleven thirty- three 1971 Tr ibestos 1971 Sealsafe 1975 Goldbestos* 1959 Novabestos* 1947 Fluoro- bestos 1955 Terrybestos* Felts 1960 193B *0 100 95 100 80 95 100 80 90 90 95 80 90 85 75 100 65 90 ' 90 80 70 95 75 80 100 Convolute coiled felt On twisted thread Twisted thread Twisted thread Twisted rope Loosely twisted Woven fabric m m Adhesive coated woven fabric Electrical insulation Raw material for textiles Electrical cable insulation Raw material for textiles and sewing thread for lagging and beat resistant fabrication Sealing material m Miscellaneous heat and flame resistant applications such as welding curtains. fire checks, lag ging cloth, lam inate reinforcing, etc. Pipe lagging Woven fabric Woven fabric Treated cloth Coated cloth Woven cloth Miscellaneous Safety clothing Safety clothing Ironing board covers Miscellaneous Fluorocarbon coated cloth - Tufted cloth Paper coil or roll Chemical resistant Gloves Electrical insula tion and/or laainate reinforcement J<r Approx. Date .-t First Sold je 1910 Cttor tape 1963 Glassbestos 1942 ' Sealsafe 1975 Novatex '-1970' Pyrotex -1938 Allbestos 1941 Novabestos* 1947 Tubing 1910 Novatex 1973 'Sealsafe 1975 'Discontinued products: Approx. Max. Asbestos % Aooearances 85 80 -80- 80 100 80 - 80 ... .85 "loo " 100 80 Convolute m coil .. r " ------ ft * -- ft -- .... Novabestos - 1964 Terrybestosi - 1965 Goldbestos - 1970 Speedlag - 1976 Intended Use tr . Electrical end/or thermal insulation and/or fire resistance Filtering and protective covering for pipes and tubing II. Crocidolite Products Packings* 1920`s Valve Rings'* 1950`s -- Coiled or twisted rope -- Untwisted Thread 'Discontinued products: Packings - 1972 Valve rings - early 1970`s > III. Anosite Products Blankets* 1920`S 100 Woven blanket Tape* 1940 -- Convolute coil Discontinued products: Blankets - 1944 Tape - 1970 Mechanical applications Mechanical applications Electrical and/or thermal insulation for U.S. Navy Electrical and/or thermal insulation IV. Ar.thophyllite Prod ucts Pape r 1958 100 Compressed threads Automatic trans mission applications pLft fyfc.Z :rj? 1 STEVEN B. STEIN 2 LAW OFFICE OF STEVEN B. STEIN ONE EMBARCADERO CENTER. SUITE 2112 3 SAN FRANCISCO, CALIFORNIA 9*111 Telephone: (*15) 362-1371 4 5 Attorney for Plaintiff* RECEIVED JUL 12 1984 pi^UCO ' UIIOCT 6 SUPERIOR COURT OF THE STATE OF CALIFORNIA 7 COUNTY OF SAN FRANCISCO 3 JANES R. FUNSETH, at al. ) 9 Plaintiffs, ) NO. 82383* ) 10 vs. ) NOTICE OF ORAL ) DEPOSITION OF 11 FIBREB0ARD CORPORATION. ) DEFENDANT ) 12 et al.. ) RAYMARK, INC. ) 13 Defendants. ) ____ l 14 TO ALL PARTIES AND THEIR RESPECTIVE' ATTORNEYS OF RECORD: 15 PLEASE TARE NOTICE that purauant to Article 3 of the Code of 16 Civil Procedure, the oral depoaltlon of Defendant, RAYMARK, INC. 17 will take place before a duly qualified Notary Public on the 18 date, place and tiae apecifled, and will continue froa day to 19 day thereafter, Sunday* and holidays excepted, until eoapleted: 20 21 Date: 22 Tine: Location: 23 August 8, 198* 10:00 a.a. Lav Office of Noraan J. Landau 233 Broadway, New York City, N.Y. 24 Witness: RAYMARK, INC., by an officer, director, aanaging 25 agent or other person including but not Halted to 26 the corporate record custodian with knowledge who 27 consents to testify to the following specific 28 natters: i b t / <L 1 (a) existence, preparation, receipt, Maintenance, storage 2 and location of recorda reflecting blda to purchase, 3 sales, purchase, transfer, and delivery of textile 4 products which contained asbestos with forseeable 5 application for use In shipbuilding and ship repair 6 during the period 1950-1952; 7 (b) existence, preparation, receipt, Maintenance, storage * and location of records reflecting bids to purchase, 9 sales, purchase, transfer, and delivery to the United 10 States government (or agency thereof) and the shipyard 11 located at Breaerton, Washington, of textile products 12 which contained asbestos with forseeable application 13 for use In shipbuilding and ship repair during the 14 period 1950-1952; 15 (c) existence, preparation, receipt. Maintenance, storage 16 and location of records reflecting Worker's 17 Coapensatlon clalas filed by eaployees of 18 Raybestos-Manhattan during the period 1936-1952 19 alleging Injury or sickness arising froa asbestos 20 exposure; 21 (d) existence, preparation, receipt. Maintenance, storage 22 and location of the documents which are Identified 23 by a checkmark on attached exhibit A. 24 25 I PLEASE TAKE FURTHER NOTICE that the deponant(a) are required 26 to produce the following original documents at the tine and 27 place of their oral depositions: 28 (a) records reflecting bids to purchase, sales, purchase. 1 transfer, and deliver; of textile products which 2 contained asbestos with forseeable application for 3 use in shipbuilding and ship repair during the period 4 1950-1952: 5 (b) records reflecting bids to purchase, sales, purchase, 6 transfer, and deliver; to the United States 7 government (or agenc; thereof) and the shlp;ard * located at Bremerton, Washington, of textile products 3 which contained asbestos with forseeable application 10 for use in shipbuilding and ship repair during the 11 period 1950-1952; 12 (c) records reflecting Worker's Compensation claims filed 13 b; employees of Ka;bestos-Manhattan during the period 14 1936-1952 alleging injur; or sickness arising from 15 asbestos exposure; 16 (d) documents which are identified b; a checkmark on 17 attached exhibit A. 18 19 Dated: Jul; 12, 1964 A 20 * STEVEN B. STEIN 21 Attome; for Plaintiff 22 23 24 25 26 27 28 in* ins im !> . If14 Itsi 4 "u HuiUf. 1., *tvl*a*erv tmiiNU.' *MV1M jMrni ftf Mtif BSlIt, . im HtfiicU* rtftn (Mt (!? 4lumr4 1im4 mt itMiui i|irt mi Ml Ull }M (MM*r Nrl #f llrtfiM* wnlMt CPM*r MtUti altm (ill lUlu # IM.MMI Mtiiai tMMMl tfm ftttMMf M Mi KIM (ariMr nIu ^ mmm if mini >1. Its), mmim ktm* um. Irmt UMM*4*a*lUal. li*a*M |lafMit#aaMua Mlaa Iiicum Miira ft# af>*M nl| Mim Ui*a f##r# aarUir fray. Mmm ft.f.. Mft#rw#y* tiatMt* > litlniM. Mtthav kalir * ca#My uieti Cta? aa MMici) MraftM far Aataa Ufa iMiraftaa CMMy- IM aifttai Mbaitaa partielt IMatrl 1dm tfta )*ft ftralti aa aaaaaltMlr aaaara aM pftrMpe fatal iaflMMtlM. Titla aaalltlaa. filial aaMHMia. 1ft t aa Iftpartaat aa May #tftr fan* if alMtaJ Irritetifta ( laaf tlaiaa. latiiN ( lift larraiaaafy. Imiiii. aft vail hacftM aara MaMlaM aa tM (Maatry fran.., tine# aalaattiii la laaaraftla, aM aeelly tatalti I# latal faiMtaat liaafeiUiy (alliM |y Imft. ftftfft iai raatlM mmII ha aaal ftalara filaaaa la aaaiaal. fill ift ft aary earl*** lliaaia aai la trrnl- ally iactfMla. SartirJai aat laaaitai aauaat their alp*. iaillitaa. tliiaa Mitrar tlaa tftital*1 yaara. tMavftfi aaaaiafa My laay kava tiratMtil... laitlt tlMlly atiwi vital* # year alur tM yaUaM im m laayii fllftft*. V. yaiMWimlMU. lift Sit TftlaMftftfy laftaitaiaa. frit. 1. ftaltal.. )i 111 U9J4I ftaali M. aal M. filar**. Nlanary laMitaali, ft Mum a( 0* IhMlral C*#ftt. Unfit. 1. J, ftSfJl)M (19SH eparte ftt ! three caaai ftf aiftaataiia fna I*aa tfta* aM ytar ( aaanifti eapeeara. an ft* ft clerical verier. ua ta vertera MaHiay etheatee wtlaari. aal im cam i U tamaaai af tfta Ina. BuiMir IS. Uttar fra* attaiMy Mftirt ta inn. Uya) MyartMit #1 Mafittaulla Canaay Mparti Ma haa cnyital yallrya vlftft yraltaiaary repart af three yaara earlier, create ahaiMtlaa f canariaM af ailacaaaa atft eeft*aetia Ueiaia f ft*ftfte*cy af a(tMi>'a ca*a"aatl-- Icfailetaft* 1* ev Jefaey Mari Sahna*m*ville vaa Iftftftyiae HiMt raeftc*ltift* ftf atMitai aa ft# acrayaUMal fiifteaaft. aM it it li t*e yallry af Macaivtlla ta ftapaae a*y hall that ativ**teft ta taclMa aiheatoa aa ea*p*tfttf. it mlf ha vey heiefel ta have a* afficial rtyart ta a*ev that there la a eaaetaatlal ftlfferame hatvaea EXHIBIT ft tt)l 1134 10)4 nIrNMMakypMf,atirti.tMiPiaItMfIitrlamnlmalciiealWpNNplaiiltatmUwr tPfnMralairali*InmllIa4Mlam*IrUifIlNaaMlalalthtaalwfma*l#l,iC,a*rUIifala flUtaMplatllnla* alataptapww#afaalratw*af alalttln*ayaaN**llpMy**nN. *Craaf*plalaa** tMitMrPwaPaaMypaaaNtacwptttitaptpacrtnapaaaaltaaaaittank`patevwtirlNaPaaaiMtyaattai*ttinPayltiaa*aaatIMItriaIwilIaimptPaMaaaaraca*ea'leivttp*alptlapyaNJaalraaap*pa*IpatpptaatpraMaaaaliraa.areat*rNnatrptaatOr*lawaymfPaa*a)(ajclaaipnltlameaaPrwPmtraa.tifUlaa*p*lta*tltt*ayaaN*#taaCa4atIptttaaalaal*myPattrPaaPatl|Nwaa*)ataaaatiauNta**laya*i4.', paatacaaiaaic Nr win Nra raaiily fra* aaPaataa tHI*-*Kpaialaan|tati*MiptlUaPrtatlaMaiaMn*iataaaPaanaPit*afaattr*laralaatl.anp**aap*rtTwtaaPariaiataattpmaa.*f.la*(tUraam*O, apc4aa*aPpnay*c'rtlvItnHaatilaIawMp*.tplaaPanlti*tpttfiu W AMPfIa*aaainenIarNawaPriflfelaair ) 19. 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P(aacy*t* tParty lMaretauritlaaacaaaac*l*wtla*lfentPe aPt awaayltaarcaiai.atlflc *1aapa)'P1aapti1raauprent*aaiewrfkaaytyraa*trwa.iactaaltfaItaltia*iifaetnOrtetfPr*ac.l*awceNertrrvea*eaCtPneyelnfllmaiPeicaataPnfiII*tltNtcaawta**lamNffcataPiaaviwaaaleaaIirtreNkaaapaepwelnattnmaPluilatatyti W MMptaaaai ilntlKryvaattaparMai>c.4ae.caALtatrptitetiaala*riytPCitfa*reaaPtea*acfaaP-wrraiai*wr**rnKaaawtftatarpanJwtwiP*rai*liivcrta(aaNtvitaar.aNraPtiwtaaattfaa* pTraatcawawtaaiaiaar*iffaalaratiapafaapieflwr*PraapawatPaa ltpacaareatimaPr*ttly*laaaraaamwtai aw*t*aatlwaril.i * Pa*a *tPat will P* Prmflclal twmm tPa laiwatry *Mtetaraaa*va*lipltaat"tr.taiaaTiPaaiwImmr utaatcrcaaia)atytaaiitfwteywaawMt latcfar*aJ*papama*ayrt**l*ae IN rapart will Pa far tPa *penaftt af pat*.* 1 t t I 191% tfton, l.f,, ftiMitMli, at TwAsrewlast*. Nl. )l. pp. Il*)t IBIS 9*19 till e. MSS l?l im p|4 MK, f*tltoaa Ul* Bl MMr (lUl IIMI |ll UlMl UpMMI. Pvltaa. at tl. Aatottaala, Part It* Vltt Mttfl 4 AMtfdt af tort Cm*trH la ftilttwi rttrutUtf tlMti Part III. to Cffactt af tiHtvi* It tot S*raw*tv4 in itNitm fatrilatlat Mints to tto tolth ( a trawp at Mrttn, Ciwm1iI> al Paaa- fitttosr II, 1111.fltiAi*. to*rtM*t at Uto to Itoaatry* BarrlaBvrf* FtoM that siM lit) tsrmt af tto wartara Mtotl to an avarafs lft al fl*a allllaa psMititt par toil laat to aatoatasiai tostr tto ilMI paiaaaft aspasto at tto amstras aUltas parUcls lava! to imr*** IS7tI psrnn Mtotl at a fartp*faav UUm partlila la*al to# aatoataaia. fcaata. A.J. to V.l. nrCiaasil to 1.1. rstol, tllarta al tto latolatlaa al Aaatatat Pwat af tto ttoo.ftppa. li*Aisitasimiasutortora. Ptol. BaaltA Bap.* val. tttoy ravaslto ttmpttm lilt) al ttoaa stMlto Bal siffls al aatostaaia ilttoft to aa* 'm aarktl 4Saaaillty.* Ba rttstoMtl ttot towitry *ipsMr Pttoiaa aa tssw casaa af astoataala as toll aa ttosaa aa afltvta #1 aatoataaia aa tto toart." Mmi Ittir tocaas a eanawltaat ta jatoafia**ilJa. ftoiila tons* all tat ptoliaa *atil itifc ala attor waa atoataatlalip toplstN la 1IU.) S*acA, 8.B. to a.a. lattl, *Paltoaary Aatoataaia* AtoMcaa torssl al Caarar, iuv, p. M to* Aaetara at MHlrsl Cal lav* al ItsU Carallaa rtpartst aa isttfir aatoataa toraar to* M aatoataaia ato lav aaaaar. Brtator 9. Prato tJa*a-Ma*ll)) ta Sasatcr flapaaa (rtoat*aMaatottaa) r*i Aatottas topaslaa raptoat ta pwaliaa* *9 tsiti avraa all A pa* lAst wr iataraata % art tost itrto ay toviap aatottas ratal** ta* *imm af ptolltity ... f tMsi i ****14 torn tto ptolistora Ilf ttoy 4aei4a ta paaitaai ta as* Atorict* tats (frstto By taatal aa tto a*a>*t rattor ttoa tovllaA.* Btata #1 as* Tart toasts torsaaa'a eaapaasatiaa to* asvriaf aissss* al wamsiu Btotolly. J., tolaaasry Aatoatasiai |acl4aata ato Prattot Is. I. Jto. in., tol. It. pp. IIMII (1991) Pawto -rsy **J4*tot af astostaais la 19 al 191 ara*ra (ls.it). Ba atatto. *Ttot tto aarlaa* ItovstrUI tovsto af tala tjrps al *i Has aat prs>lawtly rtc***to anfficjsftt attratian la tocaaiav tors appsr*t. Tto M*u(srts* p( sttostas prtoucts Iim isrrtistl tors tfcsn fa*v*(a!4 la tto laat It p**ra, ato toa*a. tocaaaa al mi mi 1IM 19M th trtiur MN( mt Mtkin rtpMH, Ml tM wt |hi nc*f*Mii m tot**!****** MUtf f tlw ItltlUkV pnliMir nMItlM, Ua Nl)(rt mt MMIIMU IM MMH ftMUf Kiator II, Uur ( |Mr ait***1 to lr(*ri (CtMnl Iimiim mr Mut rUit prnviatf miiH iimi Mile to# It* Nrvici tttPntl **r*r *y, Imik'I M*t Mnyi M to i*<r tt ii iM 'mjfwr --s i* um tocawat / |*r tl Mil*. Mr* *1 toltf to tt M*a I'llfl ( *tl to HMI UM*t it ftttltf i Mftlt ( MMru ttoli H*Mk!y to totitr %m lt wrftl to it i #it mU to at* y f tM* vkttotf irMiint tok to IM mm to Ito toltyttr toito itiarimil to *M tolto*** '! M*if MM MMWftlM vitk tM iMitl / Mt>' *#* mmmmi aiMtn t*tr allfarttit# tl 1m mIu. MnaMf Ulktr tf fvutr liM*** (lifMilti* NikmimiiI it Mlftili ICtoni totottto to toMar l^ititol iMMtt mt toMil it t*rty toltrM* tt CMriatto*. Itotr iit#tat ytmu tortjrt. tot rtitrlcu tMlr m tt ptollc Mini ItUfMItM to jrto mm to itrtM IM fact tMt m to tot mm tot flat* to afcyttar Ittytti to twtm to to to ito avtjart ! nui (?, yM kttv, to M to# tttv|k MjMHttu (to tty /'Mtrhti to MM to tola tto* m fu to ttoy rtUy cu. %~s mto>.tortMtr 19. Umr tl Itawtr Umm* to IttaUer, htitltti #f TtortMl itMtr rtttrllM pr*toati Ito ItrtMi tiMNMMi citti to## Iw Itu it %to ettn totot t Mtftkt ttoir ftoltito. Cltt to#t 111.*#! tor yttr fatarallr to*# Ito to **#ttry. I Cancan Mit ttoBtttortltlrtHitiMtrtiriNM|fm.iI.m tl Mtottot |t tf tot Ito* It tMt it Mil# to tfto# tkiM to #latntott tto itltrMtitt t--M to Mlictl frattrtitr. totot#tf it it ml tot riyiit trto it# (toll tot 1)UI MT tMMMfl.* toviti to#ti*t *1 totfMMiu*. tortott*** JtoiM.NltMmt, Bttttor tt# MtlilM, Attotttt HlMltM iritf* TMIMl u# totMil MtvfMtwrlto* W t.m. torr tl, totttr tf trMM Mthti-MMlUti to |.t. toriMf rvyiNuif utti tf ifrMtiMi it It mt fvrtMr vft#trattn#it tMt tM rttwltt attaint# will to **ftti#t't# tM yrtH'iy tf to Mt art mmucim to# rtfvi'H f*Mt, Mt tin IturtiM Mtthti, It tMt ttttftt Ml it Ml MMtr lity Mlil to Mtr MUie. tt tM ttt it It #ttto# liiiMbii tttt tM rmlii to Ml* tht MiMierifi tf ytwr ttwlyr will to uMittH to m far atyttnl ptimr to ptoUcttito,* I. I l to. |/ tom* w ttoommr L.l. br#Mr, littMf uirwlM ft* Crai< af *,*. if**'* trUUiM af C*rtr'i Mttf ttearit*. IwffllU tfMHi'f Mf MM i tea* lihMUfl iMUM ifMM MimM It i SiCMtifi m*iMki mu a. tiiiMtf t. MrMuti* // MDMiuK. tm jMtriiM imr eMn, AMMttMlf CMHMItlM cut* ( f|Mt MAtr* UlMMt *t II4M.M la mi a. i*n UfaMnnaerry t, Letter af Ufftrli fCtnareJ mMiim M " IPMnaMtar tIviliM) I* iMMf fiMM* (MfMitM* 4 CmtMMaMn* Mitial rtftfliM receipt *1 M. InU'i erticle. *mhi Mticil terae t* ertlrle. le palnp ! Placate t*c ertlrle vltt if. MimiIi Lynch. 2'eceirie# tne ereelereuan mt erticlee in literttere atmeteat iiMhm Mlct Le ear* * *Mt uM U eel** /,M^t*e pretie*, il it At e preplan.* /3 */ 14, Letter fra* Jafferte fCentral tetter*# a*P >ter MvUimI t* tenner lin*#an IMrHftee* Mental teal enrJeaiap * repart fra* tr. liytn eatltAaP *1 ftePy tf Pert Centra! Ntttaa* 1* a* Aimmm Petriretlnp fleet* Mtet *imn t* tatllat, PafferPe 1# aritcli!* the repart. Belare ta aeparinent *f ftitOM aff renewal faa m4 laereeeiap Mi ee*t t* fifty *illien pertlrle# per even fact. PafferC# le feerfvl ttet plaintiff# nay aale* apa* tail e* eaiPenae *f prlar aeplipeeee, // 1 im *#f envrea, fee. a* eel! ae attar, vta are ca*P#te*t ta Juppe. In* ttet aathiep vee knave af ttc aeaectac Peat Mitrti, A* ttla y aavntry. prlar a* mi...' flapem IMrtl/ ieptenaar N. latter af r#w (Pa*ea*ie*eille ta r tiertee tkryteetafMeaaatieej. Caneernep ever early l*rM Latatetary rapavt ttat ana ln)eetlan af anaaetaa eaaeaP tta ln*ePlata Paatk af en aniaal. teta af Peaaariaeaia anartr Mart***** Caapaaaatlaa lev ra*rin* ftmia af aepeataala /& 1J /e ! > CanpenaeUaa <v paverinf derate af uaeateeie /*fCali e. teyaeetafnenhette*. Vta AnarIren taraty ~ rC--aepany, Tta tertfari aaciPani Infawar Capuy, Tta Travtlare leenrance Cenpany. Ceaneatical Aeteeteen enapefteetla* alaia af plant warken eitlenent af U.IPP Aa 111) v/sflfeat f. t#rkaeiee*Menkattea, Tta Mart Iran tartly Cenpeny. Tta Ranter# kenPtnt i Ineanatiy Canpeay, Tta Traatlar* Jneuranca Caapaey. Cammirtl liMitnii ranpan#atiae rial* af plant warier: eertjeneat af I4.eee.p0 In IPJt. ty latter PateP feptenper 1. ll)f. af Pr. fall k. Citee*. fwprnn* teePeet m4 aaciral Plraetar. UMlerclifft feneierim. Ull /f. U> /?. UM 20. M 2/. 1 irtlit, HmwiIi !< apaa un*f| r iInih* yun aafctttaa vaatar, Mill af yatiwti, iMrMtit if lydftm Mrf lurNNpli lay HaaiMtiM uutt iaui *aat It. till, tf ftr. R.l. Mtill, tHWfttltfl. Villi IM Milan faiwii la aafcattaa ( aaat yarlat M taaaiy yaan aa| in (M pitatact af mini atyailva via ... If aaii^ a l^faaaii at MUutal yalaanarf aalaiiMia liar aiviMHI. Imata. i.R. allavalta. i.l. Blurti. i.l- Millar aai I.R. taytra. a liaff at *taaataala la II* MMtlM Taatlla latvatry. MUi Paalta lallaiU, aa. Ill, mi Mata a urawaMai aiaaiaii tot aaairalllaf aapaatra M ailaaua tail M Cl*a ailUaa yaniilaa par aaMr bai Mraalt, irtfev J. aa# tana v. Karr. 'Naaamiaaia aa# Pvlaaaary Catciaana** iaarlcaa Javraai al atkalaff. mil. p. 41 arart af garaaar UKaratary IrtlatlaaaJUp af "ctara aa# laiaiu; aaa#iaalaaa#l taalay K*#tlatli a. KayfcaatafNaaNattaa. rat ImiIcm artty Caapaay, Sattfar# lailtaai a laiawity Caapaay. Cuairilm AaKtataala aaf*Miiaa alaia af plaat tacMri tuamt ia m ai ii.taa.aa fca#ra* M*a t. KayKaaiaa*Maaaattaa. TKa Traaaltra " la t Caapaay, Kartiaft Mtlitat a la#aaa*ty C*m*I aa# TIN Aatrltaa Partly Ctaptay MKtataaia raapaaaatlaa alaia af plaat aarfcan ttlaaaat la ml af II.MI.M laartiMid a. laytmai-RMimM. Kanfar# ftnlltai 4 Ia#Malty Cwyiy. fftt Marlcu tartly f|uy, Caataatiral taitaaatiaa alaia af plaat Mtiui HtUtMM la fttai af IIM.M % Marc* >1. Uttar af tMr tlapaaa riiyMMM* Naaaattaat ta >*tt*t Mayatlaa ra Oraataa artiala "1 (MM Mta pat tMravp* vita avr tavaaaa invittfittM, vt till ! ta*t (Mi aaatr la aaat&irraaiy #lttant4 tltHawpa Ka Matt ay at latt Uit vfcart Ut tit aaa ta aaat #ava ta livt a*11la* turvi tvraayl tatrt it aa aaaytr, a*4 1 (til yat cvaf*#tatally, at I aa aat illif ta ai it pvaitc. tan (M ait cat at itfi at law (tv* *Ua* atcraat aitto prapar aattrala, aat X a* tat vtllitf la lart a caatramay vita ay eaapatltara.* Kay* fca M Mm*MmU1i will iMri 4vat cattral atcrttt vt* ea*ttttur *wttt tat tiat la rlyat." Saya at Uti tat plana ttirfiti My Krttatai *h%4 aa atarly aa I cat flM awt taay u*a aa 4tat caatral at all (Mat aaawata ta aaytMlay.* J2- in 2. 3 * i/! ItorH t). UUtr *f IiNiIH NMltM * IffMI IMfIM r*l ItfiMf'# ^UAlMry *tM f CMtii. (fcil ftll Ml III* ft* Mbtltll ll tl fet l|t mllllMill Mi Ukit ftftilUftf *tol4 to pftUftto# iMul mMiim i* liMitii h|i1m prmn Xtar , Iftur if IftMtr liifiM U Irtaft (Mw lr tanlthl. fflap*** (Mrtoitfti-Nftfctott**) lynti Uwt SiriMf Ml vtiUMi (Mir Mximmi. a-/ till W mi Xiit a 7 in? 4M( ttaf mli cjvm m m Utafcl* Mi ttar M )ttl in* MM*1M Milk mii to wy Mtornlto>* Utur # AiMmi tafiito to Iftvwr itom . tMykmM'taitatual i to Mm vrittM yw toy ttol r*r pvtllitelftf ft IIMMM 'llNfl yw Mm IMt ill ttrtlii Mvitai rillMi. to ptoliifc MIMaf, Ml MtariUyi ftoff vtlMl Mvt toftft mymii.* tolllllr, 4 liMlfliM If I* (llktllMllI llMf IM riyii Uni ftftwU nr** u rtotoc mm f tto mMr Mliilriiu yulUiUy fie** to it la ivmt mvihmii*' tetter # itotr ItoyiM ItarNitiftatoUMl to to ftolltottotoft (MMfMMiiU) (fti MMlIN MflliM fftfwftftt *Stottotoiftrfe#tt#otolatianMil toftn Mtofttoft to* MMitii toft *kM wry Imai iMM aat vayriauif tto taplii* miclti/* Ctftto if Wftfthiftftaa inch MrkMt'a CHmnmUm to imriif iiitiM if ftitofttoftia luti if taryliai itacti tartoa'i flaaiMitiM MMilay liMiM # uMitMii iftto tot4 V. MyMitii'taaMttM, Tto toftriftM Parity eftay. icrtliri mi^Imi i IMmity aaft .Trmlin imitmu CMMiy, CMMttint UMitMii ftftftftanifttiftii cilia a# plaiat Mtiiri pftttifttoat a# it**.*# it mi Mirf liiliy (wlftto # ftiptoa Viilty) ft. MyMitif taatattia, Tto Tritolcri lainriNi Ctoftiay, tariitrl tocaftftftt I IMrwity Cftapany, Tto ImUcm limy , Cftfttofttiftftt rftpnftfttlftft till* # pitot tort>r> ^It.tmlMltoftt ft# mi.M is 11)1 prmitokt rTftrftt ft. MrMitit'taMtUM, Tto rrmlm iftiwraiiri (aiyiiy, Ririfirl imiiat l taliMUy CMMafi Tto MtftIM Iftlty t-- iiMiuiii iMpiaMtiM clilft # yiiat nrkin* (.tll.ani ( Il.tM.M U 1111 v u SO 3/ * 32 > 33 3? mi ^ mi 37 > |ai Nf| ft. WytoMM*MUUM, Itllfltl iMilMl CMuwcilni Mhmijii Vn ftmliti Ihiiim* CM>my AlltltNlI MftAlltiM lUla t( |1M WlMl titilMtit it l>,Mft.M ft* lilt teftjMlft lute V. IlfltlUfMlMtltlM, iHttMl tetlMftt * teiMitf C--f *y, fte MMllM NHtf e-MCllMt * tetftfttfttlft IWHMItlM lUll if |lMt <WlM| ` lllMM *1 U.IM.ftft u lilt it niMr ft. iiriMWfMitMttM. iMitiri CMMtlUltlititei I tm CtHMii Tm terliM limy tetellllNil Cllll If flWt WIIWI itlMIt If II.NI.N U lilt ^ f*MtMtrlWtiMlVi ITllCtieiMytlIeIKftiy,U, fMtuyrW$ttwllulHiy>MCMatiaMllffoUttMr*f.tCtItMUetMMTCRytltlym**lui Mtotnila muimlw iliti if ylut wfUn ^mlmM if IMtl.N U lilt tetfi ti**4ir . k*rii(N*iiMKUM Tin Vimlii Immmii Cnfiiy, tenter! * fnOMUy TM iMtUM Iwity Cn|*M CtMtiilm MMltMU IWItMItlM Clll* If |lMt nrMfl ^Itt>lHlllMUMMM If tIIUN.il || lilt tete Mill ft. ihtykMiM*HMMitM. TM nmlm Jr Immmiiiimmi Cmnn*m* urtfMl teciteM ft liNMtty tefMy, T* amium lamy Cter< NMmim ftHtituli HMtMitiM cUte if yliM wrkin NulmM if ftl.Mtft.il la 11)1 l*ttr Mite laly 1. Iftftft fr Dr. Clift I. Cite**, teterclifte UMtattei tUteft tel te Maury (iMruaa yaar* a* aaMatia maw) fttattftftftft IMiteUiy if NlM*ary aaMiuali. Dr. CUm * aa dataa tte ukmiiU ateitiM fayi**** tea Uni ft* IMftVtft (m aftrlllf MlfNMKti Cteflft* ttfttftft ft. layftate*ftitetui* tte terlm tetftty CftMaay. CwwftftUf* . . aaaliM W1* if ftlttl wrliri ttlaam it tlftft.M ft* 11)1 Mat tetftt* ft. ftaykaUfMaMtua, TM urifirl tecxteM a tMauay Ca>i*l TM wiiim Iwny Ctany. CawarUM tetefttftali aaiHMatte tlala *f fteaft awMn ` ttlawai t DM.N ft* 1*1* laatM T. Star* . ftayMttM'MaMtua, TM tertfftt! tecateat a laamity Cftftya")* TM Marie** Iwaty Caaa*r< eMMtaum ftaMauala cmaaaaUia date if ylaat weftart NtUaaaai *f IftftO.ftft a* llll Uuai lital Uyuftar 1ft. 1*3*. tm *r. tea) T. taMMli lri4faaaa< Ct., ftUua liicaiaianaa *1 Ut ate tiaffttteUft Nifttau qaaaala mmmmm ft* i.. i. /* 31 **" Jf *" yo un y/ t> i* y3 yy I... ys * wkiri *> IM IllitM *H By IN I m urail *tlaa liMiM* pwi 9* If HUlrt W K. litNil V. ft>rtnM*WMttM, TM wwi* Cfnay, iMifiH mum CWfMy, m AMritu ftaraty CMH*r* CMNtunl I (m ) .la ! Ktak, MBfklfI Umat af U.ftM.M U m . *. Mi ftfiM . |irNUM>%aMttM, TM AMVlNft lriy CMar> CMMUUwt ftMitHil MNamiN Ut mt ftlaftt NTlWi tintM f u.Mi.M u me %upft lika . liffttMti'Niaftitua, tfw TrmUn laituat* CMyi ftaritftrt MiltM ft IMianity JCm yay, Tft* ftwritaa CNy< CftMtctliiK ftiNiiHii ttaU mt ylaat rUii MAlawftt at I4II.M 1ft UJt viDUa Pv*f0 a. aijkiitaHMaaMltia. TM Traatlftfft |arie Cm+smy, TM UrtMi amMt ft laftiftaity C-->*ay TM NtriCM Itfttf C--ftaay. CMMftlmt MkMtiiii wHMitlaa cliia mt ftlMi mkftn tliwat mt I1.IH.N im rni taawary M. Utur mt ftr. ftlfiM laraftim %m Inmi lain* (ftarNiiN'Ntftatual rayifilH Ui iMly4 ! CarlMt'i rcfuri lira Irniin Italy It yraaf Aft Inm lmutaty ( tM *ftmil it tM ari aa| tfta a| niilta a( tM iffMt.* Oafttat IrMiiia fintliU Uut viJm lUtmatt laraklit rtewHalii btiaailr fn tM yraftlaa mt Ml natfil Mrt iiMitM ia Maftf afH' aaatlaai ta ftreftli yanliUa a, kirMtiat'MKMttu. TM trmlari tiaMuriMt Caaiwy. Bart fart Mnltat ft lalmity CMa**y Ml TM kairicM tartly CftftM| Ciaanilnt MMttfttla cmhmiiIm rlftla ( ylaat aarftafj IftttlMiat mt II.IIMI 4* llll BtMftitiftft ftf Dr. Ciftaaa, (Mar*tiff* laaitarlw. acataa tftac IM (ray aiMttai af JkrrMa Ncilaila itill atlirm MittitltUl fiiraiU iM i^|taaa talny Vftwf1*4 vitft tM acrvftatiaaal ftiitary mt ftartita yvari aa atftattat waavar waaitlkii vitft ft ipliriM Imiii ftf fiMtiri fiftraait vftaeft it yftftaftly tm yalacaary aaftaalftaia c Cracca a. ftirMitM'PUMaltii, TM Triailtri iMunaei eayay, Bartlrft ictiltM ft IMraaity CMyMy, TM ftwiiraa laiit* (aaam. CMawiirtl iiMitftiii caaMiiitlai data af plant wrkari IjftJmai ftf U.IIMI ift tt ftanjaala Craaki a. hyMiitfPUMaiUa. TM TriMli laawraaca eaatiay, ftartfatft itciitat ft iMtaaity Crraiy, TM Miritii taraiy Cftayaay. Canaamtat ftaftaataaJa ceafwtatlaa cUia mt yjaat varfcan taltlaaaat ftf IJ.lftft.tf ftft Itll i ! i*" **U ^7 1*41 1*41 *S 1*41 1941 luiait >. tetitf fr irm rat nvU *1 tNk, tef* H S*ya MRfWfiUl Mt lTfcilHtoMlUi MU kittt. Mi r(m w NMitlvltf ( 9ai * IMaatiy t*oto lU af MktHM M4 toMilUiUy *1 to ti'feMa 11% Ntllto Uta Iltlkaii toui to toto tton4 (rw tlaa ft* itt* toy MM Mill* ! tea totoiuy.' Itiu af toiiMfi iMfii torltt, i rlH ftiiuN af wtotMli nmlto Um M^ir Critill v. ftaytoitiHitototltoi tartly C-piny. Ci--icUtot -Altoiml* CUift If 1UM NfUll ktllN**t af IMII.N to 1*41 Hallato. *.*. ito ft. toflctt. *lrw<totli CiiiImm la 4iKUUto alift Nl*Mry Utotwili,' toariua iwrMi af NtwitoT* wm, m topMt ( Ih tmi af ukutNli Ml ltof Itftot la MtoiiM ItoUiuri toMtoii torwtitoiitl T*n Ml Mll4 Hmhh. Uiu MtoiiM a Nrnr* cm* tcyam* ul *!! fat hi to a NtoUMti yrtiwt tontoir >* latut tm tortoiiwftMfcattM ft* 1mm Mvim Uu ( mmIiii imm law aait toy -- will valla trtatiny to*raidaa a ftMtii ntoito toa la Halito arrays ft* tor. toaataryraaai at ctola data My alto a* la ttoa Ctom, I m vfltiay yaw fid tM toapa* ttoac yaw aay toa afela u ntott at ttot uiiitiM* Mick Mt ton aa iavtlaatola ft* aa la ttoa toaat.* iwyit. toallatia fa ttoa tear, tac^ty Car ttoa Caairal al Cut*, *alaa 11, aa. 1 11*41) Ba lum at to*** * *ltoiMi*t caaetra* ara la yaavral aat toarticalarly itoitw ta toil ttoa tcmrtuM af aeewMtiaaal caarara iaaa| ttoair aavlayata ac al aviramafttat caaaart MMf ttoa canawMra af ttoalc prMwcta aatoa a aattar af yw*lc ttcari*. facto ywtoUclty aiytot rtflaet n%faaraaiy ya* ttoair towamaaa aatlvitica iM allift ttoa* ta a*4it*tt aatt*i*t aa* t***al*t tactoalcal aa* iMiurr ctoaayaa la ttoair yratnttla* aattoaa* mi la ttoa tyya* af yrNwcti aaificuril. Ttoara ta. Mtiavit, ttoa linnet H'lilUtr af toacaaiay iawatva* la catMMiU4i awita viik aatravayant financial claiaa toy tea lafwiatf yartiaa. l ^ r. ito MO till uo U) ftftO 1941 194ft 1944 Y7 ~0 ** it It, ttmfm, ati 1WtU( IM MM irlHWI ! flM C u fttrto* IImmoUt It iwcii Mtttrt m fttcp itltmtilM h UM KWriMI l U4MUU1 Mf Mil Itit* mt ftrffM imcu iMtoM'i C--fi til-- It* Mttitft Hit liMMI MMIU4U * |UU If IMCtl MtaMal eiflMIllM U* *404*1*9 (It 9144044 *t4*4lMl4 |(4U,f NiftNMU IKMtl MkM,4 fWpIMlUll It* MURf (M IlMIM IMIM14 ft(4t tf Mdl((U IMCtl D*rkMR,l CMftM44li*4 |m 4400*1*9 IM 41mM iiNIImI* '1Iteu mt (rlM mmii NtrkMt OmhmmIm It* MV4(iHf 1*4 IlHtN UMlWlll luu 4l VlrfUU MMII tWkMI,l It* MMflM 44* IlMIM MMltMlI ' N* Nllttl IMMI MMlMl'l I flM tit 4144*44 4M4MNII 4 4144444 4 44 4luu mt Cmlmrm4rn mmii VirkMt'i Om^iUm It* mU Uw IMI I I 41W ). a, 9 (19441fl4lMUr Ml 4*14444, ft, 4l lui. in, 444 (MlnlM*. 4 40*147 44444l|i(Mi lt|ll (iMllf tltfH mt 4 4 4 47**4 9 144*1s t*ii* I* ** Ml fMclwNi tro t (44 44 114 1*4 4 4 *14ItiarlMI ** ( **M l tl 04 4UivliUn tuft M)trltf mt mmm nm| l Mi U* i Mu flft*44 fOM4 UpMUl.l r owimtoft** II, totUf Cr*4 Cllkl (ft*411444*, 941*4 ff*rin*tl4l (t MtrMc* OiyMttiMi>ltiiti> C*4fUl44 utt ri44l *4ft4Tt *4# 44* *444 fUillli. 4(4*4 *4 14*4*1* r4f4MI IMt 1444 t*44 llV4 *iCtM 14 iMtCMIl 44ft 4*ftB (Ml *44*14* iW| f9*44(4* 044 f|44 4it*444| C44 *4 IMirtllti If M*fn( NMU4I4M *910 1*4 44 t4 (rt* 4414*114*49, 411*041 l4)Cli44 4f ft44il*Ultl44 #1 I C4444f. 414> 4*4., 04 Molt *404 44441*149 *4(14114 M M*1*0*11 tm 44441t 1*4 Cl44 mt 1*444 44441** 94414*4* 0*444 1441144*7 14 44*4*149 fcf IM 944114. *4 Cot 14 (OCl 1*41 lU IMt oo4t 14 Oli to** mt 04 *4*4*1 44* *04 !)( l4t 1*4 *441 4f II (44ft4*i4C414l 94 *7 04 *44*9.* II, t4!4r 1*44 9*004 (JMI*MIVU|4 Miii *441.) 14 UMiul (ftrto4K UMriUry) Mil VfcltM* 1441441 4l44 440It C44f)u (rlWf, !I tn a c r.n ia t'l'M i- i:) STATE OF CONNECTICUT) ) SS. Bridgeport COUNTY OF FAIRFIELD ) CERTIFICATION THIS IS TO CERTLFY.that the attached is a true.and accurate copy of the Agreement to Compromise, Petition to Compromise and Order, X-ray resort of Or. Parmelee, Bacteriological Report of Or. Peters, Results of Bacteriological Test and transcript of Dr. Gibson from the records of the Office of Workmen's Cgjnpensaticn Commission, State of Connecticut, Fourth District, in the case of: Michael Ambrozuwich vs . Raybestos Company, now Raybestos-Mannattan, Inc. and The Hartford Accident and Indemnity Co.; Tne American Surety Company of New York; and Tr.e Employers' Liability Assurance Corp. C : / e n under nand anti seal this \ J.0l!!:"A. ARCUDI, Workmen's Compensation Commissioner ^Fourth District kiceau iisaozmcs(~ iTieti S Stratford, Ccssl-T claihast T3 XAT3T3T03 COIT?AST sot v- &i.23ssTS3>iuiisArrjur, etc EtPiOTSS * T' eoKASiTtr*. .'eir f.:. * *rj- CQGT53ATIC3 eOWISSICnS . \ f * . 9'- * * m* pomes cosojwsicFJi dst. ASD - tss co.sasspoio Accmrr? asd nDnatirr SWIT5B AUESrCAS STOTT COMPACT 0? TORS TSS ZSFWTZM' LIASHITT A330XASCT CORP. XSSTOR3*HS3 PORDT RT3 -O*arcs ;-i94o ASRVjA-.Vr TO CQgTROMTST. PTfTTIOR TO CCMPEOKBT AHD tssber of 7ears prior thereto, tho olelsast, Rleheel lobroxeTlefa, of Stratford, Coaseotiewt.Tas aa asployo of the Sayteatoe CoBpaa7, sow Raybestos-Sasbattaa, Is*., of Bridgeport, Concoct!sot, tad fSSHRAStha said oaployr aad ospleyar bad aeeeptedasd Terr at all tisae mentioned hereis subject to Part B of tba TerJoes'a CaspaaaatloB lot-of tba -State of Connecticuti aa asaadad, aad tba employer bad lsasrrd tta liability tbaraaadar for rariouj period* dsrlsg afalah tba ad elaisaat to* employed eith - Tba Sartf erd Aeeldent and Indemity Cespasy, Tba -tearless Surety Company of Saar Torie asd Tie feplayer*' Liability Aaroranee 'Corporation, oil of ~ ablei (add ocapasieo azlat asd do buaiaesa' der tba laee 'of -tbii ' * Stata osd in daly authoriied to tain aeb Plain Is tbla State, asd - ' -teESAS tba elaisaat elalsm that ea er aboat tba 1st day of Deeesber 1933 he laffarod as ooespatlocal ilsocao, to alt! Aabaatoala, aad-fartbor elalsa that (aid occupational disease areas eat of asd Is tba courts of bis emplcysant eitb tba employer} asd fsrtbar ' slalss that said dlaaasa Is oospaasablsi 'asd farther 'alalaa that'" ha has toon disabled Irea all -cork flsea said December 1,' 1933} ` asd fa-ihar elalss that ba Till be disabled Is the future, all of - wblab sold olalsa each asd all of said Toapoadoeta dS7, 'asd ' , ft'.'wou a -partial hearing of said dials baa been bold bafsre tbs Scspocsatiea Cosslaalcsap of aald Pourth Congressional li-itriit aa Till sore filly >;;ie Is tba files of laid office, asd - WHSSEA3 SSX SIS Xieha*1 Astros awish. taa a *tS, feaaphia#, As La o potential dcpanlist, aad .'' '.*. - ' - ' THEISMS A* uU alaisant iu repreeeaiad' at tha afortsaid- haarias' ^ boy rapraaaatad by aeesaal/ and ' ' - mstU it la tka da*Ira of tha alainert aad th* respondent* ts raaeh 12 eieable adjuafcsant of th* abOT* dlspnted to tha aad that ftirthar litigation ha aroidad aad doobtful aad dis puted el tins ha rasdarad certain* BXS B SO CHHTZ7T that Z* tha elainant, bars a^aad to rooadva freni th* Hartford Accident and Zsderaity Cospasy $83.86 Th* isarisaa Surety Ccnpanj of Her Tori $730.88 Tha Zapler*TM' Liability Aaruranca Cor;, $88.86 H-t a total run of ZXOBX B03I)RS3 ?X?7I A30 XO/lOO - - DOXUJtt muaad tha insurer respondents ds iprat to pay to tha olalaaat th* ta ahera specified. to viti Tha Hartford Aeeidast aad Zadtesity C^pasy Tha Aaerleaa Surety Cngjaar of Her 7orfc $33.86 $730*88 , 5h* Thpleyoror Liability Aasuraaoe Cor;. $68*86 la fall aeacrd aad latlafaction of ahera disputed eZalso*- CrnXSUiAXS SO iWatasH that la aoaaidarmtlsa of said *o to paid. I, th* elalaant > harab7 roads a* ralaaaa aad fererer dis charge tha aoplopar aad all tha lasarar raapesdaata fhon all elaisn for easpensatioa hoaaflta afaathar far compensation in ay Torn ;*7-- abl* ts aa radar said Act,far surgicalRadical or hospital banafita payable oa *7 behalf aad ahathar amid elains hare alraad7 ariaaa or haraaftar ~jht srisa b7 raaaea of aforesaid slain for oecn;a- tional diaaaaa* Z,lira TO Jt3S2JSS CSCZ77 that fcsapb^nbroraaieb, Tifa of aforesaid claimant. Kiehaal Ambrcserieh, ds ipaa that in oonaidar- atics of said sras so paid ts rasisa, rtlaaoa and foreTer dlsebarsa aaeh ted til th* abort aasad raapoadacts iron any aad all slalsa rbish I sight haraaftar hara against te7 sad all of than by ratsca of tha allsgad incurring of an occupational diaaaaa by tha said, Hisbaal Ashrcosrish, rhila in tha anplty sf th* aaii anpleyer- reepoudeut, -2- iSE T9. yudtsss. cSStTT thii > tba aladaaat eed tha ru* poodact* ratals ska trlttan *sramact to tka CsEpanaotlsa Cossdaaioaar of U< Poortk Cs^***iBaI Btatriei asd raapatfull7 oak that laid xgraacast 007 to approTod with tha foraa of a Ton aad flsoi rnri. Zs olt&aaa tfearoef *a barooato a at ear hamda tka dap asd data firit xbora orittao* fltsaaiiit -&3TV 4-6^-------- /' ^iotaesixi blxisoss"- alfa iss jnazcjt* soaeTT coapiar cf rar tosi ss zs?xz?33* UiSTUrr xsssajura soa?. Brt Xpprorad / 4*7 of Barth, 1P43. CoBstpaassaaattlisma C.ststaallaralsainiaar 7eurtk Caapaaaiooxl Slatrlet Sartfriolcgiral lahnralorjj DETARTME.YT Or HEALTH liMwol. fiw. JW 19 S3- Bortnr nfc.tll Tit_____atnifrjn -- tf/ia/sa (a b* OOBlMd far Ika --<* ?a<*iT jabaittad by yaa is'--i;-Ti- *g<** - *iawad 'O i cvtJLk..-  CO1-1 3- 0I3S0*f. (Swore by Coe-tiar loner) Kozaes it as. HeaosAM: 4 Hour full ease, doeterf A Cola a. Olbaoa. 4 Z*^ addreaef A Herlden, Connecticut. 4 Tou in connected with thin aacatorlur? a Superintendent tad -radical director of Onderellffe Sanatoriirs. (4u*llfletlooe of doctor admitted] 4 Sector, did you eake a phyale*l esrelnatlon of oae Ziehael Aataroarrlch? A Tee, air. 1 Thia exw-siaetion wee aade when? A fatr-jarj a, 1539, and aubaequent one so July 31, 1939. 4 Till you report oa your fIndiaga of thia exaelaation? A Za the aa"w enaar aa proTloualyr 0. Tea. A He vs'agod AA, son la y.uaota oad c-uw to Salted Sts tea la i913> Ba ecrted flret la a eutway la Hcv Zork aa a laborer far four yeara; thee far Johre-- Sasrllla Cespaay, roofing paper daporineat, for lj yee.ro; . he o~*e to Brldge-ort la 1933 and m a g-ocary bualaaaa until 1939. Soring thia period, of 9 yeara he alto did tope factory work, eas free 193d he worked about 3j yedre for Columbia Sraphaphone Coepaay aa a prwaeaan. he began work farSaybeetoe Co-peay July 1, 1939, rwieiaiag there fora fee eootha, and he wsa laid off beeruae of leek of work. Ha weat to Crtne Coic*o; for 6 ooatha, working at trucking. In say 1931 ha begra working etedily at the Haybaatoa Co. -J !a aad raaalaad thar* antIX Daeauoar 23, 1938, than b* aaa laid off baeauaa of bo aork. Bla foot Hlaaao: St had a tonalllaetoiy la 195*; otharolaa ha baa alia7* ' haws **1X. Tho ranioo for tha toaalilaetony aao that ahaa ha had eelda ha u*ull7 had aavar* aora throat. Sla pranat Ulaaaa, ha a*ld ha sotiead that orar a porlod of about too 7*r* prior to 1933 ha had gradual d'aalopoaDt of ahortaaaa of Sraath. la tha fall of 1938 ha darolopad ragua p*laa la hi* *s'.trior eh*at, oora trrkad dyipsaa on eliohlag atalro aaaoelatad olth ina ooralag cough hut oo *sp-etor*tlon. Shan thaaa aysptona daral- opad ha daeldad to eoaault a phyalelaa ahleh ha did la SoTanhar-1938. Ba aaa z-rajad at that tlaa hr Sr. ?ori*l* Slae* ha aaa l*ld off la 1933 .i* faala ao-aaohat l*?riind; ehact atllX faala ha*ry; It la difficult far hlo to tke a long sra-th; and ha ha^ vague dull pa la la hia aatariar eternal raglaa. Ba cave that h* alaapa poorly and hla appatlta la eaprleloua. ca phyaleal azrniaatloo, hla i ordlaary aalght la 183; praaeat 136. Bla gasartl appear- tnc* la good; la aonahvat a*llo; ha doaa act po**r 1X1; ha la wall developed and aourlahad; ayaa and tin .*ra saga-, tiro, *5iro*t-oodar*taly ensgaatad; alight peat a*al drip. r**th-uppr and lover plat*. Adenitis negative. ' Chaat. *#11 davalopad ad vail-oacladj ao flattening of supraclavicular poea; so avidane* of #nphy*#<ra. Breath counda ara clear *ae*pt la astr**"* left baaa *Bra a faa ' fin# eracklaa *rt htard ehieh clasr al'oa*. eoeplotaly after cough. Heart - fa lot roughening and prolongation or breath aound la 5 th lstareoatal apace; so daflalta mnur, euaeular po-lity fair; rata 73 alttlagr 80 atendlag. Blood pro#aura 136/86. Abdonen negative. riscere aot clubbed. Co saving aroatd tho taa daoa aot appear to bo particularly iyepnele; ha eertalalp la aot acutely 111. The eputm revealed oee#lanl goldao globule* jut ao daflalta aabeataa todies. X-ry of tho ehest os gotou^rySS, 1939. revewla a floe locr**ao la dene itj of the Sronchoreecjl.tr wrklaga la the lanorasd riddle rone* Is the loner portion* of both luag fields, dare la very flaa beading of the truncal *hadowe la tho elddl# aooea. The upper portions of both, losg fields are entirely within oorvel Unite, loth hila are aoneetrt lncre-eed. Is ilza sdaro ragged. There la n aril eelelfle deposit at the eater lor level of the Ath rib os the loft, apparently fro-r a *th rib foreor tuberculoids Infection. 3 heart abedoe la allghtly enl-rsed to tho left, the left ventrielr apperri&g aoeeebst flabby. Both diaphrngna are curv ed asd free. Be rr Ida nee of reel at exudatlro laalsa. Suv-ary: Thla -an eovplalna of gradual davelopnent of ahortaaaa of breath over a porlsd of a coupla of year* aad taro recently vague pain la the eatarler cheat, ho haa node rata voralag eough with ao aatpoetaratlos.- So ha*  history efbaelog hseo rspleyad ms ta asoastas eeaeer far a period of aOast 7 I`r - s-raya reeaal Tory sodarate lacrenae la denslipaf tha truncal markings la a Halted portloo of the lung field which appears ta bo due ta laterstltlol flbretle e'tange af olid degree. On the baa la ef this history aad the findings I felt I bad ta assume the preaeoee ef a olid de^ee ef pulmonary ssbssteala. Zt la unlikely that oar aerlous degree of disa bility exiata as a result af tbase rather teep-e findings. It seats oldest cart* In that reaeeal free the ataosphere ef exposure ta aabestas dust sill be falloeed la six ta alas tooths by aa abatement ef sysptons aad that there elll be no further pregreaaioa ef ths olid flbrotls ehaages described. ?jr seems little likelihood that this taa elll rrer becs-ie completely disabled eith pulaooary asbes tos la if he dose net return ta the occupation af aabestas eearrlag. St ess reexamined oa July 31. 1939, and ^t that tine ta reported feeling hat little betier aad that far the past 4 or 5 peeks he has had a heaviness la hi* aaterlar eheet eith act* saeeclated Tagus pals. He rsnort*d cough la the -ornlng at ehleh time ha expeetormtea moderntsly, ead this axpeetarstloa la luapp. Shertaass ef breath has bass about the ease except far the pest 3 or 4 seeks this has bees slightly ecrea particularly during . the time shao atmospheric eondiilooi sere bad. Es sleepa poorly, mu fairly well. Ha itlUbti difficulty la takiag a long hreth and this um to U t pradonlaaat - symptom. Ha hsseeeaaloaal distress la hla aplgastrlum aftar me* la. Ba b*a ao ga, acid, or belching. Oo phy lel esnmlaatlen, hie general appearance la unehengad; ba deaa sat appear particularly 111 or lacapacltated. He baa no obeleue dyepoee when alttlng quietly oar deaa aay noteworthy erldance of dyapaaa appear after coughing or mooing around moderately. Sa la te-mth.it aalloa, e-tooth akla; baa sa blulah dlaealarmtlaa. Freeent weight la 1ST aa compared altb 156 oa February S6, 1939* Bleed preseure SB la UB/Tb aa eoiparad altb 126/86 on Fabraerj/1939. Syee and ooaa ara nagstie*. throat la slightly eiroeieally congee ted. art- {spacelea approximately eqn*l; ae appreciable lag; some alight impairment ef reaeaaaea orer the extrema baet; breath aeuada are heard clearly throughNt; ae ralaa; no lscreaaed ehlsper Heart-rate quiet, 68; aftar cough er aedarata exerelee 78; occasional dropped, beat during quiet examination which cleared pm-ptly following alight exercise. ruseular quality to good; no purcurs. Abdomen la na catIta. Flcgara all^tly thlelcanad; not elubbad. 27 general lnprwaaloo following physical examination la that the patleat has thown Improve ment la hla general condition- Repeated x-rwy examlnwtlcn rerealed elearlcg ef the haplseea In the lower per- i -I 6 tin of bath ling fleLda. Zb this fils the haziaeaa u> - taada to the. periphery: Bara to all lataata aad purposes It- la Dorsal Cpolatlog oo x-ray) Aloe a Tr7 definite . clearing ot the beading which r erlled attention to; la the aeeaod flla It la entiraly elaar. TTha rcfaladar or the x-r-y axrsiaatlan ana approximately tha ease. jha trawl aarklagt oa tha loft alia era aall dallaa*tod rad probably aery slightly thickened la tha aid aad tersloal port loom, aoth eeatophranle aaglta are clear* 5l*ptr*gss are eurrad *ad free. there appear* to be alight left deflation or tha heart aad poaalbly aase aeeastuatlag of tha right bordee or tha eart. Oa tha b*ala or phyalcal exaniaatioa aad x-ray asaaliatloa soa't Ispreesln la tha thla patient haa ahoaa Ispi-ore-eot. ala la aot corro- borated by the recital sf aysptsfe by tha patient, bat Z as aot too eocrlsced alth the raalllty or tha eysptoss { which ha recited. ?Bb vary slaer dagrao of bronchial j ehaaga which aea rlaaalixa la tha x-r*y fight aall bo uaeceorapaaled by aay phyaiefi tlgas or aay ayrptass what- > eoefer la aaethsr lodlrldufl without hie scrap* tisaal hiator7- It suet ba admitted that frof a theoretical tandpolat It la peaalala that tha rary floor ehaaga a rlx- uall sad fight produce aea-lacapaeitatlog fUd dyapaaa alth possible oce*aloc*l ceugh aa a rasulh of tha Irrltatlia eheagaa. It la sy dlatlact l-<preiai3a that thla sac la E i 7 not totally Incapacitated od tint even an It la quite likely that ha could ha doing a one g? inful occupation . af light.and sa-ardaaur variety* It la alaa 47 fading tthin a year It la entirely proper to anticipate that tha very minor degree of Interstitial flbroala may hare elaarad considerably tad th*t he *111 h*T* no algnlfleant r^Ptoia tolop. Certainly, thia man na*ar had # oaff1e lastly advanced degree af pulaonary aahaataala to baeo-w potentially liable to the disabling end reeulta of pro found dyipaea, eeeJcaeaa, and eough. It la 47 foaling that la all probability one* hie financial altvtloa la straightened out,, hla dlfflesltiaa *111 fade like the morning mlat. Q Soctor, I gather from that report thia *an via suffering fro-J solid degree af flbroala and from your flrat report end ejamiamtlon' on February 38th, and your liter report Is Inly, there hie bean a mrkad Improvement la the nan* acondition both phyeleally end a-r*y; that et the precast time you da net elaee him ee * totally disabled patient and he ehould be able to do some gainful type af occupa tion outalde of that eonsectad *lth dust? 1 5*t la my opinion. "5 It la your opinion that *lthla a year* a tine hla eymptomt *111 be entirely cleared? A 7ery largely eay symp toms be has will be noo-diieomfsrting at any rata. 1 A year from your anamination In July, 1939? A Tea. C aCt-'.i-j i v n iT 'STATE OF CONNECTICUT) ) SS. Bridgeport COUNTY OF FAIRFIELD ) CERTIFICATION THIS IS TO CERTIFY that the attached Is a true, and accurate copy of the Agreement to Compromise, Petition to Compromise and Order, and transcript of Dr. Cole B. Gibson from the records of the Office of Workmen's CqjnPens4tin Commission State of Connecticut, Fourth District,.in the case of: ArcniePoceluiko vs. Raybestos Comoany, now Raybestos-Manhattan, Inc. and The The The Tne Travelers Insurance Co.; Hartford Accident i Indemnity Co.; American Surety Company of New York; Employers' Liability Assurance Corp. and JjOHM A. ARCLDI, Turkmen's Compensation Commissioner ^rjc urth District A2CSI3 fOCTUTIXO, 707 Stilttt Sfc. Bridgeport,; Cosu ClAU05? rCOJUX, - id ei.'l- i- MXStSTOS CCU7AJT BOV saxsesscs'Icassattas, xsc. nrpicrpa ASS . CCXP533A5I03 0010113310332 30U1H2 C0S0RJO3IC2AI S3?. 323 TSA7K2S3 ISSnSASCS CO. 323 1A33PCHB ACCI3E33 A tSBSSartTT CO. TEZ AJK22CA3 502333 COUFAXT OF 330 TORT 323 BIFLCX333 ilASIUTT A55U2ASCR CCXF. - 2330XZRS BSSF0HSX2Z3 BH2DC2PCBT , CC3SWIIC33 nutei to , i9*o. ACRFUlf H3 TO COVFRCHISZ W3T?303 TO CCypSOWISb. \\ ASS qpg \\ ------- \ tfm.Hj.A3 sb or about tha 3rd d7 of Jaruary 1939 aad for a seb; of yeara prior tharate, the elciacat, Archia Poeelaiio, of Bridgeport, Coaseetieut iu as employe of the RajHJaatoa Cccpaay bo* 2Li7teatoe- 3aahcttca, las., of Bridgtpcrtj Coaaeetiest, asd `- 12SSAS the said eapl070 and employor had aooeptad asd woro a* all tlsaa hereis aaatioBad aehjaet to Part 3 of tha Verlaas'a Gospesaatloa lot of tha State of Coaaeetiest, aa ananilad. aad the erplcywr >! ia- iwad Its liability tharwoadar fer'warienj parieda Carlag which tha said slaisast wma employed with tha Srawaiarw las-crwcce 00*7027. tha Hartford iaeldaat asd Sadeaaity" Cempaay, tha Aaericaa Sorwty C ospaay of Saw fork aad tha Ssployars1 Liability ' Aarcranee Corporatise. all_ of which aaid eoepasdaa asiat aad do buaisaaa under tha laws of this Stata asd ara daly authorised to taha aueh riJirw is this Stata, asd 1 S2T2SAS tha elaiaiaat olaisa that ob or about tha Srd day of Jasuary 19S9 ha. suffered aa occupational diseaseto wit! Asbeate'alsj aad father elaias that aaid oeeupati'esal ddsaaaa* aroaa oat of aad ia tha eoeia of his aapl07=ast with tha aaid employer;' aad further claims that aid diasase ia eompessablej aad fsrthar elaiaa that ha has baas dia- ablad from all wort also a aaid January 3rd, 1939; asd farthar'' slaias that ha will ba disablad la tha 'future, all of which aciid'alcias acch 1ad all of said'respondents dasy, aad 'i tfS^SSAd a partial hearing" of ;*aid cilia W, bald before tha - Coop .nation Ce=*i*iiona>'for-the''Fourth Csagrtaiiccai Elitrlst ii *111 ** Mir aar ia 'ew hlM of gold oflio.; ltd 5=22x3 *14 fewislio has i rifs, Seders, and Me kisor tUld'ta, to olt, Tltr od Hichclas Fmlattt) all ef *iom in potential dependent#, sad fcr.nsM tha fold eliaisant m represented it thi aforesaid hi-'*; sad La now represezSad by aoeaaalj'aad ^ ':'r * Jflc.--LA3 It ia the desire of the'ela*sMt"i'the'Sild riapiadeat#' ' to rasch an saleable"adaatseat of the'above dlepsted eiaiss to the osd that farther litigation be "avoided tad 'deabtfal'asd diapnted claiaa to rendered eertal: SIS ZS 50 C3SCET that I, the eliiisaat,'Save agreed to reeeive fSosu -- Travelers'Xarsrasce Co^aa7 ' 1184.08 Tto Sartferd Aeeldea* and Isdenaity Co. ' $884.77 Ito Arariean Surety Ccspasy of Sew Tork $730.08 '* 5So Bspleyers* liability Assurance Cor;. $71.12 =aii=g"a total awa of FSTES3 H02DKSB ?1755 A3D 15/100 ... -COllAas, and we the insurer respondents do agree to pay to the -*<< elaiaaat tha sus iboro specified; to Tit, . _T.' ... .... 525 Travelers Insurance Co^asy $134.08 So Zartfsrd Accident aad Zadasalt7 Co. $864.77 So Asericsa Surety Ccspaay of So* fork ' $780.03 tSs Zaployars' liability Assurance Cor;. $71.12 la fall aeoord aad satisfaction of aboro disputed clains. ASD 55 7UH5SS3 CS25I37 that la oenaldaratioa ef laid sans ao paid, Z, tha elaiaaat, do hereby releese aad forever discharge the e^lcyer aad all tha Insurer respondents ftw all olaiaa fey eotpensa- tlea benefits whether far eoapaaaatlea la 1=7 fora payable to aa Trader aald let or for ear;leal, radical or hoapltal baaeflta payable ea =7 behalf aad whether said elalaa haw* already arlaeo or hereafter sight aria* by reason of the aforesaid elaia ef occupational lie ease, ASO 55 yUHThll 5135175 that 1, ?edora Foeelaika, :wife of aforeeaid elaiaaat, Archie Poealuiko, do agree that ia consideration of eid si as to paid to reeise, release aad forever discharge each aad all the above aaaed respondents^' frea^azy'aad all elaias *ish I sight hereafter have acaiast acy aad all ef thee by reasoa of the alleged incurring of az .2. oeespatlesal iliiut try tea uld Artel* Peoaluliss "still*' Is tea'a^lop of tea aald at^lopar-raapondast, 1ST TO TOtTSSa CAdTIPS teat I, te* olalsast, lw>` ?e#l=dist aa Jtsmt, natssal gsasdlss tad east frlaed at afereaald *~r childran, potastial dapaedastt, asd I, Mon Poealaito, ti*i of . iw Pocatello, potaatlal dapaadasti, asd aothar of afartaaid *iaor ehildran, and potaatlal d^aadasta, do, la fsrtear eeajidaratioa at aaid rasa ao paid, dlicharga aate asd all tea aboro Eaxad Poapesdaata teoa *tt alalsa shite sight hasaaftar b# sada bp- teas agmlsat asp or of tea abase sasad raapeedasta bp raaaon of tea aforasastlssad allagad Iseurlsg at as eeespaiioaal dlaaaae bp tea laid istela Poeatellco, tell* Is tea o^Iop of tea abov* sasad aeplepar-raspeadaei. 13S TO PGBT55S Ciu!Tl?T that VO, tea olalsast asd tha rasposdacta, harabp aabslt tea stltton agpaasast to tea Cocjacaatlcn Cacsiaoiene? of tea ?earth Coagralaal Biitriet asd ?#p*etfall7 ate teat tald greesast sap ba appro-rad site tea,fere* at a fall asd flsal award. Za witsaaa tharaef w* haraesto aat esr bands tea dap aad data first abes* written, Titsaaaae: __ . -- toilsane, parent, aarura. goaresas as^saxt frlasd of Yalta? a Plshalaa Pocatellcs, potaatial elalsaata. ~&34/trt^r "?ow*asial Ciaisaas are rarant siTBff.^va^yrececMPPniarr. XirssT09^U5SLTTJjr,13C TBS JpraASCS C0S5AJE Apprepad tela T3S AH3ICAS SSKSTT CtTJAST OP JET TORS St; ___________ TSS 251CT3S' m3HITr A5S13USC2 OCR?. 37^ U7 ot iUreb, 1940 __*cnteu:::a wcciij-sser a -tv i PH. cols b. otascn. {5anrn hy Coasis sioner} ECX2ISZB BT 10t. H80C3: ft Doctor, what lo yocr fallaaset A Calc B. Siboon. ft Too tra eonneeted with this sasatoriina? A Superintendent and sedioal dirsetor of Pndareliffa Sanatorius. , {Quallfleationa of doctor ateitted) ft Oectar 3lb*on, all! you outline tha reeult of your find* iagm of jour enaalnatiaa xada on Sah 6th? A fesmory 3Sth aaa tha ensninatlon. ft Will job tall ua tha result of jour enmulaotlOB? A Z flrat aaa hia rabrumry SB, 1939. Ba aaa bon la Russia aad ears to tha Caltad States la 1913. Ha flrat be pis eoifc la Bridgeport for tha Bridgeport 3r*s* Cotpany aa a la sorer oa tha floor far 2 or 3 jaara. sa than sorted far Hetlagtoo aa a la Sorer far aieut } or 4 years, or natll 1919. ha than sorted la tha 51=gar shop for a hart ties sa a la Sorer, asd than fBr Hactric Casio Cotpaay aa floor laborer for a short tlee. Ha also eerie far II C ' ' aa floor Job far a short tins. Ba aae out of aort for quits a lone period around 1932. la 1933 ha Sosas sort ' for Ks7batto4 aa aa aabestoa aacrar, days, and etoatiauad at that until 1937. Ha than aont to Oeoeral Electric aad aarkad aa a floor laborer for a abort ties; asd than i at ilunaathal4 a, searing plush far a short tine; than fsr Saltan Tensile Coapany, aeaaing relTat fora short tins. In 1923 ha returned to Raybastos Canpscy, retaining there a r H5*'to MTr until Zoetrzjor 31, 1938 ihio b* ui laid off. Subsequently be IU called to go to Stratford to cork for the u-t company but did mt real call and eeuaaqeastly ba did sot report for duty. Bla ?mat 111eaaa: Ba danla* any acrlaua past Uloea*. Iha praaant lllncaa: Laat nil ba aetlead tb difficulty la breathing aad eenkaea* as enables atalra aaa baeaelag ear* satleeabla. Ha consulted Cr. Joha Adeem* la October. ?*dleatlaa aaa follaaad by so lapravamaot, aad tba doctor aaat hie to Dr. Aatell aao e-rayed hie abeut tba lat of Savaubar aad told bia that ba bad aoaathiag aroag vlth bla luaga. At tba preheat tlec, February 28tb, hip coup la aomachgt laaa savor* theuit aaa la tba abap ahara It aa quit* trouble**-*.. Sa aald ba facia considerably Improv ed; ba aaa baa alight expectoration, tlraa easily, baa ^shortness of broatb an aaartiaa, particularly aa alias- ! lag atalra, buttbla la definitely laaa than abaa ba quit cork- Ha baa ao->* vague pain la tba aatarlar ebaat far four ta ala month* paat; tbla alae baa abaca lo-a Improvement alaca ba quit cork. Thyciesl tnaiaatlon: 21* ordlaarr caigbt 1* 185: blaaalgbt at tba ti-w or examination *** 173: ba la call developed *sd nourished, : bsa a florid esmplaxlea, aad did set appear acutely 111. Bla aya*, car* aad threat arc aagatlca. Taeth; acccral visaing. 31* ebaat aa cell muscled, call developed; I! sose fT*rlng of loer riia; aligstly diniaiaiied reap ira- afc7 aouada throughout; flat crackles oror the loft boa# ' posteriorly, nt eiearisg after cough. Som lapairsest of rtaoeasec oror both.bases . Searis Xuaeul- r quality fair; r*ie 73 alttlag, 80 atasding; ao sursura. Blood - preeeure 130/90. ibdeoes segatire. flagere eat elubbsd. Spare# apeeioas sf eputus raro<la opaque apecka la shleh aoro found sets#tea bodlse. X-ray of the eaoat: our flrat files aoro on yebruary 28, 1939 - aha* a ratSar diffuse flae granular daaaity throughout beta lung flalda, aoro particularly os tba right alia. She deaeesdisg breochlal trucks os the right aoro aosssbat exaggerated partieul-rly la the eardlo phrenic eagle. Ska periphery on bath a idea la eo-eehat haay, Seth bila, tba root abadsaa, aro wdsrately laeroaaod is daaaity asd the right la especially tagged, flee grassier iseroaao Is density soted la aot sf typical spider-sob typo asd ia dlatribut-: ed ts a dagroo ehieh la eospatibia with a aodsrate extent of Interstitial fihrcaia. the cardiac ahadeo la lecatod ts tba left, tie ds-o of the left dlapbraga ia curbed asd free. that of the right iadcproaaad asd aot eurred. Both eootsphronie aagloa aro laar, the sumsery ia aa folio*a: this aas baa boos osployod ao aa aaboatoa osaear far a total of eppresiaataly 14 yearo. Curing tba other 13 years he h*a baosis the country he baa baas os- plojad varioualy >a a (hep laborer. Ha eonplalna of dyepnee, vabue pais la tha antartor ehast, and fatiga. bllity* Cough vhleh ha had, has asa lapfarad eonsidara'hlj asd h has alight, sr so axpactarmtioo.- -r*y azaalaatlon rrvaals iaSnti asoust of Interstitial flhroals la tha upper halraa of both lung fields. Coupled sith the history, syoptosatology, thaaa findings ars eaopatlhla 1th a roderata degree of pulsonary flhroals ahleh la all probability la too to pulsonary aabastaala. Shathar or ' not a rary slight dagras of underlying flbrotlo ohaaga say bo duo to dust factors rhleh ha encountered la othar occupation* caasot bo datarslaad oe tfca basis of this sstslan tlon. Thara la, hasarar, aufrielast flaa inter stitial flhroals to ba responsible for the not rary severe srrptosa of rhleh bo eorplataa. Stia flhroals aay ba attributed to tha sabaatoa .exposure*alone. The dapea of disability rhleh this ran baa at present la prohlena- j tloal. If tha aysptons rhleh ha racltaa ara true ha should, la all probability, ba considered aa disabled for .tie tire being. It sass vary llhsly, hororar, `that eaaaatlon of oceaptlon aa an aahastoa raarar should ba follosed by daflalta Inproreseot, eartalnly rlthla o year, asd * t tha and of that tiaa ha should ba able to return tos gainful occupation providing It Is-not asbos- ! tos or rhara ha sight ha exposed to dusty ataoapharr. !5 I see hit Urmia an July .31, 1S2?. a* esisplaisad sf osueh la the -sralag, has 1 k iputan ahleh is luspy, states definitely to doea ant feel Improved; a till baa pain Is hla anterior etoat, praotleelly constantly. Aftar calllag or aay moderate' eaereiae tba paia la mare seeare and la accompanied 67 definite shortness of breath; to doea aot sleep mail; to aata fairly mail. On physical ex<mlaotlea tto man does aot appear particularly 111, but to la definitely depressed aeotelly. Seen lneooparatlra and la laeliaad to ba sullen. Hla akla la mall taoaad; aara, ooaa and throat wehaaged. Hla blood pressure tala tine 130/90 aa ec-spared to the ease finding on ratruary88th. Hla present aalght 184- aa eompared elih 173 on Tehruary 33th. Heart rata la 72 sitting, 80 after cens ing or slight exorcise, IseuLtr quality fairly good, os svmurs aairQTtha regular. Cheat call shaped, sail euseled, mall derelaped* no lag, so lirpalraent of raaao- j anea aspopt saar the boaa. Crackles heard la jetruary ; are elaar. ringers slightly thlekeoed, aot clubbed. Curing the coarse of the examination the saa a dyapsad after esughlag, apparently toe*se fstlgnad 3apea ted staraoscople i-rsy exaainatioo so July Jlat, rareala little If any ahaaga la tba fllns aa already described. Che tosTlly daflaad haslsasa 00 the right aide has undergone ssmeelearisg aa you eaa aaa. It la ay faallag to has shoes a one 1-prtrranast la hla eondltlas aa ertdaoeed by -J i! , M* laerwoaw weight; as daubt h mi (till dyapnead and batdaaelf ns greatly eosetrsed about hlnself ad his con dition, eory doflaito about htha ptia la hlatfst sad thoro la as wothad la dlocssolsg this 107 fhrthor, 3ha j j nn*a condition and x-nj fllsia show toadoaey toward l*proTrtest. The tlw between the tso earoiaw ttaa saa ast sufficient to brlag to light aay noteworthy changes, sad It saa too short a tit* to rw*ch aay conclusions as to the ultluate oatessa. It is 9 feeling ths osa'a Mo tel ettltudo sss sot good, sad aeasth.ag of a radical nature neat ba sada to leprae# his outlook, otherwise ho la going to aagalfy hla lyerto-e. Bofloltoly ho is not to bo el*oolflod ro a far tdwseod enso of pelaoaai7 flhrosls. SO has a nodirat* da grit which quits probably arose fm pulaon*; 17 aabeatesls, bat there Is awory rwacoo to ballcTW 1 Inc hs Is rnored fros the stneophorw, that l-prcewaoat of this eoodltlsa should crlco cisco It baa ^ 1-rproTtd without progm*# of the disability as secs, Scwerer, at the nocent he seeds sene phyeolegloal sttsa-- : tics, act co nueh psychology, but one thing te give hla daflalte lift. It Is posaibls at the cad of year his k-r-'y tod physical condition will ba rary Materially laproewd; eartalaly tha saa eassst be gslag dean hill, for the laerwaac in weight and hla blood pressure shews | as ehaage; hla goaerel eoadltlsa la not worwe but bet tar I I ! tha I flret aa* hla; tharefora It Is ey faellag that aeenturlly ha should ha bla to ratura to oo-io gainful _ occupation; not a* baa to# ooTlag. 5. Z think, doctor, Z haao. tha picture bora. If Z Interpret your report* eorroetly,' that. tho tea ha* baan and aa* suffering ahanyou Zaat examined hi- of * nodtret* degree of pulmonary aabaatoalr? A Tea, air. Z thethar that eta la r our oplaloa of auffleleat dagroa to bo classified aa total dlaahlllty aboa you l*at a^alacd \ hinr A Z think *0; I don't ball*re the man could pursuit > a gainful occupation steadily, being aaally fatigued "nd abort of breath and with vague palas la his chest. ft Than you say that you taka lata consideration hi* moat*! condition! A Tea, I fait that tha nan doaa not faal i sell sad ha la unquestionably definitely concerned about ! aynptoea aa you or 1 eight bo uadar tho us* circa - I ataaeaa. r do faal, hoeerer. If ha could under*tend ! tho a Itnation there la aa opportunity for hie to got *oll:; hla ehancoo are axeollaat, cortalaly better thmsgsod, rarr goad. q la your aaeeod aaaniafitloo aa July list, you stated eery : definitely that a* far aa your x-rry and the physical ' anamination rrva'lad, hla luag condition sea vary dafl- 1 oitaly laproredJ 2y feallag aa* this: oa physical ***s- ; iaatioa tha ran abased an laprorament la hla gaaaral EMPLOYMENT CARD STRATFORD UAirr /.in j012; caojco, of conn i Eriicepart, Cons00tlout,; children sad alleged devaccuats doocasod olnliscst, ccLMj'D/.'frvN cciiMiacioiain Crcoco, '3,, 0 ' (JL/ !H. fj!T3 V3. " iUYJSisroa - iSAt.niA'rrAii m:., cf Stratford, Conn,, ittUDiH COlidlKSjI'JTIAl Mf'f.ii:! Enployer sod 2i\V3ISE3 EITJPJiSKlS COiPJMT, of Hridcsport, OS!KU, Insurer end Eft&X?ORI> ACCXSSKS St HITCUNOT CO f of arldcopert, Coca., Ianuror ^ #*3 I .,*^'0* . [*r and . . aizsicah trsirjr cou'jct of .New Havea, Casa. , Insurer . . end aa WTEHO' LIABILITT AiiTJH. cxhp of New Haven, Connect!out Tnimray Tnas?QKT);r?3 OC'XHsffi ^ 19/.?. rrronr? avo award hy y.T tomaa - Uoca tha within end foro;iag otipulaiina boing subedited tc end examined by tbs undaraicaad, X find thci the ease is a fair ad oqnltatla nsttlonont cf a disputed Plain. vircnccrciT it Is ordered, ad'adgod and awarded that the sens ha in nil reonoets ocnpliod with, and tint a canpldareo tharswiti ahall ho a final and ocapleta settleaant cf all clalas of snid olaisants acnisnt tha respondents under tad by virtue of Chapter 280, jtnena ea the t'orhsen* 3 Condensation i.et* . ini'll I-J jcusca aascgsgfccsii :nx vi-UKhM0 rr first rasifestatlea of tba sysptoes m la April of 1919 *fctn a UMrtoaii m sailed to tbs attend! sa at tti Ascaasad by _. ssarga Labors# eftor elaissst bad saffand as attsak at riros aaBEsaia] that sold daaaaaad was out af sort daring tw separata *riod* fro* Hank 26, 19*.? astll April 6 1919 tad free /as# 30 u.;i9 astll tbs data of bis daatb, all af which alalia n dsalad by As resvaadaata it beta* tbslr slsla Hut tbts is act a aaepaasabla tin and that said ass*stoats arcs* aat of aaodltloas aoaoaaaotsd rltb bis teploresat asd iborsfert la sot ooronnaable sod said raaposdaata farther aoatasd that tba olalaa la said aasa an act Itpaalaots aadar tbs forksaa'a Sanpacsatlsk 1st, sal .mat i_i tt all Of sold eoaftreseos a daolra cas snatfeatad by tba vtlsa harsto to caleobly adjust and sattla sold slain oaaa tad OT ill tlM . : row lEiSiroffi It is SanUy ojsresd by and batman tba partis* barw ra barr drocao and J'o&a irocao, ahlldna aad alleged dependentsif daaot;*d_-J'-.i Croeoo, olaLsanto, and kaybeetoa-uashattas Xssi, ldbj^T-r>apeail6stl aed Trarnlan Ins. bo*, insanr-nspoodeni, i tad Hartford .'.aeldaat fc. XadenaJty Co. , inaarar-xvapondaat, and nerloaa iferaty Co*, laannr-rJ spondee*, and Krplorr* Liability isoar, Corn*, isauwr-respo'adant, bold* an t* pnrtiaa to tbs isatroTOray, that whils taslr rsejoetlr* alnlns an nod# la good 'altb, tbo olaloa * disputed ana tba result, If folly pnaaoutad it a bearing, coal! bo doubtful. ifo iifiL.'C.Lj It Is agreed by ad bot^ros Tfsry CTsaegJ tart fobs Croooo, ihilArra and alleged dsyoedeats or dseeseni' IdbaCroBoo. alslsaata. 1st Isybestos-ioniattaa loo.. erplcycT-rtspondcat, asd ZraTolara ,, So., laocrtr-reajoadeni, asd Knrtferi seoldont X iodocaity T>O.IZ7 T"0 /iTOiVlS /JO TZ77T C3LMS3 (*2250)(5*aod Upon tbo ollowiaj azpcsansi Zkavalars la*. Co..*..,17j tenths j Hartford ooldest - at. Co*......72 eoathc; 'nij-r'enn Puroty Co.....Sl sost. nd Jfaplojcr*' Idol. Aasor. iurp................13 aoaths, usd tbst said naurssco oasrlers hero apreai to pey tba foUor.Ins sucsi Lnrelsrs ns. Co. - 1495*CO 1 Hartford Aesideat Zadssaity Co. - $750.00 [ . sarleua 3arot7 Co. - J370,00j asployaw* Uab, Assnr. corp. - - 135.CO. Jayna* of sold sun of T12J7T TOO 3SK)a3 IHO JinT aoLLLTS,(j2250) do aboro *11tea tod in to bo Is fill art! fieri eettlc.-act, adjust* d:nt, aoosrd end setirfsotles of oil elnlss iseludinc all roileal ssd ecdipv&aatloa, past, nnsant and futurt wtdeft tbo tfortoaid cilalsonso bn71 or uJgbt haw ac'lsrt th# mnnondonta, or eltbar tbes. tad to bo coda nad occopied la Ilea of all other cospeasa fnt paysunta, eltbar total, partial, porrsnent partial, apoclflc d for neric-uii and por.-ssert dloflitrtssst asder tbs tor=s of sold jbrlroa'a Cecpensstios .'rt. 9 7s ana of TVS!HT 7r.O mr.n3 AT3 71 ~~ 20U1X; C11253J shall bo spespted ae full and flael aertlcnat, ed.'untsp.-t, eceord and- tiesana- . --------------------------------------------------------------------------- Croceo, osesasad elolsar.t, and far all elnina for radical, sarjioel, hes- nLtal end al^>so8, orpoajoo post, rresast =d fatiro. asd for thn s:tatory fouswol bill, and for oil eosrensotlca sbisb say ba due th iivrsr.B an n renult of said injury to tha and that tbo poysont eT said aa-. shell eosntltate a eosplata satlofnatioa of ell sleiss elm or to boec-o duo at any tins in faror of anybody on account of 1 ild injury. ,. * is try?2:i7 anderotood asd ajrcoi that the acs-jytasso of said 0= of .to lnnasio a.*s> t/T/i zous >ti T*i!b5`.'i io la fun adeord end oatisfaetioa of a disputed clois, end tint tba paysost of oaid sun la aot en odslaslos of liability. - . . Is io further stipulated and acracd by anil bot-eces the pertics t|-.t `bis stipulntion and opree.-*nt io intended to.deal with any .rv * * C- i ' **' 4 ; -U. v/-' A *!# jr'"; u it.: it-.-.".era . ; . i~v:: !.-t*`j *' 1 ii . , . i ;o r i i" f;' 'X " Ki-nr. -!S; ..1 `-.A ,r.,iA .> n r:.<* i * hereof, or aay abuses of'ocnditloaa afcleh. say ariaw* *iaoTrtha ftniatr** oa aoeoont of tho elsinad conditions. TS3ZAS said daeaased ilataut, la tho nut of a of cespeasabllity la this un. rnU hero beaa oatltlad to 53*7.20 for tasporory total disability, aad said tlalsaata aad dependents aro the oalr lair* at la* of laid deceased* aad by tila acoosaat they (:< to aad do hereby ladeeaify aad arra baralaaa the eaplorirr*spoodont aad inauror-reapeodeats ftaa any alala of binding apoa all partial. It 1* farther a^ted that thia Mttlaeoat ohall ho apoa aid elalneats, thalr heir*, exaeutars, edaiaistraters, assigns aad neither aha, be aor they ahull horsafter cala any alala of aay character osder tha touts of acid Ceepeasetlaa Act by reason of aid alleced Injury] end It la further agreed that aald alalaaata boll aot aaJco aay auah alala through aay emeu-tar, eldnlstratcr, strht later bo appointed to represent tha Interest of laid Clalrw- eat. - It la further atlpulatad aad eerood by aad batueoa the pertlee that thl* a^t rtlpoletloa aad acreenont ms not Induced or ontorod Into ftlth fortbar reftrosae to aald elute, It la abroad by aad bataooa tho pertlea thut said eleiunnt hersSr aerto to iniaenify aad sot* hnrsless aald rsspondssts frsa aay eials that say hereafter be aad hlsrjefer7l.l alalssat, or b7 an7 person, or paraaaa oa aaeouat of Said El 7IE7 07 S3 TB!C30H5, *s. tho aaderalcsad, hereby unite la raisestins that the Compensation Cccalssioner far tha Xeorth Caaistaclanol District saJso a fisting aad a*ard puraaaat to *m stipulation. e* hem hereunto set our hands aad aeola this day of October, A. D. 19*?. Sails enJ alleged dsponcasOf deceased elnisnst. iijilla end allowed aoponaea' of deceased elaleast. Sayhottos^eshattan Iso., Usployer-roapond eat a*4 TiUTlEDO DE. CO., Insurerroaper.dcnt itayhestoo - Vaahattaa 2ao,f Ztep loytr-rs aposdo nt aad _ EASiTCXP ACC317^4 DO. CO Insurer-respondent il I b 7sz rassrss on . *1 'r **T rv r" J J-.- -L-a. tI : ' *1 o Ii \ SBTbastaa-l'a&hattaa 2,( 2aplarsr>ra>panatt m4 jtsaxsai scasrr co'^rjor, luonMiapoad sat BT iliaat Ai'ioraey Baibastoa-Caaiatton Ine., Enplajrcr-reapondact ttd aartoTsmt UA3nxrT ssa. CCBP,, Inawar-rcepondaat t/O't Bt_Ot^aiw. 7ohftoa a 0>Baaf p 'ttoir Aivoraaya --r*--*"64 *-- * V1 **-- *H* ** **W.tW tAt MW MUWUMUtMMTJ P -J `XHUOtt* n inotfti* jnddv ttorrvradmos Innunp nocatf jrq* ms tp /Rwnbijj pov vf tt Iwm r -mrf a. . nMaqnt iq p*n*asB oq _ _ --|UMI aoaopaouo *pq Mooddo op mi^i trwoito jj rttco an * in axaqp pq 'rannii ue pq p onpopt oqp p imln oqp inq jm iui q^s '"f*"* W af P* I ***qa o g `.pportjoptt oqp do* n igpnud mTnS*J *oq Xuid oqj, Sapnoq qj p ixupf qp aauiMpuiuua oqp p maid * *5_*"**" 'atfJopnp oqp soda nztn op aapvod aqp joj iotpoq n ij -Bound patoamup P" W*n1 *0 w H "rq "jpafwd pq2ia aapprod >qp p no nip* dpqminpnpai --eptOq pa [fauad a `op dpqtspq moqia popdano aq m joport.*opnp os Opaafqo joooaiimmo-j aqp 20 1 ad ouoapo am jj popuort tq ppiogi npojdutm popodowo o atonSsop qnpSoa B dpoopo pop opa pa qtodt op opqna ip mapjt da to `uppjod oqp p pqppo qoq* pqp pnppsoaot ip py 29pMSoopppoqn gSWWSBPH^,, ^pupiiu.arn pappppa pa noun. Ispaart p jadopdm* qp oda w puaq qp nop aop og span op qaoq oJ op apqn ap aodOpdoa poqp atort pn aq `paooufo n Jopoa saSaq anq aaaq opaanM qao> npp aappooaadmao p paandod doqa sp mfop ndopdaa aqp oq* `apdana ndopdat qp aada ipau part p aopuaq aqp dppaoaaay _________ nfm`ftlW**? qp p aappuap pa uspob aqp pa pqp tasaoBao dgpnp aao pa spq popoaip oqa tnoartqd jo mioudqd aqp psnaid t*oq tftmmtm pa `Xnfap aqp p ooappn pqpo to 01 nanopia opqpoood g 'Sairnq oqp op 2qpq ppnoqi pa rtrqs oqp Ippaa pqpo J popup 4podnom *q? leap oq *9auttq oqp uofq ptoaao nq Xppaodoo ! n (P) "P* panqp Pjaau 0 o atop phm aaqp azota jap qua op popopioodooap dppoprtd jo dppop op o ndopda oqp poqp (a) InoaLtopdmo p oona ap pa p pa ooan pp paqp (qj `paoiapmo i.n nnidart oa.ftn npdnopoO" Stratfoid, Caaa. Tal. WPS 'V IV T, IMS / J[ a V 2IP Urbaotao st-rlalea of ItfbutooadttPtt, aa. Strata ra, Coaa. Poor Seetar Baborqos mfSo folloola* la a roper* of eesplata asaalaatlea of Hr. ia(tla 2Croeoo aa May , IMS. CMof Coaplalst: Coach, axpoctoratta tad Tomtaooo. 7obUp Hlatory: Tatbor aad aottor Pott doad, oauoo apmeoa. la ae hlatarr of ary fastllal dlooaaoa. ttoro 7Put Elatar : HPSaealla so ehlldhaod diaoaaoa. na la tt# 8 193rldoport Saipltal lar a kldray aeadltloa la ** bad aa treeblo alaea. Sad ao sttor oorloaa lUaaaaa or sporatlou. Harlttl Slateryt la U aarrlad. BU rtf# la dad - diod of aseor. 0400 26 2Oa aa aad oaa daochtor, aad C - Uolac aad oall. Oeeapatloaal Slatory: ,Li'C</f.nz lilt la tto old aoaatry la Italy ha oorfcod oa a m< aad acala ohoa ho rotoraod ttoro for aboat 13 1914 1920yaan, botoaa aad . So earn tt tto 19 1906iltad Stataa at tt# aqo of , la . So oaa trot ovployod at tto Soo Soparturo Coepaay la rlatal, Ooan., ohoTo ho oorhod aa a altar of aoap. 1 oorkod ttoro natU ha as# to Srid*jort la Jtn t 1913, ohort bo flrit oont tt rh at tta Saybootto 1 a oaaTor. la 1914 ha on# laid.off aad rotwaod taiy Thorn ho rtala#d antll 1920, ohoa ho anla itmad tt tto Oaitad Stata aad no aqala onployod a Jaaaary 10, 1921 by tto Baybootoo Dlrloloa la rldcoport ao a Toatar. Bo bad aero or loot ooatlaoou# aaloynont, aeopt for toroTOl oall layoffa, fro* .921 9 1939 at tto Haybat too, aad oorkad ao a mayor. In 919 ho oa# trarafarTod tt tt# Stratford plant, la bo allion*t dopartaaat u a aooopor, ohleh ho boo oaa qa to tto prooont tla. tto flrot fa yooro ttoro o oorhod sera or laa* la tbo factory, bot for tb# pa#t hroo para ho ha oorhod tt tto loehor room, *bleh aa rolatlraly fra of aay mki or dnat. S*ai ETsi\: v -- . * :i- i -- uapaT. ac--7.'ir rrT`jTavri jijj .a.sit tjJ3.ff.T7 731. r 7773*1 otrjTr,-^ -- .... _ srn e=rrs?M,* trieja*.* ^ rr- 13=77* ST*70hi; fa BO 77*30Li 31 0=1 73=77137 77trfw. *,if*" J-s sr,t 33 77 7*7* cane* urjcsesr* j=oa* CTT*t ert?* isi;3u;j:r 3-- iarrse**'. . e*cea as r- ;* rtf0. ^ WTUapS f *. laiots 1 A csshpefa exaE7srf7oa 07 7=5*70 rBi SOS.-oi i?ua: a*:-,;h- --JS;, cio' gdhld&lO' JOO* T- Il.**<* 7fi7*7o 01 3oripe*re--yspp-*9 jee** 4*r* i-roas -v * **...*. ,.ar-*ias1 3h tha hjiutN iltialn of krTaitw-kililtu, 'lili, IlntOH, Cta. >t >. Asolo Cmw Slatorr of Biases &1* M clTM a hletorr of bar la* had a ahnsla eoh, oll*bt arpaetoratloa of a jaara dsratlom. Sa aaaoot raeall axaatlr Mas It first hofsa. Eoearor, dorls* tta past aororal faara ttl* ecs*h haa bocoae Bar* troablaeemo aad peraletant, ad ho haa baas fit lac *70ta tallr. Bt atatad that ha fait that aa If ha had a aald all tta tlaa. Dulse tta laat aoraral fttri ha haa had to aoaaolt a faallj doctor baeaaao of tta ehroalo soufh aad opactoxatloa, fbr ahloh ha aaa *lT*a *ou*h . atztarao atleh ** hla aana relief. Sam aaaallod ooldo did sat eaaaa hla to lea* too ash ark. .In 1M7 an s-rar aa takas hr tho StobUs Ofclt of tta Stats, ahloh aa aid to aho* a spot In 'hi* Ins*, alch aa oeafizoad hr x-raya taton hr Ihrsalea-woekOrt la Brldfapert, tta doctor told hla ha did at hare tthareoloela aa h* had sothis* to coiry abeot. 81* seat recast Ills*** bafts Is Baxeh SS, *t atleh tlaa ha aa aoaflaad to hla hen Tlth fmr, ahllla, eonfh, expactentlsa, aa It a* fait hr hla faallr doctor that ha had a pesuaoola la hla loaf, for atleh ha racetrad . traataost. .At tta praaaot tlaa'ha taltla of.aofh, arpaetoratloo, aarXed ahortass of breath, aspaclallr so the last exertion. Stortaee of breath to tho joint There ho require* at laot three pillor* to aleap. aa at alfht. 8e soils** aor fatl*u*,.and etates tat he fall fossr all ooar. Bier* aa ,, has 30 appreciable velfht loat. He belleree tat the 173?to so of tho couch ad erpectoratios, ....................ihortaaa of breath asd seaJaeaa, a* proposed aa Oo beeooo nor* atlemhlo dsrls* the past too pears. Phyileal axial aaties 1 Sat of a falrlr all drreloped asd aurlawd ale, TOO dee* at appear acutalr 111, at 7. : senenat ebnslcellr 111. S souped asd erpec tore ted frequently durla* the ezmaiaatlsu. _____, Star* la a erldeae# of uf cruoolo or odea, .... * hut there It ilight elobhlaf at tho flaforsail*. 1S .`t V' /- 01. it* atjxp /* ssr; co r.-oa a <34 ;a I WA *3 *-t*l "> **S*3 pi 3* nopTT* 07< 87*sxA 03 ^.in: aoxp* 0077*7 0077a flq bo* etna 77a *a pot* poo stop 373*3100 30700 *tit 77= let 7*77*7* ^ttt tdaaxbiccoxixreB' tsz xsre? 30 in tjxi* asst; XIR77I Toejox pterat 01 *?* 03x0370 soot? ppq *9* jni imiu; iitni pa pn 735 co 90011175 o P'1 n n po pa? 00jo rr ? *? x30 732 m*ro* oioww 9*771* 8* mn? 13*1 n i#r* tLesprnen *33 A*xo711107' too pa paw p0 Nuu; 1<RI (373 e=x23 pwa possso 3070 pas 77 73Xic palps' iKun' gw^ IF* bn* lana psiaor E casn* xn.o;j 12*0xjl 933370 attics' (77290 axbaeeivsi* 07 ana 773 on (70*3 r P7a*asl 07 3*073* 3*9 r go: ]9l* too*jo eposes 30X3C70371 CSff* jpa Bile*col 37071703 07 S3lwF*!-9V0033* ISO** 'BfUTHHol iMim t apMBfnFTHw,' In., Itnttard, C*tm Ba: Hr. lao*la Cmao g*d - smKtt. lor* - SagatlTa. Drama aot *ooa <ao to (as. trio Sonaebat prodBoot. Pap11* *3* roaad ad . aqnal. Sooot to llcBt ud iceoanodatloa. Blaaa aot aaas. Aron* naUla praam. Boa* Sagarin. goth Koeeoa naobranai aro aomal. tongua pro - tndoo la tha aldllaa *lth ao trataar, loorattoB or flaaora. ghorrts - Baxsal. Taata - liosr slJaiag, rniaf ting 1b poor aosdltlos. Boot So itifsaou, ntraetlon or ripUltr. ttjrolj sot polpoblo. Qsm - SpnntrleBl, 190*1 axpasaloa as OotB aldaa. Sptloa la raatrlotad at tti baaa. ^nga " Blast Sota la lapalrad batnaa tta 79S - . tat tui. Braatb aeoada in bans Toalenlar rlta aasr sodarstaly eoaraa ad Mint ralaa haard la thla an*. toft Bata 1* allgstly lapalrad batnaa tfca 7TS tad baaa. Tketllt malts* aad tocb! . raaoaaaita 1* laera*aad. Braatti aooads ara harsh naleolar rita nany aodarataly aoaraa ralaa aaard 1b tBla araa. Motion* of tha diaphragm tro rootrletod oa beta Hdeo. Boart - Sot aalargad to poren*oios. Seoads in ragular *ad of fair qpallty, *oaoaat dlataat. . Blood pmion 138/84. Ibdeam - Sosnhat obiii. or tha protradaaaaa aj bo dao to poatsra. ... - LItit, roliio ud jcllnin - Sat palpable. Shore lo ae toBdOT3**st or Baaata notad. Bara la a rl(Bt ladlraot lagalaal baral* aatad. laft rla* 1* ralaxad. Canltalla * Ifermal Ball. Botnaltud - SiaintUllf aigatlTi rxoipt far mild T*rleo*l*. t* Laboratory data B.S.S. S,050,000. S3 87$. 8J.0. 10,550 Borsml dlffaraatlal. SidlxantatlDB rat* - 4 asd 10 as ti* boar. SpstaB ixtBlsatlsaa art to ba rapartad. SaaaorBaa to bo roportad. Badlegraphic araeiixatlon of th# ebaat roaalid arldaaea of aaricod thlekanisg of both Sllar thtdc*a tad a ratbar dlffaaa pari-broaehial typi of flbroala aeattarid throughout tb* lo*r to-thlrdi of both loeg find*. Ihara la alao aeai aetabli plaara thlekinlag at both baaia. both apleia ara eliar. Shari li aa dafialt* aridiaeo of asy anpir-lapoaid lafaetlec. ^i sardlae alllouatta appaara alljttlp aalarjed. r r itt* zeal ]`jiwrl cans* wsa can:* iot3* ______ =_?<! pneos Toirn rj y*ias wi;a7n r==u - 37-ve - 73M r* I-Sopte o#na##o <p# s io ;a ma;ia; i: w* ? 3i35is - Bhuactjcay* adi7 nsirapos or sac? *77*** ___ jyliJT7 roc teytesT** j"2_* :.3 irrusno* MSaCCTBX 91 17*797*1* - -na Z71*7 ri* stanvrsS rt loot *0977*799' Szs - aM=*r 07:01*009 at trrassa* *197** jo ff sroTir* utf to r.i*. got? - Km*** aaceiaaa* aia sotaar* ipriaa >u - HIM - seSrtTia* t;in sat aas* -tana *#97771 Ssnnr adairy Jwwc* 0 J7*ta* ret rc10=7**709* jam jerura; Issrtist* yd;n *t* us; 10 w*i3 - uttew buss as* taoo 79# *0 193* *7 - -C*7A** i ! S*: 799*70 ciecaa atrxuoia* jaw aT*7aSsnssssTigyiff.1#1 / -j" ".1 j 1. amttsro, San. ___ __ ^ I to: fc. litilt ftw >, Caquiit tUi x-ray ilth a fila hh* la la(Sit S, 1M7, tlar# tea ten iaflalta fnpinlm af tte fltnali Is tte lowwr two-- thirds of both lane#, altte an* af this laaraaaa at tte teas* my te do# to tte ncrat naplntery lafaatlea. Xowawar, I fall that tear* te* baaa.daflalt* proenaaloa af tta flbnala, whlah was aetad Is th# x-rmya of logost 1947. lapraoalon: &ls ass'* hlJtory af czposun as a waawwr far U yaara. alaac site hi* allsleal ayoptasa asd x-ray flndls**, I ballrra a dliB0*l af labastosla eas te sad*. It la aotad that hla sas te* ted polaoaary craptoa* fbr folta aaa* tls*. 2# aatleaa alio that rlthls th* past two yaari that tte7 tew* iseraasad, ahlah I hallow* aelasldas with tte lurta** aotad Is hi* x-ray platans. I tell*** fortter itudlaa ihoold ha doss niardlac hi* aputtn to ha car* that than 1* so aap#r-l=poa* lafaetloa of Siharealsali, which wool! ah* hi* aoadltlaa asn sarloaa. Slaea than la so ascapatlecal hazard la th* Stratford plant, aad this xas ha* hast Trw# iron waawisg slaea USB, I da set faal that hla aaployaaot wall* worttac at tha Stratford plaat, osatlrbutod to hla pnaaat aoadltlaa. la It Is a wall known fact, that. SUlsaals aad lahaatoala one* tha lose* haw* hacoa# lswelwad, will prosrws# whathar tta sas 1* la th* aowlroisaat or set. Ihil# working at th* Stratford plaat, te aaa only a swaapar, tha laat thn* yaan af whleh ha aaa not la tte faetary at all hat la tte looter rooa, which waa * nlatlwaly fra* af say fan af note or dost. I teller# that hla tea 1* aooplttaly dlsahlad aad theold laad a **datar7 typ* af Ufa baeaus* of th* fact than it #o aoeh lawolwaaant frea as x-rsy ataadpelat 1* wall a* from clinical cyapteBa. Magnetic iabacteala. Slaeanly, SPD/T 1. Philip Slaas, 1L3. j j I [ _ _ ASGZIO CRCCCO^ orroticx hkajunc s -34 East Maia St. * Stratfordy-Conn. --of SRitThr3aeEstSfea.TerCihiTS.Kb._.C.;,po.nInnKiS. ..ICea_79F*_3B-1232SKS-fC -f.oCuarmthpoCsosaaftTioOtaBffalCciooaaomaflmDiinsitorBicttr TRAVELERS INSURANCE CCUPART --HiRETORDr-lCCIDEinrriaDEatlTrXO ,{PABTa> / of AUZRICAR..S.UREH..CQUPJOT..QI...KE2, .ix: EMPLOYERS LIABILITT ASSgSg^KfeP Too tad tach of 70a an harthf notiflrt that th abort aotttlod raattar wfll bo board with nfvoaca to tba following quoanona by tbo aadaraignod at bit offlea, Soon 404, No. MS Main Stroat, Bndgtport Coca, oa tbo ,?Sth-------day afArril....lSA9. at UtOQ-A. M. .... Asbestosls eossencijtg January 10. 1921 Netict iaauod A.?.ri,L--S._~X943 Aoteowlodn rocoipt 0f tbia aotico at oaca. ROMOALD J. ZZEUNSKL CooiMtaaumar I J 1 i* * jom*?o na Joon*mnnoo *<B Toanoo woqita rnaaj nuX fj ; CiOn SOJ oovn a Hi ITad OX H3KOISSmWOO 3Hi 133JX3 N3H1 CIKV S3SS3NIIM itfv^ntTN' SHI lovnw) oqi or >u>03 uo oq qoodtnj fim m totjp* oa taga j*ao<nninm>3 n jnq an* * inoqiia J*dd muiuHum Jaiuitp toound jq> *** 01 <nmbui inn ti i| Iqo* Xq imiorfooa oq X*a njqtpann ttq `imdd* i *rapj ttncjta * jj -tmj a tttn j*qp n uo inq imnui tu rq j taapa*u q> p nods oqt xnq nuts Xjj*d qng 'ovun p jo} tpro i otaqo * jj `jopjdjnjS! q X*d ana aopnajd q aunitaj Xqoatn*) oooqa Xu*d *qj, *u*q mq p ntupt p oaompmao^ qi jo i**ojd tqi MddM JO 'jtnJdj*iBi qi soda oatl* oi *ru*d *n joj JB*q *t II twH pooaraivnip ttq*n*j toot oq ana *h "op atpnrud jq3m jw*d q p ao pva dtvuon*ij Minq praonad jo * dq*atq oooqa padoso* oq ** J*x*JdJm os tpofqo jnaoiniuimo-j oq) jo Xi I oojp oqi n `popvwJd oq ppoqi Jiwdarn poadaot Umtss* qtqXtQ *<n ftnqa P**Wos pa qoodt oi wqaan n ombu Xa jo onruod oqi a Mm* *qa l*n rtfisoo* n ti -ptftn* ti n oqa .sonoopmau ^xpsoora pun* pc* mount. InuoJd jo joXoidnt soda >mi oopjnq *q (top pot 1>s "V 0**q olKqap oodopmo ton * ana oq aoojt* n apan andoq aoq o**q qaaXM qono joip oofaosndaas p p*ou*d doa a up jnxoplan oqq oqa -opon* ji -aXoplsa oiq sods ipu pojd p snpaq oqi XnaaOjj Xttnqvap *qj Jo ooj**mp pa* nattra oq> pa* Xisfa j % Israaosso X^a*l TCP pc* tstq pnrtnn oqn nsowdqd jo aowudqd oq) imud *0 Xqctanda * `(an oqt jo toe*put J*qa JO oi totoosqut Pnjtoorf R isupoq *n a ttuq pooqt to* tnp nq} apjaa Jnqn j -p*a*| Xwsodsost qj ]s*t aeq `Ssumq aqt ojoprq porno q Xjto*d*o 1 a IP) "pc* ptaq* n***j " tXtp SMJO o**5 jo JOJ qaa a pmtpodisai Xirryod jo Xgg * ooxoplsa oqi itqj (J) TBOo^daa p mjsoo at pa p po nu Jt 1*01 (q) twapao* > tr*cm an (< * " *Iw4 H 4uflTOJ0 PfTIOIn miunifj wi aouwuwaM m *. .. .xa* Q. *) t/2^- /' <2y ^t .-- , , , , r . /7-- ^v---t fig- . ......................... ^ nS Bn^Jbfr. (K^t. \ TT Ib)'7---------------^-------:------ ' +-* eli !7 litr -------------- jL2z:.'Szr:r. rks. / / 0--JVi f) UU1 / JU|i O'uhl .'v^t.|n t> ttju/so/^-,^ *K / 4vll L.U Mu ilu.Ui|? V*'-^ /gw 'SLi wL-ei^U v "VC^lSL- t w t-U \ - W.' - cL^ tAvfcwI&lvl, XfciL^ ./JLl^c i.>( ^ iH*? rtvJ Cw^Clvc*. ^ ^**1 T ru, ^ ^ ^ S^V zluhu-. ^"V (f^" J y-*^ r~h (J - .uV 1^.3 -jftwO 11 ^ A< it >hi - w4.j> uj^jif 'VOW* Ift ^ ! t VV^Ov^V Ut_L'O^VW| ^V\ ufy ^9~Sh 'fc$e( /^W w^t (C^> A la^J^ -- dfcfcafc u^^tCw^- (i *Q .V "t u^v|\4 "V*^ ** --^*>*<0 \^u[u> 'b |J,[ujti p- 0 Vj^/ # t_ ilMu. TT ukkt '~\^\ \ iJLjvM 5 lu X ill* lilt liKi/u \V|U(v>T b' X STATE OF CONNECTICUT) ) SS. Bridgeport COUNTY OF FAIRFIELD ) CERTIFICATION THIS IS TO CERTIFY that the attached is a true and accurate of the Agreement to Compromise, Petition to Compromise and Order from the records of the Office of Workmen's Compensation Commission, State of Connecticut, Fourth District, in the case of: Benjamin Crooks vs. Raybestos Company, now Raybestos-Manhattan, Inc. and U The Travelers Insurance Company; The Hartford Accident and Indemnity Company; The American Surety Company; u! u n J 0 f iny Hand and seal 1S7E. J3IIN A. ARCL!01 N `n u r < in e n Comoensition C o nun i s s i u n e r Fw u r t h 0 i S t r ' c t > I Bnijjumr cRoera -' 32 Seward Rlaee Bridgeport, Cooa. CiAIttAHT' W` CORAH f coemsArroR conussioins JU73E3T03 COTPAKT sow RAT3TSTCS -HA5BAT7AIT , IRC. . rmata WORTS COSCRRSSXOnAX, 0X37. ahd n* sxavexzbs rsstnujrcT co. iwryoro accxdbwt ajd numjiia co, AJTTRICA3T STOETT COOTAHT BRIDGEPORT. COmCTXCOg OCTOBER r* , 1940. AORTTitTC TO CnTPECTtST miTIOR TO COCl'ROriST AED ORDER El"`ERAS on or about th 18th day at April, 193S tad for a waiter of yean prior tharoto, tho elainent, Boejasia Crooka, at Bridgeport, Caoaeetleut, ni as eeployo of tho Sayboatoa Coepaay ao Haybeatos-Hashattaa, Ine., of Bridgeport,' Conn.', and BRRRRA3 tho aaid `espleya and esployar had aeoaptod asd ooro at all tisae bereia seatiened aobjoet to Part B of tho Bortason'a CospeBtati OB Act of tho Stata of Cobbsetlsat, aa mended, and tho esployar had insured ita liability thereunder for aarioua poriodi dariag whieh tho aaid elaiaaat oaa ea^loyed with Tho Traoolara Insurance Cenpony, Tho Hartford AeeldoBt and Xndesnity Ccapany The'Aaeriean Surety Ccspasy,' all of ohish aaid eespaniaa exist aad do busisasa ssdar tho laws of this Stata aad aro duly authorised to tabs aueh Mika ia this Stata, asd WHEREAS the elairent elaisa that os or aboet tha 16th day of April 1S2S, ha roffarod aa occupational diaaaaa, to olt, aabaatoala; aad ftrthar elaisa that aaid occupational diaaaaa aroaa out of asd la the escrso of hia esploysent with tha eaploye?; asd further elaisa that aaid diaaaaa la aespenaabla; asd farther elaisa that ha hae beee diaablad fros all work aihee April 4, 1940; and further elaisa that ha will he diaablad is tha fttura, all of ehieh aaid slaisa aaeh asd all of aaid reapecdente dairy, ar.d a partial beertng..cf aald el ala *aa held an June 13> 1840.before the Compensation Geaalsslener of (aid fourth Congressional Blstrioi aa *111 acre fully appear la the flies of aald offlse, aad -RvrvaS th aatd "njania Crooks baa a Tift, Bora, oho la a petastlal dependent, aad ranois the aald olalaaat oaa roproaaetad at the aforesaid hearing aad is boo represetstad by counsel, aad HBW It la the desire of the olalaaat aad the aald re spondents to reaeh aa emieable adjustaant of the abeoe disputed elalas to the end that farther litigation be avoided aad doubtful aad disputed elalas ba readared certain. THIS S TO CtHTlr'i that I, the olalaeat, bare agreed to re ceive from The Trerelers Insurance Coapany the eta of $200.00 The Sartford Accident end Indeesnlty Co. tha tua of $700.00 The American Surety Coapaay the cua of $1200.00 aakiag a total atsa of Teent? One Ruadred aad So/ICO Dollars ($2100,00) aad v* the Insurer respondents do agree to pay to tha e-laisaat the la above specified, to sit: The Travelers Insurance Company, $200.00 Tha Sartford Accident aad ledamity Coapaay, $700.00 Tha laarleaa Surety Coapaay, $1200.00 la fall aeeord tad satisfaction of above dlaputad dales. ABB TO 7VRSHRS CTRTX3T, that la eenslderatloa af said suss so paid, X, the elaiaaat do hereby resitas, release end forever discharge tha employer esd all tha Inaurar reapendenta frua all dalaa for compensation benefits ehethar for eoapensatlsn la say fora payable to aa uadar aald let or for ewgied, Radical or hospital benefits payable on ay behalf and sfcather said elalas have already arlaan or hareafter sight arise by reason of afore said data of occupational disease. ASD TO RV*iVvs C,S?IrT that X, Bora Crooks, vtfe of efsretald elsiaant, Xenjamin Crooks, agree that In consideration of said suaa so paid, to remise, release end for seer discharge sash -2 Bd all tha-aboet aasa4 raSpnodentafros any aad ait eiaixa blah Z sight harsaftar hara agaiast aC7 tad all of tha* by raaaoa of th alleged laeurriag of as occupational dlaaaaa Iff tha said Benjamin CrocSea, while la the employ of the said asployer-reepoadeBta, AID TO niiZSS CZSTIFT that ee, ^ tha claimant asd the Feepoi^enta hereby tutaait the arittaa agreasest to tha eoapasaatlen Ceaalaaleaar of tha Fourth, esaaraaalenal Eiatriet asd reepeetfnlly- ask that aald agreement say be approred with tha fora# of a full aad flaal award. Zb witnasa thereof ee hereunto aet our handa tha 617 aad data flrat store written. _________ _ WirR Alio-#OTF.hTiAL CMiiUST" JUTBraMSrc'eifPATrT BOW *AZ3r3703-KAJmAT7AS, OCORPORATTO txt. TRAjr-Kns zsajSASc* cchfawt gyr HAitrrottD acaiagT^p np^ryi^cocPA^r Bn ATWR1CAF SBBETr CCHPAfT OF Iff TORT Bn Cfrv . Vtehr.NSZ' Approved thia ` 1/ day of October, 1M0 w / OA*t/<*~$***--- Compensation Corrrijalonar .. Fourth Concessional District |w \ f / Hired 6/7/35---- L.C. 4/14/38 " jo-.T.ir. - ./priced in. cue ape. ?laa t. as..a..weaver . i .ce ve r. pr&$.d.. ia..Pe. - : ratford Hiaat -........No .re cord'. of. .pis. .^apiov^ent. .**...7er..sJ.V9S..Ko....... nf-- **.^1 No card ia easir files w.i-i; were started Id i937..u.t^::^:fvss:rua^:::::::::::::::.::::::................................................... Pfcns..request.. fr.ca,'taa..nurse..ia.f&sss&st&t. factory,lie-tical. Sept-fo j iaf.cra&^.too. .casa,r.d.ia*5. Jc...PX-cotes..........3Jas. .aoi.e. .ice. 7as. ,v;cdciag. .Cox.......... tad .s'eeo suffering.frcm. c.ca.?iau*i.. .attacks ..of..crcauPitia and... :it..2e . nad coil.-er ie..was..conpeasst tar.. case. wra.a.for.worked..fsr... 5if..r:*y.l9S7OS . J0B?ea7ft............. la. . ix.s... .f.orCA.......... ! sack. .r.epor.ds,..it...fd.s..discovered..tost. !,...p.r.cpks..*us..a. eoap.eas.at.IoQ.^ case. of../asbestosis" ..ii..l&Q..dfti.?!**..4..case..wc.i.ci was ,settled for-'' v2i.C0.6p. ' ...pais"rife:rred. to. iir.,;.;7.. iiap.sor. 'c'/ jEudaooi SeU^aE?iJjM-4jeo0Mjr'v--'.v'-;iz-:. *+*?" Er> ^^"_2mJ5, -r ZC^aM5Or >MM* -'' dg a CO J ! Os -- j t53,3-J]i] rtj ao-* oh<Hii {- n9M*- * wo Ma9 MWca wu C 1:WU ;t: * ' . ^ Wuoa4Oco*W9a0>gS,--aWpJOfbOB4i 0 <*o*0 s>D: 0c tt * ID-C ?4 .- 9*5 ** 09U a-c* **0O M0 --ce4. --sc a w- ocbOO M0a9c9 b--aeCo0-* *abbo**mcOwWwuwCouM>nsca% - mWC.SStS3oOh* *WbSUtrUo0H-9-jM09OTes5-m*0wMWa5rCU*S*rw*MM4--99*-*-WskwwboouhC.>owMawWbo0ow9w0C9S00o 00409 , ^' ,'j^ D46 0* 0O9 009-0a 0UJEomJJ03 -W0s bb0 *Ww4WDBSg0O094 wOoB Mwww>090O3s00C00*00a0mSau0>e0O0C1L . W 0 Wa, m jCzD cm . Cr 53 Zt.'G -'X0. 0 wj=c o0cc 4*dc*.m m ca e Ow 0 0U --.904 2 a c ^3 Oa ^ 9 VMS 9c2 9 a a 90 ^ >0e02 1 0S r-sta --' --- a* cCS' .Cii *^01 ^ " 2fl E 3 r0* 0 90 o ---s m . <^o4M*4 U(o4 it yoeWcs -h a 3-- L, 3wS* S*t Vl >a 9 2e 0m -- 3 aO_ ^5 O0M0 C BMW --* *-- o-- y>ci'or rC?E <<b ^occ :uo 3--< S a 3o' sso M J 5 02w* 0 >**> Ha - O0 MC. o C3 uc ue: "i ^--r0st> w'wJtj0S0eo+Z>-4--*~e*00c45H,*re-bb^a0^a~"3--o=9c=1..w"?a-cOH3V'j*Oi wb0(.*--r&ryc-.----e^ii3BaSc- it ^ 8J! a --t. *to- :3a O bi M XaO2Mbe3eUt ww^-0O--0a** O 0 ?^ STATE OK CONNECTICUT) ) SS. Bridgeport COUNTY OF FAIRFIELD ) C ERTIFICATION THIS IS TO CERTIFY that the attached is a true and accurate copy of the Agreement to Compromise, Petition to Compromise and Order from the records of the Office of Workmen's Compensation Commission, State of Connecticut, Fourth District, in the case of: Pasquale Crocco vs. Raybestos Company, now Raybestos-Manhattan, Inc. and . The Travelers Insurance Company; Tne Hartford Accident and Indemnity Company; The American Surety Co. of N.Y.; The Employers' Liability Assurance Corporation. 'j 1 U .'I U t; : ?tw. in / n <111 c! jnd Workmen's C on: u ir n i a t i 0 n C 0 mill 1 S S i 0 r, e r u r L h District  f-set /as csecco' crvznTbi caress Cospeasatian Coaaissianer for the -Fourth Cangraaeianal 'Blstriei . a* *111 sor* fally appear la tba filaa of aald.offlea, aal ... WT!HSlfl tba aaid fasqula Graces baa a alfa, jury, ed mtib adaor children, to Tit, Anthony, Xlebaol, leotard, Tasquale, Sr., 1MT7 Louise, Eaysead tad. Eaiat Croeoo,. all of *hsa are potential dependents, asd. r 1.- . . fF^BSAS tie aaid elalsast *as represented at .the aforead d hearing tad la bo* represented by_ counsel,- asd . . - VBBSAd' it la the da aira of the 'alaisant asd the add res pondents to r*aeh aa aaleabla idjuatsest of the abo*a disputed elalaa to tba asd that fwther litigation be arolded and doubtful asd disputed elalsa ba rendered eartala* ... T52S..IS TO CSt3j?T that Z,. tba els'.sent, bar* agreed to re- eelra tree.: f --. /v- &a Traaalara Zaaurasea Company . .. ... .. ^a Sartford Aeeident asd Isdaailty Co, $3iM. 3*5.9li Xba Asericas Surety Cp. of Se* fork 530.82 The Ssplsyert* liability Assurance Sorp. - 11.10 saidas a total aus of TTCL7S 7D7BRZD FITOC ASS 70/100 - - - DOIiARS =d *t tba insurer raapeedasta do agree to pay to the laid clad the rs shore specified, to vlt: . - . Tba Trs-ralera Insures: a Cospeny 3WulIi Tba Hartford Aeoldast asd Indeetlty Co. Tba Asarless Surety Cospaay of 7a* Tork 5*3.9t 330.82.; Tba Saployers* Liability Aaaurassa' Carp.' * 11.10 Is full aeserd asd' satisfsetion of abora dlsputad elalsa. ASD TO /ITHTbib CS3TI7? that is ooaaldafatlos of aaid itsi ao paid, I* tba elainant, da haraby rasisa, ralaasa tad forarar dis- sbarga tba asplsyar and all tba Issurar raepesdeata froa all - - eld aa for eoapaasatiss basaflts vhatbar far eonpensation la i&7 fora payable to aa usdar said Act or for surgied , aedled or hospital benefits payable on ry behalf 'and father said elalas bars airsady arisen or hereafter night arise by reason of the afore- ~ said' oIlia, of occupational disease. . ' " AMS TC 77R.Z?.I?. C3TU7 that 1, Hery Croeoo, *lfe of aforesd d oiiinai, ?asquale Croeoo, do asrea that la consideration of sd. d nu.10 paid, to real**, release asd forever discharge each and all th* above naned respondent* from any tad all elsis* which Z might hereaftar have against asy asd all of them fey raaaoa of the alia gad incurring of aa occupational diaoaao by th* laid Pmsqjial* Croeao while is th* employ of th* aald employer-respondent. 1XS TO PCSTSES C2STZ7T that 1, th* claimant, Paaijuale Croeco, aa parent asd natural guardian asd next friend of aforesaid miser children; potential dependant*, asd Z, Vary Croeco, arlfa of aald Pasquale Creeeo, potential dependent, and sotier of aforaaaid miser eiildren, asd potential dependent*, do, is further eenalderatios of aaid ansa ao paid, diaeharge each asd all the above caned ?#*- posdenta froa all elalso which sight hereafter be aada by ties against any or all of tie aboee naned reepondenta by r*a*on of the aforementioned alleged incurring of as occupational diieaae by tie amid Peaquml* Croeao, while is the eeploy of the above naned employer-r*spondent. AHS TC on*"** CZaTZTT that ti, the elaiaast and the respondents hereby enhait the written agreenest to the Cospessotion Cesaijsieaer of the Fourth Congressional Biatriet end respectfully .talc that acid agreement any bo approved with th* ferca of a full asd final award. Is vltneaa thereof we hereoato aet our hand* th* day asd data first above written. s-- //r srInI ^ /o -.-yoJLlw: CH'.aant, parent, nature, guaruian .and- next friend of Anthony,diehael,Leonard Pasquale,fr.,a*ry Ionise,Sayaond asd 2m*aut Cbrrooseccoo,, p;eoietean~ti>a.l es laisssta. fotec SAZ3ES?c9'em?air;,5oir iaxhestos-dASEimj Ccr.5r93sicr.Al >. .ITT ASS02A5C2 CCRP. U 204 4-14-83 EMPLO ;ard TUI RAT* ISION W RATUSTCSJWNHATTAK im. S3 /C49-C7-6396 Croeeo a ___________ lagelo intho^ nmwr to Main St., Stratford, Coss ESSSt*. Catholic Italy M Mala _l2i/zr-2K ____ Italian M4CC sustncaa csuiat -___zsa New Departure Coapaay, Mery Croeeo uAunn rot Bristol, Conn. Ibcrw Seater MNuer fife I to wtoN tor tSS U11U70I 0ITBI0M. * ftAYSBTOMLUIBATTAtf. tea. *.* m tea mar at s. lrw< ad wwHku by -tear tea wnw to tontoM far ay -- blaimadB to Kartm-- Maabatraa. tea. itoaMifto nadlttaai ttmad Z totto ayraa pi--Ur ladana _ tea. ad. sad w>ww fawto mil ftdai a ta paami aiad ail latmmaaa ar iiipwb aa ar --waa by an (im at ar mtrrt>eymtaua --itoutwasr. a*tto<Rayi bfmamaanaMa.aibittnakrtai ai . teat. astol mr ailiwat totb Rarbrnma Waabanaa, toa. to tanamarad ta ar to aar nr l ar mid by Bayba* km. racardlna at naiba mid iataaC, _ ________ _______ _____ _____ __ _________ .. ,, _____ __ _________ _____ __________ ! aim araa that wttou firttor ar atom araaitejama I mil i--tr Raybarm Maatoamaa. toa. ar to-maanaa ar `"'r* ttoa tfUa m ail mad ------ ttoa add rw--a sad mU ana sad daitoar say sad ail man aaamaary ar dmim**# (a ao*ty (ar ar abaaia Uaitod Seatm ar faratya paiaaa add na saamam otlr tbmwta to Riybmana Maabanaa. toa. or to <aaamsor ar aasivaa. aad wiQ partarm ail yaaaar aaai vttete mr gm mairr ar tomtoad by Harontm toaatartam Isa. n abeam --a. * -- m Bartimim Miaaaaaa lam. (ar mab iavaamam ~tara add a -tonaerm aptwa Rayhauni Maabaama. tom may toan 12*19-32 bsry t-irrvr_ aaacs ro* acmsvcmmti. i*pmna, auddcariona. ere. tnr.otri naiuTMSf CMtoUOVMCNT 6**0. mnaraa w* toto^s. DAt 1 KfATU ; okpt. n nent I _I ATT I *caoonk won CMAMOK IN KTATUK. CTC. :|rm -t,..,-, . COMMKTKMCT Part}: aj ~/7 " 1 / i~i z.0 U I * 1- 7/i (A UiAjUl Mucu ' ,1.~ `TTAN ^C. ~-r'.***f~ ' . 5--1-- ~ ( r `f-fr^LsCA^ t , .'*-4lCcj* ' _ ' ^ s?*-//'? "it* Ct'io/Jtm** %** syyt&CL* ~ u/-2~ ~ sssssr I*c *MO/HIM(l< (KUII , ^ s%u<r<5&ej^ sC</L4s*t*+~' rf tkt A* W<1lw< MMimtf ----- t r m Um teu bn( 4 i--iaaiia kr wtW a* asm 1laifcMi MiiWWi la^. . aai nwww n________. __t_U___4_a_a_i_M_a_____iM _____________ ___ ... n am* *t my Mtmt ta atitr at lUmaw Miaha--a. taa- atil r biiif n Mia lirfi m -----------l---l-a----u---i-n----i-a---a------a-a--4- M-il-------------------4*U*m mr aa4 ail pwri mmij m 4tnMa tWt fa* at atmta Uium* itua ar twin i an aatiM tm* tMaa m ! Kiilinn laa- a* lb imiwh ar Min, m *iH yea *U r------- ~ - - - hiMM Miiaat laa. tm wmk b /&A? & /!*> n a fn r '? " *""* ' ' iwA.tr, .H..TVM IM^UOTHCNT CJJID. a IM* IbbMM . i r4-_/- /-,v*f [/aor^e*^ -!** off 1 i/tfj"rttSNT *ATB *' V/lj7 UMUHT ,/2 Casons row tnansfcn. CMAMOS IN STATUS. CTC. nW <i**K iT-r-Jil r-<^ */ ! J/5 lr 1 *-^-57' - `M-jt -./-* k. t'ri.^N 1+^ *(L <#*(! 3/8 .(To <M 1 l8S~ /37 .*l j/ ,' t`>r?9'*csuA t'Tifr /< n j^-jy /cH hL\ io-i-if <%. l^cJZ ___2 ?iiljl. jt*/'' >iT' 2j-^ *2 fo ,i"7 J7 .tf/f J2l i. j/ I 3-/5-Va '.' J jli ' $*<.tt -* mj4*. JaI^I ,i ANNUAL CANNINGS || SATC AMO 1 TOTA4. ANNUAL ;| BTT* SOW* KAMMtMOO AIN I1 II l II 1 II 1 ri 1 1 'i i ^ *S cvoLOr vkn t meo is at m scsrot clock no. I **r* } twTT | joa I tlilON worn CHMOI -5-a_ %M** 1 1 /S' \ gtU JuJ 1 .n. 1 1 2 I 7/ ! I? ^ A l'9pt Cfcaeg*____________ 1 9rift~*z 1 "7 "1 1. l 1 1 i/yfr Jot ,'i* iS****^ ^rr. Ii lI '. Ja-ofl ir 1 J</ "l /S 1 1 1 i ! /. 52 1 t-i 9-4 i "<*n ' ' i 11 11 11 11 -- - 1 1I 1 11 1i I _L 11 1 11 1 * i1 1 1 11 11 1I . i I !' I ii 11 11 11 liI Iii IIi i1 l1 ^1 i IIii! I! 1 I I` I I iii I! I iII1 ii ii ii ii ii Ii LSj___204 Crpeeo jLngaio_ i&tteaz. 0 tO 28 JO III TO 0 { 90 100 trii;cp<v3.ci-jto,i2Ci onr.aoticouri,. ei:ili.-ci sad cHas'-i dsyongutta or ioscnsad oiclnsuit, reoeo, c -o s a a o;::.::iCA^r-u ccjanujiviss CL-'K'j.'TS VS. JelAi Z-itSrSs-tXr3sr-di,SACtKolArTaT.A,H I!W., ituriis! cciisaxcsr:?:.*! snrrr:a Employer end 72-\'.rz:zr^ ruJ?_'u-iJ3 cai'pjirr, a? Sriicsparc,InIsssuare*,r *cd hasisosi* acrossr k msrKr?r co ; oS l^iigspart, Cans* , Insurer usd Of, f,tf ; r#cr a.HmeweiEmejvecar,aSssarnac.s,u'dST or Insurer . . SUi-LJEMS' t-TABTf TTT A3.TJ2. CCH? oT Hew coven, Connecticut Ywniff^y sras?opsff?3 '* OCVTDHHa ^ i%5. rr^Tif, av3 .w-s s? y_T <-!.> nx? - Upas ->** Triadin. and roresaiss stipulation Heins sah^Lttoil rd -w< ~-ji b7 tSs arisraiessd, I iisi. --=t tie sens is a ini nsd squitatla acttlcuoas ci a. dispetad clala. rc~?JS?orT it is ordered, adjoined nsi awarded tint tis an 'j :l i*'v X ... f * * .*. " * ' ".* - * \ ` \, * .* *' . Ti'bp* I : ... -.V.-sn ii . ,r,..s, ..... , '5*- ; i <1' --. -- iwr w nrIII | ca KBIT XT ortsr Sia "T- Carver, or ibt alaaaaa at sosditloaa lSilsl of arlaa la tho fstar* as aiieoeat of tio cli.iaed soeditisaa. rZSSttS Mali daeaaaod iliiaii, la fix mat eT a llsiisj et ooepesaablllsr la tiia taae, scold Sm baaa aatitlad to $317.28 iter tejotw? ttal 4iaaillit7> aad all lUlacti tad dapozdtsta in tin oalr lairs at lc at tail daeeeasd, aad by till eeseaaat tiar tpM to aad do lara^ ladasalTy tad aare leslau tio aspiartr-reapoedsat asd iasBrer-reapeBdaata JSsa aay alala or aay elarsoter ti*t aisbt SareaTtar i sad* rsr as7 tsepcrary total 4iel aeeraod dcrls* tie lira or tie fiaeaaaed eseustlag to >317.20, aad It rartlar aoataadad Hat aold aattlacaot aball b bizdiic upoa all partial. ZS la Tsrtlar acead flat till aattlasaat ahs21 la apes aid elaiissts, tialr loiro, exaeutera, d._aiatratart, caslgsr aad saltier its, bo tor tiiy elall feereaTtar eala tty cieis or air ala;attar aider tia lasts or aald Cssjaiaatisa let br maea or aitlslricr tiia astota o." aald olalaasts, or .tier alali set bar*-- arter aoice tar asal alala tlroucl asr geardlaa or startloro ato ilrlt lator bo appsiitad to rtpreseat tla latoraot oT aald elais^ eat. -- It la rurihar stipulated aad t(?eed br aad between tla partial that tbla t esipalatita aad a^aaaaat tras sat ladueed or altered lata br iraad, ossilent, slates or tass ea tie pert or liter pertr and **-- -- -- --------------- *- - - -------- - flit! Tsrtirr rolorasse to said air. la, It la agreed br aad betseea tie parties tiet aald tleltv.t Sara if agraa to laleaairr asd ic-re baraleea sail rsspoidoils drsa ear elala that aa7 ierearur bo soda by *eld alaL-r.rt, or br aar porsea er partcas ea aeaacss or laid ST TCT7 97 TH3 Tcnrtcst, os, tae eaderslgssd, let-sir caito la reduestia^ tiet tie Coapaaaatlaa eatslaslaasr dir tla foertl Cea.7ea:isael 21ctrlst --trs a rindIts aad rsari pcrscaat to tUa stipsletlea. 72 "333557, sa ItTo larecato set sis laado aad aeala tlie i dar or Cats bar, S. 1919. r? CTl nv' ' jl--is ua aiicsea csscicsit eT deeeesed aleiasat. ttliila'aai allseed aopeeaeat. Soar ydbeaeaotoeaaa-drr/sirl-aialtataaaa*tZZ" aeee..,.* I (fcplarr-rospeedoat EU711ZB --. Iiaumr-rsa po.tieet Sarbcitse - faalattta ie.,i1 Seplorer-Ttapo.tde.tt ; ftsd ( Ha.T CC > t * . \ * V ` j* ! l /-a a;, ru ^ 3hy&iytai-4>pwitttt &ectad jBcnZrssAaicr vss^snsfrprocssd^dajtst9 .BT u^jLZJ; IUircidMEsUplla^r.o'srE-rsaaptcttcti^liireS ., astffsiB' izashitt azccz. CCS?,, Ieac*r-rt>pcsiUai , 'aoir A^t^rss7s t Miwa^iu --r*~n ** * > ww*** *# *uw^{hWyj m ji** *itZSO\Xi n .**iii wr.wrCTdsM Scrsttp vsoAd ttq hts q-. Xfitrfibj7 ;*oax q jj __ `IMOftl!iUiU*J TfI .Cq pvnfll iwotferi * Xq pnd= aq Xaa aosapsact arq `rertia n Imp, nnu * - -papa ntoo jaqp sc wi iflr. q tMiosua site trq p nn;uci aq; p inadn aq; Jaaq ns xuad qseg ___ *>E? ^e^saa t?q ioj apis *? *Sjw5 f 3 `erartoa;si aq; xad ana goqTniari Xeosvaai aaeqja tisti iq -tsunq aq; p aaeeape m `raesittqsseg aq; p y^ojt * q; ua< n aatimat r. aedn a wind rei joj .-ar>q n ;j wq ^guqgqq 9"* Waqw leM *q gng *H ?d ottn(od ;qfrs aqM aq; p ns qwn dpiBugapo mandq pn [mud *e *fl drqtc^ atqqm paidaeoe aq q jaiud-fin; oq fBafqo raqoiasnsoQ aq; *o X; dad waap aq; n WMaed aq ppioqt xaurtiaiat ptpdioea a tdanfaa; qi|dita "B Xpaaje peas napaa pea 1"4< at ttqiim q fetes* Xee a 'mued aq? p xaqqe oaq* aq? (a??s*aaa a? g pafcqa j? etqn .aqisaae?. r .gBpeaeaic [sap* pea noue,, Jqpiart p axotdsa a^ada a< sapxsq aq; sop aa? -05 -qa* a qeeq aS 0? qqa q aaxopsa aq; anoid ^ aq qajirmja a apes taSaq ?aaq aotq nosXtd qeee jaya nnaaeadana p jaaolXtd 40a g aaqa p adsidsa aq; aqja apnea lai -axotdse >q? aada ou paid p aapoq aq; XRoeeSaij ajnqatip aq; p aequap pea anas aq; pqq tata qs *mpmm ivn saa pea sp peteag aq* teamlqd -1 aawudqd aq; icaaaxd ui? Xffepaq* pet `Xaife; aq; p aeepp* aqp a a aataaettn etqpaod a rtqraaq aq; a; Stgtq ppaqt a qa aq; apma. aqp ej -paaai Apadaae; aq; Pep aq Pqxaaq aq; ajar? Pa aq Xnsadaa efl (?) ?eapaaq;qeiaiatdapaa*aaeaq?eiBBia;qje*?aia;padaseiXnBPdpd(ta? a* * daid= aq; rtq; (a) qeasXopsa p atsua e? pea p pa aaeiv q pq; (q) *paep?ana nf*-|-ff in f iiwi 1 Stnttort, e8Sd * ?*L. fUS3 --1 V*. H T, l* ^ A. / ' . TV. b^ntti SlTiaias of Stratford, Ceaa. Zse., Saer Saetar labarca: l! IB* tweM - pa- falia1=* la a report ef sr ee^lata nulatiu or IB. Issale Craeaa on Slay 1, 1MI. filaf Coepialst: Cogl, ?aetoratlea and atateane. laefly Slatesro Attar asd aotbar bott dead. at aslcsaa. Sara It 3S blatar7 ef any fasdldal dljoaaaa. Teat: ________) ealltteed iiinm. So ana 13 tSa irldcaport Sapltnl far a Histr oaadltlo# la 1939 had ttaebla lion. !id to ataar aorlaoa lllsaaaoa ar aporatlaea- tribal njtoryn So la ported. Sla rtfa la dead - died ef Oaroar. Osa aaa art ose iar*ltar, aaa M ud * lifts* asd anil. Sesepatta fiatery? //d- ____ - 77. . .-/L'4 U " c.` . L // i - J ~r>TZZ Thila la tta aid eenatry la Stnly a* oriad as a fua, art a*ala aton bo rettrsrt ttatt far aboot ala yanre, botaaon 191* art 19*0. Sa oaaa tsa 331 tad StaOaa at tta a*a of 19, Is 1903. Sa aas Srat aeployad at 1* far fopartsra ZsnjtV Is jrtitg;, loss., atara ba aorrad aa a selter of aeap. Sa forbad tbara tstll ba oaaa ta Jrtd*aport Is fasa a' 1912, abate ba lira*, aast 00 writ at tta Uytaatsa aa a aamfas. to 191* ba ana 1*" "`J*"4 * Italy anara ba raoaisad astll 19*0, afcea -*aqn--s - ter*ad to taa Tsltad Stataa art aaa a*als aeplayad Is fassary 10, 19*1 by tta laytaataa toflalas is 3rtds*tort n* * mT,r* -* ^ ser* * *" ntl3Baca_ ecaleyant, assapt for lararsi assll lay-off*. Son -fa ta 1939 at tsa Saytaataa, art aortad aa a mte. J 1P39 ba ana trassfarrad a -- a Stratford p-ast, -- -1 alllftltot laparBaat aa a aaaopar, atieb ba baa Saa^Tta tta jraaart tire. Sa ^ ba aortad sera er laaa Is tba faettryi bot -5r -at,, run ba baa aertad Is tsa looter roes, atieb aaa raU-.ltaly free of *ST * " id*1* till 1949 till IMI 1949 1949 1949 1941 V/ 4M* MM ( MUhii Mtti aariaaa's (npiMillM M Mvirk| ilk* IIMIH, MMftMil miiii mrt r im ew#f twfew *f rmtiu* Id ilk* MM 1949, 9*1 Ull 9M 119111 M total**' ft M *rr MMIIff 14 9*0 * 4HI MtCMal *f* far ilk* MV MM #f * MllM I* 44M MMlmvim 41 MMr ftMMI, t*r *IM*ll M lllfl r MllllMI vk*r* tM Mil Mr M M4rtlU* 9y MMM Ml tally r*SlllHf iM MOMitr *1 *r*v*Mtlikf * f*r m SMfllll ilk* IkklllUM #( MMMM IMI Ml 4Mt.* S*ltarl*l, It# MmmI f tM iMfiM* NNlMt MmcMum, 1119, *t*M Cmcw' (19491 *fl*CS IM 99,999 **rk*ri * M9l*r4 | tlk* MMttM prMMIM IMvirnil af Ms mtrr kM CimIi m4 mm MIIUsmI VtttfMMi Is ViriMI MMlIM IMMtrlti iMriml IMNtlM t* tM* fflMII MtiMliMlI Mlirl af a*a* al ilk* 1M If ilk* Mflul 9M(l*llM 1* **lr*M*.* situ, RMMtl M4 ;sMl*MMiU SlflMM salt* *mr *9 Mil m4 rifMil (sr fo4 i* #* 4vit ImII* an# --ti4s tM sail I* K4r m 9r*Mst Mr* mmi af MMlUlU. CMMIU raik#* *aMtui a* raMr a**t aaf rail* tor llltkM M4 M*S#9 (w MMMIStS fMtMta rvMSfttal Mlial r*yart af aiMitMii la aa iaaalatar MMitn *trlk la OmMi as*a. ArfeitntlM Mfir* 0kMc LaMar MlitlMi 9Mr*. tortuMr 14, 1949. fritlMif (ra iMwstry aa* *t**t* Mrcars m asMstas 4mu iM riMutr level*. CMMltMM toy nMMii i* re*art *aat IrvtU. tat* af Nit Virtiki* Marts NrUak'l CsayrsMtiM Uv esm>N tM 4iimt, aaMstast* Slats af tortl) Canluu Marts MrkMa's PmshmUss csvrilkf tM Slaaas*. iiMitsais Mrr CrsrM t*i4a> af Mttto Cracral aa* Jslw C(rrarr# t. iirMftifMMiktiM, TM Trawler* ^ Ilahsvraar* Cs*ys*y. sarifer# MttStat t fatossalty Cma**f. TM Mar Icaa Surety taapsay. toMrtini asMttasfs iwytMitiM data af yU<u Mflrvi Settle***! *r IMM.li it |94* latter *sts* My t. ilil, fra* tor. k. Millie tola**, Jr.. firstfar*. (pasmirvi, iMiestri Mt tkistary f tavsmrr s# a sftvrr far *iatr*a years *la*s silk rllairst im(mi aa* i-rsy /|n*ia*i resell*# fa itifMiu af stwetatta. TMrt was a Mrs** ratrtastM af tto* ftortiti frM e-ray la 1949 proof or service by mail - c.c.p. 6ioi3a, zois.s I declare that: X am over the age of 18 years, and am not a party to this action. X am employed at One Embarcadero Center, Suite 2112, San Francisco, California 84111. On the date below, I served a copy of the document entitled: NOTICE OF ORAL DEPOSITION (RAYMERK, INC.) and this page by placing them in a sealed envelope addressed as indicated below and depositing them in the United States mail at San Francisco, California, with postage thereon fully prepaid. X declare under penalty of perjury that the foregoing is true and correct. Executed at San Francisco, California on the date below. DATED: July 12, 1984 / JA^/rh Gudruncson, Siggins and * Slone 710 Russ Building 235 Montgotnery St. San Francisco, CA 94104 Morocnstein, Ladd and Jubelirer 255 California Street San Francisco, CA 94111 Winningham, Roberts, Rogie and Huber 42S California Street San Francisco, CA 94104 , Mark Rosenthal, Esq. Three Embarcadero Center Suite 670 San Francisco, CA 94111 . .... J McCutchen, Doyle, Brown ' and Enersen Three Embarcadero Center San Francisco, CA 94111 Hardin, Cook Loper, Engel and Bergez One Kaiser Center #2300 Oakland, CA 94612 Berry and Berry 1221 Broadway Suite 1880 Oakland, CA 94612 Law Offices of Fisher and Hurst Four Embarcadero Center San Francisco, CA 9411 Roper, Majeski, Kohn Bentley, Kasner 4 Kane 655 Montgomery Street San Francisco, CA 9411 St. Clair, Zappettini, McFetridge 4 Griffin 235 Montgomery St. #635 San Francisco, CA 94104 Mullay 4 Cederborg 1405 Central Building 436 14th Street Oakland, CA 94612 Law Offices fo William Duke 433 California Street Oakland, CA 94104 Foplka, Allard, McCowan, Cabrinha 4 Jones 1 Almaden Blvd.,,8th FI. ' San Jose, CA 95113 Norman Landau, Es*q. 233 Broadway New York City, NY 10007 PIfj txL i-h ieP RIDER A STATE OF CONNECTICUT) ) SS. Bridgeport COUNTY OF FAI3FIEL0 ) CERTIFICATION THIS IS TO CERTIFY that the attached is a true and accurate copy of the Stipulation and Agreement______________ from the records of the Office of Uo-fkmen's Compensation Commission, State of Connecticut, Fourth District, in the case of: Charles Mizinski and Julia M. Mizinski, individually and as guardian Of tU'O Oh 1 1 dffert , FTTimT ana uorothy M..-Mizinski vs . Raybestos-Manhattan, Incorporated and American Surety Company 3 i ven ari'Jer 197E. hand and seal tnis JOHN A . ARCUOI , Workmen 1s Compensation Commissioner vF-burtil District  * .`i -rf:jaU*K~-c'mj staa I Charles Ulxiitaki, Bridgeport, Connecticut, Eaployee tad. Julia?'. Klxinskl, ladirldually tad ta guardian of tee children, Frank B. tad Dorothy K. I'Uinaki Cla inants n. Raybestos-Uanhattan, Incorporated, Bridgeport, Conatetieut, Respondent Eaplcyer, tad Aaerietn Surety Connnny, Hew Tork City, Respondent Inaurer. | Corea Coapenaetioa Ccuaissionsr fourth Congressional District. April 14, 1936. STIPOLATIOS Affi temL'?#. It it hereby stipulated tad tgretd between Chariot iflslntkl of laid Bridgeport, tt eauloyos. tad Btybcstoa-Manhattan. Iaeorporeted of said Bridgeport ta cauloyer. tad tho iaerlota Surety Coaptny of Sew Tork City, to respondent lniurtrt TBAT, ZB CCSSHiamOB OF t disputed elaia arising out of ta Injury alleged ta htee been due to an accident which oocured oa or about October, 1934, whereby the said Charles BixJajkl ia al leged to have suffered ta occupational disease kaowa at aabeatoaia while la the eaploy of the aald Rsybestos-Benhattan, Iaeorporeted, a ecBprcBlae settleaeat haa been agreed upon by all parties son* I eeraad. In aeeordaact with this agreeaeat, said Charles ltlsiask, ia to rceciTe, and said Aaerieaa Surety Ccapeay, respondeat insure:1, li to pay, la a lump aw, without discount, the sta of twenty-one hun dred dollars (|2,100) ia full and final settleaeat of any tad all eltlaa ehieh the aald Charier Ulaloald ao hao or ay la the fatal bar* agalaat sold la^iatoKilubitUi, Xaeorpented, for ompoaao- tioa, aedleal, eurglcol or hoepital expeaaea, due dlnetly or ia- Unotly to the Injury alleged to boro boos natalusd by aoid Marita Ulrlnekl oa or about October, 1934. It la farther aadantood aad agreed that la addltloa to !bo Imp am payaeat icatloaod abort, that all aodloal, aurgieol md hoepital Mila laeurrod to tbo data ot thi* agreement bar* boot >ald or an boroby aaamod by tha nepondent employer, tbo Kayboat tanhattaa, Incorporated. It la alao aadcntood aad egned that raid nopoadant nployer, Kayboatoa^Caabattaa, Xaeorpontod, valroa aay elaia for for payments e-iabuneaenti ehieh It, tbo aald napoadoat mploytrHaoTaada to ho elaloaat Cbarloa Kltiaaki by ray of otsnoaaatloa. Tbo olalaaata, l.o., Chariot dxiaaid aad bia vlfo. Jail ! i. Itlziaakl, ladlrldually tad aa guardian for two oblldna, fnnk.B lziaskl, aged yean aad Dorothy Jlarioa ttiainakl, aged teal; tan, fully aadantaad the faeta to netted herein, aad aakaovlodg< bat payment of twnty-one baadnd dollan (?2,100) la a lan am ' ill ooaatitate a full, flaal aad aonalete aattlaaeat. Julia K. HlcinsM aa Guardian of Troek B. end Dorothy U. Uliiaelci *\ MYSMTOff-MArt'SS.rV-: V.S. Saaueadaat ttflqnr ^w^ZAZVSQCC8{S^9 Kaapoadaat lasortr Tba foragolag stipulation and agraeaaat la baraby found to ba fair, Jaat and raaaoaabla aai aquitabla, aad tba rna la taroby approrad tbla day of April, A. D,, 1936.- Conpaasatloa Ccnisslontr fourth Congraaaioul Diatriet. i tv ***'? ", ' V.! i*. STATE OF CONNECTICUT) ) SS. Bridgeport COUNTY OF FAIRFIELD ) CERTIFICATION THIS IS TO CERTIFY that the attached Is a true and accurate copy of the Agreement to Compromise, Petition to Compromise and Order from the records of the Office of Workmen's Compensation Commission State of Connecticut, Fourth District,.In the case of: James Cali vs. Raybestos Company, now Raybestos-Manhattan, Inc. and The Travelers Insurance Company; The Hartford Accident and Indemnity Company; The American Surety Co. of N.Y.; U en under my hand and seal this JAKES CALI, OAHIANT. ) CORAS: JTS- ) SAZBE5TOS CCUPAKT, now ) ooufssaiion coasssnans RAISETOS-iUNHAnAN, INC. Itaployer. And ) ) iwsra coNfflissiDNAL mssict AMERICAS SG3ETT COaPANT and ) ^ HARTFORD ACCEEHT k DTOBatnr oo) budgstokt, cunkelticot. And TSA7XLE2S IKSUSANCE COlffANT ) C M5BBNIIESTS. ) jtiO&Sr, 1937. XASgniBiT TO COUPROKISE^. PETITION TO COJtmaSS.W^* ------------------- w* - And w*' ORSBL. NBXS5AS on or abont the 22nd. day of Jnry 1937 and for o number, of yeere prior thereto, at Intermittent period! the elalaant, Janes Cali, of Bridfeport, Connecticut ma an employee of the Raybertos I Company now Haybestos-Ksnbattan, Inc., of Bridgeport, Connecticut, : 5 and . i wranaLO the amid employee and employer had accepted and were at ali tinea herein nentioned subject to Part B of the Eorkncn's Compcn- | .action Act of the State of Connecticut, aa aaended, and the employer had insured ita liability thereunder for various periods during ! which the said claimant was employed with the Aotriean Surety Con-j pany, the Hartford Aceldent and Indemnity Company, and The Trarelan Insurance Company, all of whieh said eonpaniea exist and do hoaineas order the lawa of tbia Stata and are doly authorized to tales soeb j risks In this State, end j IHEREAS the elalaant elaina that on or ahont the 22nd. dey of Jan- j naxj 1937 be aaffered ea oeeopetional disease, to wit, esbestoaia; j end further claims that said ocenpatlonal disease arose' oot of and in the course of his enploynent with the said employer; and further claias that Mid disease la eomponsable; and farther elaine that ha baa baaa disabled from all work fine* aaii I*muj 22nd. 1927; and farther elaine that ba *111 ba disabled la the future, all of i bleb aaii plains eaeb and all of aaii respondents deny, and VKEBEAS tba claimant and respondents ara in farther dispute aa to : thr actaal period# of neployment of tba aald elalaant with the aaii ewployer, aad , IHSIEAS the aaii elaiaaat and the raapoadaota ara in farther diapata aa to tba partiealar company carrying tba compensation inuranee during tba period* of the aaii claimants* employment with I tba aaii employer, and ;i VH2EEAS a partial bearing of aaid elaia waa bald befar* tba Com- | pensation Cooaits loner of aaid Fourth Congressional District aa | will aora fully appear in tba filaa of aaid office, and [ VHX82AS tba aaid Janes Cali baa a wifa, Fanline aad firs aiaor : oblldran, to *lt, Baserio, Pater, Bose,* Salvatore aid Joseph Cali, all of ebcn are potential dependent*, and. | VH2tAS the aaid elalaant sgs raprasentad at tba aforaaaii bearing and la no* raprasentad by counsel, aad I matS it is tba desire of tba claimant and the aaid raspondanta to reach an aaieabla adjustment of the above disputed elalnw to tba end that farther litigation ba avoided and doobtfol and dis puted claims be rendered certain* : ISIS IS TO CHITDT that I, the elainant have agreed to receive fron tba American Surety Coopery the son of Twenty Seven Hundred Dollars (2,700.00), froo the Hartford Accident and Indemnity ; Codpany tbo era of Five Handred end Fifty Dollars ($530.00) end fron The Travelers Insurance Company the cum of Two Hundred and Fifty Dollars ($250.00), asking a total sum of Thirty Five Hundred Dollars (3,500.00); and wa^tbe insurer respondents do agree to pay to the said claimant the eua above specified, to wit, The American Surety Company, Twenty Seven Hundred Dollars ($2,700.00), the Hartford Accident and Indemnity Company, Five Hundred and "S" Fifty Dollars ($350.00) and Ths Trarelera Insurance Coapsny, Two Hundred and Wtr Dollars ($230.OQ) la fall aaeord and satlsfaetion of dor* disputed slain. AND TO TUBEHSL CBUilT that la consideration of aald subs ao paid, . ; I, ths elalaant do hsnby reaiss, rolsoao aad forerer discharge ths player aad all the insurer raspoadeata frea all elalas for eoa { i\ | poBMtloa benefits whether for eoapeasatloa la eiy form payable .to as aadar said Aet or for surgical, aedleal or hospital hoaoflts . payabla on uy behalf aad ahethar sold alaiaa bars already arisen or horaaftar Bight arise by reason of aforesaid elaia of oesupa* ^tional disease. ARB TO 7US3BSL C5S32Tthat I, Paallae Call,wife of aforesaid I | claimant, Janas Cali, do agree that la eenaideratloa of said anas j 'so paid to noise, release and fororor discharge each aad all the j shore asaed respondents froa any sad all elsins which I night here-. gftar hare against any and all of theai by raason of the alleged I ! * Incurring of aa oeeopational disease by the said fans Coll while la the eaployof theealdenployer-respondeats, I ADD TO rromrra C1STST that I, the elalnat, Janes' Call, as parent, natural gnordian and next friend of aforesaid minor children, potential dependents, end I, PealIns Cali, wife of said Jane Cali,' potential dependent, and aother of aforesaid minor children, ond potential dependents,, do, in farther consideration of sold son so paid, discharge each and all the ahore Band respondents from all elains which night hereafter be Bade by then against any or all of the ahore Band respondents by reason of the aforenentioned alleged incurring of an occupational disease by the said Janes Cali efalla in the employ of the ahore Baaed enployer-respondent 'AND TO mroua. CBairr that we, the ellisant and the respondents, hereby snbeit the written agreement to the Coapensation Comlsalonex of the Fourth Congressional District and respectfully salt that said 3* agreement may be approved with the forte of * full and final airard* i \i i .T/TE QF CONNECTICUT) ) SS. Bridgeport COUNTY OF FAIRFIELD ) CERTIFICATION THIS IS TO CERTIFY that the attached Is a true and accurate copy of the Agreement to Compromise, Petition to Compromise and Order from tne records of the Office of Workmen's Compensation Commission, State of Connecticut, Fourth District, in the case of: George Siket vs. Raybestos Company, now Raybestos-Manhattan, Inc. and ~ The Travelers Insurance Company, The Hartford Accident and Indemnity Company; The American Surety Co. of N.Y.; U l-n under my hand and seal this 19 7a. _ 1 day of V^F^urtn District VW-iftil. GEORGE SIXET, CUBU8T. ` CORAH: YS. RATBtSTOS COliPAHT, now RATBESTOS-MAKHATTAS, ISC. Employer. COffESSATIOS CGUUISSI08ER, ad. AMERICAS STOETT COffiL.7 and WORTH CQBCSESSIQSLL DISTRICT. BRUCE?CRT, COK82CTICCT. HARTPCIRD ACCIDEUT & XRDEUNXTt CO. And TRAVELERS IXSTOABCE COUPUT Insurers RESP0HDE3TS. I DECEMBER AGRESfEHT TO CCUFROHISE. 1937. FETITIOS TO CCHFROHISE. And ORDER. WHEREAS, an or about the 11tb day of Jmo, 1937, ud for a ambir of year* prior ther*to, at intamittant periods, th* elalaant, Georg* Silcat of Ptlrfleld, Ccnneetient, wu u wsploye* of th* Raybeatoa Company, now Rnybeatoe-lionhnttu, Ine. of Bridgtport, Connecticut; and WHEREAS, tha aaid taployee and enployer had aeoepted and were at all tinea herein nentioned subjaet to Part 8 of the Workmen's . Compensation Act of the State of Connecticut, aa mended, and the enployer had iniuredi it* liability thereunder for various period* during whioh the *aid claimant wa* employed with the Aaerlcan Surety Company, the Hartford Accident ud Indmuity Company, and The Traveler* Insurance Company, all of which said companies exist and do business under the laws of this State ud are duly author* lead to taka such risks la this State; tad YHE3E1S, tha olaiaant claim* that on or about tha 11th day of Job*, 1937 ha suffered. aa occupational disease, to wits asbastosis; aad further olalas that said'occupational disease rcae eat of aaS la tha aouraa of hla plojaaat with tha aaii mploysr; and forthar olalas that said disaaaa is eeapsnsabla; aad farther elalas that ha has baaa disahlai from all work aiaea aid Jana 11, 1937; aad farther elalas that ha will ho disabled la the future, all of which said elalas each aad all of said respondents deny; aad lOZiS, tha elalaaat aad respondents are la farther dis pute as to the aetoal periods of employment of tha said claimant with tha said employer; aad 1HEREIS, the said elalaaat aad the respondents are la far thar disputa aa to the particular soapany carrying tha eompensation insurance daring the periods of the said elalaaat1 > aoployme with tha said employer; and SCO22iS, a partial haarlag of said claim was bald before the Compensation Cossaiaeioner of said fourth Congressional Oiatri aa will sore folly appear in tha filaa of laid offlea; and HHEtiiS, the said Gtorge Sikst has a wife, fherosa, aad six uinor ohildraa, to wit: Ealta, Ethel, Margaret, Goldie, George and Comal Sikst; all of whom ara potentional dependents; and WHEREAS, the *aid elalaant was represented at the aforesa laid apntad mhtfnl 4 to 0; ;un if .ts, do to d SODS rar . all n any or turn fore- of hearing tad Is now represented ij counsel; sad EffiliS, it is ths desire of the elstaunt tad tho said respondents to reach sa saleable adjustment of tbs above disputsd elaias to tbs sad that farther lit!cation ho avoided tad doubtful tad disputsd elaias bo rendered certain. THIS IS TO CERTIFI that I, the elaiaant, have agreed to reeeiTe From tts Trareler* Indemnity Company the in of $741.90; Froa The Hartford ieeidaat tad Indwity Cobssay the sm of $1,514.92; Froa The laerieaa Surety Coapaay of lew Tork the sub of $1,743.18; a total sum of $4,000j tad we, tha insurer respondents, do agree to pay to the said elaiaaat the sub above specified, to wit: The Travelers Xndenaity Coapaay $741.90; The Hartford ieeidaat sad Indsanity Coapaay $1,514.92; The laerieaa Surety Conpsay of Hew Tork $1,743.18; ia full aeeord sad satisfaction of above disputed elaias. HID TO FURTHER CERTIFY that la consideration of said subs so paid I, the elaiaant, do hereby renise, release sad forever discharge the employer and all the Insurer respondents froa all elaias for compensation benefits whether for eospensation la any fora payable to as under said let or for surgloal, medical or I hospital benefits payable on ay behalf, and whether said elaias have already arisen or hereafter sight arise by reason of afore said claim of occupational disease. iHS TO FURTHER CERTIFY that I, Theresa Siiet, wife of r lionudd claimant, Georgs Slhst, do ipii that la sonsideration of soli subs so psii to reals*, nltui sad forertr ilsshore* tad oil th* above named respondent! from ny sad all elaims mhioh X might hereafter hare against any sad all of tin by reaso of the alleged ineurring of an occupational disease by the said George Sliest while la the employ of tbs said mBployer-reepondenti HID TO mm CZKtITT that X, tbs elaiaaht, George Slhst, as psrsat, aataral guardian sad aoxt friend of aforesaid < children, potential dependents, aad X, Theresa SUcst, wife of said Georg* SUcst, potential ispendent, sad aether of afore said minor children, sad potential dependents, do, la farther consideration of said sons so paid, discharge sash and all ths aboT* named respondents froa all elalas which sight hereaftar be aade by them against any or all of ths shore named respondents by reason of the aforementioned alleged incurring of sa oeenpational disease by ths said George Sihet while in ths employ of the abore named employer-respondent. AMD TO FURTHER CSlTlFT that me, the claimant aad ths respondents, htrsby submit ths mrittan agrement to ths Compensation Commissioner of ths Fourth Congressional District and respectfully ash that said agreement may he approved with the force of a full aad final award. IN WITNESS WHEREOF, me hereunto set our hands ths day i Ci'iKiltil! ShChT, of l'nirficld, Conn. ) CORAH CLADlVNT. | VS ) C01U2ENSATI0N COJCIISSlDKia ! laYBFS'ruS-MuMLVi'T;^ COitTOr.ATJ.ON, ) SOURStt CONCESSIONAL MSEUM ) BRXDGUOET, CONNECTICUT. American smuax coubani, And ) Hartford accjd&t mnuMm co.And ) TRAVJ&SSS INSURANCE COUPAOT. ) November 3, 1937. Received NO'45 - 1S37 Cornpe^sstn CwamisdoMf CIAIlS^)F^jUijSiA.tfIDE|^r^^rn3S^rRAyfiUriWS^jPlSlffi|^iC3S^Cj^.- e "rjjMBiocil Wstntt I The Respondent, The Travelers Insurance Company mokes the following claims with respect to above: 1. That there is no evidence before Commissioner which would tend to prove that the man's health was in anyway affected or the . r . +. ,,i I /: y.i ' .ir-S> V jir; asbestosis caused by his work prior to December 29, 1924, w 2. That the only evidence of claimant's health up to liarsh 1925 is that his health was "very djood" at^that time; that he bad never exhibited aily symptoms of disease prior to that time; that he had felt no effects of his work up to that time and that he had had no doctor up to that time. 3. Thai his employment on December 29, 1922 was a new employ-' ment since he had left the employ of the Raybest os4iaitiattaa Corporation and engaged in the business of farming- for a period of about two years and a half. 4. That no employment prior to December 20, 1922 could have Ji ,, " ontriauted to his ailment in 1937. I4i 5. That occupational diseases were not compensable until I July 1, 1919 and that therefore no work prior to said date could he reckoned as a period of exposure. j 6. That claimant voluntarily left the employ of the Company | I in harsh 1925, according to his testimony, or on August 22, 1922, j according to the Ccnpcny'3 payrolls, and engaged in the business o. grocer. ! I STATE OF CONNECTICUT) ) SS. Bridgeport COUNTY OF FAIRFIELD ) CERTIFICATION THIS IS TO CERTIFY that the attached Is a true and accurate copy of the Agreement to Compromise, Petition to Compromise and Order, and radiographic report from B. M. Parmelee, M.D. from the records of the Office of Workmen's Compensation Commission State of Connecticut, Fourth District, in the case of: Stanley Dudzinsk'i vs . Raybestos Company, now Raybestos-Manhattan, Inc. and v. ' The American Surety Company of New York; The Hartford Accident & Indemnity Company; and Employers' Liability Assurance Corporation, Ltd. _ C: /en unuer my nand and seal 973. starlet DuDzissn Qolnoat RATBESTOS COtPAHT, so* RUBESTOS-HAHHATTAlf, IK. taploysr CCRAMj CGMFERSATIOH CGMHISSIOHER, THE AMERICAS SURETT MUPAST OP SEW TORI, POORS COHGRESSIOHAL DISTRICT, THE HARTFORD ACCIDEHT ft IHDDDHTT CCUPAHT ud EffLOIERS UABILITT ASSURAHCE CORPORATOR, LID Insurers BRIDGEPORT, COHHECTICUT. Respondents October 1938, AGREEMENT TO CCUPROnSS. petition ro cggRoasi AMD ORDER. WHEREAS, on or about the 16th dm? of April, 1938, tad for o amber of toots prior thoroto, ot lateraitteat ptriods, th* elsiaoat, Stanley Dadsiasld of Bridgeport, Connectiont, ni on employee of tho Roybestoe Ceepoay, now the Roybostoe-Moahottoa, Ine. of Bridgoport, Coanoetient) tad WHEREAS, tho said toployee oad Employer hod ooeoptod tad wort ot til tinti horaia mentioned snbjeet to Port 1 of tho Work* sen's Cespensotioa Aot of tho Stott of Coanoetient os aaeaded, tad the Employer hod iaonrod its liability thorenador for the period daring whieh eoid Cloiaoat ni employed with the oboes named la* tupere, oil of whieh toid ooapoaiet do business oad ort duly authorlied to taka suoh risks in this Stotej oad N 1H5SZAS, the Claimant tills* that on or abret th# 15th day at April, 1938, ho ashlbltad syaptona aad 100 fond to bo offering fros asbeitoeis tad pasreoocnioaiaj lad farther that raeh ooaatltata as occupational dlsoaao which tree* ret of ad la tho souria of hi* asployaaat with tho said feployarj tad' further olala* that laid dlaoaat la easpaaaahlej and fnrthor olalsa that ha ha* bora dlaabltd Iran all work alaso aald April 16, 1938) aad fhrthor olalsa that ha will b* dliablad la tha fatar*, all of whloh aald olalsa each aad all of aald Baapoadaata danyj and BHHJEAS, It la tha doalra of tha Clalaaat aad tha Raaposdaata aad aaeh of thea to roach aa aalaabla adjustaaat of tha bora dlapntad alala to tha aad that farther litigation bo aadad and that drebtfnl aad dlapntad olalsa ba rendered aartaln; T8IS IS TO CZ.'aUT TSAT I, tha Clalaaat, bar* apead to raealea fros tho abowa named Respondeat* tha fell sua of twentyfire hundred dollars (12,500), la foil aceord aad satlafaotloa of tha abora dlapntad elaiaj ADD TO JURTHZR CEP.TliT TSAT, la aonalderatloa of said res so paid, I, tha Clalsant, do hereby remise, release aad forerer diecharge tha Ssployar and the Insurers, Respondent*, fros all claims for compensation benefit*, ehathar for oospensation In any fora payable to ao under said Aot or for surgleal, nodical or hospital banaflta payable oa ny behalf, and whether said dais has already trisen or sight arise by reason of tha aforesaid dais of occupational diseasej *w r-v 2 -7 : . *- - IBS TC FURISER CXRXITT TWt I hart so wife or ahlldroa, ad that X hawo parents wheat naata in UXChaiX SUDZii'SXI tad ahHi. osszxsaxx , who lift la tit Ton of Dtitmbroa, . la Polaad, whlah parenta aro la no way daptadaat open at atthin tha prorlsicns of tfea Rorkatn'a Cot- pauatian 1st, which feeta shall ha found aad itttralatd by the CeeptaittloB Cocalasleaor la aeetptlaj tad approring tilt aettle- aaat tad eoapreoiaoj ASS TC TtmSR CIBHFT THAT Zt, tha Cltlrant and the Rt- apeadenta, hereby rubait this written Agreesent to the Coopensa- tloa Connlaalentr of the Teurth Congressional Dlatrlat, aad re apetfally tat that raid Agreeaent say ha approved with tha force of a full aad final award. XE SXT3ESS H22EC?, Vo hart hereunto tot oar haada the day tad data flrat abort written. CaapcitiaB Conlailoaar of th 7ourtii Cragrotsieul Dlatrlet* STATE OF CONNECTICUT) ) SS. Bridgeport COUNTY OF FAIRFIELD ) C ERT I F I CAT I 0N THIS IS TO CERTIFY that the attached is a true and accurate copy of the Stipulation from the records of the Office of Workmen's Compensation Commission State of Connecticut, Fourth Oistrict, in the case of: Anarew Urban vs. Raybestos Division of Raybestos-Manhattan, Inc. and The Travelers Insurance Company; The Hartford Accident & Indemnity Co.; The American Surety Company of New York; and The Employers' Liability Assurance Corp. JOHN A. ARCUUI, Woriunen1 ; Compensation Commissioner rfiu r t n District JiiLiL**"- ' v . . :-V ?.< < sogTzit's corPCTSAnoH act Andre Urton K1 I'ldlnnd it., Srldceport, Conn. . Clolacnt Bator* : :t . ' . . J *: Hon. X* 7. WnaVIntfiMi Carpenaatlcn Corataeicac^ JUpbeatea Diallion of noyb3to*-I.nhatUn, Ine., 1<37 Railroad Are., Bridgeport. Conn.. &3>le7er and r.o Traveler* Inrurar.ee Cccpimr the Hertford Aeeidcnt It Xndrmltj Co. lhe Arerieen Suret7 Cepeaf of tea fork The Lrpleyer'a UebllltT Aaauranee Corp, Inaurara Reapondenta Toorth Cancresslenal Diatriet State of Coenefctieut Xovasbof l M1 0 STTFCLATTC5 Agrccaont lada betroan Andrea Urban. tha abora honod elrlaant, of the ona prrt, and nayboatoa Dina Ion at JUTbratoa. lYohettan, Ine., the tbovo Based acployer, and Tha TreTelor* In. eurrnee Carjamj, The Hartford /.eeldaat and Zndesnitp carpanr, Tha /sarican Coret7 Ceripnnj of to* lork, and Tha trploTor** Liability /orurenee Corporetlen, tha abera nanad Inaurrra, Heapendenta of tha ether pert. " (I) **** On or eboat rupiet 20th, 1S30, and for am tire prior thereto, the eald elelaant, Andrev Urban, *aa employed a weaver 07 the rbore nared ihrploytr, ne7boetoe Mvlalen of Reybertoe.f.'Rnhettan Ineorporatad tt Bridgeport, Connect!cat aid located In the Fourth Canrreaeiennl Stetrlet. (2) Cn said Aufaat BOth, 1930, end for aeaetisa prior there, te.'the partlre hereto tare eubjeet to tha previa Iona of tha eslceta'a Corpanaatlen /et ef the State of Connecticut, ard each had eoaplied with all rc^ulrcncnta, ef eald /-et.." : i.i :\ On or (boat /u^eat 20th, 1938, tha acid Claimant, .'ndre* Urban, became 111, and ee a result ef aueh llleata ha *aa eorpellod to 41eontlnue hla erpleysent. ' The Clalzent, Andrew Urban, haa been acen 67 Dr. F. J. Antell ef `Bridgeport. Connect!, cut and Xriyi have been taken. The 2r*7 report rtada "Sllataral pulaonar7 aabeateala*. >1. (4) ' St La and bos consistently baan the elala of tha aald Andre* Urban that ba U suffering from a jcnditicn which ha be lieves to ba aabaatoala, aad that tha aaid condition aaa con tracted by hin in tha performance of hit duties at Ski Hsybsato* Dlvlalen of Rayteatos-l'eahsttsa, Incorporated, (&d that tha aaid catfltlen arose out of and in the eeuraa of hie employment aad aaa aithia tha aoopa of as occupational diaeaao aa referred to la the 'ortaan'a CaspensaUca Act of this State, aad aa haa bean previously definted by tha Supreme Court of Errors of tha State of Conneetieut, - . i.. . So eereeaoat for the payment of the Tcrlaasn'a C<&- peaaatloa Act of tha State of Ceaaaetieut haa ever bean entered late b< tween tha aaid Andre* Urban cad tha proaeat carrier, She Csployor'a liability Assurance Corporaties, aa tha preae&t oca- ditlen ia one of a meter of yosra. Wl She aeid claim'vea assigned for a hearing es the 36th day of September, A.O., 1938, before tha Compensation ecemissloaar of tha Fourth Congressional Dietriot, aad after a brief hearlag tha oaaa aaa adjourned to permit discussions. : Vt) . After earere 1 dlaeuaaloaa 'of the entire setter, it aaa finally agreed that a aattleecnt la accordance with the follow ing tanas ould be cedei Share shall bo pcld to tha aeid Claimant, Andrew Urban, the ain of Three Shouaaad Two Hundred ($3200.) Dollars, aaid sim. to ba divided aa follow*! (a) She Travolara Snsurvaea Company ' ... *644.32 (b) Sha Hartford 'eeident k Indemnity Co. 1123.05 (a) TheAsarlean Surety Co. of Jew York . 1310.24 Id) &-eDtploywr'a liability Aaauraaea Cars 122.30 .......... . $3200.00 ~ (0) Therefore, there exist Inc at this' time' "im open end _' her.eet dispute tad diseftoeront tetveen the parties berate aa to their respective rights under the tertsen'a Condensation Act of the State of Conneetieut and it now having been definitely and finally agreed boUoen the parties hereto, that la, betsaea tha .paid Claimant, Andrew Urban. Helen Urban, tha wif*_*nd a pro spective dependant or aaid Claimant. lielen Urban.~aa* natural Cuardlan for rargoret Urban, a ainor daughter of aaid elalnant and prospective dependent of said Claimant, The Travelers Inauranea Company, She nartferd Accident end'Indemnity Cor.pnny, The American Surety Company of Haw fork, and She teployer'a liability Assurance Corporation, Insure re end Respondents, (a) Shat tha seld sw in tha foregoing paragr^h be paid in full and flnnl aettlancnt, adjustment, accord end letlsfsctlon of ell oleins of whntao- evor kind or nature the said Clainant, Andrew Urban, and the prospective dependents, Helen Ysban and kergaret Urban, noy have at this tlsm or cay hero at ary future tire by virtue^ of .the ' Uertaaen't Comper.tf tlcn^iet' of .theVsteto-of.Conr.eetleutjS it  k "V r. t- . <*) (h) But tha payeant as >{rnd upon la andu ^th tha full tadaratandlng of thsaa tans and conditions, that la, that aald peyeient la pajuant la full for sosponsatlen, past, praaant and futura, and paynaat la full for all cdleal, hospital, nursing, dm* ud jfcanaey blUa, past, presaat and futura, sad (e) But tha paynant aa acraad upon la nadt-wltt. tha full understanding of tha partlaa harato that than ara bo othar tana or eondltlana or praises of any kind othar than those harain Incorporated, and aith tha eoipleting of tha papBaat a sensed upon, tha natter la de finitely tanlnatad for all tlcas. ., <*> la Tlau of tha foregoing, tha partlaa hante units la ntiusatlnc that tha Ren. E. T. Duclrtnfhna, Cospaaaatlea Cu alaslcnor for tha fourth Conf.raaslenal Olatrlet, haring Juriadletlen haraln, sales a finding and aaard pursuant to tha tans aad eondltlana of this Stipule ti* and Adjuateant. ^ ; r'i* * i H VZVITZl SHIBECf, *e hare harauato sat our hands aad seals, this ia*T dap of Sortsbar, tj), 1638* fclalaant -4; or Clalaaac end fro-, apectlre Dependant _____d/Lce;-'- Voturai Ounrdlan and lother of Varga rot Drtan, a nlr.or dturhtai V^nd prospective dependent. Bia Eartford eeldant 4 Xndamlt7 Ceerpsnj ^37 Sis American Surety Co. of K, 7,  -- * V 9> Bqlqw'i Liability Uiuriaci Cory. --------490^ I Bia for*going stipulation and *cr**e*nt la haroby found to b* fair, Just and reasonable and^aqultabl* and tha aas* la hare&7 approved this /jri day of //i Statin' , 1938. tor.panaatloa coealsaioner ~ Fourth Ccngreaaicnal Dlitriet STATE OF CONNECTICUT) ) SS. Bridgeport COUNTY OF FAIRFIELD ) CERTIFICATION THIS IS TO CERTIFY that the attached Is a true and accurate copy of the Agreement to Compromise, Petition to Compromise and Order from the records of the Office of Workmen's Compensation Commission State of Connecticut, Fourth District, in .the case of: John Haydu _________ vs . Raybestos Company, now Raybestos-Manhattan, Inc. and ' *' The Travelers Insurance Company; The Hartford Accident and Indemnity Company; The American Surety Co. of N.Y.; The Employers' Liability Assurance Corporation. under my n a n d and seal this 9c,, A i- I i i( day of ' A ... G O' ^ 1 tan HATOT, CIAUfAHT T3. XATBEST03 COHPABT, aou HATBESTOS-BAIHATTAH, IRC. Baployar "d srnozzn lzabiust assukascb CORrORATXOH sad ajzrkajt sukttt copurr sad , ) eoiuuri ( ) { eorpraiTioH comssxosra | WORTH COHOmSIORAZ. DISTRICT ) ( 1 8R2D0IPCRT, CORHECTieOT HAHT70HD ACC1DCT? k XHDSrtlTT CO. ( ) (Bd TRAVBLZRS IHSORAHCH CCHPAXT ( Zanrtn } sespokdshts ( FTHROAltT 1939. AOREtXETfT TO COEPRCWSE. petxtiow to cokprcwisr. VHBSA3. oo or sbont the 30th iaj of Septssfeer, 1938. tad for a amber of jn prior thereto. at lateraittent porloda. the eleiaaat, John Haydn of Fairfield. Connecticut. vat an toPI0700 of tha Raybestoe Caapany. boo Eaybeetoa-Winhattan, Isa. of Bridgeport. Counectleut| sad VHEREA3. tha tald seployee tad employer bad tesaptad sad ooro at all ttaes herein aentlonad subjeot to Part B of tba torteen'a CcnpenaationAet of tba State of Cemeetieut. aa aaeaded. sad tba eaployer bad Insured Ita liability thereunder for Ttrloat porloda during obleb tba aald claimant osa employed elth tba Employers liability la -aranee Corporation, tba Jaarleaa Surety Ccmpaay. tba Hartford Aeeldeat tad Indemnity Coopany, and'The Travelera Inauranea eeepaay, all of Oilah aald acBpanlaa azlat sad do bnalnata under the laua of this Stata sad are duly authorized to take rueh risks la ttds Statej tad WHEREAS, tba elalsaat elalsa that oa or shout tha 39th 4*7 of Scptaabor, 1438, ha nffmd m eeonpotleul dlaeoeo, to witi asbaatools) ! farther alalaa that nU oeeupatiaBal dlaaaaa arose out af aad la tha eeurao of hia nalo^ad *tth tha said apltjirj d forthor1 alalia that aald dlaaaaa la aoBpasahl*| ad farther elalaa that ha haa haa dlaeblad fhea all work alaaa aald Soptaaber 90, 1938) aad fvthar elalaa that ha alll h# dlaahlad la th* future, all af ahleh aald alalaa aaeh aad all af aald respondents deny) aad mSU, tha alalaaat aad respondents ara la farthar dis pute as to tha aetaal periods of aaplojaaat af tha aald al alaaat alth tha aald suplejsr) aad HE1BEA3, tha aald alalaaat aad tha raspendnts ara la farthar dispute aa ta tha particular aeapaaj carrying tha soupaaaatloa lasvaaee during tha parloda of tha aald alalaaat'a pleyaatolth tha aald apl07*r) aad WHE3ZA3, a partial hearing of aald alala aaa hald ha fora tha Corpaaaatloa Coenlaaloaar for tha aald Towth Coapesalensl District aa rill Bora fully appaar la tha fllaa af aald omcaj ad SHOTAS, tha aald John Haydn haa a rtf*, Inns, aad aaa alaor child, to alti John Haydn, Jr., both of ^en ara petastlal dapaodanta, aad SHOTAS, tha aald alalaaat aaa represented at tha aforeaald hearing aad la aoa ra proa antad hy oounselj nd SEEXSA3, It la tha daalra af tha elalaant aad tha aald reapondaeta to roach aa saleable adjostaent of tha above dlapntad alalaa to tha aad farther litigation ha avoided and doubtful aad dlapntad alalaa b raadarad cartala. TEEH2 13 TO CISTITT, that I, tha elalaant, have agreed to receive Trot tha Eaployara Liability Assurance Corporation $12.44 Troa the Aaarleaa Surety Ccepe-ny $293.32 Tram tha totftrl iwUMt cad Zatesltr Co. $433*46 Ita tbo tnnlm brnnan Company |24SJt) la foil aeeord cad eatiifaetloa of above disputed alalaa. an to rasa.at csstpt that la aosaidantiea of said mu w paid* X# tbo alolBcat, do bmtx roatco( rolooao cad forw dlaobarge tbo amployoromd all tbo laawar raopoadaato f*aa ill olalss far oaapaaaotloa boaaftta whothar for copy oaoatloa la asy fera payable to aa aadar add dot or far aargiaal, madleal or hospital benefits payable ea 17 behalf* and abatbar raid alalaa bar* already arlaaa or bareafter night arlaa by reaaaa tba afareaald alala fra occupational disease. UB5 TO SCHTSSH CISTITT that X* daaa Sayda* alfa of aforoaald alalaaat, fobs Xayda. da agree that la eoeelderatlon of aald aoaa ao paid to ramIsa* ralaaaa ad feraaar dlaebarga aaeb and all tba above aamad reapeadaata fit* any aad all alalaa ehleh X sight bareaftar bare agalaat aay aad all of .tbaa by raaaaa of tba alleged laearrlag of aa occupational dlaaaaa by tba aald fobs Sayda ehlla la tba amploy af tba aald employer-reepcadeni. in TO POgglUJI CCtrur that I, tba claimant, John Sayda, aa parent, natural guardian aad next frlaed of afareaald alnor afclld. potential dapaadaat. and X. iaaa Sayda. elf# of aald feba Sayda. patantlal dapaadaat* and aotbar of aforaaald minor chin* aad potential depandeat, da* la farther eoneldermtloa of aald aara ae paid* dlaebarga aaeb aad all tba abort aamad reepondehta from all alalaa ehleb sight hereafter be nde by them agalaat aay or all of tbo abora eased rejpendeata by raaaoa of tba afaresaatloaad alia gad laerartag of aa occupation al dlaaaaa by tba aald John Sayda ablla la tba asploy of tbo abora sasad asployar-racpoadat. m TO TBZTSgR CERTI7T that ra* tba elatsant aad tha raapendaata. hereby aabolt tha written a^aeseat to tha Coop-' aaastta Canalaaionor of tho Fourth CaacroaslaBal Btatrtat ad raapaatftlly aak that said acrasaaat my ba tpprorad. with tora* af a faU and flaal anard. a mim becteup, bararosba aat oar bands tba day and data flrat wittaa afceaa. .taasssd by 7 dlaisastt paraat. naturaj. fuarttlaa sad east frlsad af John Sajda* Xr.,j petsatlal elalaaat. fetaatlal elalaaos and paraat. " SASBKSTCS COWART, sea IBS KAIBSSTOa-tOTSATTATT, SBC. Baployar 4^t Attawaaya^^itZ IMPtUSUB ilABXUTT 13SQUSCX CORPCRATICI - its rttrnnnj~ AtSXXCAX SUBETT CCKFAZT *faaaa HARTFORD ACCIBCTT AITS HiBMCTSCO Bp. toprowad February/'J'l 1339 the travelers irsurarce coepast ^ Auo^aS V*_ j Coapenaatten CocniJatoner of tha Fourth Congrajsional Dlatrlet, I cLex. t/-/a - VV j"-yti~ -- /&JQ 6^/z -J -- /3- V<3~~ /S*AiTQ A0-JS' V? - U./riO CsSjC ' V' t - 0 - 8John - g i> M - J20 h o o te rs D ept* TrftnS* from Bpt 0 /0 /8 fl 'STATE OF CONNECTICUT) ) SS. Bridgeport COUNTY OF FAIRFIELD ) CERTIFICATION THIS IS TO CERTIFY that.the attached is a true and accurate, copy of the Agreement to Compromise, Petition to Compromise end Order from the records of the Office of Workmen's Compensation Commission State of Connecticut, Fourth District, in the case of: Mary Kisley, Widow of Stephen Kisley. deceased vs. Raybestos Company, now Raybestos-Manhattan, Inc. and The Travelers Insurance Company; The Hartford Accident ano Indemnity Company; The American Surety Co. of N.Y.; The Employers' Liapility Assurance Corporation. I KUCT T031XT, Widow of Stephen Sisley, Deeoaeed, CLAirjlW 8 tUCEBESTOS-COHPAKT BOW XAZBEST0S.KUSIA7TAR, ZHC., SJUS2 ad TRAVEI2RS IRSURAJIC* COHPAHT ad HARTPQRD ACCZZOT * imeairi CO. ____ ad aeerzcas sorbtz cohpart ___ aad HTLOURS UASUOT A330KABCX CORP . XS50RER3 HESPomizaTS CORASt coepebsatzoh cotsasszoiat WORTH COfluRKSSluBAL OXST. 8RHUEP0RT, COHBECTICUT MUCH J2 t/% 1939. A0HBBSBT TO COHPROHZSB PfiTITlOR TO C0KPK0KI3S ad ORBS.________ OBStSAS ea or abort the twenty-ninth day of Am, 1938 ad few BBbw of yeara prior thereto, Stapbm Xlaley, bow daeaaaad, wa aa eaploye of tba Raybeatoe Co^atgr, bow known ai XaybeatoaEubattaa, Zno., of Bridgeport, Connecticut, ad WBEAi, Mid eqpleye aad ecploywr bad accepted aad wara at ell tiaaa bwrala BaatloBad eubjeot to Part 8 of tba tortaen' Coapenemtioa Act of tba Stata of Connecticut, aa encoded, aad tba enploywr bad laaarad lta liability thereunder for warloua parloda during whleh tba aald Stapbn Sialey waa ceployed, wltb Tba Traralari Znaurenea Cpapacy, Tba Hartford Aeeldaat k Zsdeoity Co., Tba Asarleaa Surety Company tad Tba Seployara liability Aaauraaea Corporation, all of which aald eoepaniea cdat ad do baiinaaa u^ar tba lawa of tba Stata of Connecticut and ara duly authorised to talca neb rlalea la tbia Stata, aad enBtZAS tba olalnast, Kary ill lay, allagaa that on or about tba 29th day of June, 1938, Stepha 73.1lay nffarad aa occupational dlaaaaa, to wlt< Aabaatoala, and further elalsa that aald occ upational diicaaa arose out of aod la tba eouraa of hia acployacst aa a wearer wltb the aald e^loyer, nd further elalsa that tba aid disease la eoapeuaabla, nd further elaias that Stephen Slaley waa disabled fro all work froo the 29tb day of fuse 19fflj aad further elaia that aald Stepbea Zlaley died on July 22sd, 1938 aa SI a hrelt of Mid Mee^tleml Uinii, to tt, ubutuli, all of Aieh aald claims aaeh aad all of tho said respondents doer, aad rfjir.AS it la Aa desire of As claimant asd As aald ra- aposdonta to reaeh aa amicable adjustment of tho abort dlapotad claim to tha oed that farther litigation bo atoidad aad doabtful aad dlspatad alalaa ba rendered eertala. CDS ZS TO C2RT37T that J, I137 Eisley, elsiment, hart agreed to receive from* IBS travelers ZRStntjures cospary .......:...;.;;..:$is2.io THE HARTFORD ACCIDENT t ITHEnTITT CO. ............ 396.65 THE AMERICAS SURETY COWART.............................................. .. 473,80 THE 11IPL0IER3 LIABILITY A3SURARCB CCKF. 8.66 airing a total ra of RISK BURDRES FIFTY ARD 10/100 DOLLARS ($960,00) aad o, tha respondent insurers,. do ign to pay to As amid alaiaaat, tha aaaa abort ^oelflad, la fall aooord aad aatiafaetioa of abort dlapntad slain. IBS 00 FURTHER CERTIFY THAT la consideration of tha aald anaa ao raid, I, tba olaiaant, rto hereby rtalit, rolease asd for- ever discharge tha e^loyer aad all tba laonror respondents from any aad all Claim far compensation benefit*, Aether far eccp- msatlon la my fora payable to a* aadcr aald Ast or for surgical, aadlcal or boepital benefit* payable on ay behalf and Aether aald alalaa hart already arlata or hereafter night arlae by reason of aforesaid elaia of occupational dlieace. ASD TO FURTHER CUtTTFT THAT 2, Gary Elslvy. rldev of Step baa Elslsy, deceased, do agree that la eonalderatioa of said sum, so paid, to roola*, rolcaso nd fororor discharge each aad all tha abera named .respondents from say aad all claim * 1A I night here after hare agaiaat any sad all of than by reason of A# alleged Incurring cf aa occupational disease by said Stephen Flaley, dec eased, Ails la As employ of said erploysr-respondmt. AKD TO FURTHER CERTIFY THAT U#, Ao claimant, Gary Elsloy, end the respondents, hareby submit this Witten agreenent to the loeper.sation Coenissioner for tho Fourth Congressional District, md respectfully ash that aald agreement ray be approved with Ae force of c full and final trerd. XB vitoaea ttaraof, baraosto *t eo hanta tba taj usd data first abovs Bantloasd. Vitasaai ^7- JM-4^ i UW> or Stsnosa lajlaT.saeaajsJ bjukot MTSOTOS CSfiFAiar Q0V BASBCSTpMASUSTAS, XBe. O'rT't, V- suvnats XES8RASCS COQF/Uff BTt V_c&aa*^ SoAARiTcFrOalts accxtcct a immure eo. ur^l -V^Q-ry.5^4 o^tiffUrnfl 1IACILITT AflSCTlAltS CORF BTi, Approved this JL t/ ttareh, 2939. toWA.iX 4>-iaI Co^oneacion tocaaeiocer ror the Fourth Contesaletasl restrict, Received MAR 24 1939 Cfmptnsatio.i CmmtiifQnif c *,*h Oiitr.'t STATE OF CONNECTICUT) ) SS. Bridgeport COUNTY of FAIRFIELD ) CERTIFICATION THIS IS TO CERTIFY that the attached is a true and accurate copy of the Agreement to Compromise, Petition to Compromise and Order from the records of the Office of Workmen's Compensation Commission, State of Connecticut, Fourth Oistrict, in the case of: Frank Torok vs . Raybestos Company, now Raybestos-Manhattan, Inc. and The Travelers Insurance Company; The Hartford Accident and Indemnity Company; The American Surety Co.; The Emoloyers1 Liability Assurance Corporation. nuns TOROS, TS CLAOSAST i . : RAT3ZST0S COE?AST Bow 2UT3S5TX*HAS5A??jUf, SIC. ' teplejer tad THE T7UTELZ2S DWaUHCE COKPAST i FOURTH C05CRZSSI0BAL DISTRICT t HARTFORD ACCISEST ASS DDE33ITT CO. t SRHCS?OHT, COHBSCTIC5T. AZSRICAS SU2STT COE?AST r C9Z.0TZR3 LZAsnrrr assorascs ccrp. t eat Threrere RESP0S3QT3 t f * 1 339. ' 'S' Agy^v^rr to cc;g?.es:s3 PETITIOS TO CCKPRQEISR Jsd \ "i y. \ '5 CRggg 3EESEAS on or about the 4th dayef fowesbsr, 1938 asd far a BBboro ef toots prior tharoto, the elaissst, pnsk Torek, af Bridgeport, Conseeticot, was as srplcwe af ths laTbeitoa C=pas7, new Ra7hestc-Sashattan, Ise., af Brtdgops>t, CoBsoetled, esd, 9ESSSA3 the said =pl07e asd osploTer bad aeeepted aad voro at all tiro a haroia sastisBod rob 'act ta Fart 3 ef tha Sarisas's Ce^eaaatioB Act ef tha Stats af Connecticut, as aea&dad, asd tha scploTor had insured its liability tharwundar for warioua triads during- wfaieh tha said elaisast was eoployed with tha Trawelars 2s- nocci Cet^aay, tha Hartford Aeeidast asd Indensity Ccspasy, tha Assrism Surety Ca=pS7 asd tha 2=pIorri Liability Aee&resca Ccrp- oreties, all 'of which (aid esspasiea telit aad do bueineea oslar tha laws ef this St ata asd ara dily astheriaad to take rash risks is this Stats, asd ASZ3FJL3 tha elaisast elala that e& or about tha 4th day af Sowesber, 1S3S ha aoffarod as oeeupaiiesal dlsaaaa, to wit, aabaatoais; asd further elaisa that laid oenupatiesal disaaaa areas set af asd is tha ecurit of hia ssplo7est with tha said e^loyer; asd further elaisa that said diieaao is eespeseablej asd further elaisa that he has bees disabled fra all work sites tha 4th sf Sewesier, 133S; asd further elaisa that ha will be disabled is the future, all of which said elaisa eaeh thd all ef said reapendeste dary, esd -1- 1E3SA3 a partial baaris* af laid elals ni bald befwe tbaCespesaatlsa Cesiaalestr of laid yosrtb Ccn^-essienal Blatriet u tin sore folly ??ix is tb fllaa of said effiee, nd Pfl-tma tt wid Prisi Torok 1j a ildonr and baa a aotber, folia asd three slser children, to alt, yresk, JT., Ces-ge asd Seles Terek, all of whes art potential dependents, asd TTI'VH tba aaid elalsast waa- rapraaastad at tba afsreaald baarlst asd la sow rapraaastad by eonssal, tad 11BSU It la tba daalra of tba.elalsast asd tba laid reapoedasta to raaeb as sleable sdjeatsent of tba aberra diapnied elalsa to tba asd that farther lltlgatles ba aroided-asd dsobtfol asd dlspotad elalsa be rendered eertals. THIS Z3 TO CilSl'iyi that X, tba elalsast bare agreed to raealTe frcs St Startlers Throrance Ccnpany tba res of $426.2S Tba Sartford Accident asd- &deslty Cespesy tba ass ef $429.49 Tba isarleas Soraty Csstsy ef Paw Terk tba as ef $10(0.90 Tba Sspleyers Liability laaeresea Corporation tba ass ef ' $83.23 raV"*~g a total ns ef Two Tbeoaasd Sellars ($2,000.00}; isd we tba laaerer raapeadasta do iptt to pay to tba laid elalsast tba ass abort rpeeified, to alt, Sit Trarelara Seuraree Cespesy $428.28] Tba Hartford Aeeldest tad Isdesalty Caspasy $429.49; Tba isarleas Surety Cesptsy of Pew Toric $1C60.90; Tba 2splcytrs Liability Aasurasee- Cerperatles $83.33; la foil aesord asd sat lafaction ef abort dirputad elalsa. ASS* TO ?02T2ZS COTITT that la consideration ef said aiss se paid, I, tha elalsast, do hereby resist, release tad fortrer dlsebarse tba t^lsyer asd all tha issuer respondents fres all elalsa far eespcssatles benefits whether for espensaties. is tsy Cars parable to se seder said let or for nor sisal, sedieal or hospital benefits payable es sy behalf asd whether eaid elaiss hare already arisen or hsreaftor ulght arise by reason af aforesaid tlais af oesupatiesal ASS TO rCICSSa CSSTXTT that I, Julia Terok, sethar of afor*- Mid eliiaet, Trask Tarek, da ipii that Is eeaaidaratlea of said let sa paid ta raslia, release asd forever dlaekarge each asd all tha akeve seed reeposdecta fra as? asd 1 elalaa efciek Z sight hereafter have against 107 asd all of the ty reaaes ef tha all eged iseerrisg of a occupational dlaaaaa hy tka aald Trask Terek itili Is tka e^loy of tka aald aployer-reepesdesta, ASD TO TTSTS3 CSST77 that I, tka elalsast, Trask Terek, aa parent, sateral gcardlas asd. asxt friend, ef aforesaid slser ekildres, potential dependents, do. Is fatkar'consideration ef aald aa so paid, discharge sack asd all tka abova nasad respondentj fra all elalsa vtieh sight tare after ka sada by tka against 1&7 er all ef tka above nasad respondent* by reason ef tka aforenentloned all eged incoming ef a eeecpatlesal dlaaaaa k7 tka aald TTesk Terek, Oils is tka esploy ef tka akera scad esployer-respondant. ASS TO TUrfl'kSa C3T3T that it, tka elalsast asd tka respondent*, hereby rekslt tka erltta agreesent to tka CoepeesatldB Ceolssiaar of tka Tcnrtk Congressional District ani respeetfnlly aok that aald a^easant 5*7 ke approved with tka forse ef a fell asd final award. & vltssaa tkaraef va barevato aat os hands tka day asd TSZ TSAVZ1Z3S EJSTSASCS PHPAST^ EAHTTORS AC"SyZ'rZTZ CC&3A3T thz ais?.:ca:i sorstt ccipjctt c? !ir~ toss By E2>Lff!2?.s ixabhitx 1ST. 1538.37 V It * f f 'l'l ,J,|y } | l i l | STATE OF CONNECTICUT) ) SS. Bridgeport COUNTY OF FAIKFIELD ) CERTIFICATION THIS IS TO CE.RTIFY that the attached Is a true and accurate copy of the Agreement to Compromise, Petition to Comp-romise and Order from the records of the Office of Workmen's Compensation Commission, State of Connecticut, Fourth Oistrict, in the case of: Gus Wargo vs . RayOestos Company, now Raybestos-Manhattan, Inc. and The Travelers Insurance Company; The Hartford Accident and Indemnity Comoany; Tne American Surety Co. of N.Y.; The EniDloyers' Liability Assurance Corporation. 003 7AJW0, * '"CLAEUITT . ' 78 HASSSTOS COT?ATT/ BO hat-sstcs-i'-tuMif, ns. count* ccBTSSAnon ccaasioss; ad AnSXCATT SOTCTT CCKPA3T BAisrora AccranT ato xsoesnrr co. m7s.m cTcciuBcz cctast CPLOSitS 1IA3T.ET AS33RJUCS COW. Insurers BS?aiS3 iotcs caracssxatAi, oisr. Emcz?oRr, cosascnco? 'yiu~s ^ , 1S39 ACfCzm? ?o cis?e!csg pmsTotT ro coT?rg~5S fa& CB33 OJSTZAS, en er sheet ths 4th da? ef Sweater, 1030, and Coe ft sister of jaars pries' thereto, ths elaissst, Ous lirp( of 3rids=pert, Connecticut, to* an *s?lc7 o tha Hft7taeto Colony, asv 27tcatcaSsrhattas, na. ef Bridgeport, Connecticut! and VIZLAZAS, the said alloys sad s^Iejer bad accepted and TCt at all tlass herein sstlcsod subject te Part 8 ef tbe Terisaa'a CsspeBsatiee Act of the State ef Connect!nut, as agended, and the epleyir bad incurtd Its liability thereunder fer rarinua periods dsrlss ehieh the laid elaisast sae espleyed edth the Anarlean Surety Cavasy, the Ssrtfcrd Accident and htdosdty Csr^sny, Tbe Trcrelera ihas-ssea Csspasy, asd a^li/eri IT ability Aaourauce Ccrperatiea, all ef vhish said ecapasisi exist and do business ritr the 1m ef this State asd are duly etherised te tabs such risles is this Stats j UH5ZA3, ths 8It least -that es er atest the 4th day ef Sweater, 1S3S ha `suffered sa-occupational dlssaes, to -alt] asbeitoaisj tad farther elaiss that laid see-^atiesal dleoasa srtss cat ef sad ia the course of his cple7=cat -rith ths said a^lcTerj sad farther '-- that aaid dlseass is ee^easahlaj aad further clairai that ha has bees disabled free all eerie idses said TJcrnaber 4, HCSj aad -1- fartbe^elaiss- that ha rill'bo 'disabled la tba ratall" Of '" atleh aaid rlaT-i each el all of aaid reapadesta daay, aad .E.7UA.*, o partial bearing of Mil*, elafn tu hold befero the O^eaaaila COBlsalsse of uid ?erih OcsgreasicBal Slat- riet as rill sera rally appear la the Hies of sold sfriea; mad 385SM, tba told Oua Varga, baa a rife, Scae. MUir tba told claimant ns repressed by the aforesaid hoerlas'aai la sev representad by eoessel; aad VSEBSAS, It the desire ctf tba aad the aaid re-- apofsd a to ranch as arT cable sdjea'teast. of tba chore disputed nTa'-m to the asd that farther litlgatlsa be arcldad d dschifnl aad dleptted cla^-g be rendered eertais. T2X3 TO CSSlii'J that 2 the clai;aat, bare agreed to ra- eslTa free The S'srolera Seoraaea Cspaay tba arcs cf 246.38 ?rm tba Hortferd Accident aad Scdmity Cscgchy tba aua Of $001.30 7rcn Tba tearless suratr Cccpasy ef 3e Test tba asa of $1074.00 ' Tree The ?lc;cra liability Aasnraacs Cssp tba aoa ef $97.35; noting a total sis ef $2,300.00; and re, tba Isactr reapedcats da Cpeo to pay to tba aold elaiast tba ns above epoelflad, to riti Tba Traveler iffssnee Cu ,*uij $240.38; 2* Eoatferd Accident ed Indcnnity Co-puay $501.30; tte tearless Stntifrp Canary ef Zar Tnrie $1074*80; Tba a?lo7CT8 Ucbillty Astrcmr.ee Ccrpcmtlsa $37.33; la fall eeeard and eailefaetlss ef above llspatad elnlrs. AZ3 TO f1'-- ^ CZ/C1TT that la cesaiieratica ef aald isi se paid 3, tba elniasat, do hereby rsi.ee, release and forever dis charge tba e^lojer aad all tba inacrcr reapeadesta fpen all claim fts esspcnaatlcs bcneflta etetbar f espeneatis: la ary fan papnilo to se Oder seld Act er for ssrgieal, nedlcal, e* beepltal becafite payailo ea =y bebslf, ird itctbxr *aId slalaa have already arisen horenTter sight arise by renaea of aforesaid elala ef ocrspailcnal disease. AIIl TO pcsTTC?. CUTT^T that 7, ?.aco "arge, O cf afnresald 2 > al Cua Btorsn, do tsr* that Is easaddsratla of aidd rcsa- - t-- a pall to reslae, releana asl fcrrror discharge Mail and all, ttoa aberwsjead raapeedasta f?ss aay aa all cTa.toi shleh 2 ~*S*~^ baroafter taro against ay and all of tbs 67 reaa<* of tbs all- aged IsetrTisg of as eee^patlasal dlraora b7 the tall Caa Varga* atoll* Is the aspicy of the add o=plc7er-rapdasts. IS- 70 i Uil-13 C72777T that n, thselalesat d the responded a, tnrator cetosdt ttoa aristae ag:t&saat ta ttoa Ca jwr.itatlai grr--f.galeaer of ttoa 7sstto CcsgoBirtrrnl Clrtrlet and raspoetffull7 ash that tail apeeseat =07 bo appeared with the feres ef a full aad final avard. ST 0772715 777775?, n baretrrto'aot ear basis ttoa day esl date flrat arittes there. Oltsassed by . n 1/ JLu Wslaac -ty***" 7>- if- /2ra-c Yyoaj^ Pile asl potential clalaass 777 2AJt7TC37Aj Sr 7 AS7 BSigSTSg CC. ' .V TT7 7SA771I2S 35771752 C5ESA77 7E2 237,57775 17133177 *153.273 C57?. =T ______ Agprsred, Yka* 4 , 1339. / of ttoa ?cis-tto Csndesaise&l I h i<* * * STATE OF CONNECTICUT) ) SS. Bridgeport COUNTY OF FAIRFIELD ) C ERTIFICATION ..THIS IS TO CERTIFY that the attached is a true and accurate copy of the Agreement to Compromise, Petition to Compromise and Order ________________________________________ _ from the records of the Office of Workmen's Compensation Commission, State of Connecticut, Fourth Oistrict, in the case of: Senjamin Szabo vs . Raybestos Company, now Ra.ybestos-Manhattan, Inc. and ~ Tne Hartford Accident and Indemnity Company; The American Surety Co. of N.Y.; "he Employers' Liability Assurance Corporation. BESJAcar szabo, '* clacjuit i1* ccsahj" ~ T5 t " RAT3E5TOS COSAST ser JU33ESTCS-CAEEATTA3, SC. s^io7*r And i ' COH?ElSAT103 COMtTSSIOHa r | rornca C05S3ZS3Z0SAL DISTRICT EARTrORa ACCIDET A3D SSS3CT C5. J ACTICAS SdETT COH?AST asd 1 HR2EOOORT, C0H3ECTXOT? BEPLOjBtSl L2A3H2TT ASSCSA3CZ COS?. J Siam i' HEsrotrumcs. /< > 1939. . . Acar;,,,T? to cckprctiss PSTITIOK TO COirPRCgTSE Asd wAlAA ob ar about tbs 4tb of Eorosbtr, 1933 asd far a rssbor of yeara prier tberato, tbs cl airart, Basjasds Szabo, of Tadrfldd, Consaetiest tu as aspic?* of tba H7b#tca Ccspasy scr Haybeataa- Easbattas, So., of &idspcri, Cessaetieui, asd tba amid. asplcj* asd asployar bad aeeeptad asd vara at all. tisaa barala sastiesad aubjact to Part B of tba tericas ' a Cesp- aaaatles Aet aftba Staia of Cessactlest, aa asaaded, asd tba osflsrjnT bad lsasrad ita liability tbarousdar far Taricna periedj dsris* atlei. tba tall elalsast aaa asplcyad, vltb tba Eartford Aeeidast asd Isdaeity Cepary, tba Asarieas Suraty Cecpasy asd tba Zsployara Liability Aaasrasea Ccrperatlas, all of .stieh laid ecspaslaa asizt asd do bcslseaa ssdar tba laaa of tbls Stata asd ara dsiy auibdzad to taba ausb risba is tbia Stata, asd ... sit-otic tbeelairast dales that os or about tba 4tb day cf BeTCsbar, 1S33 ba tuffarad as oocupatiesal diaaaaa, to Tit, aabaateaia asd furtbar <z '-- that said oeeapatied diaaaaa artaa cut of Bd Is tba ecsrao of bia eplsysast Titb tba said asplcyar; asd fsrtbar elalsa tbat said diaaaaa la esspasaailaj asd fsrtbar c laIsa tbat ba baa baas disabled Ire all Teb zlsoa said Boresber 4tb, 1S33; asd furtbar elalsa tbat ba Till b* disabled is tba fat-.ee, all ef wbieb aaid dalsa aaeb asd dl of aaid raapesdasta dty.- ssd 1 v&SS&S a jtrtlii hearing of said eiais tu hold befara.th*. Cpaatien Caaiaaieoar of aadd ?earth, esagreasisnal Slatrist. fti *111 sore felly ifpw is tha filsa ef said offlea, and H'H SHEAS tha said Benjnsis. Ssabo ha* a rift, snsia asd tvo sdser children, to Tit, ,-enria, 14, asd 7iHiss 19, all ef its are pet. estial dapesdenta, asd .TT-VAS tha laid elaisart *aa repressnted at tha afertaaid heariss aed la see reprasasted by eoessal, asd SZSSAS It. is.tha desire ef tha .elaisast sad the. said.respesdeats to reach as asdeabla adjustsest' ef theabova disputed elalrs to tha asd that further litigation he avoided asd doubtful asd dispvt ed clairs he resdared eertais. T525 S TO' CSSm that Xt the elaisaat have a^eed to receive fres The Eartferd accident and fidesity Ceqjany tha av= of $350.25 TOe iserieea Sera17 Cespany ef See TSrk the sa.ef $744.06 Tha Sstlavera Liability Assurance Corporation the scs ef $55.69 nki-ig a total ra of Thirteen 'Stsdred Kfty asd JSo/lOO Sellars; asd ee the insurer respondents to ftpee to pay to tha elaisart tha n= above specified; to wit. The Zartferd Accident asd hiesity Cc=pas7 J3SC.2S; Tha iserlcas Surety Caspary ef See Terk $744.06; a&d Tha Bsplayera liability Aercrtree carporatias $55.69; is fall accord asd satisfactios ef above disputed elaiss. jura TO CiHSit'i that is eesaidsratiss of said n=s ae paid. I, tha claisa&t, do hereby rerise, Ml case isd forever discharge the es^lcyer esd elltha insurer respondents free all elaiss for ecs- peasatics .benefits whether for compensation is aay fees payable to ne under said let er far re'gieel, ssdisal or hospital benefits payable on =7 behalf asd whether said claisa have already arisen er hereafter nicht arise b7 reason ef aforesaid elais far oeoupaiicnal disease. ... - ATT TO 7UTT5S3 CTSTST that I, Susie Ssabo, rife ef aforesaid elainarrt', Bon Jenin SsaSc, is a^ree that is oonaideratien of said ; c^sts ,trt ksi ao to Ttsisaj -rtlaaaa cd fs"a"rsr'diseiarss each asd tia abora sagad respondents fres ss7 * ait. alasa sbleh 1 iaraaftar bars agals:it asr asd all of ties by rauss of tia alleged Isesrrisg ef as oeeapaiissai disease by the said gasJasis Sabo sidle !s tie *=plo7 of tia said cjleyar-raapssdact. ASS TO FlX.'rSH CSSZXT that I, tia elaisast, Sen Janis Jubo, as pan-et, satval goardias asd Bast friend of aforesaid xiser child ren, potential dependents, asd X, stale Szabo, alia of (add BaaJasis Szabo, potential dependant asd Bother of afsreoadd sdser children, asd potential dependents, do, la farther esnaiieratias of (add rca ae paid, discharge each asd all tie abora named respendents iron all elaims ehich night hereafter be sad* by ties against a&7 sr all of the above eased respondents %7 reason of tbs aforesenticnad allagad iseurrisg of as occupational ddasasa by the said Sasjasls Szabo stile is tie ergloy of tie abate nsnsd employer-respondent, ASS TO 7UIT5H1 ticm tint n, tbs elaisast asd tia respondents', hereby subsdt tia eritten agreement to tba Compensation C=is3ianer of tia Fourth Congressional district asd respectfully ash that said a^-eemact say- ba approved alti tia fsree of a full asd final asmrd. St 7itsass tiaraef aa hereunto sat our hands tia day asd data RAZSTSTS- C0K7AST new Bx'ssazes-taxsATzxs, ac tsz ausszcut srarr co. cf az: toss s-Fionss LiAanrr? STATE OF CONNECTICUT) ) SS. Bridgeport COUNTY OF FAIRFIELD ) CERTIFICATION THIS IS TO CERTIFY that the attached is a tru and accurate copy of the 'Agreement to Compromise, Petition to Compromise and Order ..... from the records of the Office of Workmen's Compensation Commission, e State of Connecticut, Fourth District, in the case of: Steve Molnar vs. Raybestos Company, now Raybestos-Manhattan, Inc. and The Travelers Insurance Company; The Hartford Accident and Indemnity Company; The American Surety Co.; The Employers' Liability Assurance Corporation. S'fhTS tXEliAH, CLAUJUIT . . COflABs ., . VS ` 1 ' u c ; ./> '. SAVSiSTos coupaiit now RA23ES?0S-:'^ISArTAX, ISC. 3sployr oosPEtSAiios coiaiissioKa t And ?00315 C0HG35SSf I.0HAL DISTEICT. Thai Travelers Issurtsce 00=5007 1 ' 1 ' f , , Eortdord Accident osd Isdemdty Co. ' ' 22=03?C3T, COaSECTICCT A=orica= Surety 00=50=7 usd 2=5!oyers Liability Assurance Corp. Isourers RESPOJTBOTS BAT / ir,-?Tr~'r7T" yp QQE??.Cm5S PETITION TO CCSP2C5ISZ Asd 0RB53 . 1939. 1 V y v5, V % <+> & 5.-4. SSSgAS, oa or about the nth 107 of 50-resber, 1938 osd dor 1 =u=br od yeoro prior thereto, the claisost, Stephen Bolsor, od srldgepcrt, Ccsnaetieut raj oa esploya od the `aa.yiostoo 00=50=7, box Hoybeotes-Sasiottoa, 3s., od Bridgeport, Cansoctieut, 0=4 SES25AS the sold ecploya end ec^loyar bad accepted osd xoro it oil tines herein sectioned. subject to Port 8 of the TTortaces's C tspsnsoc 1st Act of the State cd Connectlost, oa trended, end tbs '4 * * " e==loyer hod insured. its lloblldty tbareundsr dor Torlssa period during hicb the sold, elodnant xoa employed, sith Tie TroTeiara Insurance 00=50=7, Tbs nartdcrd Accident end Inde=it7 C0=53=7, The American Surety C0=5*07 osd The Bnpicyera lloblldty Assurance Csrperaticn, od thdch sa asles asLst osd do business under the lass od this Stnts osd ors dsly autbnrisad to tola such riots Is this State, osd VSZ32ZAS, tho claimant elains that on cr shout Sonenter 11, 1132 hs ruddered 3= occupational disease, to alt, osheatoslo; and durth.tr :lsd=h that aedd occupational disease arose out cd and . In the eoursa od his eoploynent rlth the aadd eorplc-er; osd durtbs clilns that sodd disease Is cssneneahls; and further chains that he has been Headed dro= ill ecris since soil h'ereohoar 11, 1332; STATE OF CONNECTICUT) ) SS. SriOgeport COUNTY OF FAIRFIELD ) CERTIFICATION THIS IS TO CERTIFY that the attached Is a true and accurate copy of the Ag reement to Compromise, Petition to Compromise and Order from the records of the Office of Workmen's Compensation Commission State of Connecticut, Fourth District, in the case of: Andrew Vajanvi vs . RayBestos Company, now Ravbestos-Hanhattan. Inc. and ' The Travelers Insurance Company; The Hartford Accident and Indemnity Company; The American Surety Cc. of N.Y.; . The Employers' Liability Assurance Corporation. C:/o:t 'jn-Jtrf my h a ti C ana seal this ! H t d sv of __!> , . i \ Workmen's Compensation CommlSSioner \ J oouurrtthh District ('tf3---' i ATORZW VAJAEYI, CXJtE'JUTT I CORAM: VS t BATBEST03 COS'?AFT nos RAIBXSTOS-MAmTTAR, IRC. Employer 60HFSR3ASIOR COKVISSIOSai > And I WORTH COHORESSIOHAL DISTRICT THE TRAVELERS XESURAXCR CO. I HARTPORD ACCXDERT ASD IRDEHXITr CO, t BRIDGEPORT, CORRECTICC? AMERICAS SORETT COMPART And < ZEFLOTSRS LIABILZTT A3S0RAKCB CORE, t jdxb /'J , lass. Insurers-RESPOKEEBTS AORZErERT TO COMPROMISE PETITIOR TO COMPROMISE ORDO WHEREAS on or about tba 27th of September 1938 aad for a mnaber of jnw prior tharato, tha claimant, Aadrai Tajasyl, at Palrflald, Connecticut, aaj as employs of tha Raybestos Company nov RsybeatosManhattas, Inc., of Bridgeport, Connecticut, and WHEREAS tha said employe aad aaployar had aeeaptad aad vara at all tlsaa herein mentioned subject to Part B of tha Workman's Compensation Act of tha State of Connecticut, as amended, aad tha employer had Insured Its liability thereunder for various periods during which tha said claimant vas employed vlth - Tha Travelera Insurance Company, Tha Hartford Accident and Xndsnilty Company, Tha American Surety Company aad Ike Employers Liability Assurance Corporation, all of eblch aald companies exist and do bualsasa under tha lava of this State and are duly authorized to taka such risks In this Ststs, and WHEREAS tba claimant claims that on er about tha 27th day of September 1933 ha suffered an occupational disease, to vlti asbestos!*; and furthsr elaima that said occupational dlstasc arosa oat of and In tha eourse of hla employment vlth the employarj and further claims that aald disease Is compensable; and further claims that bs baa bean disabled from all vork tinea said Septeaber 27, 1938; and further claims that ha vlU be disabled In the future, all of vhleb .-id claims each and all of said respondents deny, sad i* VHEKSAS a partial hearing' of laid siala was held bsfera the Compensation Coemlaslosar of said Fourth Congressional District aa all! aor* fully appsar la tbs fUa* of taLd offise, end WH9BAS the said Andrew Tajaayl baa a wife, tatherlne, aad m alaor child, to alt. Alias Vajasyi, 11 years of age, both of Aem ara potential dapan!acta, and WBKISAS tha said alalaaat was represented at tbs aforasald hearing aad la aoo represented by soussal, aad UHEKBAS it la tbs doalre of tbs claimant aad tbs said respondBits to reeeh aa mloable adjuatment of tba abort disputed olalaa to tbo sad that furtbar litigation bo avoided aad doubtful aad disputed alalas bo raadsrod aortain THIS IS TO CXHTXPT that I, tbs alalaaat bars agreed to roaaloa free Tba Travelers Insurance Company tbs sua of $1227.77 Tba Hartford Aoeldsat aad Indsolty Company tba sub of $1881.87 Tba American Surety Company of loo Tork tba am of $1SS0.88 Tba Ecploytr* liability Aaauraaea Carp, tba sua of $88.48 --vttig a total ano of Forty Too Hundred Fifty aad lo/lOO Dollars} and oe tbs Insurer respondents do agree to pay to tbo claisent tbs sub ben apaclfladjto vit, Tbo Travelers laauraaea Company $1227.77} Tbs Hartford, ieeldent aad Indesaity Coapaay $1881.87} Tba Aaarleaa Surety Company of Haw Tork $1880.88} The Saployera Liability Aaauraaea Corporation $89.48} la full aeeord aad satisfaction of abore disputed olalaa. AID TO FURTHER CERTI7T that la ooualdaratloa of aald suss so paid X, tba el tinant, do hereby ranila, raises# aad forarer discharge tbs employer and all tba Insurer respondents froa all alalas for sob* pansatIon benefits whether for eozpenaatlon la aay fora payable to aa under said Ast or fur turgleal, nodical or hospital benefits payable on ay behalf aad whether said elains bare already arisen or heresfteralght arise by reason of aforesaid eltim for occupational disease. ATD TO yoarHHH CESTIFT that 1, Katherine Tajanyl, vlfa of afore said elainaat, Andrew Vajaayl, do agroe that In eeaaideratioa of aald f iMf I *' MIt STATE OF CONNECTICUT) ) SS. Bridgeport COUNTY OF FAIRFIELD ) CERTIFICATION THIS IS TO CERTIFY that the attached is a true and accurate copy of the Agreement to Compromise, Petition to Compromise anc Order from the records of the Office of Workmen's Compensation Commission State of Connecticut, Fourth District, in the case of: JoseohTivadar vs. Raybestos Company, now Raybestos-Manhattan, Inc. and . The Travelers Insurance Company; The Hartford Accident end Indemnity Company; The American Surety Co.; The Emoloyers' Liability Assurance Corporation. -J . - 1/ JOSEPH TX7ADAR, claixabt 93^ RAT3EST03 COH?APT BATtESTCS-XAHHATTAH, VK. Smployar t CORAJti ; .1 t'**l C0KPE53 ATIOH COUHSSIOHXS t 'V And The Trevslers Ina-ortaes Co* | POCRTH COHOXESSIOHAt DISTRICT i Hartford Accident aad Indemnity c* BRIBOEPOJB, C0HHSC72C0T American Surety Company t J-Jr-t ^ ad Employers Liability Aasuranos Corporation Insurers lttSPOJIMSTS 1 I ^ , 1939 AffRElMJSBT TO C0MPR0KI3E PETITICTI TO CCMPR0HI3H And OHPER TOEftEAS, oa or about the 7th of April, 1939 aad for nabor of years prior thorite, tho claimant, Joaoph Tlradar, of Bridgeport, Cossootlent was an oapleyo of tho Xoybootoa Company, now Xaybeatos- Manhattan, Inc., of Brldgsport, Connecticut, oad WHEREAS tho oold employ* and cmplcryer bod oeeaptad and vara at all tlsaa harala mentioned subject to Part 8 of the Workmen1* Ceapeaiatlea Aot of the State of Coaaaetloat, as aaeaded, aad tho aapleyar had iasarad Its liability thereunder for various periods during afaleh the said olalsaat was alloyed, with Ola Travelers Inewiae* Company, The Hartford Accident aad Zadeaity Company, The Asarleaa Surety Company, aad The Ibiployer* liability Assuraaee Corp, all of which said eoopaniee emlet aad do business under the laws of this State aad are duly authorised to take sueh risks la this State, aad , .. . RHIHZAS the claimant claims that oa or about April 7th, 1939 ha suffered an occupational disease, to wit, esbestosis) and further claims that said occupational disease arose out of aad la the course of hie employment with the said employer) and further ela las that said disease Is compensable) aad farther claims that he has been dis abled from all work since said Iprll 7, 1939) and further claims that he win be disabled la the future, all ef which told claims sseh aad -1- -J all of <oid respondeat* deny, aad WHEXEU a partial hearing of laid elaia i hold before the Compensation Comal*eloner of aald fourth Congressional District u Bill aero folly appear la the files of laid offlso tad VRSBZiS i the laid Joseph Tlvadar hat a vif*, Ansa, nd too alnar ehUdren, to alt, lathany age 10 nd las* a;< 9, all of whan art pot* ential dependants, tad ROUS tha aaid elaleant waa represented at the aforesaid hearing ad Is boo represented by eeunael, aad WKESS13 It la the deelre of the clalaent tad tha told respondents to reach as amicable adjustment of tbs shore disputed olalaa to tbo oad that further litigation bo aveldod aad doubtful aad dlapotad olalaa bo rendered certain. SKIS ZS TO CHHTIPT that X, tba elalaaat baoo agreed to rootlet frm Tbo traveler* Insurance Coapaay tba am of $406.81] Tbo Sartford Aeeldeut aad Xadeonlty Co. tbo rat of $829.81] Tba American Surety Coapaay of lee Terk tbo ana of $1101.19] Tbo teployara liability Assurance Carp, tbo sua of $163.89 making a total sum of Twenty flee Hundred tad So/lOO Sellar* j aad e tbo insurer respondents do agree to pay to tbo olalaast tbo raa aboeo poelflad,to alt; Tbo Travelers Xasaraaeo Cospaay $403.61) Tba Hartford loeldaat aad Indasnity.Co. $829.61] Tba laorleaa Surety Co. of Hoe Terk $1101.19] Tbo Ssployere Liability Assurance Corp. $163.69] la full accord oad oatlafaction of aboeo disputed olalas. AID TO fCHTSSH CSHTI7X that la coaaldorstlea of a aid susa *o paid, X, tbo elalaaat, do hereby realse, release aad forever discharge the employer tad all tba Insurer respondent* froa all elalaa for coapanaatlea benefits whether for ecnpenaatloa la any fora payable to a* under aald let or for surgical, atdleal or hospital benefits payable on sry behalf and whether said elalaa have already arisen or hereafter sight arise by reason of aforesaid elaia for ooeupatloaal dltaae. UTS TO yOHTHSH CSSTUT that 1 Anna Tlvadar, wife of aforesaid elalaaat, Joseph Tlvadar, do agree that In consideration of aald ausa -2- ao paid to ratio* release aad forever dljeharge e*eh iad all the abor* named reapondent* IM any aad all elaiss shleh Z might here after has* against say aad all of them by r*aaea of th* all*(*d tn- corrlac of aa Moapatloaal dla*aa* by th* laid Joseph Tlradar atlls la th* employ of th* aald aploy*r-r*pendent, AID TO mgmt CglTIPT that Z, tha elalasat, Jo*ph Tlradsr, aa parrat aataralcoardlaa aazt frlaad of aforesaid minor ehildren, potential dependent*, aad Z| Aana Tiradar, tlf* of aald Joaaph Tiradar, potential dependent aad mother. of aforesaid minor ehildren aad pcten- tlal dependents, do, la fvthar *oaald*ratlon of aald anas ao paid# discharge *aeh aad all tha abor* named raapoadaata from all alalas ahleh might h*r*aft*r b* mad* by th*a against aay or all of th* abor* aamad respondent* by rsasca of th* afor*m*atloa*d alleged Insarring of aa ooenpatloaal dls*aa* by th* aald Joseph Tiradar# still* la th* employ of th* abor* named employer-respondent. UR) TO 70HTHER CUi'JiPI that **, th* alalmaat aad th* r*apoad*ata, h*r*by aaboit.th* *rittn agreement to.th* Compensation Coeds slonar of th* Peorth Congressional. Blatriet aad r*ap*etfally ask that aald agreeaant aay b* approved lth th* fere* of a fall aad final avard, Za sits**a thereof * hareunto sot oar beads th* day aad data first abos* srittan. . Tltneasea: . Jr A , Lx?, - - 7 A ' I'1 ^ f_it_e_l_m__a_n_t_, p,are,nt, n__a_tu_r_a_l guardian aad aazt frile*and of Anthony aana.d Aana Tiradar, potential claimants. yt^--__ Potential clamant aad parent. SAT9S3T0S C0XPA5T no* Received JUL 3 -1939 Ccmptmatton Cammissiosir co.amerzcav sorstz op ten TO! Pourth Congressional Diatrii. I o STATE OF CONNECT 1 CUT) ) SS. Bridgeport COUNTY OF FAIRFIELD ) CERTIFICATION THIS IS TO CERTIFY that the attached. Is a true and accurate copy of the Agreement to Compromise, Petition to Compromise and Order, and Medical Report from Or. Cole B. Gibson from tne records of the Office of Workmen's Compensation Commission, State of Connecticut, Fourth District, in the case of: John Rusko vs . Raybestos Comoany, now Raybestos-Manhattan, Inc. ana Tne Travelers Insurance Co.; The Hartford Accident S Indemnity Company; The Amt:rican Surety Company; ana Employers' Liability Assurance Corporation. U 1 .' C !1 Lllit 1 57S . hand and seal this - / "tx. cf /l-Cc-P' / It, l JiOHIl A. ARCL'DI, \ Workmen's Compensation Commissi oner ^ 31 ui s tric : JOHH RISES, CLAStAST I Tt. , t RAISES73S COM?AST now RAT3EST0S-MABHATTAN,ISC X&LOTB. 1 t And t SHZ T2ATZLXRS IHSORA2JCI CO. THB H1RTTORP ACCIDZNT AHD t Z1TDBESXTT COMPACT AMIRICAB SQRISr COMPABT X HCFL0T223 LTIBTT.TT ASSURABCI COEPORATIOB CORAM: caupmsAizoH comuzsscobzb J0BST3 COHCRZSSZOSAL USTEICt BHIBGSPOHT, OOHHZCTZCOI OCTOBER 1939 dCTTOtgfff TO COlgfiPMISI PSTITIOH TO OOigROMISl And "iv'*# "S$N OHMS WRTB'XAa on or about d Sd day of Pune,19 39 and for a number of tuii prior dereto, da olaimant, Pohn Reako, of Bridgeport, Connecticut, was an Bployt of do Rayteetoe Company nov Raybactoa-Uanhattan,Ina., of Bridgeport, Connecticut, and WTSTA3 de aald employe and employer bad accepted and vara at all tinea baraIn mentioned eubjeot to Part B of da lorkaen* a Compensation Aet of da Stata of Connecticut, an amended, and da miployar bad insured ita liability dareundar for rmrioua periods during which da said claimant <ti employed with- She Traralara Insurance Company, Tie Hartford Accident and Indemnity Company, She American Surety Company ad The Bcployara Liablli^ Aaauranee Corporation, all of which aald ooapenlea exist and do bualnoaa ondar da lava of dis Stata and are duly audorlsad to taka neb risks in this Stata, and MH7HTAS tba claimant claims that on or about da 8d day of Punt,1939 ba suffered an occupational disease, to viti asbartoslaj and further claims dat aald occupational disease arose out of an< in da oourea of bis employment with da <mployarj and furdar claims dat aald disease is oonpensabla; and furdar claims that 1 baa baas disabled from all work tinea said Puna 8,1939} and furtbar claims that ba will be disabled in the future, all of die aid claims each and all of said respondents deny, and WTTTMtm partial hearing of said elaia vaa bald before the Compensation Gaoissloaer of said Tourth Congressional District aa sill aora fully appear la the fllaa of said offlaa, aad WFTRTlfl the said John Saaks has a wife, XUaaboth, too Is a potaotlal dependent, tad WUHIifl the aaid alalaaat aaa represented at tka aforasaid bearing aad. Is aov represented by sonasal, aad HHTBB13 It la tka deair* of tka alalaaat aad tka said respondent* to roaok aa aiaakla sdjurtaaat of Iks shoes dlsputad alaiaa to tka aad tkat further litigation ko avoided aad doaktfal aad dlsputad elalas ko rendered certain. ISIS IS TO CPTIfT tkat 2, tka alalaaat kava agreed to resale* from Sko Travelers Zasuraseo Ccapany tka m of $70*87 Tka Hartford Jceidoat aad ladanally Co.tka sms of $423.6* SHI iUSBZCill STOUT CQHHAHT 07 HCT TOES tka stai of $426.77 Tka &pleyara liability Aeauxanc* Carp, tka sum of $78.74 making a total soa of Oa# Thousand aad Bo/100' Dollars; and ee tka laaurar raaponderte do agree to pay to tka alalaaat tka am above spaelflad, to witi Tka Traveler* Zasurases Coapaay $70.87 Tka Hartford Accident and Xadnaity Ccspaay $423.62 Tka iasrlsaa Suraty Company of Hoar Tbxfc $426.77 Tka Bsployers liability Assurance Coxp. $78.74 la fall aoeord aad satlafaetioa of abcT dlaputad alaiaa. 1KB TO TtSSHS CZSS7T that la soaaidaratloa of said iuu so paid, I, tka elalaaat, do ksraby reals*, rales** aad forever discharge tka aaployer aad all tka laaurar respondent! froa all alaiaa for eoapaasatloa benefit* whether for soapeasatioa la say feta payable to ae under aaid let or for surgical, aadleal or kospltel benefits payable oa ay behalf aad whether aaid olalaa have already eriaea or hereafter sight arise by raasoa of aforesaid elair for occupational dlataae. 4HD TO 7UBTESH CZKTI7T that I, Xliraheth Baslco, wife of aforesaid olalonnti 7okn Basko, do e^eo that la coaslderatloa of >2- nan COLS B. CI3S0I7, r.D. UKLRCLXF.,'B SAI'ATOaIuU ;xrtee;, corn;. 1 July 7, 1939 . Er. B. ?. L'anvllle iceri can Surety Company Bridgeport, Connaetieut Saar Er. Kanvills: Tba following report la submitted upon the azaalnatlon of JCHT PXSKO. JR. PE?S0KAL BISTORT: Age 50; married; rife living and rail; two children, oldaat 19, youngest 18, both Heine and wall. Family history unimportant. Be m horn In Bridgeport. OCCUPATIONAL HISTOTT: Be begun work at Anerlean Craphophone on Edison records where he renaiaed for 7 non the. Be than cent to the lialleabla Iron working as a core Baker for 8 aontha; in the oxidizing plant as core maker for one year. Be was In the Army from 1907 until 1919 after which he went to work at Bridge port Kstal Coods, remaining there about 7 aontha and then went to Celunbia Sraphophona Cospany, pressing records for It years. Be was laid off and than worked for the City for 3 or 4 months. After this ha entered the eaploy of The Stanley Rolling Bill working for 3 months. Then he rent to Raybestos Sfg. Co. about 1920. Be quit twice and remained out for a short tins, but the third time ha remained for about 13 years. At intervals he work ed e month or so at Lighthouse. Be quit work about June 30, say ing that be could not stand the work any longer. Be had been reaving asbestos while s t lbs Bridgeport plant but whan he was trans ferred to Stratford he was trucking. Be said that he found that this was such too heavy for Mm. PASS ILUSSS: Be had influenza In Panama while in the Araj; Grippe In 191S; no other serious illness, aeeidsnt or opera tion. PRESENT XIUSSS: The onsat was apparently In February when be was cut of work sbovt 6 reeks with severe cold and was short of breath with feeling.of heaviness in his ehest. Prior to this time he had occasionally been bothered with some shortness of breath and sensation of heaviness in his ehest but net severe ly. Since the acute illness he hns been weak, has some dry cough in the morning ani at nig:t but otheircise during the day hs has little or no cough. Be is dyspneie on exertion, especially on climb ing stairs. Bis legs are weak but this has improved somewhat since he give up work. Be has a vague feeling of heaviness in his anterior chest and occasional ache over his sternum, and this is sometimes accompanied by a painful sticky sensation within his anterior chest.' He consulted Doctor Antell s-ut three weeks ago after having Doctor Turehek during his ante illness. At the present time hs sleeps poorly, his sleep heir.- scmewhtt interrupted by occasional cough. Appetite is finicky. Bis ordinary weight is 200 pounds or better; his present weight is 186. I PHYSICAL EXA^ETAUCIT! Ee is a heavy a st can, vail developed ml nourished, doss net appear aeutsly 111- Eyas Glasses. Throat: Tom Lis either removed or deeply buried. Sara negative. Kota utrative. Adanltla sintlTi. Ciaat: Son flattming of the suormelavieular spaces; not shrunken; no lay; has diminished rssonaaes over both basts; ce daflnlta ralas; bresth sounds elaar; expansion good. Heart: P.2-1. In Sth Intercostal space In nipple line; faint bloving systolic maraur at the apex faintly transmitted torard the axilla; rats is Slav, 68; occasional dropped boat; snapping aortic second sound. Abdomen is slightly protuberant; no tenderness or aassss. Extremities negative; fingsrs not elubbed. Sp.tuo; speclean could not be obtained for" examination. STEREOSCOPIC X-UV of the ehest reveals faint baxlnasa over the lover half of tea ri-fct lung field thereby aceentuatlnc t- a descending bronchial markings somewhat especially In the Inner zona chars these mrlclnrs are smevbat tortuous and Interlacing. There Is, however, no d!stlnet or definite evidence of spider eeblike Interstitial flbrotie chan-e typical of asbestosis. On the left side there is sene faint haziness in the aid lun<- field extending out to the periphery at the anterior level of the Sth and Sth ribs. Again, the spider w-b like interstitial fibrosis is not seen. There la sons shagrinesa of the descending truncal csrhinvs betiind and Just belov the eardiae shadow. Thsright hilts is coderatly mlarced and ranged. The left is somewhat ragged but not enlarged. There are multiple flbroealcifie depo sits in and around the left hllum. The lung fit 11s slsevhera are clear except that there is sonehaxiness'extending up in the eld axillary 11ns on the right side to the clavicle. The heart appears to be definitely enlarged with deviation mors pronounced to the left cut also ax retracted to the right. Both eoetaphrenle en-les ere clear. Diaphragms are curved and free. DISCTTSSIOjJj Diagnosis in this patient is indetermi nate. Els occupational history Ax of sanewhat over IS years as m asbestos weaver suggests tits possibility of pulmonary astestosis. However, no sputum could be obtained from the patient to determine whether or not esbestee bodies were present. Horsover, x-rs7 examination of the chest while revealing sees haziness over the lower portion of ths light lung field does notexhibit typical and characteristic picture of pulmonary asbestosis in ths aodsratsly advanced or advanced stags. The haziness asy indicate very early beginning interstitial fibrosis and it is not balisvsd that this is of sufficient extent to esuse any severe disability. It cannot be said definitely that s mild degree of interstitial fi brosis as result of asbestosis does not exist; but eertaialy such interstitial fibrosis doss exist it is not present in any great ly advanced degree. Tfc* onset of ttli aan's Illness ess apparently so teste respiratory lnfsetlon end prior to this tics he hsd apparently been usually eell except for occasional vague sensations la his chest, above described. It night veil be that ths eeakness sad shortness of breath of ehlch he eos^lalas are sequential fron tie acute respiratory illness. It nay be accentuated by the fact that he undoubtedly has eardiae abnormality as evidenced by faint bloeir. auraur Indicative of valve failure end also b7 the definite x-ray evidence of moderately enlarged heart ehleh strongly sug-eets the heart usually described as a sdtral regurgitant heart. Insufflelen aynptons end physical sl&is at present prevents ths establishssnt of this latter diagnosis. Unquestionably, the sian has saca ayoeardial change and unquestionably be does have valvular leal:. Thee conditions could be responsible for seta shortness of breath es pecially during the per'od folloelnc an acute respiratory Illness. Briefly then, the noteearthy findings In this patient refer first to his heart, second to his lungs, la the latter rhere a Einor degree cf Interstitial fibrosis possibly die to pulmonary asbestasis can not be entirely fuled out. It seems unlUetly that there eill be any further progress in ths lntsrstltlal fibrosis If the nan Is rtnov ;d from the atmosphere of asbestos weaving; and indeed it is entirely passible that considerable clearing of this stay occur but ehethsr there eill be caseation of his sjaptoas will depend upon the condition of hie heart, I believe. Very truly yours. CEC-/X cois 3. ei3sor cors b. oi3Sor STATE OF CONNECTICUT) ) SS. Bridgeport COUNTY OF FAIRFIELD ) CERTIFICATION THIS IS TO CERTIFY that the attached is a true and accurate . Agreement to Compromise, Petition to Compromise copy of the ______ _; and Order from the records of the Office of 'Workmen1s Compensation Commission State of Connecticut, Fourth District, in the case of: Charles Brooks vs . Rayoestos Company, now Raybestos-Manhattan, Inc. and - The American Surety Co. of fl. Y . ; The Employers' Liability Assurance Corporation. Given under my hand and seal 1 ; 1'i . Workmen's CompensJtion Commissioner \ fI ourth District / (/{} TS. hjctsstos esu?jurr sow t' SiSBZSTSS-MASSATUS.IBC BOIQXES l t TS2 aioexcis asssrt cokpast or sss ioa. XfPLCRSS' LIASIilTT iSSS&UICZ COE?. I gsa?.as.gis?caseiis t CORAHt O0K?gSiSi0H eoiacsszoRs rOOHTH CCaGHSScIOJUL aszsxc: waxasoss, cosszcn cor OCTOBfiU*^ 1939 lgPTTMTBT TO caigsmgsb wnoos to cagaagsB JSas_ OffiSS BFf5IS oa or about the Slat day of Karst,1939 aad to? a awber of yean prior thereto, the elalssst, Cherlaa Brooks, of Stratford, Cosaeetiettt, nj as eployt of the Saybestes Ccapsay cct Baybastos-*hattan,Iac., of Bridgeport, Cocaaetiout, aad WESZiS the aald aaplaye aad employer bad aoeeptod aad vare at all tiaes barala aoatlo&ad mbJ act to Part B of tha KarJesaa's Caspar,aatlas lot of the State of Sesaoetlest, aa saesded, aad ths aeployar bad insured ita liability thereorder for Tarloua pariada dsrlrg eblci tbo said elalaait was splayed with - Sia iaarleaa Surety Canpasy of See Tori aad She Saplayare* liability laasrarca Corporation, both of which said eopealss arlst aad da bsalasss wader the laws of this State aad are duly authorised to taka such risks la this Stats, sad BEZS212 tha alaioart olalss that os or about ths Slot day of Xarth, 19SS so suffered aa ocewpatiaaal disease, ts *itl Isbostssls: aad farther "T that said oooupetioaal disease tail out of trd la His oowrso of bis rplo73sot with the osploysr; asd farther elslss that said ilsaase Is eespeasabls; asd farther elalss that be has beea disabled fr=a all work slrse Harsh S1,19S9{ aad farther alalaa that ha will be disabled la tha future, ill or which said elslss each aad all of said respoedaats daay, sad eu-rceic the said Charles Brtcks has a wife, Clara, who is a potctill dependent, sad WE2EX15 it la tha daslrs of ths elaiaart sad the said - respeadarts to nasb ta saleable adlustaast of the share disputed ' (TTlT-n-ri--r III ....................... ... .................. .......................... isi dlspeted *< be readsred certain. T3ZS IS TO CHTI3T ttit'I, the elslaast have imiIti ftca to, Cm Janleu Ssrrtr Ccnpaay of Be* TcrJc #74.90 Sha' fcjlaTtri' lUMlitr iMciae* Corp. #25,10 Baking a total ra of OSX "ZIUWO isd So/ICO Eollarsj aad we the lasarar roapoadasta is ipu to pay to the alalsast tSi m so specified, to aits 2hs faaTioaa Scetx Cspasx of Sew fork #74.90 She ^players' liability ioaorasoo O017. #35.10 la fall aoeord aad satisfaction of shore disputed elalaa. i IBS TO fid-.T-tii lairi-s/i that la ooBSidsrTtisB of said hsj so paid. I. the olaiasat, do hereby rail), roltaa* aad forerar ' discharge the esployer aad all the lasnrer respeadeats Iron all | I alalas for eesgeasstioa tea(fits liether far ecspeasatioa la tax fea payable to aa tmdar said lot or for surgical, aadlsal or [ hospital baeafita payable ea ax bshall ead thethar said elolss hare ! alrsadx arises or hsrsaftor sight sal so by msea of aforosald alals far occapctloBal disease, IKS TO JUtd'.-lA CHi'lfl that I. Clara Brooks, ails of aferaaald alaisaat, Chsrlss Brooks, do agree that la oeasldarmtloa of , . said as so paid to rsslaa, ralaaaa aad farsTsr dlashargo aaeh i aad all tha shore aasad raspesdsata lies sax aad all * shloh X sight hsrsaftar haTo against say tad all of that bx raasoa of tha allagsd laeorrlag of aa ooctpetisoal dlsaasa bx tha said Charlas Brooks wfella la tha =pls7 of tha said eBployer-respoadeata. ISO TO XLSi'hid CSSZ7Z that n, tha elalsaat aad tha rasposdacts harsb7 suhslt tha writ tan a^eaneat to the Ccspeasatlsa Cosalssleaar of the fourth Co&gretsioaal District aad raspaotfally ask that said agree:eat aaj be ^prored with the foroe of a fall aad final award. Zs xLtaaa#' tiaraof w baraata aat oar baada tba day and data ftrrt abora arLbtaa. vztnsszsi ag.g.tU dLnsuSc* ^"^sLa-irb - a^T j^Lrrr ' fyrrrfha__________ SA*WX J. i'WV;t'U' ' -- *" 1 * juaBssfosScapjarr as* r RiT7gaT3H-tfm;,m.H.2ae sz BffiM assart or aar tusx rr 1 xtetOTsss1 Lzagurr xssouscr cas?. -A- _ IT ^2" . ^__________ Jgpfarad i? ^dar of OotsbarjlSS# 1 Cos?reaisa dc=ij*ioar /ears* Baty-aiggal W.rtTlS, flesejvad OCT 2-11339 "rajeniatwi Cnmiiiin?.' vv> 'M,'i ' n rlilim 'Imp - fl Q C u o c r c r >*. LC > c kc ce xk r- O o c k & MM *r *% cc c e S:EC & C^T W >*< = 0 .k " mW xc c * r * * * a. it kX <c rr nk *k- ctz o c & c k 5 0a tr ** +* js ** JC p ke>xc^ ko :: *o c xcc * X E o s c u s k o, c, * u: ^ - ** 4* r S se cx c o n.' r Sw* c c c : " \C z *1 c ' cc g c >> *; tc X i* t ^ r. Z' k *' w k 44 ^ ". W C 4? ,& ^ n w . r* t.: c. . . c; C .65 * / J5 k* G *< C. . 0* Q O * x ^_ > cc > c 4* * *0 M 1 r. t r. k r " . jjS3sE5gS rw SB* aaeit 3Cathm Xanii IrttAmtn. ifl. P. Ulf Mmm ^inhifl. iLfwmrrtmt f *!*'.\rl.- i.'< t J nf .('n t'rorpt - in n y , '- im lintto ('m m . -n n fo t tn y o . K iip iiu o n r ,,, . ii. U, T ln r-irt aBMaj^ygfi&gBfeg AcciDRirr ntonHT i . ivkk i;;:n tuiKu <> tu ______ i k r>, vnim * * ACCI DKMf ngPOill' non i C"'..... alec rsczrz, cuswn 121 Dtanr Arsaua Bridgeport, Conaeetieut '5. JRATSBOTOS COMPANY now BATBfeTO S-MAMHAT7AN, ISC . : cao>u:sAT3on coiaossion j JOURTS C3NCB3SM0NAL KSTSICT : AND THZ KABTTOBB ACCISEff k ITOEWITY CO. TBS AHEICAN SU22TT COMPANY Of .'fl* TO BE : TSS ZMPLOYZBS* 1XASIL2YT ASSUP.ANCZ CO BP. 'J BBIBCCORT C0NXJCTIC5T S0VE18E2 , 1939 ' Acasararr to cohprghisz _.o.. vi aU?Je-S>,CL- ~* prrrrioH w comprokisz M--85----------- OBQSi RRSlZAS on or about the acnth or Kay, 1939 aa Tot a nusber or rears prior thereto, the cia'iaant, Alex Peltate, or Bridgeport, Conaeetieut, na ta esploye of the Bayhestoa Conpeay aev Beybestos-Maahattaa, Ine., of Bridgeport, Connecticut, and BESBSAS the said asploye aad atployer had aeeepted aad were at all tiaee hareia aenticned suhjtet to Part B of the Kcrteea't Compensation Act of the Stats of Connecticut, as aseadad, aad the esployer had insured ita liability thereunder for warious periods during feieh the eaid elaiaaat was aaployed with - The Zartford Aeeidest aad lad sanity Cospaa7, The Aacrieaa Surety Company of Sew T0rk ahd The SsploTers' Liability Assurance Corporation, all of which said ooepaaies exist tad do husiasss under the lews of this State tad are duly authorized to take such risks la this State, and VE33ZAS the elaiaaat elaias that oa or abeut the asath of key,1939 he suffered aa oeoupatietal disease, to wit: Asbestssls: aad furthar elaias that said oeeupatioesl disease arose out of aad la tha oourse of his eployaast with tha eaployar; aad furthar ithat said diseasa is eompansable; aad furthar elaias that ha has ieea disabled from all *>ht siaee said Kay, 1939; ead furthar eiaias that ha will ha disablsd ia tha future, ell of which said elaias each aad all of said respondents deny, aad VEZSZAS partial hearing of aaid elaia was held before ti * Compensation Commissioner of said fourth Congressional District ns will sore fully appoar is tbs files of said office, sad 1EERZAS tbi said Alex feketo bas a wif Vary ?., wto is a petentisi dependent, sad VEZSZAS the said elaiaast m represented at tie aforesaid bearing end is now represent ed by counsel, and TBTRTIS it is tbs desire of tie elsinant and tbe said respondents to reach as saleable adjustaent of tbe abort disputed olaias to tbe end that further litigation bo avoided and. doubtful and disputed elsiss be rendered certain. THIS IS TO CZ3XI3T that I, tbe elalaaat bare agreed to receive from: ' Tbe Eartfsrd Accident end ladesaity Cospeay $27.13 Tbe American Surety Ceepany of Sow Tort $226.49 Tbe fepleytrs' liability Assurance Corp. $46.36 Baking a total ia of THRES STSiSRZD aad Sc/100---Dollars; end we tbe insurer respondents do tgrec to pay to tbe elalaaat tbe so above specified, to eit: Hartford Tbe levu--s Accident aad Xadeaaity Company $27.13 Tbe Aaerieaa Surety Company of Sow Tort $226.49 Tbe ^players' Liability Assurance Corporation $46.36 in full eecord aad satisfaction of above disputed olaias. AMD TO m'"u CB.H3T that ia eoasidormtloa of said sias so paid, I, tbe elAiaeet, do bareb7 remise, release aad forever discharge tbe aspiayer aad 'all the Usurer respondents freo all' olaias for compensation beaofits wbetier for compensation U any fnia payabie to me usdor said Act or for surgical, aedieal or hospital benefits payable oa sy behalf aad whether said eieias have already arisea or hereafter night arise by reason of aforesaid elaia for occupational disease. AHD TO rcKTSH CtSZZTl the*. 1, Hary ?. Telceta,'wife of aforesaid elaimast, Alex ?eicets, do agree that la consideration of -2- aaid iaa so paid to_r*al.sr_ ralttsa ud forarar iliatarpa taii ......... and all tbs abort saaad raaposdassa frsa Uf asd all alaist afciab Z mlgrt baraaftar taara against asy asd all of thaa by raaaaa of tba allagad iaeurris* of aa oeccpttional dlsassa by tba aald Alax ftkata xfalla la tba asploy of tba aald asployar-raspcsdasts. ARS TO KSSSS CZKHJT that *a, tba eladaant and tba raaposdaats baraby tubnit tba writtan agraasaat to tba Cospaaaatioa CeeBlasloaar of tba fourth Coagraasional District aad rspectrally aafc that aald agratsaat aay ba approrad ltb tba foroa at a full aad flaal award. Za witness tharaef va bareusto aat oir basda tba day aad data first abort aristas. wrmsszs: ,jrA0<?. TH2 IASTJ02D ACCZDSI7 h IKSSaUTT a. /I " wr! J ' - az jmzsicas saarr ccupawt or ss: ides tss KPioiras' ltabilitt assusa&cz cck? ZT imraradSf jar of Soraaber', 1939 Caspessatisn Scesissiaoer ?ourtb Cessrtssiaaal District. EMPLOYMENT CARD I I STATE 'OF CONNECTICUT) ) SS. Bridgeport COUNTY OF FAIRFIELD ) CERTIFICATION .THIS IS TO CERTIFY that the attached is a true and accurate copy of the Agreement to Compromise, Petition to Compromise and Order, and Mecical Report from Paul T. Lengyel, M.D. from the records of the Office of Workmen's Compensation Commission, State of Connecticut, Fourth District, in the case of: Joseph F. Sturm vs. Raybestos Company, now Raybestos-Manhattan, Inc. and The Hartford Accident S Indemnity Co.; Tne American Surety Co. of New York; and The Employers' Liability Assurance Co. ~h r~ / C C U J* f .-n under my nand ana seal this L '1 r':/ day of \ jVlorkmen'u Co in Den sat: on C omm: s s i o n e r \jFourth D'Strict wtlfW Mit .oaaph T. Stsa baa a li.'i, Ctttirisi, *bo- :- la potential dependent, asd VS2SX1S the aaid Calairat eaa Ttjrtufiri at the aforeeaid fcaaslas 4 la sow repreacs ed 67 ecaael, and enlaain It la the dealre tf tha iliisMt ci the tali respoadaeta to reach as aaioahla adjuatnwt of tho abere diluted elaixa to tha asd that faithx Utigatlea ho ansidad aad doubtful osd dlaputed olalaa ho restored eartaiju' . S313 IS SO .C5E27X Ini* X, the olalaast have agreed to raealTa fro* She Hartford leeideat asd Zsdealty Ccspaay ilJC.43 Sha isericas Surety Ccsjtsy of Ho* Soli: *173.CO Shi kplayere' l|abllit7 laaurahao Corpcratiaa '-i*-7 sclrlog a total rs of SCI lltaa and So/ICO Dollars; asd wo t tha insurer reapcsdeata do agree to 907 to tho olalsa&t the te abora specified, to witl Sha Hartford incident asd Zsdassit7 Ccspasy *IC.5f Sha inerican Surety Cqpaay of Haw Xorie SSSC Sha Snpinyera* Liah11117 Jjcurasae Corporation *54*"^ Is full aoeord asd aatlafaetlos of abort disputed clalss. iBD 79 ruif.d/ji CffiKIS that Is eoaaii oratlos of sold r-~i go paid, 2, tho olalaast, da hereby rmiae, rolaaaa asd fagsrar dlaeharge tho osplsy-er osd all tho insurer respondents frm all for eespaasatins hosaflta efcrther for cospensatiss la asy fbxa payable to as tadcr aaid let or for surreal, radical or hospital hasoflts payahla os 37 hohalf asd vhathar said laIsa hare alrsad7 ariaas or hcrsaftar sight arise hr rseaoa of aforsaald Calx, for oeeupatlesC dlaeaas. " IO TO lUBTiTra CggXTT that I, Cathariaa Sties, slfa of afsrsiCd claiseat, fossph 7. Stars, do agree that lh oossidarstlos of fall fuaa so paid to resist, rCaaso asd fortrar discharge each asd all ths abcra sasad respondents frss as7 asd all Calsa ehiah X sight hereafter here agaihat asy asd all of thea by rtaaes of tha alleged incurring of as oeoupatissC disease by the aald feiejh 7. Stum while is tha esploy of tha aid esployar-reepoadast. JSS TO 7113258 CZJSUT tbat n( olalaast < tba raapacdacta-haraby aibalt tba vsittaa igrtaaast. totha Ccapanaation Ceaalaaiesar at tba Poartb CoagraaaiaaaJ, Elrtrl at ui raapaatrally uk tii*. nit iptaiat nr ba apprortd dii tit foria f pall and ft aal tuard. Za ^taaaa tbarao? aa barasata lit cur band* tba dap aad data drat abora cittu. rmsas t ~)fr nuu*tz~. Mtaatial Clalatat --ir txzszsrij can?jkifT eo- tASSisiaui unurrjj, isc K HA825&2D acczsset a XSSSSSZ CO. r /I7 5 / i / ' juacaui ram cig>jjtt o? anr tosh ar . kv-q>^vbcrS^-<b BCLSTSSS* UasniTT ISSSdHCZ css?. g ^Wsf~~~eJLP IpproTad ^lap vt SoTcebar(19S9 &r&.- Ccapacaatioa Cetstljalosar 7ort4 Co&srasaiaBal Slatriat. P*Ul T. UCN9TCU M a. tf MMtm iVCMVt l*iot*v, SAMMfntwr 3ept="r 1939 tr'sls'ttsa of Sr. Iswn1- itura 19 Jaeia jtri-t n'r'leld, renn. Patiist * i mrblns at af-aitoa rtosoany for nine yr. atartl-j "ibr-,ry IS?*. B* la a loos fixer. 3a atatad t*ot tSJi ooottlla- Jo* ii daaty. Sla body la e.0T-r*d -ltb aabiats* dujt. jo*tl=*a "a u roneis on braici llr.lnra *s- tna jo- tor-any. 3a notlotd for tbi flpt tin- that Sr ni loala* -ilxbt. ewbilnf, and i-lttlnr -nilflab, biujjb atoff, 'nd'*>' abort fc--ath fnop t.be l*aat UttV tbJn*. Se ant tlr*d r*ry oaally. "w~ln"t 'on; PitJmt la ta'I . tbln as, alrf-as Taira n **a. Tjn-lnatlon of ayaa, b-ad, south,ixtr-sitlii, bd3= In 1 oirmna r* sosatiT, Tbrrr la a T'lulab Slaooloration o* 11- and flrm-rolla aowitlnr eyan-sla rhioh la earsan In aa*`tatoa -or'-ir a, and tht dlaaaaa eanaad St t-f ra tarsad n **lu diaaaaa* wri ago.>7 tbo *rltlab dostoa. In motion of tbo ehe it abe-a that the an baa a len$ eft* at saaltr is ---ertlon 9" Ma hiiaht. Tbo dlataset vtr*ea fjnlratlon and lnaolra* ir--.only or-o<:>--tar of an Inoh. `rm.nalon n* t.bt e*ttt 14 nd. -sbla* a dro v~*tb -a* a-i-, '** tbn 1= a nsrsa! n--r. auaeultation -ltb tb attb*ass-* rronnla dr- j-jr.omi ra'*a on 'ot'h al'! of tht lor.r tasoclally andt- th* !*t .ors at tb baj of tw# lunj. Tb nwr sort of tha lanr Sa ?r*ly 000d, Tb-" la no alar, of th* ralaa Is tbo x -'-is1! xelufia th* noa-lfllltT or f. . *lth --S"a!9n. Th note la suoh hlfhsr thsn In no.-sal *ilr:?st ahe-1n an tostrya rkisb la torsos aescfat tha. s*c-l rs~ r-- ixnoa-d to aak*atoa duat ft- a !nr t1*r. Trcuralon of th* loss at th* bfi*4 tasielaliy on th- l't a!d la oer ausraatlr. idValona of tie -7ar: >ur to i Ian.- ata.ofl.or srma^. "h 'ra-t asund ar sltnr and -s*433r. "b- intlon or t--'S*--t 1. r-sml-r. ni rod rr-aaisn la '** onr 55 -b`.tb la 'airly fr1, not I-- or not Slrb re- a san of aijrty-sn* lira of air r I rjr.esinatinn ?' Hr. Joteoh jturn niuroieonls end x-ray eaaslratlcn o' the lunet -eeeol * lenlt' Interstitial !nTslees*nt of hath lungs In tv lo-er 5e#ral n-dules and *lm-*t' hai ulerj"et of the long. tissues, Inflasotary lone Hand ing o"aeetet could vt teen In both lungs core nuserout on the hin of >oth lung* and vrcrchl -sold he tecs at tho loeer port* duo to 1 ~nr (tending cough. The nluri Is tlcV--< ard could v* i*r. Vt*een tv right uooe- and tlddlc lofce. TVre is adhet'nn on tt ,*lrtt hand tif- >ut such thl-V- on tho 1**t bond aide unfernrrth tht hoert and to-rdj tho left tide. The heart Is a llttl* bit asoller In sle. There li no an'cla1 dilation or other oetalecieal sign on It. Cantor Inc fhr X-ray olet-rea elth tho other ease* I hsee oen lately, that It. !>. rareo, Belnsr, ate., I could trm thlt. This aan a lung It lneoleed Just at ruth at a-ehr-'y of tv son et-eeiallr the cne rhot" eat- -at ea"T idea-e-d . t>. itim't lunet ar Just ct hndlT lne-leed rlth eSranle leeiasatory esndltlcn eauaed hy athejtaala. There la hardly any lung tissue left eneclally the lr-er cart or the lor lungt. The elntn"* lo^ht 1IV 1* hst V-- thot r*th * twctrjn. ersitura :J the brnncri ar- n-r-e clearly r'ollad on the right tide than th* left. They try A lister due t t** s^onls court he hat. L L ?rarsetit: t ftr at hi* 11 "e lj ccnner-e-*, It It good. * far at hit _cr'*lr.e csn-elty It can-erred. It It had. He "on't V thle to rerh f-r e c-urle o' ye--t. I should ts- ohe^t three or feur -to-* oeen afte- that tlse he "?1J fc -h'e ts dr e*-- 1 Irt.t -c-h ri:i deetn't route tn-` ere-clte. ilncer*le eeurt,7 7 ?cul l+7irr*l, U 3 i>*f ! tn I STATE Or CONNECTICUT) ) SS. Bridgeport COUNTY OF FAIRFIELD ) CERTIFICATION THIS IS TO CERTIFY that the attached is a true and accurate copy of the Agreement to Compromise, Petition to Compromise and Order from the records of the Office of Workmen's Compensation Commission, State of Connecticut, Fourth District, in the case of: Conn E. Nichols v s. Raybestos Company, now Raybestos-Manhattan , Inc. ana *. The ''ravelers Insurance Company; The Hartford Accident and Indemnity Camoany; The American Surety Co. of N.Y.; The Employers' Liability Assurance Corporation. u'.vc'n under my hana and seal this -JGru A . AnCuDi , Wurrcaen ' s Compen s a t ' or Commissioner Fourth District WU Ua Hid Jota'l. Uihsliiu i tin, Baida, nt t Miaar children. to wit* fobs X. Sr., asd Barbara Biciols, all ef -etna era potential dependants, asd. r m US the Mid el al asst u represented at the aforweaid hearing asd la new repr-eeaSad by eemsal. asd WsmUB It la the iaairt of the alaisart asd the said respondents to reach as mieable adjuataast of the abora disputed elaisa to tha and that farther litigation be amidad asd doobtfal asd disputed elalaa be rendered (artels. SIS IS IS CgT*TT 1215 I, the alalaast bara apwsd to receive frtn flt-Sl She travelers ZsaBrasoa Ccnpasy the aca of It*-li & BertSard incident ft lad ty Co. tie am of fflO/4ignt -ri &a laariaas Bursty Ccspaay of Saw Tort the aisa of fe9 IBiTC naa So Xsployera Liability Assurance Corp. the am of XssooOT >-' 'c a total am ef 2332 T2SB515D asd Bb/lCO Dollar*; asd ** the insurer respondents do apes to jay to tie elalaaat tta em above specified, to witJ t1*S> Sa SraTalarm lasurmnos Ccrpezy idea." i c-r- Sa Bartfsrd IsaIdart 1 Zaiaalty Co. 1sefri3>i . <. / of/ - . Sa Jaeriesa Surety Ccnpary ef Sew Tor* jdCOS.TO Ttg Sa S^loyers liability Iseurmnoe Carp. la fall aeeord asd aatlafaotiea af tbora 41spotad elalaa. UO TO ei.g^ra cjgglTT that Is eosal deration af aaid aai ao paid, I, tta alaisnst, do hereby resiaa, relaaaa asd forever discharge ti eapiayer asd all the insurer reaposdasta frm all alaisa for ooapessatlos basafita whether far eospassmtlos is a&7 ford payable to sa under aaid let or for surgical, aodieal er hospital basafita jayaila os sy behalf asd whether aaid elalaa have already arlsas or hereafter sight arise by rwesen ef aforesaid alala for occupational disease. 151 TO strayuvti C2KTI3T that I, Bessie Slehols, eifa of aforesaid olalsant, fobs 1 Slehols, do agree that is consideration of said ix: so pall to rein, release asd forerer discharge aash asd all the shore head respondents fres any asd all elaisa which Z sight hereafter bars against es7 asd ell af the by rsaaos af the alleged incurring ef as oecupetinnal disease i7 the sail John Siebols wtiia la tba aajlay c? tbo Mid f^Tnji i >i^niiiTii_^ j_ ; - ias TO pgKldK C1SX1PT that z. Ui alalsaat, 7oba X Cabals, aatursl ' a* jowi, *sardlaa, aad aaxt fitted of afbraaald miser otildraa, potacrtial dapaadasta, do, la fetbar aoasldaratlea of said aai so paid, dlsobsTca aaai aad all tti abort asiad raapoadaata fsea all alalas siitb al*bt baraaftar Pa Bada by tbaa agaiast asp or all of tba abeTa aaaad raspend cut i by raaaoa of tba aformaatlaaad alia(ad iaearria* of aa ooevpational disaasa by tba said 7oba X * >1,^ . *ila la tbs asploy of tba abort aaaad ^ployar-raspeodast. JSS T9 TBBTHTa CZSTUT that at, tbs slaiaast aad tba raspcadarts bsraby sotait tba atittsc ifrtaut to tba Cospcasatioa Cssisaiasar of tbs Potrtb Coagrasoloual Slstrist aad raajaetfully ait that said agraeuaut u7 ba appsoTad alib tba fbrea of a full asd fiasi assrd. Za altaass tbaraof *0 bsrauata sat oaf bauds tba day aad data first abort arittaa. VSS3SSZS1 1" - f# glslasnt, parent, aatigal gsardlaa aad aaxt fiiand.of 7oba X 7r. aad Barbara Bisbols, potaatial alaisaats. 'Tzis-jL^._____________ Potaatial Clalaaat - Vlfa XLTSZ^pZ CBUPiSZ nor BaZSSgWS-BA^-jLTTAW^He ... 553 JUZSZCiS SSS3S CCVPiST OP XS7 TOS p ____________ lpprcTid / ***dar of ScTsSar,1959 CagpeasarlftTi ?--?-*< M'.aei- Pourtb Couarassiosal 21 strict. / . STAT L Or COHNlCT[CUT ) ) S S . Uridgepur-t COUNTY OF FAIRFIELD ) C...E R_T I F 1 C A T I 0 M THIS IS TO CERTIFY that the attached is a true and accurate copy of the Agreement for Covenant not to Sue, Petition and Order from the records of the Office of Workmen's Compensation Commission State of Connecticut, Fourtn District, in the case of: John Gy ana vs. Raybestos Company, now Raybestos-Manhattan, Inc. and The American Surety Co. of N.Y._; The Employers' Liaoility Assurance Corporation. . 'J e r in j hand and s & a 1 t h i nc, t- ij "S 3 'J /' <-'G Lu J i TOES GTMTA, OJttHAHT 202 0crr ATenue Bridgeport, Cobs. Tf. masons cetSAirr, bow BAXBXSrOS UANHAXTAM, IliC dad &plo7r I.COHJWt t couPS^AsioH cciscssxosrs t JWJKB CSHCaSShlOKAt SISTRICT I BEiniI?C8T , COHHXCTXCUT TSX AUlSICAa S0R2TT CO 0? H.X. I > TSX JEFLOTEHS' LZABHITT ASSUSaKCZ C3EP0RATIOS I Xaaurer-Saspondeata OK&aa 1939 , . ACTUBgST TOR CCTSWg BOT TO SU* PETgTOH ASP 0PJZ5 nr-n.US os or about tba I2tb 17 07 7ebruar7, 19S8 aad To? a tiaber of rtiri prior thereto, til elalaaat, Jobs CTaaa, of Bridgeport, CoBaaetieut, wae as esplor* of tta Rarbeatoa Ccapesj, ow 5e7bertoa^(esbatta8( lae., of Bridgeport, Coaaaetlcut and *HXSB*S the said eplora asd arjlays- bad aeeaptad asd vora at all tlaea stationed heraia tub}act to Part B of tba Xorlcaea'a Cespaaeatios dot of tba Stata of Consectlsst, aa Band ad, asd tba Bjlajar bad taaurad lt llabllltp thereunder for Tarloua perloda during which tba aald oloiaast aaa aBplc7d with Tba dsarieaa Suret7 Cocpasr of Saw TotSe aad Tba feplo7ara* liability Aaeuraaee Corporation, all of wfclsb aald eespaaiea exist aad do bualaasa uadar tba lawa of tbia Stata aad ara dal7 autborlaad to taka tub richa la tbia Stata, aad TCBRTAJ tba alaiaaat elaisa that oa or about tba 12th day of P<b7uas7, 193 ba auffartd aa eeeupatloa dlaaaaa, to wit: Aabaatsala, aad firthar elaisa that aald oesupaticasl dlaaaaa aroa< out of and la tba oouraa of bla ?lo7sest with tba aad further alalaa that aald dlaaaaa la eespasaabla; aad farther elalaa that ba baa baaa diaahlad fros all wrb tinea fibmcy 12,193 { aad fartbar elalaa that ba will ba disabled la tba future, all of wfaleb aald elalaa each aad all of aald raapoadente das7, aad wwwwTi.a t partial bearing of said elala m bald baftra tba Ceapaaaatloa Cosslaaleaar of Said fourth Congreeeicnal Siatrlrt aa erlll sort full7 appear la tba fllaa of aald offlea, aad .U WCM *6a Cyasa hi * aif, Suit, fotantial dayandoot, i4 ^r 't nui O* **!& Cilsat tu rayraaaatad at tea sorl4 asd is boo npniutil tr koiiI, asd id la tea Afiln of tea alaiaast * t^t oaid l7dJtci Vw'iittia, Iso., Jaaxiaaa r*ty 609127 a? Saw Tote ** tia teyloyara* liability Aaattnsea CcTjormtioB, to raaoh as. teoaUa adjarteost of tea abero diapstad < ta tea and teat fetiar litigation ta aroidad aad.datetfsl aad diayvtad ta rasdarad cartels- "S*8 IS 30 CixtSJj ttat Xt tea alaiaast Jura agraad to raetira Jrsaj fta Jsarliaa Seit; Co-paoy at law Tor* Hddl.49 &a teyloyari' lUtlllty Aarsrasaa Cory. |5B.a *Wng a total na of SStxrza EUffiaS} aad Jo/100 fiollara, and aa tea aaid iaaarar raayaadanta do agraa to y7 to tea alaiaast tea no atora ayadflad, to *itJ Si Jearioaa Snraty Cccp27 of Jaw To* $1341.49 tea Joyloyars* liability daaaroaoa Cory. $38.51 ia ratara for ts.a falimrfsg ecraaast aot to as*. or -gj-j,*, .1.^ IBS 30 7CZEES CSTUT teat la ooaaidaratioa of aald icu ao ?aid, Z, tia alaiaast, do barab7, sew asd forarar ooTaaast aad agraa aot to safe* aay farttar olala against, tsa or aeloot tea j osyloyar, Saytastos-JIaBhattas, Xss., aad all tea issurar rasyondasta abora aasod, to wits tea iaarioaa Snraty Cesyaay of 3r Tote asd tea Jsyloyara* liability lsasrassa Corporation, oyoa asd aa to aaid any- loyer aad aaid isaurar rasyosdaets, only, ta fertewite disaiss any asd all aaed alaiaa, rsita or yroeeadiag* far eesyosaatioa basaflta, atatiar for eecyeaaatioa Is asy CSra yayahla to sa aniir laid let or for ssrgissi, sadieal or Soayitsi basaflta yayabla os sy babeif asd atetear aeid eiaiaa iara alraady arisen or haraaftar sight ariaa by raasos of afsrasaid elais far oesuyatiosal diaeaaa asd to fararer refrain fysn instituting, jrassing, ealiaeting, or is tzj amy aiding or yroeoadlag uyea 7 asd all eiaisa, dcsasds, eauoas of actios, rsita, yrseaedincs " adjudications MietaTer ahiei I irer * 5^* fi.ee* Soetc Xaehlsc r tic Inu Tc*1Ittcc r-ojery. X <biu ticreef n iamstc cat ie > f tic icy 184 <rt* J5xt chore Rttta I fatscsaecs _r: ,>. "CLciacat ~ Ckvueu tcatici cidacst. IUi. J823?^ ca<?ssr as* jg%MjSgrS!.- _, "a? *w=t,. cy yz joa IT ^V^.^-.vv>r.5b.s K0S2S*lX*HILm 4SSCBANCZ CSSP. ippiofcd/F^tay of ScecEic?,1939 vTj wapcaactioa cosaicalonar /orti" Co&grtsslsacl Blxtriat. /0,JPXa I A v '*/ T * 0 u n o n m i " STATE Or CONNECTICUT) ) ss. Sridgeport COUNTY OF FAIRFIELD ) C E RT I F I CA THIS IS TO CERTIFY that the attached is a true and accurate copy of the Agreement Petition and Order to Compromise from t;. records of the Office of Workmen's Compensation Commission M State of Connecticut, Fourth District, in the case of: Joseph Resko vs. RayPestos Comoany, now Raybestos-Manhattan, Inc. and The Travelers Insurance Company; The Hartford Accident & indemnity Co.; T^e American Surety Co. of New York; The Employers' Liability Assurance Corp. Give 19Ta. s/1 \ my hand and seal tr.is - l ' cay of A L L..-1' l .19! SISSS CUUlllCT 379 Boatwlck inmi Bridcoport, Oomoctlcat 73 UI3BRS 0O7J2TT, in lurgsaiea-HiSarriff, etc 'SIUIU ecSJJt: OBSffEStTIOS cetmaiosa rones cosMsssiem phijult osaen, eosaencor 33 T3U.73LSS SBw&UICZ Miff1ST S HUC708D AC0I3B1T fc 3JPBSITT OS. am.ss itzsiour sctttt ec. or tdez s STiotsa mans* assotusci cost. v V' 'us# t t5 st.V\i. <is&* igmss? yi.mc?r isp cwm ?c caiyacKSi U lr--^ii5 ea ar aboat tbo I2tb lop of Isxut, 1939 si fa a osbsr at poors prior tboroto, tko eiaisast, fosopb looks, at Srldawport, Oosaoetlest mo as oaloyoo of tbo Saybotteo Co^ssy, so* Bayhowtoo-Jtasbattas, lac., of SHdcsport, essasetlcst, asd 11**3313 tti aid a^lojaa asd qlojar bad sessptsd asd oara at all tlsoa bsr*is aostlosod nbioot to part 8 at tbs Worlsaa'a Cospasaatloc Xet at tbs 3tata at Cossaetlsst, aa asosdod, asd tbs ^leyar bad iaaorod Ita 11abill ay tbaroasdor fsr warisos p sleds Mrlsf tieb tbs aald alairast tu i telsyod alts 2a TTitwIot* Isssraseo So^asp, Tba Hartford issidast asd lad*c=dt7. Cos?asp, 71a laarieas Sursty Ocspory of Jaw Tori asd tbs 2?lapara liability lawnseo Corporal os, all at Ttieb said eespaalao aslat asd do teslsaas ssdar tbs Isos at tbs Stats asd art dbip ttxtberlsod to taka sueb flaks is tbls Stats, asd nsaus tbs eiaisast alaisa that os ar aboat ts 12tb day of ls(aal 1339 bo ssffsrod as oaiupatiosal dlaoaso, to wit; laboatosls: asd fortba alaisa that said oeespatlsBal dlsaass asosa sat at asd 1s tbs aaorts at bla ssplsyaast oltb tbs telsyar; asd farcbar slaisa that said dlaoaso la otesssabls; ad firtheT claiss that bo baa boos dlaablsd Sta all terfc alsso aid Assart 13, 1939; asd fartbor alaisa that ba oil! bo dlaablsd is tbs Sates, all at oblab aald alalia asd all oS said rsspoadosts dssy, asd 9BSS1S, a partial bsarlsc at aald alals ma bald bafarw tbs Cteasatlss Cesiaalesar at tbs Tsortb Csscrooslosal Patriot as *111 sot* filly appoar is tbs fUoa at aald sffloa, asd 9S3SA3 tbs tail fosapb taabs baa a wifa, Slxabotb, asd tre sissr ablldros, to tit: fobs Cosoph asd fasa Zarios, all of wfaea aro potsstlal dsposdssta, ad 1E5BA3 It is tbs dsslr* of Ss slaissst asd tbs aald rosposdasta to roaeb u olsabls adfcataost of tbs abem dlapotod claiss to tbs ad that fartbor litl^tios bo amldsd asd doabtfal asd dlspstad alaisa bo rosdarod fbsa S3 13 TO Li/C'J i 7X17 t, tbs alaisat, bat* acmd to rooslro Tbs TSawolara Issurases Canary tbc cos af $10*.73 Tbs Sartfsrd Aaeldest k Tsdaslt7 So. $12.33 Tbs isarlsas S&rcty Co^ay at Jow Tort $3d.Sl 2s &vlsy*ra liability Uotrtss* Cozp. $133.73 rnttwy I sal JOS of JTOR ZSPKE TSS3TT7TTS ad so/100 Psllars; ad ** tbo isoaror roopoodosts 4s aa** to pay to tbs claisast tbo cess a boro poolflad, to wit: Tbo Tbawoltn Isscrtseo Ooaasy $108.72 Tbo SarlPari kiiiut k ladaslty Co. $12.33 l Ska Jasrlsaa Saraty ea^sy af 1-- Terk tkd.Ol Ska ^laysr* Liability laasnsaa Saq. tLM.TS is fall aeosrd asd Htiiiutln at ibm iiqcM alalsa. IBS 3 illtram OSCSTT tkat is aassldsratiss at tail ass la paid, L, tba aniaaat, is baraby rsoiaa, ralaasa asd SaraTar iiidup tba aplsya; tad til tba lsaurtr ssapssdasts fits til tiaiaa 1st oaspasaatlsa basafita sbatbar far essyasartlna is asr is paysbta ta aa ssdar said dct ar tor aassieal, aadlcal ar hospital basafita payable n sy babalf asd abatbar aaid alais baas alrtady axlass or iimitat k(it arias by raaan at afsrassid dais tor aesspmtiasal iiaaaaa. JBB S TOTSDt CEE37 that I, Zlisabatb laako, nil at afarasaid tiaisast, feaapb Saaks, is tpaa that is aosaiiantias of aaid ansa to paid to rslsa, raltaas asi faraway iiaebarpa aasb asd all tba abet* aassd raa- posdasta fita.uy asd all alaIsa Slcb I k|b1 bsraaftar baaa asy asd all of tbos by raaaes of tba allapai lsocrrlac of as aaaspatiasal iiasaai by tba aaid fesapb basks abila is tba a^loy atjfta aaid ^layor-raapesdast' iBB ZB tutawtt-J that I, tba tiaisast, feaapb S. Soaks, as parast, satssal casdias, asd sari datd of afsrotald sissr eblldras, pstastiti dapaedasta, ds, is fartbar aesaidanties af aaid assa to paid, die- ebarpa aaeb asd all tba abora 3asad raspcsdasta fsaa all ela *= abieb abfbt barsaftar ba sada by tbsa tffisst asy ar all af tba abets sasad raapendaata by raaaca af tba afafaeastiessd alla<sd Iseams* af a aaa^tlssal diaaasa by tba aid feaapb basis abila 1s rasposdat. IS* elsiraas rasaraas has er asy hart araisst the IBB IB rafUT ttat as, tba tiaisast asd tba raapssdasta baraby asbadt tba trittas acraaaaat ta tba Soppasaatias CnaiT taiaatr at tba Teartb Seapasalesal Harriet asd raspaotfsUy ask that said apMaatt sty ba appraTad alts tba farts af a fill asd fiaal award. & altsaas tbaraaf is baroorto aat an basda tba day asd data 'ixri abets arlttas. mr1 isar af bi' I aaasdaa | tba ska 111 ' Atisl 7h-1 pree, aanrai {aardlas asd *M*t ibitad af feaapb fobs Saaks asd fasa gt*aa Sasisa, potaatiai tiaisasta. Jotastial Claisi Ufa caviar ass TCB-EWEimS. SR posdt , asd rasdai > ratai- ippratad tba _______ lay af /SLIX?x!!IcICzCU.sT&T *?SZZEIC3TT, SO. Scspeaaatioa Scnafiaienar af tba jsj jjeKSiS hiT.-j.BT CS-TlST-Sf SSI TOSS Tsurts i=^cn*risral BlitTis! . T3 2.?imas H12HZTT 1S3CTUSICS ZS73. _>/ -p J /T art; a> `w STATS* OF CONNECTICUT) ) SS. Bridgeport COUNTY OF FAIRFIELD ) CERTIFICATION THIS IS TO CERTIFY that the attached is a true and accurate copy of the Agreement to Compromise, Petition to Compromise and Order from the records of the Office of Workmen's Compensation Commission State of Connecticut, Fourth District, in the case of: Wi11iam Punyko vs . Raybestos Comoany, now Raybestos-Manhattan, Inc. and The Travelers'Insurance Comoany; The Hartforc Accident and Indemnity Company; The American Surety Co. of N.Y.; The Employers' Liability Assurance Corporation. 7%, ,,,/ jcc jy /en under my nand and seal this 1 H-l oay of j>nl r~ j0ni\ A . ARCUD , , Vornmen's Cainoer.s a t on Commissions' Fourth District tSLUAM POTTEO, mrutu- , co&Ui: 80 Boatviek Ara., Bridgeport, Conoeetleut T*. utjscsms coupast, eov BATBrtSCSJdAMlAl'T.UJ.XHC l t cokpuisatxoh connssoffia And tuswns. ii ioussh coticais&zoBAL nsrarcr TE3 TBATO.ZRS DBURANC2 C0KPAST: bhotzpobt, coxhictxgjt T3US HAkSTORS ACCIDrrt AliD Iju>D4hitx cou?ai<7 t TEX AilBiZCAli SUBXTZ CO.01 S.T. THX EfflOTHS* UAB&ITT I Paswry , 1940. A&0BA1.CX 03KP0SLATI0I zssuasi&^irbPonoE.'TS t irvTTi-nr- CQlgSO'gSS ysTmow to coapgMxsx MKHUS ea er abort tba latb day of August, 1939 art far swsbar of years friar tiinto, Ui elalaaat, Kllin Punjka, of Brideapart, Coaaeeticrt, *aa as asploya of tba Baybaato* Pespaay aov Baybastoa-Uaabattaa, Zac., of Bridgeport, Coaaeotiert, art nin/AS tba aaid sEpleye art aaployer bad aaeaptad sad vara at all tisaa barsla aeatlaaad nbjert to Part B ef tba Borman* a Coapessetion Act ef tba State of Comet!cat, aa asended, asd tba aepleysr bad laaured it a liability taereurtir for various periods during *biab tba aaid elaiaart ama asployed aitb Tbe ^revelers Zaaoraaea Ccapaay, Tba Hartford Aeeidaci asd ladaoaity Ccspaay, Tba laarieaa Surety Cc3jas7 of Baa Tors art Tbs Zsplsytrs' liability Asouranoe Corporation, all of vbieb said eoapaaisa artat art do baaioaaa under tbs lava ef this Stats and ara duly artborisad to taka neb risks ia tbis State, art W-TrTttS tba sliisast elaias that ea er abort tba IStb da7 Of August 1939 ba suffered aa occupational disease, to edtlAsbeatasl art'farther elaias that said occupational disaaaa areas out of sad ia tbs eoursa of bis ca?l07seat aitb tba caplayer; sad furtbor olaias that aaid disaasa is eoapeeeabls; aad further elaias that ba bas baea diaablad fns all erk sirs a said August 13,1919; tad Turtbs?-elaias that bs sill bs disabled ia tbs future, all of vbiob said eiaiss saeb tad all of said respondents dan7, art awrtria a partial baeriag of aaid cl ala vaa held before tba Scspenantloa ecnaissienir of aaid Pourtb Congressional Clatriet aa sill aero fully appear la tba filea of aaid office, aad -1. Wmm said WIIAm Pmyio bn a liri, Pearl, efco la a potential dependant, and 11fTiri*a i4 alalaast nt rtjmactH at tia aftnatid hearing tad la sar represented 67 eeuaaol, and fcn fatT4."i It la fit desire ef the alalaaat d tki aald respondents to rated a& aaleaSl* adjastsent ef the abort disputed tafrra ts the and that fartbar litigation be raided and doubtful I, asd iiijttad tlilw be rasdared certain. tEES IS SO C3S3XT2 that 2, tba alalaaat Sara agreed to reealra from; Sba Travelers Xnsurasse Cospary $18#.70 The Eartfard Incident tad Zadaaalt7 Ccspaay $438.83 The J&arleaa Sarety Ccspaay of See Texle $922.40 Tbs flsplcyera' Liability assurance Corporation $21.8? aaklag a total ana ef TtfETT S0SSBZS and Ic/lOO----Boilers, and aa tba insurer respondents de ipti to paj to tba alalaaat the bob bora apaelflad, ts eitj The Srmrelara Insurance Cespany $U6.?0 tba Sartfsrd Accident asd Isdenity Company $438.82 Tit Aaerieea Surety Coapaaj ef Jfew Tori $222.40 She Ssplajera* Liability Assuranes Corporation $21.07 la Ml accord and aatlxfaction of abort disputed <- ISO SO IWTHTB CiyriTT that la eeuldaratlea of aald naa ae paid. X. tba alalaaat, do harsby resits, ralaaaa asd fsrarar discharge tba eple7ar and all tba laanrar reapoadaata frsa all alalaa for ooBpesaatiea benefita abrtbar far eespessatioa iaasj fora pajabla ts aa under said let, or for surreal, :adleal or hospital banaflta pajable on aj babalf aad etether aald alalaa bar* already ori sen or hereafter night arlxe bj reason of afnraaald clala far occupational disease. iHD 10 jnasssa C35H7T that I, Peerl Payis, rife of aforesaid elaisjsnt, TUliaa Papin, do agree that la consideration of aald runs ae paid ts rsiae, ralaaaa tad forerar discharge each and all tba there named respondent* iron any asd all elalss ebieb I sight hereafter here ag-inat any asd all of dwa by reason- of-tba alleged tsenrriag of an oeeuyatisnal disease by the aald rillisa Ptnyies rb_a in the eplay of tbe aald esployar-reajotdenta. .2- 1X9 70 rsesiz czssn Uif *,* tiaelalsari asd tba ' rtqetfutt fcartby tubalt tit Trittan ipiaut to tit Oaajtsjttiaa CMinlKtr ef tit 7srti tospaittatl SlMsiet asd ra apartfalir ak tbit till ifrieut 117 bt approrad add ttt Area of a foil aed Z.aal raard. - Xa vita* at tiaras? rs iaratsto art ear basda ia dar tad data first abcra written. rrrsxgs: "yit ti> Ybjj^oPaq ' ti XtTZt!'f * i<LwA Clalsast. v $aa/rA y Potential Claiaant-Jilft liSBISM^CCKPUTT sew !!&} SJULHEima ,XJfC iprsrad day of ?ssarr, 19 aa asiaa*? /OUiTiA Coagr^islooai Dittriov. CE3 1H33XCX9 SCS37I CCSP1H7 0T 5IS TOES IT; TSS BffWTSSS* UaBXim iOCBl.'.CZ CO HI m ----------- __________________ S*ai ET5i\: ji.'iJis;: o*'* J j a s yolr.-.t- 13i f jrrral'enryTdrih cr7; .-do7 777J.-I*a --a --- : f.Ti-tajc;) r? r-r:i - J* ^?**-*2 91 ** SJSfT77 ;ntm3' l*a;*s 9T1' =--sr .!*? earnae ;gjLjaag. --Si W7X r=ir!=.': CrtJ` ii;3U:;:: i- urcani- ` Ciaesa ar r* ; Wr 5s yjT8**^ ?* *. u^at; c; ^ 33^71:1 t ?<s joauia: ISiKsia' ;aa* K*s .A" ttU;: ;^::: ' ( *,; - sa-'i** jtn ` S*T* l-TtS3 '<* I*1* 33*v* ^ o. . .1, ,ia . _ ' &< ly***ts iltlilit *f lijlaiiwaiiilMa'lMi, Inittri, Cta, Vi ' SlJtB7 ( man: 21* m i!tu a Uitarr if harlsc St< a afcsssis *eo*l, alifat asyactoratioa a? mb* fears dtsatiea. Xa ea&set recall raellj ttn It fSit Sofas. teooror, tei^ tH ;u1 aorotol 710 tali asset S*e tiesi asn treaSlescBs asd poralsta&t, asd la ha* hoea nialsf ayitn daily. 9a atatsd that Sa fait that a* if Sa lad a told all 2* tis*. Boris* . 9a last aaranl yaara 1* 1** lad to assaslt a fasily dsetor laeasaa ef 2e t&rasia assfh asd sjaeteratlas, far 2ish ha aaa fires aos*l . Mstvt* raid gm his sesa raliaf. 2eaa eo- '' ~ sailed aslda did sat easts Sis to Isa* too assi tort- ... ,Xa 1M7 as r-ray aaa takas hy tha iiobila C*it of the State, tsieh aaa aaid to anor a qgt 1s hi* l=f, aeieh aaa eoafissed hr x-rxyi taJats hy Jtssalao-LeekSart is Sridfsjort, 2* daetsr told Sis Sa did set Sato 2h*rsal*ala asd S Sad aathisc to aaiT7 ahaot. 2a seat sent illsase Sofas is Bassh 2d, at atiea tlsa 1* aaa eesfisad to Sis Sob* *12 .*1111, esilla, acuft, trytotssi ted It aaa fait hr Si* fasilr doctor that ! had .. a yaoosoai* la hi* lasf, for -teles hs raoavnd .traataaat. . `it tha yrraaot tisa'l* aerials* sf aoofh, arjeetaratioa, rarkid asrtaia if )ma, aeyaeiillr as 2* laaat aartlas. Shsrtssaa st Irrmtl to 2a joist that* Sa rafhira* at laaat tarts ;On 2 alatp. on at sifSt. Sa aatioea aaay fatigaa, sad atataa that la faol* farw all mf. 2*ra ha* ,, loan to ajjTaelaSl* ralfSt last. S* hall**** -- v* 2a t 2* lytston* at 2* asufh ltd azyretcration, ................ aftertaste af hraeth asd *mais*aa, Si ^cpiaaad asd Saa haeaaa sar* aetteoshl* isrisf 2a 7**t tao yeara. SSrtieal isilot 2at ef a falsiy *all daralayod asd clit sals, ne dcoa at ayyoar aettaly --, lot *. ` aeeerut imnirally ill. S* coofrad asd cryoelon dod fsi^oactly doriif 2a lanlsilaa. 2ara U to arldieea a* asy ryannali or adaaa, " hot 2are 1* all(it iliStls af 2a fiz* ETHad e: J";i' ottos c.1 c;;'s * tio; ~ TWi r l-SJi so* )1 ttm r=prr* CT< acta* ern1*-! en> TTd "t crw yja ga jnto tea --or ^unn ir;:: test tea :;; n. ticnaKn1 K;c: n on l:;xr eecS? ;=TIl losjoi soema ei 0310170 eertx os? (ga pni (uo; Xiri pi ora se a ccerryi (T'l n c n csr *77 pi =o* wa nst shops T77i` e* >nn; mi ys ;<r napTtia (R SpUR.'n:' fix am m ease M*tsr7 Ixr.i s;i east? R> )si su K r: ;ri; ;<br pnu:' so in; Imi 71=930?* 2* cxsxso 1*0x77 fxxsofl 0753170 seitfx* 1774x0 oiKeusoc 01 woo iTT* as traoo o rrmii 04 ip! 7n 0 hot js1 rsesje CiaSSa JB--ox;* c~ jy* junjer 0: sxlsesiee-i'.x.'iis tar* txx** f "B* HfUibi JlTlilu'W ItyiitSlHuSHu,-^------------------------------------- :-------- -- ItnlAHi ( lot fc. iasols irww food - Sottiro. Ion * SsfstlTo. Ssoao set sooa iso to w, stop Seneit RteUut, ?qU> sxo rood esd oqed. Xoost to UU1 (S3 seeessdstlea. Sloes sat soos. Ixens aoeilio 7x00001. So00 -- Jofortro. Month - Hues* aoeSxesso irt aersd. fssfso jxo 7 , tndso Is tho sldllso oil! se nwoir. dsoxetioa at fisooro. Rirrr - Sosel. Tooth - lh-7 sdseisf, roraftrin la poor seadi&es. Son* - So attmaao, asutltt or rigidity. ayiuld set ydyehle. Sena S7B3otried, aqsd 0370soles os Seta stdso. Mottos is reatnotod (t tao Out. T-m. . Stott . Sots Is la^lxed hotooos tSo 7TS - iM heoo. beta acnoda co Sixth wetedex olta soar sedosstolf esoxeo lot soon*. rdaa ^71 - Soto is 0II4SII7 iSftLrmi hotseos tta TTS tsd heoo. fSctila Sosltso ssd teesl roaessseo Is Isoxeesod. In* to accxds sxe boxes woleslsr oils 3007 sdantolr oemxso xdae heard is tsio tree. Sotlaso of ISo <*j^np it* natrletod oa Seta sldsa. l**rt - Sot eslsxsod to jemoolos. Senses m xs*d*x itt of fslx 0111117, aesoosol 11Jteat. . Used tnoann la/Si. Waoot - Soonta: shoos, or tao ;xsdasooa e* So tee to jestse. Hoot, reItan tsd Pisan * Sot Tdtohle, Bote is oe tosnoriaas, ox ssosao is tod. --an ij % rtpt ladlxoot t-fltal lorsio 00tod- loft ri: Is roloxoi. Costtdto - Sored ads. btnr.r.'al - Soststldlr ss*stlTo axeo;t Jsx add Tories*to. i 1II I losersterr lots 3.3.1. 3,158,000. S . IJ.C, 10,210 10rad dlffsrtetid. Sodlxsstatlsa rsto - * tsd 10 as tis hoax. Spntna exosihttiosJ tie to ho 7*7ortad. Tatters*! ho rofertsd. 3odtaai;tlo sxsx.il* tios of tao eiaot rorodad rriisrcs of a*Tied tsicXtilK of Seth Sli*x .halera lad t nttar Sl.fJi jeri-hrsieSid 077a of fthrsai* tosttorad tii-sslout tao laoor iwtSirii of hots lan ftelda. Than -a tioo cca aubli jlttn tiieltoiii* at hots htaaa. Sots i;t:ai txt tltor, flora la he iaflslto artiste* of 437 aca a0*1370 a ad Isfaettos. fia ttrllte allSouotto i?/*tn dptlr adtrjad. t oi joattTOo tn* Jaaoiaonmoog pt TWOboi laspit* JT*ddT nsx j; | 303 33Y3 HHA 3303S=a OA KS.VOISSITPTtOO 3KA A33oX3 X3KA OTV S3SS.CU ASVS .V SKA 3HAIM lauTTy hr at aujoi wo C ftpi ot nupr oo uago jaaomqjno^ n bo TOT IT tBOOlAK ITTddt lOtlTTOJdHOI lOTUrTri ISOUad TOR KT3 tpj iRpaapuJ n<B t U amiirSOWJ MR Jp P*BTH tom t io pnawea ap jCts mmomsi o 'uadda oi mcpj naoirn * ;t *; JO iwao japia ro umr tap aaanaii* cm rp jo aompaoua MR Jo xbbOos pi Jo0 via dwad 00*3 aaoijjaa qp J >P* l aapa * n 'Jaiaodjatp? pi dad was oonit 0 0 >01 01aoiiu dcosinai napa duad * A Innio jo wbtadt q iaaoassj > jo (TAOjd 01 naiaoa jo `janjtfjatot oi odn most lotuad ot joj janp IT;j wouad pauajoiamp *01qpapaj sn iq ms >u -sip orpofiJd mats weird p ton -pil* Ipmanau fawiiBo tamrad to dipaoip woo* paidaoaa ap ato awtani ao TOsaJpa jauomimamo oi A 1 mjojot hr n -papyiodd >0 praopi Joi*odjoa> Tmoiadmoo o *trnlOT| pri*S3 *01 duaan pom. m pm mil 01 Mpam *1 -mew dm 'lanjad 01 JO -WOlt* s*0 pnr. rrr.omm 11 po*n r oops .ouinoaoiai, J> .papooora mtTO*. pm moyao. tsusid ,w J<iotd=> oada w papjap >01 sop wsi -05 PJO oi poop oj o upa <1 aadoidim noi aoja nan ft muq m japaa mXaq nap Map naaodad pm* si*> lur.irjMtaaa ;a lomsdad deu 01 i jadqdsa sr op* TOParm J03 -aAotdsa oi aada now joojd jo =*pjsp hr djimaPajj Anjpaatp *oi jo oatpuBp pm tmaa opi pm dtafw 1 ]ii[lLaiiliii tparx m pm Sip paiaan ap* rmnuApd jo aomdpd apt imaaJd aaTP Jffreadta . `tafaj api jo aapapw* Jopw J mciv atpjoiod 3 'Jiiyiap opt oi *uo Piaooi im trap opi Tpn apto i -pairp fipjdaom api Jsot aop oisymp hr anro potaao np Airaadm 13 !P) pm ^ajapi pmao a nr tdap am arpi ajos aj pjoa pampadTaai Xnamad >a tun 1 m Mjojdoro >pi -.to: (U saasdoidcn p naaa q pm jo aw aaooa p noi (pj paTl" T;:::rr.:," ----- --LTHtwI m raw. (> hoot to SMTpaia " JiyraiOJO PTBOOT lLIUl.HJ O.L wocowidona 5w ' Q- h-+----- * szj~- /OJyjjL . (!' r ^ ^ /r +S /LyJ-tX* >~L-J /%_--fci-T i~'q v CTz/?r ^ "y ZJ-- 1 u.- 1 ! ^ / ^/4,J - (ftr '^ i? cl-------w*tC Nf JSk Ii C'lj "a /pw.v- iowevj, 0 ^ 1* 1-777^ t .> ^ ,*, U'.'i i'+ ^ wl; 1, (u-1^ |) jv ' |1 *) ^ 4 'V*V^ ^ u/if/jf ^CV. Ilk (LI -. Vwu^a^v^| ,^v> U -^1. ,<*ev^fi /^W ^ Wf^t <C- 6 J,o*UV -- ist^r o^a^J tC^'c- iJ? 'MM'! ** "Vo* - "hi u[u|i| . C3 Vi^ < ! ^ |i. [u. "V l 1 | ',,]).} (2^e: 'MM'-t- * ivUJw & ihh.f ri f-. i N f * --^ i- - r>;! QJ$jj *lj !$g 'V'ST+.h.rf, i* <* L5 T;J ^ v;3 * Ml**** rt v * 1 -- >.*-; *? ,_*> <r-sAui>i t^J-j;.^ <* : s;ri .:su0^.r* ,-s f. I 1 * w iu . n iu u io o c n p o . i r.c ro c e o r- - '|t*fr y m I A i/ . u ; STANDARD FORM FOR EMPLOYER'S FIRST REPORT OF INJURY M L A l A ! C. P!eo*e C f7 ud return promptly to Tl Employers' Lability Ajwrinc* Corporttsoa, Ud. wMccticat Claim Department *4 >hhitpijr A>tn*. N% Haven, Cam. r:e *121 lamer liigAl^ ZSOCCO:=ri >'z2sairazsazs=z. so; ruyia. w tecs. Ti*r' ru -\. i*Tbe seam avovn awr : ae adwt .a ,sr rjnptoeer* -n i pl*M of *>lac*. h**ne acciiiert winirr<r1.._. r;ot !oois !: ; .ml m * nunc. ii<i Date of Injury.. jcrtr *.n *Mr:a,-c. uBiirrrr^i^jl. jhai;. Jr;:: -r *n: !I__ 2. _ _ _____ iA?j *tek.... 1______ _______H,.-s .L\___ A II y >:. htr *Jii; *r-n `~r iraur. nri nnn.. N'ane AttfltlR .act# sf rrtpart^ .---------J(l- Ja.,r: ..,n- rC> ct. 1 n*k 1V330( ieearaiss"-----------------* to' aep*leyb --pgaseScSfSigaSff.Hi: fUme f __ i t-rm !*> A<i;rri, aai jx 24 "net Teir jt. ( \ Married.^ 'Ip.r__.. AXthSSS' n* * C,y ,, T\. .. ____ . . swerruu: 3L-^^^9P? Uww4 , .Chi >oa save M: litnptoymtnt ctrtincatc or *----**~ SOSOOgfl^y 1 s'cupauor. when inj-Jf* rot ssotr: .{b) Via* chu ** ij he- vJ- **,f. *cte hi what department or Afaneh wcirlc regnluriy employed)----____ ___ __ -- _ ._ i- ri^w !.mv rmpicjeii *y y>u<Lt--aatcsun, Piece or time woruer-J^es:.^..-.. 'ct Maaet per hour i- 'a. hr un worthed p** hv,,g*r9V* ? -1-* '.View per day ---- ^ : Hl worker! per werk_~____55__V_.___________ Ml Aerrape weekly rarmmri i--^SQUt_2S + C0^ ' Il;: VSra.arrdd. iaei -f other advaAtapn were tnrsi'*d m addiuen to wa^e*. five eaemated ratm per * .r nwaJr---- Ivs-r r.l ' r`Jjiiif raume ;njsin* _SrBO __ ........ Jtt- iCfld .r^^ower, 'hand. rcot. rtret --.a . r.* .. ----.. _XI. Par* of machir liKh vrdffl: _ - V. a .jirn- appiiaucr r.r reiriUaon pr-.ml*-^___ 1 n_^T.' sb) M as n ! :t* 'ire i .t.-.iknr ;*uc'.l by iniuri-d'' tiiiurr t' n^e ve -ihterve -at-ty appliance r *ir-ilAt;v:u_' Deyjh# ^Mjr hew -c- l^c wLr^.^ Dipio we* doi whom tojurwd. . --a ^~*****-*.*-; '^iia about 4 as 6 weka rnrr rowrticc 'iia_ canffattsn Ir. ^S^r.T'l t!r:.:eet alioutgagrt"a.i?ir: 7InjieteTiTrTn^esrhybhtrecuec 'acllo.'uthtfttotpfoai-n -Is rt. * ---------- '-r am eildrmx? n - Q prlptnAafli g ______ ___________ _____________ ____ _ ___ sT :.r, ..lrroa -;rc'jlut' "hl^Vit homin* 5 ^4"rli "i `(ihIiI-.' fllSatl y H* iftiured relumed te werk .. . h. tjj Surioo nrtr...A> a-.a : hv ji li' M,!t.l r?r;.irr<*c rrtrr.t>lnt-XS35 *atmoic .-.vs, ron* -J I.'st rs-crtec to Cozxiljs'.owbt ea i - ; '.;tC 1.r- jiii r^osiTn-i us "n7n jurr-lcel Zo. for Znu ;* liava" iiirgioal to. for Tr^sa - yr.vz - Jio.cc W.$S ! C*3* #121 I'.ot rspertea .c. rlaaiccer _C3 9 -a* ?? t. '< l t ) Xl * XI Ease ACCT32TT RZPCRT 11 rr^-.e :tco -^.^ ;' AEthsc; r:ucber_ 'iaC4 iddress^ Cit7 '5?___ 33. Sett '* Urrlrt ~aa How long ecplcyed here 13 ts W3lar r t-1. 7 --. Kesalar Cccuaetlen ____________________ Ears i Tiae of Accident ~ot 'sz-Qm. - Sail It *as a, %, or a w--ica pre*"4 Cate Eire Retorted October 17tb. 1S-S. Coot. ir. which Accident Cccurred_ ::ot ixorc C ccuraticn ~Y. or. Injured"at icaowa Statement o:' Injured Said shout c, , or 5 '.'.-setts trior tc reccrti'-ff t dcczcitict he ic a cueer sensation m his rignt acae, ?ertic'i_rl7 no iceabie -ri; he lirtea asTthlng ter- heawr. Then arter a m':: cr as ooartec tc aotlce a slight tala u. tie rigat''sroin * tines. " itr.esoeo--.____________________ Mature 1st eat of Injury. hcmca ...-ru tr. tt or. g If so, at what point -------- ------- Attending Rhyslciar. Cr. ALcrea Ho ret hi at "is AddressIsoS "airnela irs Briagetcrt - Isr.r.. ~r.et ."cr-itil"oce_ Has Inured Inplcyee Returned to '"o.tSc______ 7*s If sc, ~h;r. Imeaiata-7 trier `set nr erarlrwu it tr.s I-;.i- Eect. by rr'.tebl- lencri of Incapacity. i.or.e to cct- Iste cf Retort Cet, I", IvcO ::ede Jut Sy Tcrec an> < . ph ah-:e _ater iacatoo 11 ouestAJCt-.Cis. --> > I 3353s ftoSSSE n v .-4 September 17th. 194B, - >ir. Tmar Eartail an isplo7*rs' Croup 132 Tssple it., ;:* lares. Cob* Ho;-- lassie Craeea Cow Ur. Bartells- ^ *e reported lagelo Croeeo u a sue of right Tgn1*hi hersia os lfi/lE/39. Till hsmia heeast sore pronouaeed os 2/27/40 asft Sr. Eorablut (ge Plaat rtTsieiaa)- adrised the us of a trass lastoad of surgical repair la Us coos. .. --rii This ease *es dlseasaed with 19 Saadoll by onr ?lirt Safety Saclaoer 'Jr. Cartes Elisey, and Ur. Sandall approrod the purehase of s tress, shist eas ftrsiahed to Mr. Crooao. ;* !* . . ^-.7; Cn. 9/17/45 `hr. C roeeo repartod tho need of a as* truss, Ss eas exssiaed by Sr. 27de she stated the aaa seeded a nee one, and ho eas seat to the `Tee seres largioal Co., to be fitted to oao. . \ ; *r/AiS Tears res7 truly, ae Baybas tea Cirlsion Of iiybeataa-uanhattaa, Ise. By - 2at:illt 3. Surfee. 3.3, lied leal Oept.  l.r?^ " --l'- * . '; .. * ^m.-^i/fi/'' `^,i> *" ' 7" ' '* '* .',* * ------------T52JI .^- . N '-'-hr -, October 31, 1843.: &r rr*k 3artll. Tie Siplcyers' Croup 132 Tea pie Si., How Ea-rea, Coan. Bear- lir. 3*rtall: , :* .-5-1i fc^M Her Aarelo Crocco r-." 'tf `r-V *.,--P?i iia<1 " rererriag to our seat records', tier a--.' truss ocs. j,; i7.20 sea furaitbed to Aagelo Crocco by tie See EaTea' Surgical -c. la either yehruary of March of 1940. Its ia-relce froa tie Hew Zaias Surgical Comoaor' waa^aec. to u* aa& e paid for tie truaa oa April 4th. 1940. *I*a referred iti3 bill to 70U aad we osts- a record, tie. run '-" seat ua ycur eieoJc for tils wiici was dated Sept. 13tt. i>tc. - \4A \'A Tery truly yours. r *vr.*3"1 T >' i Tie Eaybestoa SiuisldaT' ^ CT Raybes tos-12achat tac Iae2 By: Sstelie.2.Curfee RM Vadleai Cept. .V; .. ,. Bridgsport Ceaersl Hospiral. Great Street, Bridgeport, Coaa. June 3 Geatiasea: g-0 KJseew piysiciaa, GPolertaosreGaedormgeit Htioebebrgeeariears, m.uasdgeelraeaGeror.roac t*o-iVc.Va. foCrurJtPr.leat Greece far 7rid*7, 7uae ICta. 1349 and. iaatruored. ua to aead dim ia duriag tie moraiag* - - -- .. Very truly ye^a. Tie Paybestos Ci vision 01` aybeatos-liaa,lattan Zaa. of: Sat alia S.lurfae SS .Uedisai. 2e?t. 1 KsuKAt IM UOl&CM ftn.L 4TMKIT --..-'CC'.' & B. XlLLPLAORCUKClfLAg.KCT.. 1LD. iL O. j. j. Esposito. vl o. nttoo KPOIT 1* COXM. lT.13h 2, I'll? Index* -c. 2ocoS Ir. holert-e A :rEhhir. `somr-atior a;' :.--o chert shor.-s thie.-:-.r.ir. oi' octh sh*co-..s ana * ii:;u3* aenbror.shiai tr-** or I'lbrssi* threi'ho-rS .he te.-rhsr;.' j.' the _v.-:-r two-tr-ircc o:' octh icr:-s. .here ar...t -ss, to.--ji::er z*.?r. t.:c 'dtieht' ' jovariuicrsl. hurt htrtsry coul-i os rtiov.-d &3 ' -neur.-.corios-.s or iroeshosir. Iher*: is r.o oot~._sr.t Itni- oonoclitition sna ooth i.-ices hre doer witho-t rr.tetcs or Tiles: .ary vooerc-iosir. .here i.* o_i;.-.t rer.erai oorv.-c <rlhrro.t5r.t. .iestecclill;.- r-.'oriited. 1. _jcih.=rt, . ... (si r..-'o; CC hI I i H. PMIUP OINAW* JR.( M, O. 94 maim *Tcrr T*rroe. conn. BW T>1I33 \ . .. ; * - ; * A .. Heal Suildim; i Coleen Hill"street 3-a. PifiUn.EE, U.D. R.H. LOaHiKT, u.c. J.J. ESPOSITO, U.D. Bridgeport 3, Corn. a?*lo Creeeo fjr'f August a, 1917 Inaex .'io. S6S65 Or. Esberge *.f`"iicrrephie exunicatiin of the chest shows thickening ef both hilar snaicws anil a diffuse peribronchial type of fihrosis tnroughout the periphery of the. lower two-thirds of both lungs. These changes together eith the patient's occupational dust history coulc be " * eitssified as a pneunoconiosis or asoestosis. There is r.o confluent *--ccnsn.iiaticn ar.d both apices are clear without any evidence of pulser.ar7 tuberculosis. There is silent general cardiac eria.-gtoer.t. Respectfuily subeit-tec, R.E. locktart, !/.0. (signed) L:C STANDARD FORM FOR EMPLOYER'S FIRST REPORT OF INJURY M>ed W L A. L A. I> C. <1 t# sttel *<0 : Vi New IH.PMirMP.Sf ta Suit l NuaiDtf Fqi: 1 Me ----- -tr-f-L Cuarr -- E.Tpt^t tJhr' < l IIP .Sal. ! 9 e -- & *sc s as i 89 s tite- i* i iT J 1 * o a* 9^ 9u C-i * 9 ft t r- i f - ;>*. tv^. ~; y - - .^-j-.':?>!. '"*T"',',';4' \. , -i r*M '''" 1 I ^';e'2a^:;esi pltiS - . jc^' *,, v .. ,* "'****' **. ***'*.C.n* * .- 7fe*t J Dtotor a.?. Olaua 3486 mils St. , Stratford, Casa. . -April 4, 0949 ' ` V-r#Mjl "re.*?-' yjf.4 5i iarelo Crocco Dear Doctor Siaaa: ,. .... . -V v; ~ > t' - 'Tbe-aSoTe a*B4 employee baa dona eaTitg while la bur eaployee sose yeara ago. It* folio-alts i&ta sar So of ser-rice to 70a la ocaseetloa ' . j ltt this case. '-* :-' - --r. - asczio csccco ~ ....... ,, -l- ... *; .'r^s*sSKj ' ' ' " Orlslsali7 blrad ' 6/12/13 - s.y - . / 1*11 off 10/10/14 .. r-'t&.g,eg Retired .."' 1/10/21 ' ..-.. .'' r.'-V:. -_ _ -- * *-> -' " ^ 3*78rai. lay-offs aad re--emplayaaats froa 1921 to the preaest tlaa which were all periods of abort duratiea' .- suet as s aootb or two. . -. -. .; ' - - ... ' : * ' '.-* ""'_ vr-ag ~ajye Searltg was bis woric la oar 3pt, Plaatr 1921 to 1939. ' taXPafjJr ...................... . -(Ujri.) - .- Transferred from the 3pt. Slaatfaa wearer} to Stratford la oar Millwright Oapt. as sweeper oa I/U/39.. 7ery truly years. The Rsybestoa DlTiaioa Of Raybeatoa-ilsahattaa lao. By; 2 at alia J.lur fee rlt Medical -egt. 1 !9 3 i c rv cv r; r; r; w r- i 9466 lills St. Stratford, Cass. TaU 7-2633 April 20. 1942 tSHaybaatos Dlrlslon of Ssybastoo-iliBhattab, las.. Itrntfttd,. Cornu. Ba; lagelo Orosco A radlognphic azsalsatlen of the ebast of Ur. Aagalo Croeso as Apr! 1 !, 1949, rsrsalsd srldtnee of aericed thisianibg of both hilar sasiow, aad a rather diffuse perl-broaetlal typo of fibrosis scattered throughout tbs lower tao-thlrds of both lungs. Than is also sees notable pls_ra ttitZening at both baaas. Than la so daflalta loag consolidation. Both aplcsa an elaar. Ife dafl alts misses of any supsrlrtcsad infection. Tba sard its allhouetta n slightly aalargad. &aae change* la tta z-ny plctons, togathsr sltb tbs patlaat's oesontlssal history, I bailora la sufflelsat to she a diagnosis of Aabastcs. Slscenly. -i- Ths -ay'nastea Iiriilis ef rayseatos-tdaahattaa, lie., Stretford, Tors. ?: Xr. lanlo grocso 'distory of Hirsts: tils aau giTsa a iiJtor7 of haring bad a ehroale cough, slight arpsetoratioa cf sees years duration. Ea eaaact rseail exactly wbsa It first began. Eowarer, during tbs past ss-Tsral years tils cough has teeoae art troublssose and peralstsdt, and bs baa been ralsiag sputum dall7. Es statad that bs fslt that as if ha bad a raid all the tins. Caries tbs last ssssral ysers bs baa bad to consult a ftallr doctor because of tbs etroaie cough aid expectoration, far wnlch bs sas giren cough aixturss which juts bla seas rsllsf. Tbsas eoeallsd colls did aot eausa bit: to loss too much la 1947 aa x-ray as taicea b7 tbs tic tils fait c* tbs stats, which sas said to shew a spot la bis luag, which was confirmed by 1-117* tabsa by Paiaalss-Lacsbart la iridgepert. tbs doctor told bla bs did aot haws Tuberculosis aad ha bad nothing to 10177 about. Els most neta: illassa begsa la 'larch ZS, st which tin* bw was cohflaad to bla beat with fwrtr, chills, cough, expectoration, aad It was fslt by bis family doctor that bt bad a paecoocia la bla luag, far wbieh bt rtesiTsd treatment. It tbs present tin bs complains of cough, expeetoratloh. sarlrsd shortuass of breath, expeclaliy ca tbs least exertion. Shortness of brsatb to the point sbtrs bs requires at least three pillows to sleep sa at bight. Ss sstlsss easy fatigue, wad states that bt ftsls fuaay all orsr. Then has basa 30 appreciable weight lost. E belieraa that the syaptoas of the eoigh aad expectoration, shortness of treetb and wee cases, has progressed sad has bacons aan aatlcea.ile durlhc tht past two 7sari. 7t.jaltal examination - That of a fairl7 sell derlsped aad nourished aels wno toss aot appesr Keutsl7 111. tut somewhat chronleall7 ill. Vs eourbad ihi xpsctoitad frequently during ths exanlnatlot*. Tiers is no scldsaos of *37 cyanosis or ids-v\, Tbs Baybsstos SlTislsa of Saybsstos-.'abhattab, Ire., Stratford, Coaa. as; Ur. Abaalo Irccco Eead - Magatlra. San - SegatiTs. Dross oat seen due to saz. ijM - Sob**is; praeiaeat. Puplla ars round and aqaal. 3aaet to light ard aeeeaaodatisia. Discs oat nat. Arena aaollls prasent. Sosa - Hegarlrs. Mouth - Mucous sasbraaas asa ooraal. Soegua pro-- trulas la tba atdliaa vita sc trsaor, uleerutioa or flsaura. Pharynx - Sorsal. Taeth,- Many sisals;, remaining Is poor condition. Mack - So stiffness, retraction or rigidity. Thyroid set palpable. Etorax -- Synnatrieal, equal aspaaaloa oa both sides. Motion Is raatrletad at tta baa*. Ign - aisbt - Mot* Is lspalrad bstsaac tba 775 sad baa*. 3r*ath suaada ar* barab Tealeular olta aay nodaratai7 costs* sad eoarsa ralss beard la tbls area. Left - Mot* la slightly Ispolred bitmse tb* 773 tod base, Taetila fremitus and tocal resoosoes la lac .-eased. Srs* 7i sounds are barab Teslc'ilar eitb san7 aodsret*l7 coarse ralss beard la tbls area. Motloas of tb* dlaphraga ar* raatrletad on both sides. Seart, - Mot saiargsd to percussion. Sounds sre regular and of fair quality, sossehst distant. Blood pressure 133/34. Abdoaea - Sonantst obsss, or tb* protrudsssss aay be dua to posture. User, spleen and bHaeys - Mot palpable. There Is so tscdsraass, or nssaea noted. There is a rlgat lallract Inguinal barala notad. Laft ring 1* related. Paul tails - Morsel sale. Bx-rrualties - rasantlsil7 aagatlra exeept .for nlld tan coals. Labsrstor7 cate B.3.C. 5,050,000. SB VK. J.C. 10,250 normal dlffaraatlal. Sadlaaotatlox rate - 4 and JO oa tae bour. Sputua txanlastlooa ar* to retorted. Basserain to ba raportad. Hailo.-rarMe *xsalaatlon of tb* sbeat rT*al*d *Tl'.*ne* n .* narked tblnienlug of noth bllsr shadow.* aoi! a ratisr diffuse teri-orsae-.iv. type of fltiroal* *-*sttsrad throughout the loser tao-tbirda tf nor.t iubg fleldn. There Is also sod notable pleura thickening a: both ?.,eo*. :n-..-. lpiees arc cloe*. There la no .il finite Tldsoce of user .viser-lr-a >ed lafott'.on, Tb. csrtlae el'.hcuette appears ul`..htl/ er.lsrrad. I i lie 'ay-testae ElTlaloa of 3aybsatoa-Uaadntt Sirstfcrt, Iota. las., J net Mr. laeeli Crooco 1 Soap-tring ttli x-ray eltd a Mia taken la loguat 2, 19*7, stara das Seer. ietldlte progression of ta 'Uresis la the loer xaethirds of Seta lungs, altto rsna of tila laeraaaa at *e bases any be due to the recent respiratory lafaetloa. Hdae-rer, 1 feel that there tia Saac definite progreesion of He flbroela, aaiea aaa to tad la taa x-rays of insist 19*7. Expression: this nan's history of exposure aa a eaneer for IS fairs, along sith Ui clinical eysptod* ant x-ray fiadlaga, I hellers a diagnosis of Isbestosls esc aa aada. It la totad tdat this aaa da* dad po'-rotary ayuptons tor gaits aooa tine. Ea notieaa alao tdat altdla tta poat tao years tdat taay heee laoraaaad, shied I bailees ^laelisa with tta Increase to tad la dla i-ttf pictures. I balls'# furttar studies adould ba 6oaa regerdlsg tla sputaa to ba aura that there la so euper-lnpoeed lafeotloa of Tabirculcela, adled would oaVa dla condition re aarlous. Since thara la no occupational ttazard la tda Stratford plant, aod this oaa daa baaa fraa fron wearing alaea 1939, I do aot faal that dla aoplcyaadt atlie working at tda Stratford plant, contributed to dla preaent condition, la It la a well knows faot, teat Slltcoala aad laoaatoala once the lungs tare oacost laeolred, U1 progress adetdar tda aaa la la tda aerlroasitat or tot. Idils working at tda Stratford plant., da aaa oaly a aaaeper, tda last tdree years of aclod ha aaa not la tda feetory at all but la tda locker room, edict aaa relatlTelr fraa of aay form of ssoke cr dust. I bailees that tdia aaa. la coaplataly disabled and tLould load a aedatary type of Ufa bacauae of tda fact there It so sued Iseoleeoeat from an x-ray standpoint ea sell aa froa clinical sysptoaa. Ilegnc.is - habeatoels. sincerely, HFI/7 rdillp Ulan, .3 E. Jfcilij Dlann, Jr., H.3. SMS Mala Street Stratford, Cos. Tel. 7-2J33 asy 7, 1549 *^a Haybeatca oixisioa of Rnybestoe^yaakattsn, Xnc. Stratfors, Conn. Dm? Coetor Roberge: Re: Hr. ingelo Crocca Tii felloelag la a report of ay eonolate eianlnation of Mr. ingtlo Croeeo on 'Jay 2, 1949. TMaf Complaint: Cougb, expectoration and eeajcnaaa. Easily History: father and notnar both 4eai, cause unknown. Tiara la ao blatory of any. faslllal diseases. .fast History: Recalls no ehlldbood diseases. He was la tbe Srldgapert So spiral for a kidney eond ill on lb 153? bad co trouble slice, sad so other serious lllsaaasa or operations. Marital 31 story: H* la narried. Els *lfa la dlad - died of saacar.' Ona soa asd esa daughter, agas 28 asd 23 - liTdbg aid wall. Occupational History: ubila is tie old country lr. Italy be worded on a fara, sad again wban ba retained there for about six years, between 1914 and 1320. Ha can* to tba Oalted States at the age of 13, lx 1908. He aaa first esplcyed at the Hew jecartsre Jsspaby 1= 2ritoi, Cobb.., where be eorkod as a seller of soap. ' He "cried there until be case to Bridgeport lb June of 19X3, wbrre be firat went to work at tba Ekycestos as s wearer Is 1914 ba waa laid off abd ra Bur Bed to Italy abate be remains: until 1920, wban be again re curbed to the Jolted States and aas again rsployad in January 10, 1921 by the -aybestos Jidsloa In Eriigtnort as a wearer. Ea bad more or lass toatlbuous employment, except for lewarel snail lb;--offs, from 1321 to 1339 at tbs Paybastoa, and wor'xac as s weaoar. In 1939 ba aas transferred to tba Stratford debt. In tba alliwr'.gtt datartaant aa i seeepar, iici i* ms `.one up to tba present vine. Tie first Taw years tiara la wor.tad nora or less in tie factory, but for tbs rest tore* yean ba bad acraed In tba lacier rccr., wbitr sea relatively free of any inrsa :r lust. '4 -e- 7i* 'nricstoe Tlfision trwtrs-h, :5na* nyhestos-iiaahsttaa, lae., ip; ~/r. .asclo drcesc His to: cd Xllr.i Till s: riwea a his tar? of bawla? had a ehroale sco^h, slight expectoration od aore years duration. 2 eaaoct raetll esaetly whan It Jlrat becnn. Xowewer, duriar tha past eaweral years this eouri has heeore ncr* troobleaona and persistent, end ha has beaa raisin* sputun dill?. ~e sated that ha delt that as id ha had a sold all tha tlr*. Sorias tha lsat sorenl years he hac had to corsuit a daailr doctor tecause nr tha chronle aoi-h aad expectoration, dor no loo ha ws giwen etu.-h rlitares which pare hl.a sons raliad. Thane so-- aalla' colds did aat oauaa hi-, to lssa too ouch west. In 1S47 an x-my was taicea h7 tha lob lie ?alt od the .bate, which was said to shea a spot it his lung, which was eoaflrad h? x-rawa talea b? Femelee--laexhort la 'ril-stort. The doctor told bin r.e did act hare Tshemloslo ar.d hr had sothinr to uorry about. HI a res. reseat 111 noe.w began la 'larch 23, at which tire ha was aor.Il ted to his hoaa with farcer, ehllis, aourtt. expeetorwtion, and It was delt by his dsnily looter that ha had a paeuraala la his laas, dor which ho raealwei troetaont. it the present tine he oonplaias ad crush, expect oration, carlced shortness od breath, ex.'eeIcily on the lao: : exertloh. -hortaees ad brsrth bo the pelht where ha reh.:lree at least three pillc* a to sleep on at alrbt. '.! cctieea easy d*t<(Tja, w-4 state* that ha feels duns? all awar. Thors a;. been he appreciable weight lost, !'e bellswoa . that the sytptoas ad the caush and sspsotor-tion, starthees ad breath md re-i.cnsss, has rrorrsabel ar.d has heeoca tore r.ntlot hie iurlr. the pss*. two years. 1 ya'.:';i ir:arih.tt Lsn - "Txt od w falrl:' well de-elo-ei - r.d A*e-.: ml# iho loeo act ''rfe*r acutely 111, somewhat shtnnleuii? 111. ewu",e.t c' ex pee tinted drtt ently I'lrlrv* try a t ***.:, There Is -e cwl'cnre t: \ry cy-*.cch rr .ren, Tie *.n7teatea Tlrislan. oi rS7tsatos-'.'athnttan, Tne., Stratford, Conn. ?. "r. m-slo *r--;n Heed - r.'i^atlTe, Cara^ iiegttl ec. Truus act seen due to ssx. ires - Ooreohat prc-nlnent. Turtle are round sad equal* Heart to light a-- aceoacodatton. Cleca sat eees. Areas teallts present. "aae - Sartre. 'Q'ltfi - ihjeonn terimr.es ire aortal. Ts.vpte ;rstrudes It the uidliae eith so trenor, ulceration or flsrure. _ - :oi=al. Van7 "lasit.;, rarest al.-_- It poor condition. So stirrneeo, retraction or rltilltp. TiTrold aot palpable. - -Ttcetrlcal, equal expansion on both sides, iiotlon la restricted at the it as. ______ Sight - .'one is trpalrsi jetseea ths 7TS and baas. Breath aoends are harsh reoleulnr slth ah7 nodsratelj coarso and cearao ralea heard in this area. Left -- "ota la all.;htl7 i.tpalred betc.sn the 77S end bass. Tactile frealtus and raanl reaesanee is increased, rsst sounds-are harsh eealeular elth sasr noderatelr eocrne rales hoard In this arse. Uoticna of ths diaphrs^ srs restricted cn both sides. Heart - .'it enlarged to percnaslac. Coords ars regnlar and of fair ;ualit7, sorsehat distant. Blood pressure 13H/34. Abdomen - Soaeetat cieta,. or the pretradeneej .-37 be dne to poshire. liter, spleen and hidsera - ;rot palpable. There ia so tennemona, or ia>saes acted. Tiers la a right Indirect Inguinal hernia noted, heft ri. . Is relaxed. Pent tails - .Comal tale. ties iasantiell/ augntlTs except 7cr tili Tarlcoels. Laboratory iota H.3.C. S,050,000. SC STl. t.3.0. 10,250 tomal iiffirentlal. Sedimentation rate - A nnd 1.) on tho hour. ..putun exarurntlonu are to in retorted. no: er be retorted, "adin ri .;.ia examination if the sr.oiit rcteului evl :euee of sir .ert ti.lcui.:!tr of both hilar sr.adoen and : rather llif.iaa -eri--.rate! it fibrosis scattered throu.f.out the Loer teo.thlrds of fields. There is also sure -.utahle tlutra thickens.- it bo*h - os. at1- ".pises -.re jioir. "lore ir as it finite ori-is-ae Ti-.e sil.tue t to tfper.-s a' STATE OF CONNECTICUT) ) SS. Briageport COUNTY OF FAIRFIELD ) CERTIFICATION THIS IS TO CERTIFY that the attacha is a true ana accurate copy of the Agreement to Compromise, Petition to Compromise and Order from the records of the Office of Workmen's Compensation Commission, State of Connecticut, Fourth District, in the case of: EcgarGravell vs. Raycestos Comoany, now Raybestos-Hanha11an , Inc. The American Surety Co. of N.Y.; The Employers' Liability Assurance Corporation. it: v nan a seel in' z or !V /. / urth C'Stric Commiss'oner 53A72LL, CLASUJT VS .EAuSESTOS COK?AST new !?.A2a22T0S-t^SSX??ja, 3C. O310S3 And lArStICAK IZT.-.TZ COI7AST usd S5Las LIA3U3TT ASSuRABCE COK?. ITSUEZRS asspossssra. CCPjLS! s COOESSATICTI coiiEissiosza - JOTRT3 CCnGHSSSIOXAL DISTRICT BH3C2?CK5, C0JTSSCTICU5 - KABCS 13, 15U1 AEGE'TTT TO C0l3>t:CElSS PSTTTIOB TO CCCePtSOOlTBTXSST5 r- te.h}V'*a n Jf And OBDSS ~u_-.SAS on or about the 12-- of Jul7, IjLO and for a cs=tr of 7eara prior thereto, the plainant, Edgar Gravell, of -Ilford, Connecticut sat an enploTee of tbs Kaftpatoa Conpar.7 ==* ^aTbsstes-ranhattan, -no., of Bridgeport, Oennsetleut, and -nipSAS the aadd pupinvee and etrplover had accepted -d wars at all tinsa herein nsntiensd subjaet to Part B of tbs 1crlc-.ee' s Condensation Act of tbs Stats of Connecticut, as - ansrded, and tba snplcpsr bad insured its -- ah111h-- there under for various periods during ehich tba said elainant saa asplcped, with tbs Asoriean Surst7 Cccpanp and tbs Seplspers |llabillt7 Asouranes Corperatln, -all of ehieh sail euepanisa jeniat and do husintaa under tbs lass of this Stats and art jdul7 autborioad to talcs suob riaies in tbis Stats, and | dm?.!A3 tba olainsnt elains that on or about the l;tb da7 of ful7, ljltO, ba suffered en occupational iiasaaa, to ) Jwiti asbeatoaiaj and further elaina tbst said occupational i jdlseaae arsaa out of and in tba ecurse of bis amplo7=ent sitb 1| Stha saidentlover; and furtbar elaina that said disease is 5* j ! jeonpensabls; and furtbar elains that be has been disabled II ifrosi all aerie sines said Culp 1;, 1*1:0 end furtbar plains that: .ba Vill ba disablad in tba future, all pf Sdeb eaid Plains jaaeb er.d all af said respondents deny ar.d T------------------ ------------------------------ --------------------- ef ear-ire to as ardcabla ad'-ostnoni ef tio disputed f i,1 ef tha clalnrrt ond - aTTir^S 1ha said 2dcnr Sravell baa *ife, fastia L., | who la a potential demandant aad i 5Z3CA3 the sold dalatai *ma represented at the aforesaid conferences end la new represented by eounael, ar.d TH3TLAS It la the desire cf the elalaaat and the said 1 ressc.dsr.ts ta reach an erieable ad.'uatnont of the abaca disrated elaino ts the ar.d that f-^rthcr litigation ^e avoided | and doubtful and disputed elair-s ba rendered certain. | j T1Z5 XS TO ClZITifT tiiat I, the elaisant have a^eed to j receive fhea j Tha Acariean Surety Cenpany ef "ev Tort: the run ef CSul.23 She ibipicyera Liability Assurance Cerporaticn tha an eft : 1353.77 g''irs a total c= ef Tee Thousand. and To/lCC DeHart; and vo the insurer respondents do 0(-re to pry to the elairan- 1 tha r-- above specified; to viti j Tha Acsrlean lurety Cemany ef Znv Toris ',01.23 b4 I 4lJ5.77 jTha Sspleyars Liability Assurance Corycraticn I in fall aboard and satisfaction ef above disputed elaira. j AiTD T> r.liTTH CilTl-T that in cans'dersticn of laid j art to fold, X, the elninnnt, do hereby reriso, release and ; jferovor discharge the enplayer and all tha insurer respondent* jfrtn all eialra far ecr-.rer.sntion ber.efita vhether fer j ecc-persatin: in any fcm payable to no ondor said Act er far lur;ieai, nedisci or hasnitai benefits payable en =y behalf ! 1land rhather said claim have airsedy ariaor. or hereafter ripht:' JI arias by re r.sen ef afsrocbid eiair fsr oeo-ipatier-al disease. Ail Ti m Cif.TTl'f that 1, cnr.ia L., vifo cf (aforesaid eicia:sr.t, ldc*r 'ravel!, da ccroc that in eensidcrot 1 jof said ours so pei'd to revise, release and fersver dijeharje leash and all tha above r.a-nsd reaperdsr.ts fror. sry ar.d all j elairs vhieh 1 nipht hereafter have sjoirst ar.y and ail ef I*' l 4 ties by riuca of tie alleged iaerrins et aa ocea?aiieel .disease by -- sold c%r Cravoll villa Is tie esploy oT t> '! said eoyloysr-ra s; cr.d*r.t. i j Ai3 ?S * ^ CS72T tiat Z, tie elainant, Edgar Sravtli {ad 1, fonnie 1., vifa of cold Edgar Sravell, jetantlal dependant, da, la farther eessideratlea of said visa to p*Id, discharge each and all tia above need respondents free: all elaira sfcieh sight hereafter ba saia by lias agsisat asy . ar all af tho above ftar.ad resr-endeata by reaaes af tia | afore-, er.tlened alleged Incurring of as oee-spailccal disease I I7 tie aaid Edgar Irarail villa Is tia eepley of tia above | nasad etiyleyer-reaper.dent. Afro rs FESTET?. crrrirr teat t, tie elairant asd tia ; rea-or-denta, isreby aubnii tia vrittss agrecnar.t to tia | Csapensatiaa Cesslsaiesor of tia Fourth Cengrosslcaal jiEistriet asd respectfully ash tint sail agreorer.t ba ap/roved jelth tie feree of a full ar.d final arard. Is Htsoas thereof ve horcur.to aat our bonds tie day ar.b date first sl-ove rrittor.. Hto fC~X.Tjrgjjfa iTTU 111, -x... J  A4 f<?`<0 / a v o id vf.u u m . OftOF.RS F a o to ry M c u m ir na"3:iT A u d i t : yrtla imaoh____________ i;inf Klin rd. Conn i f fA fte r r i o l t tv the Doqtuj-.'p lo o . I 20 3eatera Sent. In A.-- August 19 1533 ,?2C heater's lent. I - Jo& 2 7n barrel zo vs 3 coving .oving a barrel Caugbt rig.-.t fourth finger under Lacoratico (ion laceration, of lert _4tb. finger - Inner surface si finger, the first Joint L -- ? *T_5 1_*. W. . Lr_1r . f*> n T t-* . J. ! n or. i-02=r?Ai either ..5 O. *-a.. SIAIT or ECSPITAl s,i3 irrrr.ZD sr-icms hztgjsihi co vtokz J SO, TTH3T__ * oree after ireatr.gr.t by Tlltor. lr. .lra .->ld lent r?.C2A312 122203 of IJTC.iPA! lone o ror A.urufit 2C, 1003 tMi jV1 ^* <U? p\*rw.*,.i vr ;atells. . lurfs*-* Cu. STANDARD FORM FOR PLOTTER'S FIRST REPORT OF INJURY A' Ij L A L A 1. C._ ^ P1u Caapltt* f*Uy mmd mt*arn ta he Eaploytri' Liability Amruct Corporation, Ltd. Caaoeciicat Clii* Dcparami 10 Wkilaiy Avcnsc. M H*ca. Cau. ----- Casa #70...... ............ carter _3sgar GraTeiia__ ' E=si.r Ko rapt, to Coea. < rKr 4avc t.i r< ,n *y Lat9*ovrr> irwd ia i KU. .f EiT~rJcfcei3a-- Jglatt 2. (jtkee address. Xu. and St----- : i_.no by ::-c -rloror.' s _ saurian a..: asns: .. Une nature oi buaiscas (ur arucie aaruiiacturetij- .r--Ct.iZ--CllSa-C. iclscaa ^___ ____ tTT.ttZTi -- gt.S ( **S5R,MflJB!LBr :K sVC&S*Sr,zii!c rrS ut= <-scau*o -- _Jvarta*nt_______________________________ xlf' it tmpioye** prrmiw .InettlSI :a_lb.' I: injured m a mine, aid *ruitnt occur on surface. u::derv?our.d. shat:. lir.f* bf xtil--t..q. . n~ * D*t* ! lajury *s55S- '>' ------- -- ..liar <( lay-----T1--\, M. S* ..P I T f Jaxe > .M r S.V, P* ?.l!' s >Va' .-.jur? ; raid ;n full '.-r *Jii> j .`V4hrst-mw .1h;<<1`. v..*i .-r ..rrrmffuufn* t!:?r*.il k-v.w i'iw _ . .". -.ra*r*. . rcrt<"?'c" ' *' us 6:CC, t'i .\jcie ut ..irenixa......... Tree Gill 6_-__3_ 1; N** */ U|r*d.. ______ (I p't N ieci Addre**. No. asd St.. 12 Terr. 3t rsve^le. !.! .t.0M - bi> _Ct> wf T-*an liizojrz _ _ ~ht\k t v i .' . "J?.. . '". 'A _ .11 _ _ T TM 1 " N3i:.,naiit\____Ai^rlC!l_ 3IT,,.ifi?t?.__________Speak EinjU-ii-- _____ ___________ ____ D:U you lusa on nic employment crmr.i-au- ** Ves"* ..... :are neceoficrr ii- i.VcupatJon when miurcd. -, ^ '.\ aa :h, ht- r hr- n ^-.iiar ^" Tos i I. not. 'Ute m what urpwrftm'tit ',-a .ah i' aqk rr^marl.* fnpuyr'l- il i.MM{ l ^".25?*** !...v ..r II It wbrr ` . W h,'1,r * * N`... h.,ur, worketi ^ 1g?=*&7 5 - w.c ;xr .Uv ;; Nu. lay'* worked *t ric. 5? or 6 ,, ,.1; ,.efaia. ,ri,, ,TM ,A^eut. ;s8*C0___ I:* '<oarcJ. i -- k of month. rou-.i .r_*;hrr aiii'.ntaar- were irni*l.rl .a a m w^av- r^'mttri value per c !:>,, . .it la-r l l,s M ? f=. .ore n>c* f vl r- *a:' tv af'l r *o rocnine or ?.c- r.ls ro'tth ms due t> oBaorptlac of Icna Tror. t:'.e stock `ho'oea ^.H..ji^-,S"'>a vSantr'I'.'.gt jtEo "^r. j"prib|.'r.T!.ao;tfJ::irAblpoSodfgo5ucJl|'.Q'sis^zKhr^sv .: ! . .'*?** ... <*** *^.Scirrft-'^*crr"fflErjot b*no'anSrsrbrrrt*in*nr ' -'ntirrfef.,' roTof t*'.'; -rut': 1 ;'rod , trr'.t.vt.' ,-0".i? erTreto.: To loot i!:to to `.c :c roro. ii T1;p "03 - rot bt _ SlI, it * _wr SraTelle Idgar -r,t la Tern 3t. Lyrtln Beach. ignpr-c * '* 1 C1TT - Cwtu~ i; EL ;ssrs aiTLlS DBCT. S2r cale Centers lilPJUlZ hlsii. .a c-cclt-.-.t: :r ''as .atarial handler VTS. *E2C.7 EASTITTiS 7 H31 - c:t :3?Lcms r:~i; 4 reus ATI fc'TlKI C7 AC CllnC Rerorted Ms car.41Sloe thru. Si3 roreesn on 8-i~ --I---------------------------- ---------------------------------------tn . i- -- .rr tCT7 iCi-Tn^JT vcT'-ntl <luestlont ble - XT in footer? at all it L~~` *N *cn icl~De;VT -------- -"were ho -orlta acaV.rr.T3 CCTPaTIGS 7*131 IlKTRSD Handling r-ateria:. for sir._ STATBracr or rurTCE He said ha ven under traetner.t br Er. Lee of Enron recsnxiy for "Sfciaglinr;------- ST. res' TJltt-tr.T-thr.t he lose been aeaert frag---- Lthor sulahnr or lead he did not taas rhicl. and that a red lrritatec eosal SicaTs r.reaent ir't:y'W'gg ar LJa t.tmrn1 *:'dig-vjt tl:aj e? uatil' irjBgKaS r>'one)esataet r.ith those substances, 4A.yv.'H5 4 2TT3JT C" XVJ L'SV Kao recovered froc the attach oT shingles and < cesrplalr.t at rreser.t ts r red irritated coidltlo. or the entire roof of h: O 'Jtii. AMFCTATiOi ::o IF SO, AT wr,\T T SIXT A,,_ra-.c r7'\f Ca.'.e re-srt'd n snot ' z Dr. .Mfr-d "cmhlut ritt tie ........................... "'K^raress1 ar.,.rr,.r-3ti1:<.-. suts-------------------------------------------------- err3 ,`_rr.J.zn~. 1SS3 Fairfield Arc. Smi-cxot't - Ccr.n.. rr-T ` :,eae - Er. I'cmblut ordered *he crr.layd-o sent to Or. friedx. artiag er-.dmee-cf ate'j iUS I7KTF.LT anFLTTSZ nSTTETO TO W05 l^na( tiaa of tclaop.. GO 'ir-'-tj Has not lost tir.a thru this et.uth eer.altloc, hut la eontiam at his regular irori. But also belj regular!-.- treated by hi* on r t: FSCSJLHL2 T-TiICI! 07 INCAPaCITT. Hone eoq acted. oath or HTC-T June 9, 1909. man errr nr K3R3l'J_ telle. T. Eurfee /I a.; raL\fTS r".to! 1? jo::t to 0*. Itic*' f r, 3v. C --Ts rledrin wort out of ten. unext >.ctecly. t-. tic- office A;aln on S-li-iS. . ro'"!r '. . r' rt'--. t. e lime eat tl- V.r Moci tent, r ;rnvo.ic 333 lie die ai Clinic *e " n^ven 1 lew --avea, _aaa. 3a: Cdnar ... Graveile Gentlemen: One of cur employees, Idger Ornveiae, ess ad vised a/ our ?Uat ..hysician (Dr. alfrjd. liornciut) to go to tie :ei Haven Hospitni Clinic for cob.late cteci:-up ca nis physical condition.. fhs sen t id seer, having pain, in bis left hy.ocnoniriab region, and bis symptoms wars so vagus and indefinite, that it ;as uifi'icuit to account for tus severs pain cf vhich. m complained, Cn several occasions bis sttachs of pain vsre sc severe as to interfere with his .loric. hr. Gravells has attended ymr Clinic and has returned to us for re-employment. H9 telle us they focal nothing wrong vitn bin other than an a.inemia. He i; anxious to return to wort, yet is still having attacks of 7ould you be willing to till uo if you found a pronounced aecarls, end let us have u rerert cf 7our findings oc r*r. Graven* s condition us regards C-rcy findings, differential count, etc? If you prefer ccmunlcatlrg with cur physicl-n, rather than tee l_na.-er.unt, his ideress is - Ccctor ^ifre; Hcrnoiut, lo23 ?alcfie_d -ve., iridgeport, wC"3t Tery trui; your-, Tne ru>oea-.ua -ivi.ian Cf oastu^-lur.nuttfcC Inc. sfiello.u,lurfee NEW HAVEN HOSP'TAL NEW HAVEN, CONNECT ICUT ipra s, cf firar Trvrell i. 57242 3ete of 3irth: larch 14, 1S3. 12 Fern Street, Idilfard, loss* ctiout. larch 13, 1340. lisdisal Clinic. Patient is a fllty-swo years old, "retch-Canadian asbestos -.-tree.- who csss to li'.aic eoaelaiaiag of a efcroj-is caugh which is productive of thick chunks of rears rial is the norslng, of * vc year* Jurat Loc. The oou.rh :.=.c beecne gradually worse uni is sow product in of loose prosr.i sh-white mater ial. he has had a wheese asd a sense cf suffoei sirs with dyspnea os exertion ar.: a burning sensation of fullasss order the s-ersun for the oast eight weeks, -oils hate bees tors frequent .asd anorexia with a res souses weight loss have er.iusu. ?at less had aa enuyesa asd rib resecci a on the rirr.t at fourteen years are. lace a good recovery. Physical exeat rot lan showed a -enaraiioed suppression of V.-.e percussion sots asd breath sounds ewer the stirs eheet bet tors tar cad or. ths right base. There were squeoltias rr.aaa'r... aver the entire chest anter iorly but tush tor- tarred over the stemra. u-ver coirs me fis-'er. Partial lost :f heariag sa the left with bone eoaduetia i greater than air sossuctioa. : <irt c.<. To ankle edeiaa. T.o fluid wave but .bcoaisal veins a little prominsure. Pluorcsocpy showed a diffuse iase ass. sottlisr of the entire 1 field sad increased density at the apices. The right dcac :f the iiaohrags. L= h.-h aac United in s.oticn with oblit'ratior of t he cosos-phror.le einus. The rl-'.t berdor cf the heart -.rat widened curgcstiv; cf right restricui.ir hypertrophy. las ression: 1. Old ehrtiis eat-`eta., Healed. 2- T Adbest isio of lur.rc with p-.i-orevry contest} on ear right ventricular hyper trophy e-.d hestmegaly {nr'-y'. 3. ? pul.ror .ry tuberculosis. 4. Pericaa.' excoriation. 5. Titiaut :c of hsari.tr os left, c. Trachea-brccohutis. 7. Varies; veins. liboratorv fi-tdis-s: '.aha: fuutun: "Lto: nu . - > e fo 2-1 .-.0. 5,i': ' y~. acid ; in .:. o.i; :' : ut: 2 .ta"inuttca . u 2 i'T ! UN NEW HAVEN HOSPITAL NEW HAVEN, CONXE mCUT 3Cu.Se : Irt-'ell 7242 ."-7.17 llaisosio : la.-er. 1-:, I54C. 1. lid thoraeotos/, rioht. 2. :leiril thiolc9sis.r, rirht. 2. ThicC:esed pleura, lel'e oaoe. 4. 2ilc:srsl pulsssarv sot hycosa. 2. leoliosis isrc.il sells. 7 3Cist .-SS AH- CS. : 22 oe. brown sr:cus rrte 7:21 22 is."real 75 ec laecio aa-aelvo Ills seta*. i e Bleed *** *+:* '* April 4, l:-40. :-:istaEi.-.e 4c sc. brown c Free ~1 35 ss local 122 os. Lactic sspativ 311s ss-ueirc 31 sod cwtsire Facies': wso last sees os .'.poll o, 1540, at which el led to Ires therapy. Couch asd ohe. t sols sue'.. ir-pro "e era: aoCced to return Tor sheen-' c is t-rs annths. f 3eptor.ber 2s, 1S-4C. Toe tor Airree "omblut. io^9 Fairriela -ve. ::rice-port. Conn. Ha: rarer bro7clla "ear roctor Forr.blut: Do you recall tie rar. who vrorbea Tot hr. Free 0111 when he was roreran or the leetsr tost., b-- the none or "cyar braweile? ?s was a short techec ran who hac rrecuer.t attacks or aysoncee uoor. esorticr.. This wtr. hae'a history or a rib resection. At one tir.e he naa 111 er.c cnr.e ir wit1.-, a 3tory or hart nor sor? physician when he hca ccr.ouitcc tell hin he wen cufrorinor rror loee ooioor.inr. one you 3r.t hir to Dr. Treicrsr. ror blooc test which was r.e<;- stiwe. The nor. haa rreeuent ilir.eoseo with, resultin': absences rror er.tls;rent sr.o ir. February or this year he res hone wit:; a hert attach eceoreirv* to the nan's own report. Ir. 1'.arch or this year you rour.c nothin." serialtciy wrony wito. him me acwiaec hi- to yo u- to the : er "awe;: "ospital to th-ir clinic cna let ti er, -o oner bin thsrouviiy ir he renter, to tare a cot plena oh.ecb-upto tins out whether there was a conaitior. r ieh csv..a be treatee. 1 have a note rn ry care that yon 3ta* c that ir. your oersonai opir.irn, "r. ^rr.velle's concision we3 purely a reaical or.e ir.aisatir.p tre-t-trt ' y a oersor.ci physician. Vr. hrawe.;i " ectea uuor. your n. rico, er.c ir. April we revuestea the Vo- : ewei. rinair. *s me fey tent us nr. abstract. The or.i- oe:inite thi:..- t'. ey uis-" cowcrec to treat '.om - pror.our.eeu incnia. Ir. July he -art to T'lr.aan ror n rest to 1-erc <: r.t.i ho'-lth, rs. orter hron.y t uo-.vu i hi.', ir-; f -t - c*-- ' av>:. rarl tnl toar.y or r y c.. . to -.oy c : i i ror "-"nyn onetreatrer.t ot r. run-lie. - Or; OnitU S ST'1 vou ale : o'. 0 T.0 !.!' t'.oru :--r '.r"o: : f ccti:..` yc'-nry to he I'.oi Tor It 1 ut r t - : - mvlce to ro lov. ir '.a cl: <uo ~~ o. o you 0. . .* i-. . ii. : -r ;........ v : 0 , '<! r.'.'o'.' ` t 1 . eve ' ' c MANHEIM V'* j. ' l iV '5 X !>' * ?. J * "=T'- * ,r. > " *r-- . ; -ITK'vTS;*':...~ ii -7r ` r : 4.- "Frayns .-'j-jar- -:: * ^ . ^ *-- ?5 . * *'--'v . -*: Z--Jr* V.A'.ZV'* vk:. ` tr~. V* i" ' **# - *' . . '**. 1_ & - * * 'Ar-jf-s/f/ /> -5 J*r Jfc _ 7* ---*----------------,-2--z--?---<, ? /--* Bnk4n -J ,/^Vf -------------- 7 a\t. Miwlri M* V/ \ .__ wucuviauB rr^B u 1 a<u 1 tn-tx-/i J-/0-XO ! l/f-f-ii 3-Y-l/ : .jflj-.//-i/ 3--/A-2/ ! //ft 1 `,,sa ,.i-7j-2l*' rY-/P-2 1 J.r iV -T- --/I 7+LZ^e~ D-' ; 77dLS.,.J ''-/;!! r,- s 1 J2sC^****s * i - V *1 1 1 iT.JC /-A7-J7 f 7^ I/-J.9.J7 2.-X-37 7S2-/S-* `/2-/S--J7 r- i'j-1 -`-v i-__ Ht, +J )q T*tat ' -) a&dmJZ *** Waiftat .____ -- -- -- --- -- | ** *<--i ! ta. Mm 9Ti 'I"' 1 1I ! ii .T'/ft-J 1 . -s i *- i -> l \JJ i , *f 1 r*r i,- /.I /. i ? 7 U^. 1 - j/^ I.-: ! y/gfCtTT^I-- * `v'*.' ': i ' i , **C1 : '*T V 4 % C I x. Na. r N< Adrirw Blnhdm* ~ .T >... * iii. L , * ~y Moxlad SZagi* , C&UdrM ^ T<1. / H4U We-.qhi . /*. D**t. IM X. - -- . >'<. ^ ,/ , -') f-.f ------------- ----- ' /' - A>- WCtUSIYt DATES ftM , To Far S*pfat)M ternn Credit Yn. Mm. Dot* . - :-'_______________________________ i_____!_____ i_____ --------------- ----------------------------- |------- ' r -- .*_* 9. 'J.2. ** 2> 1 it 1 J? /- '-3' 1! i /- j" rV ?/ - L' ~ -w.-rr ! ! r. _r <. J? 51 ' i! 1 :r /' il y* . - -_/-4 - - '?- yJ 3. 3 . :l-> 1i i ' 1 r- q ' j. ?r. ,. - . /' / ' . ~ ' /* - C. 3. X ,1t.\ > -- ! X. -- - - i 11 1 ! If' /C* K * .-o' 11  ^-I......-- -== r *- ry- 7-v.-.^--i>- -..*. .:..._. .... --..i^-- ' ..r.j.-.i J...H. ^r* .**. .> --' f j r~V V>: '~r-:- jii ;..?Sr -. - -- -. .*.. -.- . *.i: ^-x "'_ ..r_ f * -- "* ' ~ .- *. % -*r- .7 ,W- _i, J^rZ;' _ ,-p- ^.... ;V. f f '!* -i '* _- -* I .--is. '* `".V .. :4 ,,V *' -; .f:. .? & *' -. . / -S-i 7 ?>. cMj. Z *** SSV on* -/" --1-- mCMXm DATS rum T* i----. r< r -- T. te bmr. ---n 3` 31 1*-rr O-f- - J -/ - -J T *? L. , if 3r- ``-J 7 >! t %?7i ?; r-^j3r 1 4J; ..._/ n 4* \fi \ * -/wm.L*i<ii ;a " Vi rr ? ''_________ -____ ;'-13 " H-.r->.-- -#---- Ll.r; T- t* ', --- 1*--------- ---- ' - -__ *. A/tf- V/ 7. 9.**7-yk ' V-o.- r- n- o'" :^^A / | 1 / liU? ii !1 !1 1i^ 11 1. -. .1 _________ _____ - * - -r l i _________ 1____________________ !___ 1___ !_ TT * :* ` .-* - > : t > ! ----- .-.JT r~r -r^_ .. ^rv. > _1r\sx - iA:* i. --??: * -i- _ : if.. '* - ... - - ' v ./'f^:*.:.r :; '4,. 1; T ' *- : *" . _- *: - iiS-*'7' - J- '-' ~^r-~ .n . - ^ _rf `-'T~- - * _ -. %a^ '-*k* T v '".I'rf- 'H--------------i '* T-.4- ~~ =--V - '-?" -: iT-- ^ . *3r ^-g, ; _ *' *w. : * * ;. j`5' ; t. . v*S.. 5p `- * *% ,,B~I ---- 1 -- wcuaxrxaAm m * /Ly*fL 11 --* i * 1 ~ < . .. |..................... * - V - V / U*v ^ ?-/,, -.*/ /L-'f? 2.I-S+. * / ri * i i* ' * ylT/.*r.i r-<- .-u ii 1 " -'.3>lf</-/ 1 - *- - /-r.< / j- y<-I 4,.< \.er ' ,i.a-...-:'l/-*-t-- l I i ! 2. - 1/. f/iO y-i. 'jTC. i 1 1 99yomt'^rC ,/ sj*y //mm*, * ''j^.-Z*/r:-V -tf. i UmmCmmtt 1m i Mao..Aant --i--1--! I ii 1!1 ||l` n i i; 1 1 1J j 1 ! .' i 1 i / * r.' , . twutn /era No. >s r J 'Jt* *M 4 ^- 4T I /ro-of-/9{f ' '/ft***/'/t fKrr I 'JLJLCLcaJZ ^ :y ^i'~iv 7 ****** Jy*>- , . /r i ___,, i r _____ _ ; 1' 1 A. T> '! otatamwiTo ' -- t* ... 1 liww Cm0! 1 .Mm. bar* i r, J.j f ,iL--,, 1/. f*r 1 _3. t. f 7 1 1r 1 . 1 / - / /I-*?.' Ij-.-c? 1 ! i " . !JJ. 6- r? I III! 1 - ^->r7 !!!:! V.lk\L-7-<r? 2.7 Trf -/y 1 ! P-t3^ ~e~J~J. '/ilfC'. 7-1 l -T7 m-r-71'_______________ '____ 1 "* A*s^ (fiusiJl /*iS^t-/3--s77 9-/A=ZA 111! A. ' 'i * /jy/V-zV -s-r Xuz}.{ f'/r-r? vC*:mhl~L``x-i' fir/r/ff-z-si \&',sf t-rr-TV 1 U-/-S-7 l /e-2->*7 t I 1 t! i 1i 1! 1f //-/-<T7 | 1 1i 1 g^w^ <- y-^vt- Ay? -.1_________________________________ ! 1: : Vf T" -^1:"- "=v-- . *'.:- ; ' -- ' % '1 - ... -. . --'T*- .. j "-. . L* . . -i '.. v t, ^ .-..l. * ^ ` .*'T ' % i' r'- \ tfaz,- /fitr/fit 7~* 3 3 r* 'To-or./3/V /d'/foS) /7?Z. TT-, \ . l -~ . i SA/L--fc 7- /-/? *** D ftaa iNoysivi oatcs ffM T* eLr^it-i ffi ?^r 3./Y-U. t , , p.liT ^* .----------- ----------- im+m C#ir y >Mfik Of us ^ w>vicLa >-k wfr-v >* . - - yr ..> < v /'. V. * . .,. . "^4 : ii. *"* ' * " "o- ' . . ' -.JP;. * :; --'^V t y,-. * *. -*! r:-i. ' *. . ' ' -Z :>- -r^ - j*v* .<. :-' < r; ..-..: - _**- ..' - '.*.. * ~ ... . -a-. :s:*. '?_-"' *-T . >: : Sr'.fi ^r .v ... ^ i-: .. 'V >-'. . r: - ; j?- 'rr .'s-f . '--vv. .'"f r-:,T**>-i'J 'XV^V- ** as*..: i ^ * ** /*- J* ;*f: . /t*a * -vy - j* j. ^J*r^J UA^'uj'* lV`fflIBI.^/ri-|Lv^,>..1 -*--- i i : - 'T-- '>'*"`*15 --S. S--- '^3 ?t -,,w. ^V~; % * ../MHP *u gw *f jb wti, krn'un, <.:?, lawiiT, >jftttiwi, r - '1-4*.' ir*. u^ w .".ut *.:-*. If * Cl** Ht (*> <r --_____ !fc*s,. .^m .?4ii* . IffllU__ 5partli . twr l hwtttl __ lrl(t i Iw rtMt4 i;r "ira 'Tiinui _ . XHfUL , {?***) C4K& m u swmt#_ &v. sr Zffa* . 17. CSiar emaUijru (*lmd -. urtsm\ recoaar k.M4aessi ilaawi jeiss pck omulau ilUriawii pairltadsaa &Ae*url*t 4v<' .> /u ____-- .'a* /- a-a / **7 --/ jt+m* - - .--,y - ' 3** p/W# ^ ^ ** *? i> 1--ord tUM <rt _ # y U^ftCOTi ^4 *-d* JlT-U . - k 3 +?C .J. `t. h* f J i * j i asac .*iV I >**"m * '- w -* ,,M* -; '. s*' v~- . jj-i * *,. -Tl *-- * U- vas .v^r *<pt V ?to -*i*m**` mm t AS-ST-dt i*<* i 'V't * ;> * ;--* ` . < 4* * - - ---- r **! - -:~ r kwni4 a* to -U MTMaiUQ 4 ! 9 -t1 tf ^UMi w tofta* * ft tASfr of Jl Jl tft* *9toAr* '4'KM m !fe* Wfeoi#a l <i af ur* uonu mUom m -r ai4it 'ft* Jam *?.m tb* An JtTTBI : > WJ, I *14::w ef TUr***9 Ha >."4 i,, to brfof* *. t*>fc ^6Ifc day M fcjmftW* ^ n^7 "itiS.V,-TM- .7^# C-dj.__ k^ZAni. 1 A Xf 9aMi &M TifcLWt - ,4*r ^ . -- f r]<im'.` r *<* WflfT: 7*to aott**u aar to tonod tad utr w nr inn r m* tf rr * Rtw asMr ar iwxmii far pouu V***'5 .:r'T -~&m ronr u> **** n hr AM to oWftoai *94 5r* otrt no*u thoo tr*M or 7\* ** to ITA *mt !J mjw au naatoto nfw of hmiwor ao> < toa priun*. H a t oaaarv to uu feftdant to oa* <to ** ooff a too potiuoa. Koto 4L Aa aotom hail bt dooatd to Ww had ta tirmu owtihioiwoiu of ro >-on to tfi Camnoavaaisb of Paaairtvuiia darta* tfio fnt fan nets pnoootaf oxaoauu? it ta oer* pauoa aoomat m or mwm .ittirt. fa) Wfeot Aorta* tar t*a eaiondar r** <a too proeodift* **Jrt run ha boo boon npiorad i 4(V) Tfhaa ht Hu hove amatorod to acA u aetuAacloa dansf tAa cnt roar rowed for toui aaaiaor of eerasr dT^ oa^ w nneo :h aamoor of oar* too aas tiwend t toot usds* tei. feu boon na^torod -s cacA u oesootau urv&a is? 1cotoadoo. <&to fan. 4 Ci/s PoOtiaa u*to` ha oood far dtoadiUfr rtooJein from too es^rviat dftu^do 3ufq J of toe OatouaLmai 9Mat Cafr.wui.^n 'Acs. fk) TTTirau or utorua*r^gtaife :s iar omteaBae taoetoiac dimt otaet vtCA. kutfliv d - r* . wn to owt 4t ngqn aaom tat*),t. (0. .iaam^a^Ar euapaltoa ia*atotac dim eoataa ottA. hasaaisr ot or upawai to too 4 4Tko tg ffaufdoai Oenmflon* m saod PnT*e& t yf iha CUias **9da deftnod to ftalo 1 3of '-** fffpa'j ^iUCOUinnff *aod w foUn^r * 2taio 4ft Emr asmtoi oatofray toeaw to tn oennacmai dloout Hoard easmorttod is Station of too CmmannM< 9mm CjrgAmauaa Aft oa^ bo doaaad "Kuartaaa Otoaatooa'* u toM tm v aaod ia Sanaa i ibi oad Soeswa I. JUit 4ft Koto 44 Aathnota eeto soar ftooff'ha pnwraod to bo a uumfn hartar nUa Ssaid. 47S (MU bo pr--airetitoi ol tort toa wTiceott. fltSnu-*aar ud uMati tft dio> 4on mach iimwi to poiai of dtoaotoamt sa/r /tor u crpaaan of fln or snn roan. Aar toftr a totanak bow'd, iaciadar too StoM 7erirara laouroMa Poad. raar m 4daat rwrtiw to ito too* a tar portoeator toruoea a dkmmm 6&g m fam, to 7pass of rtftofrfrmtor darar a upuaw ka than tfn an.  *.-* - ' *Vjd * *-1 .'&>* - j-ff*: . . '*'.**;r *__- *_ . , ;c. ui ss.:*??* uCJ-r ils***... . isi .t;r^*. A.'.iy csgalnsg __ -- _ x>S (i* -^^<4 is %tui xit:: %s*s iaJujr-.d * - . '- .. /*w ^* Ul is ts t a.artLat "?*", _ _____ __ __ (.; Via uj t:.j r rul-S .'< Ues o.* iajun* *>:ao: ;. ic;rtb.. in .sii S'* asi'isr esrirr-tf, <e * a.* c ii *- . . I * om** S < , '_* * ?___ _ -_ A, , , A ./* ,, * (u) &isd :f cseurrd `.oci, e ^'rlissei wit:* r,icn cscii<-St --^Sriri r- :?:* *'- ::.isi^ riswsa ;&; j.#x* cT ava*-e or c-vii. : oil..* >-celiuLt It} ?o*cr i.v^a _ .u; r,*u sr -*cs-uicti_ {4; --* isfuj*x-ni rrss*4 Jt *U-- ef . asidsnt^ / *" &7 *DOS_ ___ ______________ 'y'si5ircturw ct ini7 ** dciisidfciy ts ** ' it/ Krt ar easy iclufvd is*.*? or 'J4B&& -- a- *<*5sS.r V\ \ .> -*****2 K'.-V .* .' *** pay9i*ifcfi op !scr?i*l: .-*.r< _>*!_ >} i.a -ssicya* rcwssi *js woik // -* * < tCi ;.- , rtT -t- _ /J - 2 f - (; ;9t, jtr: isu er ^rr.t&i< Use-- -- i T* g* l*f *-SiJ Sr i-yorud jy^ \ v- a 5ci-**i5rS-?- r*^ M{I' -a . 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T tS if wtiMPf ta <a0paM an* af trpp vu> r* **. tu9Pu*T\M .nT v* naA ypan upian'* u Uu Aa. r inw Amity yo* ifcu 3am dun iQ b* !>nrt b* mm I1-: -- -M-. -s.-ait -v.. , .-V* ...1 :"-I 'r, V,, :-.5S^SSfiS i*. ?y*a*3is^ " 23:SSTS!S it* C: ." 1" * .. r.r *o.-.' : 51i ila. or c?i;.r*r. -' ', xt;-r 'i) .-**.-. eril- ;s . ......... I?! it '-t.ii wort it.uz lojuo.a^ <;j it -sat e***rw*iit ___ ( :j t*.ir . oer*p.*ilca or Jaj-.trea p-racn ,, i. .eaertl:. La Til i r.u' -crV.l* et 5.*. vjrr.;. u'.?i-* v-jv.* :aj L<u.e or tool. O- ;:f7ilai.c. uccit-.it (5; Tart rtf sttf.iat or *1 er:e* ::u:liy acsU-M.t 1 i. ec~ir 2ri?*a Siat foot or a^saaisni^ <A/ **-r-2$urvl rer-oTo. ac ti-ti; of a c ,*.tft I *as ___ :, noturt 0:' la Jury *.o Ufiaitoif :s *6.axBL (1} ?srt of u#-/ i.a*ur*i (ri-^at or left; _._ (yj pr.y ,lai*a or *o:-pit.-i: 8-au. Acur rs (-! Has -.iployc: rttunoa to wort _ _ ,*.*.J If .-.a, tire lot* (if ^ct, state, actuate or nb*.tl* of tliOiiit/ I J 'j&a . - ? awr*< :A m n-A'+a n^S.d - '3 .--^3 ~~se`%y'l r--.y*&ZZs3l i*. :.^#. t.o-s *ms 7 1- :*t *JU___ _____________ ;- OT.*>4i..es a: oa-urf a. *--:i it; ?irt of ...*1^-. or 2*-v;e ;r;:i;^ assi.-j*.* .' ?-.*7:r !r`.7.c 3.----_ r-.c-i cr n.-'sir.i < i. <jv r*'*'3T!;. at ti&i. of acwiutat^ Jjv.rt 0;' is;wry :? : ?-rt of is. ; irjur-i ' 3* AiVr.i:.^ > " .i e. ts r to;. ^ ___ (-1 dm *.3 ..rrtM ,.:J If ro, Tire +st' __ 0( .; Ir net, State aatesata : urea-ti* lasrta of of fiia S-^crt Reported 07 >dm fctf -r-> ''rrJ hljT:3ym>mw' "-v"5 . ?r?rr;-i r. -r?.j -feri Bcyt"* imr.- - L sosaaKEF" ot-r ,-rst. ___ I % i *" < T* * f' ? v;r *f a7 a. %: *f l: .1*^1 . v /> *n lArnoO, ic,-U, or ioi-*4 < ":. of oS1104 os4ar olx-**-. rttr a , (*' >? '>.- * -} * -*i j .'*--V * tW''. .. . , , *> -j !*: tnnn Soils oorsisw . Ic) T*-.- ` is iat sort oaoa unaroO r*T..^w 111 Is Wist iosortaost C. - (ti hi*u:i u> rf9l>r ooowsuien of isjurtO jeraoa & pe*r\ v >oor'.so is fall sot oooUoot ocosrroO, lU'.in nuu olsarls lal SleS or soeilac, tool, er o;;Uteao olta wsus oeeia.st (OS rsrt of saetlao or oooteo oouolss tcalitat ioi Peotr 3r. ______ Sirs fta4 or aootaslo '41 so7 oofjjitrl matteo tt tost of teo'.soat _ *7 Ttss________________________________ S. sotsir* it itlar? t* iorialta'.r o* oooaiaio .-"?- i.- ll Port of teOr lsfsroi (roov. or Uftl ri-r/'J (ol Ottosits? JSTaleios or tcosltal: Soso '* s~ itoroso *~V '-. : -- -- . 'V _ !o! "iao osoloTio rttaraaO to terse V'- .J (i! If JO, JiTO doto i' i S.Ll . . .. gfi&sSrS^?- - 1 (ol :r act, otato oatlsota f ;robobU loath of itatouitj Don at ttio rorort , Hi;sroa or"1 rj.9yo- *' *.rtiof i i*m M a, *JC i r fiktit3ica eCMTCBA^C.'l BrfSaA.NCT '*" T ^:"T ^M T O a fS K M *W ? B *s a j: eacw oqoiamx -W. ^2 a***.,--* rrPW * - ij /T x. -J .a-* -'*TV; "V I ( a, .. . 7 ' sk4rj?*--fr ,,<& ' * , i ---------------------------- rr*yM d # g _: - j-*--j-* /, jJ* J- J'.i* /y/i'V^- .-- __ _ <a -'4 /x- r 6 wr< * - - ---------- - -1 I /+- ] '/ / -- 4 ij ^-*--.'4 - /-/ f_ ---------------------- ---- --. /f/---------- J-- r /---t-J. ^4^*/ ------------------ i -J --------------------------- -- /* * r Ji S2& 1 /Ir. <^1./ "x j i>4 e , - a-r-.^tT 03S r. - v*-' (*) j"./ ^ ,'" -- 4pwA' 'j9*um~<*X .<^/< < i-------- /W- I Gentlemen: Enclosed is i check for risiin under this certificate. Please deliver this cheek to the payer or to his attorney, if represented by counsel. If as assignment or notice of assignment has bern received since the claim eras submitted, please rein with the assignment or notice immediately. If for any reason the check is not delivered promptly, please notify this Divuio. Yours truly, Gsoans C hl..oc--lm, jupan^jr Jro- > M N V h-* '- f* MeTKOPOUTAN Li?3 iKSCSAKCS COMPASTV KSCBSUOm Ktll i T laov A.LeoucJta On r 7, :;'_ ImhawG. T>.^g. fai mi n iir.-rr KATS53TG3 '-USHATTJLK X8C. rams states asbestos dit. KAXHSiy, fbh*stj?isxa ATT i 2SU A. Z-. EASK.TTSS M5R. HAJ&T HXU2R U ES? ST. AKKSIK, RlSTI.TilIU 212_ grTTSLB 7*7* *1000 Proof <Jt* 4-<3-*7 phase age p*2AcatfHrs> maass x. 1. Tbs Cospaoy is nfn--1 to Isforai yoo at tbt spgruial at tfesa efeum. The peymesa* wifl be aode <4*emj tbo sac*nce ef tool oad pssMat ddebil>t7a m eccordoaoe with tbs total at the policy. ________________ X. Tbt Company wig be pkMod to approve tba clsao opoa reodpt at the coafecomr aaermeo doty <*w aptoyo'i --* X Ftaasc send us copy of tbt Jafoece card wttb tbc sppfirvaw card. A. is a check for tbs beaadta due to dots. 1 Chvks oill be wai to you for dttiwyto tbo payee. 4. The fim check irtil be seat to yoo for delivery to the payee, sad we tbofl deliver nhnuai cheeks. ?. A ehk for tbe beaeftts due to dote u bain* scat to the dsimaaf* tturaey for Isliurj & Clods vfS be seat to the ciaiaaat's sttney delivery. 9. Tea will be nnriferi so each payvocm is made. UL Tbo Ganpaoy is plriwri to inform you of tbs approve] at this dais eadff tbt H ProAeciiflo oa Account at Toui Dsssbibcy protiiiua 1 od tbt policy. 3Caa C*.Death edt to the Eveat at Tata] Duabuity ptosidua / proof dote. *-23-47 bos beta ewpteri as tbt 12. Beta nf tbt eaployer'a certificate to tba Tout sad Peraueot DfrthiTiry firrtino for t U. la erdtr ^ tbt proper payee say be detrained. please ra&sa to fsaiah us with a aafr-eat baa tba praet attias ftb uhnfc.T. a bis opaarw, tbt apliyea is aeatady capable of craaaccEts las pmrrai sriln fnr notary. tbt che^g--with tba mihuran cf tbt saflat oed caaesuecoeo of bis am. ___________________ ________ 12. la view oi tbt raeatil iacospee&ey of tbt es?is7ce tbs disb-Uty percents are payable ooly to a U&i g&ardlae of the esute. a etroC^i copy of tbc ycanfiarsbip i rtr n1 iinn i bmi*r* beftaxsbm ^rtbaa etpeaae to tbs C/cV^ay. --:--h-t-^ Selaaba Fcm.___________________________________________________________________ ____________________________ The cbosba sn best; sade payable a tbt order of the beaedd^ry. oa tbt osssptoa that tbt beslaary b aS7. of Itpal ssuSy eospesest. iateresiad ia tbt eapfoyoe's wrifim. sad that ao turdita has boas er sriS be appdated to haodls tbt e&rltyea's asasa U tba facts w otbaprba ptosa man tba cborit sad teaab as vnh lull dtsails tad o copy cf at g--ip roir^^afa, if cat bas bea tgjniftrl IS. The checks are beica sade payable to tba order of the brsrftriaJT, oa tba aflsspdoa tbat tbo hmeftriary a sve. of l^sal z^z. stasaSy eBSpcseau sad ouere&od ia the esployee's adfsre. If the facts are otherwise, please reesa oar chart sad fv&ub ct tvab mQ TT the tgptoyec,t cerdfcate. property oadoread. is 1?. This ptyaett eoapletes our CsbiSty oader this ta abate. T a H This psymest eoapietes our SataHty oadtr tbis eerdfeat*. Resie arraace to have tbt ostiScau. vbkb is of so further taiat to tbo < ployas. sat to tbis OSee ia orttot oar rueerds aoy be cocpleto. d PLEASE NOTIFY US OF ANY CHANCE OF ADDRESS OF TSS EMPLOYEE AND OF THE PAYEE. F. G. Dtxta. . Toed sad hmriau Db^bsEr^ totrspoliiaa lift Xasornea C. X ISrilsrg Awm Wm Tots 10, I. r. lw Barry lHUar, 3rUl 7476 ittaa Sr. f. 6. SCm SMrttn InnlnMii hsrsaiUa j< ii,i find tba **rxl cwtl firsts /7476 let Sr. Sszs7 Klllsr as nl1 as U> mtirt ot Sis it. Unrflns tfeysiciaa si Mm Lueutsr Cms&j Hospital. ttls is bolag t la cccpliaoes *itS yccr Bsy 1st 1st1st. Tk7 traly XZ9 SS1S3 kSSSSKS ETHICS' at aw^-rtn'J,i^ntn> Xae. Csss.) carrS. Ssiisr T>m--gg SsfsrtaEd ' ."- .?: =. rr------- J- 71-'*J. -' -- .ftta.':*? if -v;, '**.' V'f'Trf'-y-- -> ' MMeetrrooftpsonltitmanv TL.irpws TInwsutnrsaniscrer 'rCnoumpmanwy ' ' fwiw- g ?rrr> ^V---- --i J" ' ' txaorAJLdtookxjmm _' ;' Ow MtaaatAwmStwttM axe' C I*pl9,19fc7 - "' '-.V : ' '* -* .- .. 7r )fc-. A. X. Saha, Farsoasal Mssagar 0dtad Stataa Aabaatoa Dtrlaicn Bajhaatoa-Hashattaa, lac. Minhal a, Pa* Sa ?. A ?. Oroup 8377 Sarlal 7*76 TIBET HHI2B / Daar Bahai Ob JAy l*t va *rarta that j-ca edaaror to obtain for oa tha rtataasnt of ft*. Kllar'a attending physician at th Laaeaatar Count/ Hoapital. V* also raquaatad Hr. )liar'a rial eartificata. Va baxa so raeord of haring raealrad. tha raquaatad art*rial. Va hop* that it *111 ha asst to oa hartly. Tour forthar tocparstlca la tha JBXtar *111 ha appraelatad. Tour* truly, ~T. <Z. >aaa, SSuparrlaor Total A Parrauiant J&aahilit7 Saction > 07 i 4 "S' *&? V 22. 1%7 A- * Metropolitan Ufa Inacaaea Co. 1 Kadisca iraeua Iw TWt 10, . T. Ota . f^3. Crass B* Barry KiZIor, Serial 7136 Bar Sin ZB nffrpVinna with jour Bay 19th isttar, ha** a^iia askad Bra. Kllle to famish as with tho stataasrt of Mr. Hilar* s atisodlhc ghjaiciaa at tha Unnatar Court/ So^ p&tal. Ska U1 ao that so t it ia tha rT7 aaar fotara, and at that tla* will forward it to you aith Br. HUIar*a arlal eortifleaha. Tory tZy ;wa, 13SSD StiES ig55S3 E7IS2X ef Bankart rs-^Th? ftt; n, Zac. CBra.) Barr K. Bai*Uy ... is ' > * C.-f .#. f i-7-~ ;...." -v.s;'5 r. i- : - * j '?!? '-* y?"i_H:.. ; :_ . ' tfra:- V.-V -- '. _ . - ** . - ' r - . *y.r~sy '.' /* ;^^~--MgntopoiJtA2rLira Iksvbasce Company %T FkB3BcxHJeaeat.ctiiwiVniiriiiii ~*** lsaovA.Lo>eouuMM' ' . Oa Maooov Ayzrcx.KrwYbszux k.'ic. Utj t, 19*7 ` r-tt-....; r It. A. X. Esin, Tcsaanal Manager Ttalted State* Asbestos Sirlslen Bapbestos-Meatattan, Isccrpcratad Kanssaa, ?s. Ss TAP Gfocj 857T Serial 7*76 EAEC JdI2 - -* :- Seer Sir* J2 ecapleted Cleis Tcra 0JA7 bas bees recelyed. Pleaea total* s ststesent, cb tie enclosed elais fen, trca He. Millar's Mteadlsg physician at tie L?ncaat Caaxj Hospital, la addi tion, e should Ills to tars ths aerial sartlfIcata. Towi truly, '.ate : ?> ? Sath IT. Brenner, L'.D." Itr- deay :'r. Shbera: Mr. '.'r~ry Miller has 'Myiti nrtvn' 3 rT'oren *5 a -rr.creative v-iUi the 'cajitilif ef :-<s dave'n~i- aen.tei srr-tcrs. Due to the fact that f.e dejease os beir-oinr worse, he is not able to transact bua.'aes* and t-ierefore has Piren his wife Power of Attomev. ! If pw need arv more detail, please fiee* free tc call se. | Feb. 21, 1945 nrcerelr, Bath -re.nr.e: I ! Typhoid Few. 3carlrt Few. OSeAaJSr- - JfcL y ._______ . >* Irr la^ScStdtd' . Salala'' mr rejects fbr te^eSS^- ***2^ Jhlarix .y^ iflda.lajwia#.... ** a Vt'V RreeectOjrtjjjioillaeaj^or^Ceasla^tJi (!**} Cough Sight Santa _ __________ ProdsatiTa Ihalneaa Pais_________ _____________ Looatlca Appetite, 23 Ccnstipntisa Char, of Sputa. Other nqyleiata (blood in urine; rtceasj headaches; deep; joist paia; oeeaulesal dlulseea; palpltatlse; soctsla; polyuria} j6-u^aAj_ti Cl*?- "fed-i-kriA*. tved* 7> dba* _ JsTmgt T "+*r j* t*~U+nU }2t&jC~&t- -MZlL. U. Sate, h. g '~rV Seeerd ttaakbeorn by . <y7i arao**^^ '-jk*/sSs%-. '^4^ >?^ V^u*4-r" : . " >c* A~4; ................ .. ^ i ? -7^5y ---` / n'Vgdrtr^ rj, t ^ i--------- _____________________________ jp*h drp-'*'"'^ - ....- /^gc*^La. "feeSa~.%St^; # .!. ' i--f* .JP* ' v V ;~ tJCt.A*j^~*~*jS. T // V ^ Ai^+*J' Q i&/ ijg. 4/ ! ." -- M. ~t-- - --- v. i- ~7.~ T t- .--*' * gfryrr >. r.-- ' <- #"7 v* . * vir / r. wcr .. -- * . j . ' `+ '- V" '*. -;.- . \hM*A . { : Xmd Qriyf * ?wt7 .-'*' -. i'.' ~ _Jlwami T4* . '.A*. .. ' :r~ ' ' '. ' *' V-,,- a, . * ..* > . * .'.:'-*-* * *'* .^/.:T5 TEE^" i I ' "!rv*i ^ Am ' J~. TT LZZsXi^i: r 'jf v:r*<`~ ^J. --] -tit '>*--"t, ?" X"" -f | 4tr *MH . j Mk .-- I t ftta* a mu . fl 1P ) Gan - * -v# ir - t' -I r.y.; ^ - ..'i"-v ...*'^;. :*.-; 2~2 ;>'v *r, : VT,Vv'r*i } ; ' ,?<'>.rX.* -S:, - -. iie ar** V.^4^ 2 I ... - -~ '-. JtV. -/ >k*M Ocrrw yrj * ^rXZjssi ' -!': j wqb fTsrsr* ,-.. f y * <4; g,^TX r. nrbc-gt^waallap*/ 7- ~ * f 3 / <4-* .-.(a': Sty Of *8?' J (b) Hour f1| da"v '" -:/.v--/ '. (~e>.`: 'fc'ata- disar b. ility began Sana cr Injured enclave* (X) Ecna Addreac-V/ jcX. (el Ay * - a. - t- ___. ar- *. If} Married, single', * widceed _^22=&ii2d lL. .......................... " rS-'-vv-T- W {&) So. of ehlldred under sixteen' -rwa __ - *> d (b) Average daily earrings (e) ^aTj;1*- is. shat'rotk rben injured VJ.L/ (d) la ebat deyartaant Ci.^Te.tr A>- i' fl. (e) faahtbls tbe reyular occupation of JgJured person -VC- Describe In fall-fee accident occurred, stating cause clearly /'0-c( &/ %' / ' - ii ! &<<S \cali[^ - 3J (a) Kind of machine, tool, er appliance mth vb^ct accident oocurrtd (b) Port of nnchlra or device causing accident __ (c) ?c?r Driven Esnd feed or seotanioal (d) Any safeguard reacved at tine of accident 37 Shoe ' ' '____________________________________ mature of injury as .definitely as possible ' (a) Part of body injured (right or left) J-- (b) Atten ding physician o? hospital: Bara b lU'j. *- . L * ' -'N Address r .^, *., t ' i f` ^ ^ *> mm--mmm (o} Eas aaployae returned to aerk (d) If ao, give date t >V --) (e) If not, atata eatiaatc of probable length of disability `'". ,i?;';'*i .'. t- - {", SWf *'* eatni itt. or Bwwuau .'[ 1 (y~ p-w^V fia*fi-rVtt-3iZJ1 lt**L*W*i?tx 1j J*. wmTr >^aaa. M MMnr 1 "r^4fJi-~"V* "**'"* I dj^a^ssssa - - _, i iMwrwirri ni*ow men/tAy spxljcp m.iwwHoiiF ow > ^4^ KizurnsQ Wy'frc*rTisY rr: `*'3 SSV1'1^! ?*Sr *SJ*3- , f .ttaia talf'ij ** wa a! wm v :. ^iv-Mi.-.-_. c__.`___j_g__y__tetoj ufcta 5a_. . Wi(tw U.T *v.-gSSirWS ____ .i '- <p.llinn Aaatu, Mm ------- I "aJSnSSM^Oa^M MVWM tk ------BWTWMWt Jif nmui'f*. Xn*t*K-M K*M ill ` 1ft T*a<*f 1 M* *4* Wl| < II 1 >>.* U - k 1 !*.. <*+ **1 t -a* Bm UMU( U wlinr rrmju^jj i*> <iau iji ^ ki* qnrj ~~szt iJUTSSD K2?L0Y1S __ _* oti^244a9 .: j>! !r?s tfj btfa4^>TV 9*tf Maw Jt>SLu29 i4* M : /in +*> s <% * *IL Gi> Ham TiI3jg-.sr=aJ-'- . m.i-~i. --LLiZ!i**r.r&5*zZi=-.., __ .e - ^-- ^r----. . -f '^tcww md TatftartT .5J*^3 uati ar??n; . . l^tej#Sf^s7tT > <"5 .-/ ' 1U1X1>! j^rmami Ifa^^****--** -- itimtim+S ! fi i tlBfcr 2f ^ - -- - -- - - a*> ** -- __________________r_i4__>__i__f__1______U, 4M 7W 8B&4JC93U to 10^*1 IMX> ftSf MfkM wviirant ramflwf _ ----- *'**?** lt"<r * occupatk /* ** i*k -tl t ^n'- 411) fKwamtahTr af CCwtwttriwt--tt--w--------w---------(---1-------<--- (U>) OOnoanMunttnfwfw% liwil------------------------------ ----------- Si dM5VKJBtfiUarjl3teg*?>i.JmrM*eM&2cJLSi dTCftia* .0*1 (ft) OoniftUM iju~^2Sf&SS^sgiSi93fi}'*i. ~'&i ai*?***T3Li- nnr.xmn CUpAiiVs1 '* * 0 *1CV) ( ) Saw lM| --T^r** ** tnanpaW vIMl taflBad . . (k) l*v iimt anftftnd W im '. (HI Ifaster 4 Im tr< p V . . C2 Xfltf f 4*71 vtrt4 far fe - <SS) Vum: Par knr 1 -- ---- atnw 4 iCUOUT ||4) TUI *u lapMlw 4IH **aa tka n<H MawfU . fw Waak I- .i ImN ar laftrw du. rf awu usi=a.5i.Jss..fca MtJIT li>aaen*> kriftltr * Na.n*r trtw*; afaraiiar ft 4nu yrm UOCMT r BIA (HftM If pftfft IftlUf, MM* Nft) (f?) Bfv <M tka mMmi Utr CPa--nka tu imMmi /Ur. iuuac uii*r t*irad ><m fall ar m ml a** U ail (mm minftniaa ( UU tntiluc Cm acftac tkda Car r1^ulnl ~MATUat ou Vm U aaekiafta taal r ftfcj--ft iafftaBia M aar *tft . <> If aa. tovr . ~SSSrTZ. (M> ,ClM Ua ftMiiaat'tera baa* yrtmlH? . (ID *Mf -- ,.c. A fai*M*ft frarUla* Wflift ft**) flIJ War* 1 (^1T tr*a Lajirad fttaT tt--? JUTClSi 10C1T1CS OP erjrSY Ott OCCTPXSOliLL 3I2Z1S3 aJ3C3 gfe CDMWfbB Ift at*u ska aMara af tka tajVT f inrftTurift>l Kimm, aai tfc pan afUa a*4r iffiml, f*f------- if'T "PStSSSTC iiapnf rtaa of n*ai am. crulHip (U) ifiuDlf lUMUft (ll) Su uapiaya* ratarsM ta wrkf (jftapt ftpk rddraaa) ... (It) U fta. pv* fau ^.nrU/tts At rut vUr vu>* S ftmalapaa U Umblad. ftabaftU taacU af <1--bUl^t ..... .......................................t_____~ ........... >tf) Old tkilfT naa)t > dull?-----------------------Mb) If aa. *m 4ata ______ __________ .... R$?215C5 Cinrtm 141) W4MSYUVANIA UAMUrACTUIICM* ASSOCIATION CASUALTY INSUftANCX COMPANY iI 4 S _--- vU* ^ ~i.^ * la re: _^,,feg^U*!!......--..--~. -4!r3jivC f '' Caim No. __.A!;a-25XQInal-------- We acknowledge Herewith receipt of the above accident report in duplicate, la all future correspondence concernin; this case, please refer to it oy the claim number. Sn all EYE CASES. see that the injured employe jeti :'mmedoue attention from an eye specialist. Very truly yours. i' eiiits..- i . eiita ALiiufacruie: s' .A^socigti-^. OiieUtuty ItlalUcilCe C-tr.tttXU'.y " , - if N k A . *~ r%if *. <*$/; C. 3. iabaatoc Oa. Manhala, ft. fir. . 7. 9oia 134 3. Mala tM taktli, ft. fit ra Mr. Many Millar 11 bby ttraat Kachala, h. v- 9mt Itoctaxi /* Aaoroaeeple cnalsatlaa of tka ckast ahova that tka liapbraga aoraa vltk a aodarata axscralsa. San la dlff&aa lsfUtratloa. at tetk baaaa. Sa ekaat la aod* arataly wall aaratad asd aapaaaloa la pol. SMstn&einshic a*a^4M<ww asfiiii thiM fladlrq. Sara la diffoaa lsfUtratloa ala&g tka trek akadova at botk baaaa, aapaeiall7 tka laft. Sa aspaaraaea la rorjr typical af a aaeaad ttaca aabaatodt. Sard lid `"'l aaabdatad altk tkla, plaoraparleardltla. 1 A oa^ariaoa af tkla f&a altk tka rspari raadarad M-55, dsn laflalta adraasa la tka dlaaaaa. i it 9UUDSX31 labaatoda - aaocad \ i ataca, aapaeiall7 laft baaa. i Saak yea rosy aaak for rafarrlac tkla gatlaat ' ta a vltk kladaat ftprii, lea ': ; r. J_- r 1 Kb ;:rTSY': .-'""jL - . T f+m^i7j*y -o' ns*'m fl^.YjWrtf rfVT.em ranfnij; I / 13> 1%3. a*, 7. r. obi, 134 Sooth this Strat, artflla, Pm, Deer Sector Geiot > The tallewtsg la ecpy of the reper* of the eheei x-ray of Sorry ICllor. ^ ^ Sheet x-ray wee Ufcan 2/2/45 aad road by fir. Saab. * I I i. &e hilar abadews art anlarged aad she* aa lasraaM la teaity. Sm brachial 'shades tfcich presest a fsasy cctllaa, ere qeite yrocrlnsct la both aides, i ember tfS aeall bodies la both sides, aligthly man so ia the rirt elds. Ifco iglooe uppaar fairly hlsar. Scae flxhteeisjf a* the left base, the ah - the left base are ef&aad.. &e oootoer ef the rijht baee le fairly aeeaal. fia heart shadow aad the aerte appear aecatlrs* * < fiia^B-eiat Sha ahangaa presect acjyeet a aeeeod stage aabestoeia. Ttzy appear elishtly aere aarfcsd by ooeperleca with the fila tahea ifi2/k2. l tebart ft. hat, x. ft. i asnst.. iV** OBITS trt-q Lt^aaa BI7JSE3 ;efjayhiotchwCs^rtivT 2as esa oasi7 issss^a p; -* & k-*ir- i1;- r  * \ .* ...>f v *. k - .i . /i . " z .m -*. 'v , -- ' ****t-.. J* . Osi*, 124 Socti Ada BHtftstn, Paoca* # 1*5~ n Saar Sector Oslo ta tdloalag i * cop? of ti* ripest at the ebest x-r*? at Ears? U. fble abort jr*7 J taJon >/3A5 arfija* ^ Sr. pab. F^rtieall? m >tg Craa ig ms? atorwforrint *i=ee Us*.priocj 2/Vii. . *k BUfssdit u 1fU^arf it ttA pnmSJgea jaami rwM no, a#' change *.V o. ' * 9. **, 8. ft. . # * . jf -- fnrtjsl? ssms uasxa <tt >&-,-a^t "3 Ilo,, '.cr >or-ts srrzojs Ui=. tiampuff csa' us S-e*y as'sSotia 1*- it ,A i. l1 Earry Killer & 1831 2/2/45 The hilar shadows ara enlarged and show an.increase in density. The bronchial shadows ircieh present a fusty outline, are qnite proainsnt in both sides. A r/ntber of rs.aH bodies in both sides, slightly sore so in the right aids. The apices appear fairly eleer. Sees flattening at the left base, the angles at the left bese are effaced. The contour of the right base is fairly norsal. The heart shadow and the aorta appear negative. diagnosis: The eh-.ages present suggest a second stage asbestesis. Asp " They aepear slightly aore narked by csspariscn with the fils taken 3/12/42. 0. 3**3, L\ o/" r S' X ^ Nfcf-ir *r-=r_ - ^s-.' f-'A ^ _"*.. */- *.?. _/ Itlsar Jj^ieaJ 2ssc/v 'V Mfcjw aysieil See*',_r ,,, ,.,r 5?*~ t'4f/>y ql jjutjSf **- - -t - Vnyf / * 8ECCk-tSr?A'?T'r5 ~"c^: " ,r. <r-A^- i>'r -v^ - .`^r * .*, ^ *r ". J?v;4?5*77 " V.-, 'Vi < '" '* .>'*' ;1 'T-`..t-*.- *' * ' 7'Vf s --..* * * v.- .>' BAgSB -7 -- , ^ Ui>.l ME ` , V -- -' vr* v --J ^ wi : .1A8RAjORY- DATA ' ^1 *; uTiwt ii: ifr^r. 7 ' % ; r. ;7" B LQ OP : fi.s.e.^rY'* *-^2 *5 ': v' g.^^--a"-Xiifa.'W '^ii - c* a ^ b FLUOROSCQPE it Lfc 3ha.p lft inrlela politico. Aorta X-RAY READING . *TS. r$r 1 GENITALIAS- Sears Discharge Scrotva lertielM RECTUM-3*?. Hancrrhaids Sphincter Prostate Teal ales tyyygji ?? tts isd SPSS Posture Mobility SeolUsg Tenderness SPSS 31TO6 TBS CBSa JOISTS . * ` ' .1 - . IBEXES?" CIRCULATION^^*? Varloose 7eina rid* fp***&*; irtario-aclaroais -5*# BEHAVIOR General Speech Galt Personality type - :.*CHEST - - * ' * v- * *r-. *r- *- .**------------ HEA8T ^;r' -- Xfta but looatiaa OfiT 1 ^ P3*g^ft ,-. tersrra-^tfl -my ow J ** ic* * v-; v* rr ` * j SS2CI53 ' 1 if H2ST ?iii* j""S3 raesv u rsi. ?r. f 2Sf / VZT/jf) iPTsa 2 US. U~I2 EEECISZ M-* __ ________ 'TM yaa-/-y- Stlolegleal dan Anata-loal Qaoo- ^ Fmctiaeal Cap. Pulsarr ttaxstr ~i8oci*ta4._Slp,-- Bjrapsoaa, Cymr.arta, Sack Taisa, - ' Yassala, Edsa, Prtaehia.a tepassieo if7 -- tf Swtila Tr*taa r? - BS7 Paroussiss .'-. vi-ai.-4^u-in *04. lap. ft/ Oullssss & ... r . Braath Socsda Bre&eio-raa B.7.2. Branchial B*. Sarah I=3p`. E-I.B. froleagad bp. P*E Toeal Res. ccaaoa XV2.'. S72 210312 y~< map. Pee. .?, Friction Sub. Salas Sub Crei...3ibs4 0 Crab eoooSea <323 Costs* OCCffioachsa OO T _Q^L 'p'js*-- A#tX<. Jffisk*"**. /2.<SUa^T .at nrra, *. T rrrr-.-T-^ t--rr- Sees ` Saieiis V- Lctaal V.C. PeLaa S'*) Saicfct f'f -- Hcral V.C. Jw *& lta. Sat. Tfaizirt S of Sosaal Iba. SV. SSLLl'iaL-./*-' -' -- ; 0CB}3BSti7J . Tr^ - ballai ^ aolarmai TlaicBu mtheut Slum 80/ ,. ?. Lt 20/ r, \s4-Li_ T>* 4. , ,1 x. - 7zm teaa haariag St 8t st" '|mi sisus agbraaaa. aaptaa __ *xZZ. t>gblsa*aa / Slamaas: ISosfcala St. aaaiilarlaa St" Lisa -- Saccal liueaM.< Taatiu TMU " &<3?3 5*321 * 5 21 Lt Lt /20 tt '^4 i ijf-a^ Lt. Lt. tr.u l * 3<S s;R? ije-Vsgx a l^L. " Oqsb J&TWgti:. TOsllJa Ulth. Slaaaaa: 20/ 20/ 720" 0 - Serterad X - KLaalse = - Bad Gentlemen: Enclosed is t check for rfairn omrirr this certificate. Please deliver this check to the paver or to his Attorney, if t- npresested by couaseL If so aetag-ment at notice of assignment bas been received since the *!<* was submitted. please retun ith the assignment at dotier immediately. If Ur any reason the cheek d not delivered promptly. notify this Pivision Vows LraJy, Clones C hlcuci.'.m, Supervisor (Jtoup 'i>v9k I'Mii-'niafMwgA* ' "'J' y MrrsxoLriAN LC2 Lvscsaxcs CoMP.onr lLEexst.a* *suri I uni ft T wrrnw >1,1 Oh >Ucaa A*oro*Jfcw'fea^igM.Y. 1?4T ...... .i,c- lftvffDoc: V Vii i*lw 1 < W.Srrs "'ft- U7BEST09 2UKA3TAH XXC. nurro amass ashbstos bit. aixHSxy, fshustjtafxa AT? UR. A. K_. HAHK.PtRS <a,. BARS.? XXXUER r -r 1' U KB? ST. mssa, psns?i.7im *- BrTTSLg 7*T6 #1000 Proof dai* A-i3-*T pma m PAaioairBrs) mca 1. L The Company pfoari bo talons you ol the ippniil el tbs ctaia. The paymw wffl b ssde i pmaaaest disability, a occordaaee wt the tmaa ol tbs potiry.________ ____ r el total and 1 The Coapany will ha plaid to approve thhctaia apoo raaept d tbs qnafiraatoiy taanaa data--the coptayaa'toppfk irinn nrrl Was sad m a copy el the ta4faces ard with tbt 4 Zadoead is * chafe tar tbt barfis due to dots. S Chafe* will be tat to you la delivery to the para. & The first check wtO be test to you la delivery to the payee, cad we shell deliver wihaquat -tiffin T. A ehak la the benefits due to date u betaf sat a the riaiaent's attorney fa deirrery. I. PieHre wO be eat to the deimeat's iuat la delivery. 9. Ya wfll be sotifiad u cods payment is * lft> The Caapany is pluiwd to ia/ars you 44 the approval of tbs claim anda the Q Ccsnissed Proceeiia a Aeraost 0l Total Diabi&ry provtatas 1 d the policy. TXTO Cl^Deet*! Boedt a the Seat el Total Diabitirr pwae / proof date. h-2j-47 tea bah ecapted a the U React med the aptayWi oaiifiote to the Total aad Permanent DfcataSty Seeaoc tar< 12 Za ada that the propa payee say be detaaiaad. ptaea arrs&ce to fansh a with e inf--r-f frca the j suiihc forth whether, is his omrum. the sspioym is sessady cspohW el maeacsa; his praal afitars--far i chads--with the naiiacan el the cotae and cocsajirri of hie acta_____________________________________ n. ^ tS A ecfdfi^ copy cl tha taartianhfp cecaBBsoa ehcsld be fnrrthm wsthcw epea to r*m rnripas7. The cssaiaa should alsocomplot* ttaauactad 14. The chads are beta; made payable athe order el the bcse&uy, a the imrnydca that the befcj.7 is afive. el U^d ip. acsuS7 competem. taterocd is the ptayea's wvffite. aad that ao gardtan has bea a will be appointed to haiyfla tba ospiojWs caia U the tacts are otherwise, phase nara the check ssd tessh as with fall dotal* aad a eopy ol the csa^iaaj&p gbsssscs, tf ose has bcs appointed.___________________________________________________________________ IS The checks are beta; aide pcytble to the order ol the brarfcary, a the eeapetau ead tatu cited in the caployu's wedare. If the farts ere other that the bgrrftrisiy sefivn. elUalag. ssaaSy pkaae return ear cbech and tarsish os tvah tail TTThe faployee** certificate, prepety odomd. IT. This peyaot cosBpktcs our UahtSty eader this eertzfieata. IS This payteat eoopieta oar EahiBty ante this cetificatn Rcase arrange to keve the estiSeata, which ta el no farther vitae to the e pioyee. seat to this OSee ta order that ear records say be ccgpletr 4 4 PLAS MOT17Y VS OF ANY CHANCS OF ADD&SSS OF TS3 SdPLOYZS AND OF TH2 PATEL F. G. Dasa. iifnbr . Total eod ?nr`wri DtattaBr^ atraoalitaa Lift laacaaea Ca 1 Marilann Mci Wm ft* 10, I. T. tot Harry n liar, Sartal 7476 kttax Mr. f. 0. Si'ii Daar am fafllnaart baraaiih jtm. *!! find tba aerial oartlficat* S7476 ter fr. Biny Hilar aa nil aa ti if if want tf hli at* *-~**-r jtgvleLn at tSa Laaeaatar Ccost7 Soajdtal. thla la halng east la eeapllaaea aiti your Mar lat Ta^ traly acsp sr^ss iss graig at togteafioa 25s. . {&.) itoy 2. Pallay Jaxrazso Sspartac* t . - r.--. -jr-rr *'\-r i.^ it-f ?*' st- . . -*- ' a; .: . .,.^i-tr -Si--.^ i v-' T.V, f % * ' * :;i fr . Sr.-.* i Mstbopoutax Ijfe Intstoaxce Compact W^MOHO -1- V IXXOTAXDttCUlftMfa* a ** r' ;*: r ' OnMwaaJbm!(liwaia.xt J3C IfcJ- 19,15*7 ** * n fe It, X. L labs, PtncoJl >kagr United States iibMtot PlTisiaa Bajbefftoo-Hdbsttan, lac. IfcTihrl a, Pa, Bo T, k ?. Group 3577 Serial 7*76 Tiwr MTT.rra l u tpi 7a--5-13* Soar It. Eahu Ob Ife; 1st orote aablsg that 70a ecdoaror to obtain for os tha stateas&t of t. ML liar' attending physician at the Lancaster County Hospital. 0 also roqaaatsd. Mr. Hilar's sarlal esrtlflesta. Va bars as reoerl of baring roealrad tba rsqoaeted arterial. Vo bapa that It sill ba sont to ss shortly. Tour farther cooperatios la tha motor olll ba spprsclrtsri. l k Tears tr-aly, *T. 0. Sross, Saperriscr Total X Parrwaaat . Usability Section fbk S7 - i. ; /r..-*; '. v ; *v y^ -'i - -v.vTj: -jL ` *- rf-.? * 1 -.v " 1 -T- * - .- .- 22, 1%7 wtropolitan Ufa Isscrscea Co. 1 SadUflB Incas aw Tar* 10, I. T. B Harry Hilar, Sarlol 7476 Otas . T.0. Draaa Baor Sin Zb oo^Uaaea with 7our lay 19th lottar, ww hava tgila aakad Bn. KUlar ta fUKrij* a with tha atataant af Xr, Hilar** attoadlhr jfcywieiaa at tha lannwtar Ocusiy 3o* pltal. Sba will aaa that wa jwt It is tha tbz7 soar Tatar*, ad at that tlaa wa will toward It ta yw with Ir. Hllara aarlal cartlfrwta. fary truly yean, ` ODES 5S3 JLvnr*ra rrrvrTT * ef Zas. A C2rw) ^8Jy_S^Sallty -im -y.'ji??-' f-v ^tejsecfci? 4 it..:;. ~i. ' fc..* . 7 . " ~ sic:-L-- &S5SGfeMM ;; . l:.- -\ ' w'.> ';: - ^y^^t^aaagmJax'laz iKsauSeE 'C&Ssunr * '. ~ v*-V: >V>*` .. %^/rn /`u*--^ nfflfcfwKrf w ' IjpMrrA^awom.w.Mix *yff P*:-.*,' *v,,, a . r Om*HtsmemJenarB*.iltwtea* JO. NX.- ' **? - 4 X Inci Dewtsa ' rva )ta7 t, i$fc? ; .t Mr. A. S Bite, Fwaanaal teaga Bfaitad State* latestoa Cirtiias Baytestoa-Msstettw, lacesrporatod Wfl*1 iimit.m f p*. Ba T? Ceoop SJTT Swlal 7^76 BABST KOJ2S tear Sir: Tte CB?latad Clair. Fcra. 0347 tea tew rocstrod. Floss* iutelt atatssact, an tea wclotad elate fora, tew Mr. Millar's atte&dteg p&ysielas at tte tweaste Cowty Hospital. la addi tion, so steold lite te teso. tte aarlal sortiflest*. Tears rul?i '%V> T. 6. Dross ^ Supmar Total fc tessssst SHaalsillty/Soetiw >: 5.-V ' .f * *v ; 'f:\' : r ?=, --laviK..___.-" xt, 'i-. '*.1 'U 4- -k'-V-r Itath If. Srenner, L'.O. )'x deay Jtr. Sbbero: .hr. "errp !1Utr has f'lntin.-t.p.'3 Cho"** vr< p* < 5 a rrnsresolve Je-M.se vita the "cssitilit" ef '3 deve1opir<; -entsl ayr~terns. Due to the feet that t-.e deneace es becerclnr worse, he is not Able to transact bus.'ness and t-ie-efore has siven his wife Power- o' *ttomov. j If won need ar.w more detail, please dee', free to call Be. Feb- 2J, 1%5 lircerelp. Both Sxesne: m jeCSSjfrjL..* -* - ' a, 1 - ; **rflfc CS'lSa // JT Otsar Carcaees 1 rs^* j/ i -C1 ' -V . Peed lars |"T^l Casie ' z Seathj r -. 1 i _______________ f ... :* 1 - -1 a Sis esy 09a qfjw paresis, brothers, sistars, sift, or cMldrea rrar- had tie. .;epilepsy, issssity, headi'diseas*, ar.aali5*scy? If particulars. 1- . *'*' -* ->-- " #'.*4/*r- t- ^ \ * aJeCTHlgsir rota's X ftSaersaiTsls r- H-eerisr jI--5^=1 tewsrt* Bead **------------------------ IsflwBS*_ a/cyi ` Chest Cal4s______ . arencMti3'J .ay^Miitj Skis Disease*___________ Hhematia lypteid farer_________ Av Cpei^aliBfcr. > . - Soarlat Few______ JfcLlaria__ ' . - X'. "-------------s-- ---------- >-=-i- v' lee* fcjwies._ Erer .Erplai ' Sear rejected fsr fiSeSieweaoa .- ------- --------- ------------------ X 0-%' A*" PTaagst Chrcado Hlggsa or Cacslslats (TJreqJ Cough Slcbt Seoatj _ fttfa_____ SC ftodEsttre .fealoees__ __LooaticB _ _ Ceastlpatia _Cher of Sputw. Dvemnee *<* Other oocplaiate (bleed is urlse; stesasj heartaches; sleep; joist pals; ooeassicsal # dissisess; palpitatlosj aoettria; polyuria) ,2L-~*.aAjl& c.<>e. ft'" us-eU* $> C&L2S >^4/ JL*tZ. f/et tm St-wit+yJU pata ^mL ~c V*. $ r-rf Reoprd taken by A (SrK^-i- -*v ' K.D. J - * 'f*rr> .^" '* ' ~ --------ft &* , ^gJiSf J&S5t&3; 1-t. . ->* .*/*+*? ` 'r*> C r^.-. o ~^';t; ^7^ c~~. "V - \ a * /? */<*'?/&*' $ ^/ jgl.y # 4 .*" ^'/ "l?*S^* -^,/v < >f* 1 i' ^ -i. - : i: . -2. - ' * V* __ k :' '.. '. "'- . < > : wirv.- -s,---------- /.r; '>->*____ sf *.*+*/ - ----- h:~ .?;-.-,bv--` 17-: , . . ' % - 'n * - " *v**5' ; * *; * - " ->V--T , _ --v A s j ^ITt { ' ;-;V r Dr** & - z? z i- &-V -V- t 1>-* t-. *>* - T.TV- T? 1 t i m wTM- . l '( Ln tr- we ircap . Ckn S-re-yo -J* jUl -- *l IlfMlTlil / _L - /"a w.r.-../ */s>i} d'^raJ^z. .Jt 32 ' -* '*>1 *' fJ -------- -r~ * -r M j. 4V* 7 'a J ! J1 1 ! * Sene ef. isjt........... . (X) Ecse AddreagiV/ d!*)*j -x >4 ^ - \XmJL (e ) i ~ C (f)Married, single,, ox side**! - :*># - --'*:' .>^': - V. v (sJ Xe. or cliildrad ueAer aixtaaixi.years - --* (b) Average daily earnings " '' v .... (o) fcjs^sd in. siattcTk uiea injured ? ---..*1 .,,.* ~ " -a < (d) la abet depertaeat Aju-- g,,, (a) Baafvttis taift resalar oecqjatica ef injured person : iu-c^ Describe is. full -toe accident occorred, stating causa clearly /f~3-tf V** / T' 'r"7&\ T at D~<^ -' <_j> t I i-^ "I (a) Kind of nacbine, tool, cr appliance eitb ab^cb accident ocurred (b) Port of cochins or deviee oausing accident __ (a)?cear Driven ___Esnd feed or sechanioal (d) Any safeguard reoevel at tine of accident _____ . 3r Xbcc .' 'm > - Nature of injury as .definitely as possible ; -r.u._> (a) Part of body Injured (right or left) ^ IdJ... .J, *'** ,, # #c. . (b) Attending physician or hospital: Bios _4< t(J .K t ' Address f. M< (e) Eaa employee returned to eerk X & (d) If 80, give dat$ mmmr. i WT> {) If not, state eatiaats ef probable length of disability -i i'--. ~ ;T.' * sS t?Pj*~y->*T` I , *..< U M.vrruw*!* ovr u*am /JJ r j . (- rA---*- zt- [ . .M^ ifcL`,t^r*^;rr`,V 1 'q:t * ii**1*!*^ w .-.Vw.- P5 eoW'' ^^*3% U *>.. ,,,. , >.? t i > V . %* 'a; z * j.'.i : * .V* .. -* --` -V** k.. - * ,,* . A '. * 1 . " c3._. t- - '!. i- ' -v- 1 ' - r4 V- -./ ~-j ? y-i'^r X !.V a . ; 1r':.: -- X- ;* ~T J - attga ' . r - M- ,'m ft 7 " !a re:________JjK3Z.AU}L. f Cuua No. __jiP.4}.^5Ai3._ .12.-03.^ JEoot----------------------- U'e acknowledge herewith receipt of the above accident report in duplicate, la all future correspondence concernins this case, please refer to it by the claim number. in ail EVE CASES, see that the injured employs gets imm-.djue attention from an eye specialist. Very truly yours. Pctj-j/iiiijia svLtaufaciurers' Asoc^scn Casualty !lo>iUu*lCU C. .T.rarty . r->;: rv ,/ i ' t j > i- * i 7 f. l i' > *j ;'4.. \ -i: f Smr Sootord "%> #. J&aaraacopie aaslsatles af tha ehaat akawa that tha dli^np mtm with a aodarata assertion. &ara la Alfua isfUtratlos. at both baaaa. Sha ehaat la a#datataly wall aaratad ad aapaaaloa la goad. laaatcaaecraphie taaiaatioa eeettraa thaea flndlrcm. !kara la dmaaa Isnitratioa alaac tha traak ahadowa at bath baaaa, aapaci ally tha laft. fia arpaanaea la TW17 ^rpleal of a aaeoad rta^s aabsataala. la '* f" saaaalatad with thla, plaweparleardltla* 1 A aaapaadaea ad thla fUm with tha rapert nsdarad h^88, dara daftaita adnaea la tha dltaaaa. SXifiSOaiSi iabaataala - aaocad ataca, aapaadan? lan taaa. Shah yaa t7 msb for rafarris* thla patlaat ta aa, aad with kisdaat raearda, I a fac7 trdjjesra,. . ... RftS ' * ` .," , . ^ 1-w** 'fr v^.v- it- * * \ j ) 1 i I : I i ffir. P. 7. Gala, ' 3tnak> , Dear Doctor Goici [ The fallowing la a oopjr of the report ef tba cheat r-ry of Harry Millar, tbia i (hast x-ray w takas 2/2,'k5 aad read by fir.' dab. ', &e hilar abadsoa art enlarged aad abev as increase 2a danaity, The bnecfcial <shadeas tfciah pceeaet a fasay estliaa, in qnite praaiaast la both sidsa. 1 caber efi aaall bo<aee la both aidaa, all ghUy aora so la tha right aids, tte apices appear fairly doer. Seas flaitaal^at the laft bin, tbs ---T-- at tha loft bass srs effaced.. Tha aoutaur of the right boaa la fairly &a haart shadow sd tha aorta appear aagailre. * i BLa^aaaiai &e nhangaa prngt sogzaat a seocnd (tags asbeetesis. slightly aora aariead by ecapariaoe with the fUa Utai 3/32/i2. M. fi. Tboi tS7; * i: T 'Vz' XUTSX) n-tiwga EXSISE5S .^tfjay*!! rt ^Tftbattin jha. U*h=aU.~ /?lte a,. issae acs twr-ii-.Ti *? *f+ Kf. & er; --:! ; -g .f 'EEC. Jf ** ^`*,` * ***fc`1** -- - ,-t~1J-T`-- ^ m ` V*. *- > ' j jii HR A w y m w i m ' ,w M s iw a ^ > rf7wiBiw i4w tttv * rf -I .I-'-. i fir. >. od. 284 ScstS Bala Stntk, V **=* 10, 1S43vnr H V Omlt BBetar.Gal* Ti tnil wriag Is a wft of tba rtjsrt of tbs etaai x-rax ef Bart BIUat. *** "*--` *-ev *w >/3A5 sad-ijAtf ^ *. $**b. Poetically as aharg rca aa >ray aUMjinint alas* th*,praiao 5/2/43. SagesiBj as staged *t tb* priittga jgyai rati os,' ae' *ca o. M, X. . fH7 twiy : .< BOSSES SS1233-USB3X3 BZSSSa feybaatca^a&sttAs Xu>, A r^7! 2T3KS tn^my asa &say Sg-SaaSa ;->ea 7* . I Sept. 9, 1940 r ' *, t V __ < }<. ** . 'Er. homas Metzger, 613 West Chestnut at.,' Lancaster, Fa. * * Dear Dr. Metzgers Thaalf you' for referring Harry a. Miller to se. X&ls nan's visual, acuity Is lowered to about 20/100 each eye and cannot be Improved by any change of lenses. t he has a nassive central choroiditis In both it yea which psabahly dates h&oic _ev*r _a. af about 2 years. There Is no sign of activity at this tine. 1r X oo not believe there Is any chance of nis vision improving. \ a ) i ii t : i a 1 1 Hairy 12Zlar & 1831 ' 2/2/i.5 2e hilar ehadews in alarmed and shew an. increase in density. The bronchial shadows which present a fussy outline, are quite prosinar.t in both sides. A m&bar of asall bodies in both sides, slightly sore so in the right side. The apises appear fairly clear. Seas flattening at the left base, the'angles at the left base are effaced. She contour of the right base is fairly noisal. Die Heart shadow and the aorta appear negative. Hagnosis The changes present auegest a second stage asbestools. Jhwy They aopaar slightly aore narked by comparison with the Ilia taken 3/12/42. 5* ,=' x:j ' Sr Sioert 0. dsa's, r. r ,... j t.; _ . . `i 'J*-? ____v. < ' '-/-- . j.t*. . ; '-';'. f - iflrjr IiysicsJ'Soi'ae*V:_Uajar Jfcjsicsi De*;.I' ' SIASTTC3I3^^' ~^<'lrkzr:----............ -........................ Jktf i-t* *p t4 ? $> dL~-Jl js-v*8 dt~ asc^siAircrs. -'- .` t2~:v~2r - ~ c;+-V:.?->'-.f,--'^'.r ":'. .v...f-- Y'jiZT.i: sv: -v^-'.'vv ;. ... * -: - -.. . .-.< - , ,>.i * *il ->*>**: V' *. : .*> 1 -.,*u^- V*i. *.. iv-'mX ' * :..* *. ; ,-a1rr-: - *-\ .r *-. g/ggS * i i .:<r ] r *" v. ^ ^ ; . .-3- B LOOP > 2.3.c/*#* _ 4a.!^5^5;./?' *2 ' ,, - >?.;/iK.g. >'>? s. ^ Cf. j*.}^B$icfocc and fta/Arka;* _.v ,. 'nV'ii. " 1 **V' ' - + ' - ^jj^jedlaastettea fM$i .` c* g . jm: ^ b -^7 FLUQROSCQPE Maphra^j lend Sreathdag SaearaltaL Poroed Breethlsg A.P. Ewrti Lateral Ult P.C.Zoae Shape Left Inrlele Lt Poaitiea Aorta X-RAY READING ft f Soars Disohargt Sorotn T*rtiel# screamiss tad SPCS Porter* Mobility Svtlllag Tttdersesa SPSS Bsnorrhoid* Spfalsetar Prortat* TmIoIm TBS CXSS JOISTS &esbtr* CIRCULATION^^-. Yarieoa# 7eisa ^ irfcario-ccltrosis BEHAVIOR 5 G*eml Speech Gait Personality Type V | -?.1* .*> -j;'-- -------- '--CHEST ` V'c- . \ '??. " ' - ... --">*. 'v HEART -rj_Jk "* \ -"Apex 1eat Loe*ttaa gT^*c) ^5^ ' ." -. r-*' ' V ' i>rv tami* '* ' i; *-*'> - *--- i * - > SyfttA a=l ScB5d -e^W*v ..-s> liSSJZZZr^tAQ. --1 f t. f- f -ssbcss : 1 Iff BEST 1 Paisa r ieso I 3i. ft1. 3fc . r 1 2*V APB3 12 XXB. UT2 EEStCXSE 1 - \hj5ir Stlologleal Class isatceieai Claae- ; Postleaal Cap. Pols*:- Cbaneter ' - itadrtA.3ipa,-- Dyejaoea, Cymsaii, Seci Talas, *" Tnitia, dea, Petechias LUNGS ftMESiSB $7 - f f ffaotile Prseitsa - as? Pareaasica .: '''-St,"tzs. 321 ' *04. isp. /*/ Sullssss. js# e i ; Breath Scads Brcasto-ees B.7.3. Brcsehlal 2.3. Toebla- ' &r*h. jv Sm<Ji Prol<asd &p. F.S. oesl Bn. asses Bhiap, Pee. T.P. Frictia Bab. Bales Sab Crcb..^lb4as Creb : seooSss 6C9 Coarse OCCCBcsshsa &9 * (T^l -2*%*'* V I v; 'I if : - " /: Or " t"*'- - -/ I Sesa Pulaa Vb ' 'Salzirt "~aigfet" - Astaal 7.C.Jcrral Y.C. Bare lb*. Sat. 'Kaisht af 5or=*2 - Iha. ,*rr acBjaetl***, balls* ^ talar***. j&raaastsi aanliai Titles: TUthout Clatter Histance at Lt 20/ , r 20/ tX V.th Glasses: Color Bllad ?'< - - -- iS drss hearing at at at fem' suout aabnawL aaytw >7 twgbjsataa 7 .u. /20 -..T I* Lt 2 -*S- Blatter: ftesrtalr at . Lt aeoillariea at _______________ Lt XI?a --- Buccal Jfaocaa: gratht VJL. --------T B0t 5 4 5 2 1 r- 5:2 1 C.L. 1 2 55 5 Z.XP -. . . 1~S~ ' 720 0 X `= Bartered IBaaltg Bad Old -------------- Tcaaua ^ jC^.<y+rfL^ threat* (a) tcasila fjf ----------- gr (b) (e) Harass____ TASag I. r^r. fto-*r*syfs~ ?S3 ~ 3- ** ^3-'*- -s /?. '' /lU<- . i i 1909 VaHU BW. | *"** > i__r**_ _ T* i tL Mm Pfrt ."- / 1 f. / - / JU-I^."-.! 7 i S'-.-' ' -.' /V.<y *< J? 1-/-J. r I ii **'-? ! /` ; rJ.\3-f-JLf . rs- J *>1-^-n /V \f.*-J7i J ?* y,,.* \K //. - j P> - ijr /';/"!. >/-//- *0 l * i '0 f! I//-//- *1} /i-lJ'-vxl - U.J- _ 1 WlAvgR____ P.w. 1 1 </!! Fu> t *-<*/*- 7-2r-H ! : *t 1 1 h-ir--. 7-J,/-- 1 -i/S l-7-a/.u^ 1 * ' 1 *un ' i'7/^cA' >*<<* <TZ 1 L-t9-i~\ 4--V-/J" 1 v I ' XJ~. /fa-tr-mL ' at --; ' * -- -?#~'C-y -?***.,*,~^ ' /K ___________.; /4 g___ r ***?____ , ,>,,/, T^. - e______V ////r 1* . 2--.- )faM ____.Mi_____an*~ l DfSaiTIMm Tnm I* | | r-*'! r-/5-Ai- ,_______ . . ' -. 71,/ -v. *- 'Oml r _?//-_ LA**; -/'. 1 <- I / .. r-n-J\ -u i^ 1 f.;. \jn//. J<r /J 3 - ' ^ !-ww!u fnu,**.i v.j 1 i-</-<* >*<:* H !/ mii -- - Batffct wnn -i !, , SmMOKI ! Tn. Mm. Siii 1 II. /. 1 1*7 . !/r.U? lyy v i*i V. 1 i-- iii.iii1. 1 1 1; l i 1 !. .. ! . i ,. 1 . .. i ,. ^--------------------------------------------- ir i .. - .. 1 Iii: III y iI 1> III NAME V^rC-uCt' C']\` if'fUiOvO Na / ^ : EMPLOYED '_g_ 5. <7~_3'l DEPARTMENT )-4S OATS DE7T. OCCUPATION .9,<T TIME /TZ . OCCUPATIONS^, ; | PATE J SATE | 1/ LEFT SESVICj/jlEASON <D-1 1 T-/i. f 7 L}- 7 1 1 '*/** ~~___ :_: _____________ 1______ f~j-_______________ /7fr__. ''`"-I .** 1 7 ' <lrfk i. \1 1 ! ----------- . . .. i ` & Fa 119 1-Zt37 TJ. S. ASBESTOS CO. Employment Stesrd t * iUf/y Dtaca tn bastDq. *yfti9ht ipnA. af tab . Hem ym e Kara-- Aar daae._____ Eftplgyd bat* bafcm -- 3sta. Ss~- . ., .-- Saps. Wta* tai /... jfasrJTSA&sz. -- u-h - -- la lot Uanrg , -........... - f* * bwor cantfy tart tfta 0amanam im&ta ta abara facte a m ta b-- of t kuawlatai aari babal eta pma gwa e tall wwi aettca wbaa iasrag Ceapenr ampler- I ata tanta tan oar auMtowata wittully mob* by a* will be aufanero octua* aar dusbora*. aar .r . -- * .;i. 5 ' .r t. -;V '%4-' **:>\. ;' "'- .F-. .- 4-' n*' .1 >. '"* * "7' a*~ tAi- ' * v -_r? A "V . * '-^1.-.^V r^ ; -?- - ~ COMMONWEALTH 0fr PENNSYLVANIA DEPARTMENT d? LABOR AND INDUSTRY WORKMEN'S COMPENSATION BOARD '4 *5BURG r REFEREE'S NOTICE OF HEARING 7ZZZ.Z*-- Raymond htawi=,24- S. "Vt'BPiott1 "Sfe * j " Stnvt Address ^:;elE, lane. Co.J pa. Otr Defendant -- - Addwaa H.&, Aar-**to* -w-i*.--of--------- Rsrreatos, ilanl?* ii, ------------------------------- Lar.c. Cc., fa. Petition No. 10*,323- ' '-------- Lar.eaater, Pa, -- V*rSO "Hj-ljrrcTi 19 To 1 To Lancaster, fa. 'S-.-.iA. Icr, ~rs q-.--------- ---- ~ M C.T-A &* . . . e c* , h.s ., "c-cr ;.c.l .._crr.xr,,. fa. _ fenr.a. Assoc Cac. Ins. Co., To --era.-g -. j Lar.tss tisi*, Pa. If you fail to appear, the petition will be dis posed of is your absence. Ail witnesses whose testimony you desire to present must also be present at the hearing to gether with such records as you desire to offer. If it is necessary to subpoena any of your wit nesses. subpoenas may be had upon application at this office. ------ -fetra-. Antoc-i Scr.-"2-a. Cc. ,------------ . --PTrascs Lids.* PhiladeljLLi* Pa. a *' ' * ' . * * . '* rm. * , rj-' I hereby notify you tint the above claim petition war be beard by me os "TT4I ID * 3CiTw* i A. ? Ccort 7Tcc: TTTTcurTT. . j.ccr. vcjr o T's'd', TJiV.f'an'icr, "Ss,.'f S': iJi rtrsr. OiMt X-itay Xaivrta fajoand Luitelc Claim .'flaabari 1OLA-93i fctfopeliUa Uf InawranaaCo^mny Sannay 1930 -- 1st dafraa ulmcoat* 1935 -- lo changa 1936-1939 -- Barfci.v* ra aora dafinit# progr-wa. 1930, 1935, ir*-iy> 2/2C/i5. (nr. *B*b) Tfca iiilar ahndOT* *r* r ad and aftoa a daciiad lncrm.aa i,, diaity, * aarVad 1* roala In Um rlidit and laTt 1 jMf loba i'w. n, 'tmtnv f risbt bnaa npraar* filrly Tha left baaa *rul tna '.*art eutllna, aapaeU'.ly t.*a lTt alia, ia ;uita fu:r lfK.1:.ractar. Tlia naart a-vadoa fl *n* aniarraaont. Dlagnoala i "i* efiiv* rn--., in i-- / i '. n^n'i aabaali'ala, T.icti c.'.iy of tiia t .l;-d at ,-a, Uir., Stuart 1\ >b, u. 3. yt5/6. (Or. >.b) T5>* lung *rxinp a:>o- pr*tio.-.'. ly no cJi.uiga :'im ji -ray at tha praaioua a- l'.-1 ainca Diagnoaiat 3Mrd Upa aabaatoaia, practteniiy no eii .nga froa an x-ray <tuipolnt ai.-ioa tha rrariona axjuiinatian, 2_~J/45. lobar* D. Saab, B. B, ; f *i .mrt.'.i 0. UsCaruiay J/1?A6. CdPJ-M.I1.4t--XM I t/ , PENNSYLVANIA MANUFACTURE' ASSOCIATION CASUALTY INSURANCE COMPANY WAGE SCHEDULE .. CLAIM NO. ............................. ' ......... /(iaiarad Isiiunl ..... ...........................................-...........................Z./z */P f. 7 (gamier**! (BaaaetAaaiaean THIS FORM SHOULD BE COMPLETED AND RETURNED TO THE INSURANCE COMPANY PROMPTLY. AS THE COMPENSATION AGREEMENT CANNOT BE PRE PARED. NOR COMPENSATION PAip UNTIL THIS INFORMATION IS SUPPLIED. If employ* wmj paid a fixod weakly, monthly, or annual WK|1. how muck? i (we.) (year) Data of birth of employ* .'J. fi xe THE EMPLOYE WAS NOT PAID ON A FIXED SALARY BASIS, COMPLETE THE FOLLOWING WAGE SCHEDULE: Hourly rat* paid .........................Number of hours eooat:(utiof a aotaal work day Number of day* m a normal work week ........................ Wcra meala or lodging ptovidod? ... Shew date of hire if injured baa bean in your employ lea* than three month* tDat* Malar**) WHIES FOB THE (E VEEXS UfHEDUTELT PKECEDIS6 ICnDF.M OK XlR T1IE PEXIOO EHTLOTEn Show total tarmac* ot the employ* la eacb at tke 13 week parioti*. but dv cot laclud* Upa or graiottlca.i i J 1 st period of 3 eoneecutive calendar weeks Total Wage* Earned 3rd period of ! 3 consecutive caiendar weeiu Total Wagaa Earned Frtsmj /J<V>4 J 'To (c /-. 5 s *'ri o 7 From s/Z J /,, *To . . / : J - j J r / ii 2nd pariod of 13 eooaocutiae i calendar weak* From Total Wages . Earned .. ^ 4th period of I 3 cooocudre calendar weeks (the 13 week* immediately preceding the accident) From /z.h uf-i To Total Wa*a c--I $-* ^<- NStOeTeEe:ksWIhmaioatdlbla*teelrya.pIororae'eadlu* til*baa*cucid1e* nta*rh*outorlyb*mduln.ddeadilylemi*u4.poerriobyd*tuoft '.o3uctpountae;pelu*tclr* emoircka),*aIhe*b.Atactd rtrhcenl.w-weektlhyatast,: computed by dlndlor oy 13 tb* earaia** Ic that period moat la.orabl* to tk* Injured. It la tbit proeutoe of ibt La* es,, makes aecteury ike etc* detail requested bertou. prepared l> . . e--smoww--urp* or wutmvMU iOATW4MT or I EMPLOYER'S REPORT =!> OU.O. SAW, t o- rJWUO"'PPMCN't OF INDUSTRIAL INJURY cam rwiin euoooroMTi follow CAOpnjbLr actaiuss iwp--uctjoim om IVIOTDQ COKCZU S^SAL, ST\TS* l&KJZZ glTLStiJ (1) N Rf <Z*tf ~fblvo 00m* uador wbiab Mirnra does bwoieoao) i (S> Otflao oilCross: Me ud Slmt &Ut .stavA atr (1) Notwro it >Mlm af *btae.Tatlea._ cm, LS5CU.1eir_ (O PUm *Ur iK4Mt iwimt (!) 0% EmpJorsr's PtiqIhi ------- _ <* Dot* of lomt JJ66AL. (TO ay Mr-- ^ Sot* dttwbtatr -3/S6M (b> Dot* teetlMt nftriMl tt wptortr -34A6_ ----------QiAah TeeAx* S CbiHm Ail. . nc u hail i t tat nil tt (tt tm tbo tar. .... 1 1 -- mot wo it: tmio coll* IwU'O * iooMrr US^WPfM* b*rs Wttoow OJT2ZD 1371422 mi mu rrtm im) "' diujSrIttttun ~ laA(j 'jtistk Afatlmlltf oir Km*) (!S) ^Addroo^K*. 04 Hmt atr .tear. didCIS) A ....5* _. _______________ ___ UO If uodor it. too Root fll* u (opIimMi oortiftooto_______ __ (To or Ko> <U) NttOf of Cortiftaoto ... ..... -- ,. . <l) Occopotloo tor wbiab miiil_____ _____________________ _______ 'an eiook <vi aumodJI... sStuopp!u* _- - MlOeki*AX .. prasN . -- J-J.l. so aciutitte--o ___--___aat)t)Rreo. .--oiMiitromt ----ddoor rttuytm. (11) (o) OccgpoUoa b*o laluUrrt*f&35 525? SumSo rsfulor oeco--ttm TlML --- __(SO) <o) Row lonp smplorod ait ioccupouaa *T weiob lajsrti*!^1^ (b> Bow wtf implored br roo (ST) .Sitatar of boors worked par dor _________ _______ ____ (St> Bomber of dors worked per work __ ________ CJ> Vue* T**r hour t T*t dor I Fsr Work > -....... Board or lidding CACSf OF ACCXDZST (So Whoi wos orapioee* deiap whoa n ecvtdrat ooettrrtd `ri 11 ......... iDooortbo inert? os loediap truck. operattap o drill pros*. ta--uA. Nctora.OniT 0--CMOC*^ 0C6UWOT1OI tlwi OMOU0T WAdl SOSbCT root1 ACSiOdKT T> bnvriiap din: palate** witi sprar no otc.) rkot metbiae, tool substene or obj. wos moat ctooolr eooooctod wttA lbo oco (Romo tbs maablos. tool o--uaoce. --a. llootd. its. Ibooload) (SI) If Boobloo or oobteto, wbot port of It --------- ------ ------------------- --................ (tots If poors, poilor. motor, ota.) (ST) Bow did Lbo oeeidoot boppot?1^*^ ^F*Tt"ITT* 9 *2W, + (Doaoribo (bo aoetdeat four. noHap whotbor injured porooa (on or woo struck, sic. jrUl rotrasay 1%$ tAoca tbBj bsessaa of xpY.iv3 ,traJS?car-adt_to ood oil footers eentrlbutttp to lbo Matdoot. Doo otbor tido for additional sssso) _Clstrt Facias, a^ssteest._____ __ (SI) Woo tbo mocblM. tool or obloct dofsctiro tt oor y* (tt) U -- bow* UMSA/I AC acis. OAFS rcowoM. oor MATwad bOCAriOM SOAOOT uo* (St) Could tbo oeeidoot boro boos prorowtod? (SI) How? (Spodlfr br lUumtaotlop. rtUottbC, roploetop. prwndttp roppJ-- o--) (tt) Woro mochoaicoi cwordo or otbor --doe--r7 aofopwords (swab os poppies) prortdod fSS) Wos iwjwrod --tap tb--t..................... ............ .......... .................................-......... -- ------------------- niai ud LocinoK or rsjrrr ok occcrmosu, putisz no .........................isbestssie fDsssnbo to dotota ttii'Itttwrt of tiio ttittrr or oeeopof/MTol disooso. ood tbo port of tbo bodr oifeetsd. For ssompls. IHSUSAMd. OttoaiUT* PorwCMT w Ampototloa of rlpbt onw. erwobiap Ifl)ur7 to etui offtatod rospirmtorr troat. skla lafoetiowo. ota.) (SI) Attoadtap pbrs^vfoa ood boapitoi^*...P.?_.Mb..^Ci^J...JS^3^** ................................... --. (Roms ood oddrsaai (S<) Roa omplorsa rstorwod to work? ___ _ (ST) If so. p1s dots .......... ............. (SI) At wbot wklr. rtf* If ompiaros is Claoblod. prebobls Isaptb of dlsobillijr? ..... - ------ --................ ......................... *)? Did mjurr rrsolt la d*sth* (<*> Tf o. nr* dots _____ L>5nU5C2 C111ZE1 i) FCNNSYLVANIA MANUFACTURIBS' ASSOCIATION CASUALTY INSURANCX COMPANY truck Otic* LANCASTER. PA. (41) Dot* of ibis rsport ...... ........................................ .................... Ifod* out br t Ofltciol poiltloa ?R^>CCr2Ri ........... -- -- i* rsst sf mtas srridsatt_noKw-T --*,*"*"i*.*.otbr_sidv__ occ. Oio. T ACC1DSIT REPOKT 3. Date of Accident \j?/* 6 /** 6 ( a) Day of Wee* ___ (t>) fiour of day ( c) Dote -linat 1X1 tv be/tea '^/J- '*/* i. 4. Nuee of injur*:! salovf:*: f - M s'< *'>'< p -~^ (b) Hot.e eddrear^VfM^'t *yfc .(c) Aij*-.Jwiri/y --J-L.rt (-} 'H-rieu, sii^le, or widowed ' "'*'* < > **- (g) So. of children under sixteen yearn____ (ti Kvuri.fi- Qt.il? earnings * (c) ligaged in whnt trork.-.vhen injuiud_ d /i. I j[_ ^/~*y , "* ! V' ; >' /i- (d) In whet dspnrti.'mt Gt,-- -* ?CuW, t (c) t.:;s fcl.i.*- tr.a regular occupation of injured persou_ Describe in full to v -.njclUtnt occurr- a, stating c.*:u.:e `fr sj^ *. ^ s. i '- * *7 y /> ^y v^ r elua.'iy lu t~- U. J ^4- M i.-, <S f ,, . .-r. laj Kind of iO: ;:'-la*c, tco.. ,<*o- C 2 2U rrcc* ji*- ~r jL. i&nc: it.'. -dilon uc.c( (bl Pert of aeoMne or device causing eosii*5r:t_ __,' ,\iv A (c) Power Driven Band feed cr seeniniuni A (d) ..ay s*fegUErd remove- at time of acuiucnt^ ( By wtaoe S. Mature of injury as definitely as possible \x p*\ s.f X y (a) Part of boey injuroi (right or left). .* (b).Attending physician or houupni to 1: CTan.0 ^ A'S / Adarors v ,(*.:) .a. m onployc: rut..r-.*u to wori:_ \ i r.) If .*o, giv. dot* i it Cv ( o! If not, state, estimate of probable length of disability .* C-IU-A--l#-Utt--& In re: Claimi Ni J. ,4046^21__ _ 3-26-46 Aebestosls We acknowledge herewith receipt of the above accident report in duplicate. In all future correspondence concern ing this case, please refer to it by the claim number. In all EYE CASES, see that the injured employe gets im mediate attention from an eye specialist. V ery truly yours. i'em*sy*Vail*a N.diiuiaClui'erS .Ass<JV?aiiGi* Casualty insurance Company > E. or.usiiK >T. uun'a.-t?:; r.v r-- -I Fora Uv'p-ZS* ccao^jrasAtrs of pshssysvawia ESPASTKaA'T 0? iASOf A/JO DJCnSTSY ICH&SH'S CCC&Z2EA?lCa SOAPS) HA33IE20B3 j asF2EuS'a ifotica of posTPasaasr V 1 gll--It i &SC . : .a-rlctte -t. ) au,cw f Straat Addraaa City I '* ci* licyldo; 1 nrv i. Dfrdf-nt -< rn=&. Useiwter, ha. Aw 10, 1WC, Addrvss le.j.n: Kart is, o<.,f 'fC ... --is . L 'If!: : -or, V~X . * To_______ \ L r .... -* .................................. - - --T ` " *it -. -s*.., '/c:ao. rSt To________ > ^ ^ -- -S., t L .es .s+str*!*-, 4 ' /? >' * - * y 't . _" _ ' .-a. * ''.TV; - i*"- -* .? **. ;:-. :.. Sseiiyj Aae 25, 136C, Hearing 1& tha above e&se M*fc tw sat *or. 10130 A2| Court \cuof lA^cast^r# fa* has baas. jcs^ponad* ^ rff=T1 --------- ____ Cr*or/t flUfaraa)* I -4 ':sh- 249 South Charlotte Street, Nnhela, fwu. doguat 1949* State Vorteacu'i taeureace Beard, i Johneton Butiding, 9t Bapeond Ludvig, Harrisburg, Peana. 249 Seata Charlotte Street, Masheia, Penal. Dear Sirai Cheek number 44230 3, is `he etst of eight dolltra (te.OO), payee rUy-nd Ludvig, ia enclosed. Hr. Ludvig vaa stricken tad died S-17-/.9 before he eould alga the cheek. Will you please h.`Te the cheek aide payable *.o Era Ludvig, Vidov of Bayaend Ludvig, 249 South Charlotte Street, Kiaiieia, ?eune. Thank you. I an , "try *ril7 ynrs, %'r' ... *'.tj "SSEsT^". cab*. aggy * UCS |--MU- r. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF LABOR AND INDUSTRY WORKMEN'S COMPENSATION BOARD HARRISBURG i kefbrze'S Nonas or hearing __ JUSSc&d Lud3.l* _____ CUi&ttt ...249 a. c;rlotii st.. Stmt Address Vsghat-, P#nTA. city Petition No. 104*522 0S.A*Leotos BIt. Defendant . Address peas*. Jul7 2., 1946, . . Lane as ter, Fa* To Riciawd- liart-La# isi,-., 40 n. suite St*, Xonra.-.ter, ?enrj* ------ To Paul A. tiaellor, ri+q., _ 45 H. WuJce 0t*. "tine ct. tor,*' Tear*. To Bai--* ,,a,-nej* --- -babe v. or Icier.'a Ins. Fuad, fosr-srer. rids*, rarr-iturg, 7a. If you fail to appear, the petition will bo dis posed of in your absence. All witnesses whose testimony you desire tc present must also be present at the hearing to gether with such records ss you desire to offer If it is necessary to subpoena any of your wit nesses, subpoenas may b had upon application a; this office. To gOSSSwrS-r AMO, CSfrr- IhOr-flO, ,----28 3. Oraare St*. Lancaster, ?a, (and) --HiSaei- SI^TT^lIaKI^YanPaaa e*,--. ' ' /^i' V- , * -T'_ .. ' , I hereby notify yea that the those claim petition win be heard by me on------- ^ui?-iv-ia|6r- l&tSO A.H., t Court Room ^4r Fourth Floor, -Court Hours, lone an tor, ip(nna* fb. Cl* la D*parta*ut #4046-921 Bayoona ludalg * U.S.A sbaato* 01v., _EAB_' ; 4\ u - Compensation la, accordingly, aaardad to "aynond uudaig, tb* claimant, at tb* rata of *20.00 par aaalt (66-2/3* of 931.1$ bain* Is azeaaa of tbs maximum under tb* let) froa April 2, 1946 and to contlnua thereafter aa long aa tb* claimant la totally dlaablao witbis tic linltatlona of t&a Paanaylaaala Occupational ^iaaaaa let, effective July 1, 194$; provided however, that tb* total UaolUty of tb* defendant and tb* Coamonwaalth of Pannaylvnla, tb* Stata Wortaen'* Inauranca board, Cuatodlan of tb* Occupational Ulaaaa* fund and all parti** defendant, aball not xe**d tb* sum of 94,000.CO. Tti* compensation la to be paid jointly, 8<J* or tb* sta of *16.00 par a**Jc to b* pain by tb* U. S. iabaatoa Uiv., of Raybestoa-dannattan, Inc., and/or tb* Pennsylvania Manufacturer*' Association Casualty Inauranca Company, Inauranca carrier of tb* defendant, and 20* or tb* aun of Va.OC par * to b* paid by tb* Commonwealth of Pennsylvania out of monies to tn* credit of tb* Occupational "Isease fund era*tad lntb* btat# Corines'* Insurance fund. lb* above order la to bear intarest at tn* rat* of o* on all deferred payment* according to section 410 of tn* *ct. Craft *1731065, in tn* amount of ajoO.dd, vnlcb included 7 Interact, ano ^ tba compensation fros 4-2-4b to 9*4--4b lnd, daiivarad to Richard Martin, eq., 45 OuX* at., ^aacaatar (Counaaa for tb* Claimant) f'Vf Srv 0 . l f^ r ,, * : F U I'lltiW H M i| )|M fW I W > H m yH l.|H , IH M H i -J iUcsm-iu u-4t COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF LABOR AND INDUSTRY WORKMEN'S COMPENSATION BOARD , i HARRISBURG ; i BETEBBE'S NOTICE OF BEARING U175. - will x; sr 'Aycapid Ladyir. Oa.t.c..a..a..t.................................................... gre*<nry-O' -hATlOttd .'t. Street Addreaa ; gga PetlHnn No. otr V4SiS24. Defendant Addreaa Jbnsv-s iv. cf . i.ycn ; tos--: anto: -At ans. .Vihoia- r?na. LrtfirutSt??, . ;i tv To;':*/'*- ' **> . i - > i.. 19 To To ..til ,,t.lr.. . ` Jor lutl "l' -Ajpj-s.... s--;T To fra--as. Cc, `' -rShiJt . -) uXT-jUr.'j * 4U4- ) -- -IlraaMi .dl l.;., j*.iU al^Ut t-a-___ If you foil to appear. th potition will bo dis posed of in your absence. All witnesses whose testimony you desire to present must also be present at the hearing to gether with such records as you desire to offer. If it is necessary to subpoena any of your witnesaes. subpoenas may be had upon application at this office. I hereby notify_you that the ahoee rfabn patftjnn win be heard by me on 3toafla5> -Eatesary H, 7.93,_230 . ______ ~:tr: t-n ."'O'* ftrujOi MiywwyMew tAmieMUt^ e -rwieyBiai eiailr-i:yTiw -m U.1M w *uuien.V4jnA ' "TATAt ' ' clam rerrncw for ccl2P3?isatton BY DEPENDENTS FOR BEATS RESULT ING mots SILICOSIS, A.VT3IUC0- SHJCQSS OB ASBZ3TC&3 assort or i- - -- situ otacsT*? areur or womrvs,":. ooMrEtsanott noiira; _/*w______________________ 5173 '-[ >*~t 5>Ct-|fcA Gsa^lotfcB >t. a*im p-a" ** SSr81Anggt 30. 1949 18- ^-^avi-gsr-iA- V* T. ___ PaOsAalaaSa? ~iYs -t^-5jso*=-q*T- -' ' ' . lac., '____HJShBi-., ircxa. m Etnr TO THE WORKMEN'S COMPENSATION BOARD, COMMONWEALTH OF PENNSYLVANIA: Tin Petitionerrerptctfully represents: L' ...AasRSt*.____________________ Siad on -12ilda? of 1*3 . as the primary result of 2. Tile decadent had been employed is a hazardous ocenpatio*.having ej^Jatosi in the Commonwealth of Pennsylvania for at leaat two yean is the aggregate during the eight yean next pre ceding diwfcility u follows: otjCaaM Baplem I riilri PnaD*t* of Eaptoyntnt -- To lavuostou >ur*Mt ttvirr , Ine< l^nisria. rcniw.. LW2 to rAJ>. 19k*6 3. The dependants are as follows: *-- Bobson Siva ti Lslwi#;, 2V? 8* ClOTPlCttiO St.^ WtT* *.ri * * * - -- .. .' *. * . Beadiei; total Bins *U| A If claimant is a widow crjrid-jwer state date-srd piicc of, p^jriage; and if marriage was a common law marriage, so state <^a * -3- ii** *V^v _____ S. The decedent waa last engaged in s hazardous occupation haying a hazard in the employ of the defendant on--------- S&ri?-----------day af_*2???"*---------------,,----- .____ ,. A ^Ths decedent became totally disabled on __ SR____ day of __ ________________ 19 _Ty T. Bid the deeessed employee receive medical, surgical, or hospital services ? IWe CTe aiarlay ftfcl &sSLe Si* <ssa) By, fcagr, nsriiiso ra. 5. Whit wen'thc trpmiw of that Ui rrTreat tad burial? rE*i'il--i^ ITS JU. ' ' -Hub -tbs employer paid tar put of that*, if to, bow much ? .ACTS . . - Tbw anakay wise* of tha dancient in the employ of the defendant was t TTiii i? 10- Wee oomonnatfian.paid decedent between.the,time total disability began tad the data of hie .death?. *is< * -a.-rf-i d ly-n? osgifi, Wherefore tha claimant ,, aalc-- the Worfcmen'a Compensation Board to males an award that tha Defendant shall-pay tosh compensation ai due under the Occupational Disease Compensation Act. Subscribed and sworn to before me, this --3^"L TSaJi^m* ^Sva' 2_+9_ oc--'-i-w---i-uirijptta Stee Kaoiais, rORsa'a -dayof _________ lsfcS- w/ *4- >5*. . - * M-- Ci--miuw iUmi * mv mmr "* * -TKEib B. Dei?, My tjommiaeion Expires on------ , --_________day of _19 SLOfJCt NOTICE: This petition may be signed and sworn to by aay dependent for himself sad aQ ether de pendents. Please ester my appearance for petitioner NOTICE: This petition should be filed in original and five exact copies cither typed or printed. The party talcing oath is requested to-type or prist hid name and complete address of Petitioner sign ing this petition. It is necessary to make affidavit to only the anginal copy of the petition. Buie 41. An employee shall be deemed to have had an aggregate employment of two years in the Commonwealth of Pennsylvania during the eight years next preceding disability in an occu pation involving a silica or asbestos hazard. (a) When during any two calendar yean in the preceding eight years he has been employed in each in occupation; or (b) When be has been employed in such an occupation daring the eight year period for t total number of working days equal to twice tha number of days the men employed in that indus try work during an average year; or . ' .fc) When be has been employed in. such an occupation .during any twenty-four calendar months during the eight-year period. This fora of Claim Petition is to be used for disability resulting from the following occupation diseases fisted in Section 2 of the Occupational Disease Compensation Act. (k) Silicosis or anthraeo-aBlcoeU in any occupation involving direct contact with, handling of, or - - exposure to dust of silken dioxide (SiO,). (l) Asbestoeis in any occupation involving direct contact with, handling of, or exposure to the . ..... dut of asbestos. The term "Kaardcws Occupation" as used is Paragraph 2 of the Claim Petition is defined in Bale 42 of the Workmen's Compensation Board as follows: Bole 42. Every occupation envotvmg exposure to an occupational disease hazard enumerated is Section 2 of the Occupational Disease Compensation Act shall be deemed a "Hazardous Occupation" aa that term is used in Section 6 (b) and Section 9. Buie 43. Anthracite coal mining shall be presumed to be aa occupation having a silica hazard. Bale 44. There shall be a presumption of fact that silicosis, enthraco-silieosis and asbestosis are dis eases which derelop to a point of disablement only after an exposure of five or more yean. Aay party in interest, however, including the State Workmen's Insurance Fund, may pro duce evidence to show that is any psrdeuizr instance the disease did, in fact, develop to a point of (jii-S'<r---it during an exposure of lesa than fire years. _____________________ __________ 4 r iC v. I'- ..f-.a--: M^r- ..v .m>* r, ... ..V . l* :V < > - / . * _ :`Z~*&4' V*' ...yLJi1'' - : . r._ ____ rt OMnMr V& PA. # , . DO NOT WA TMia COA. ' , Seas C02?EN5ATI0N INSURANCE ' -- CJL++* or. CP'i /./,*. CMPbOYSA eowrr ^` iiidajT--------- ' ~-rt f-T-r <T Ttlinti fnd.,1 >- / 7-*f -- -- IMOwfTt- o*rt AVM WOA. ^ S* ----- - MTS l*rf**W*i .. 1-4-4A ! jKa. 1 g V i S *, * /*. .--A-.* :^:Lz:rx< *J~H. OaUt-U* X. SMt nai DATE . Lia/ra At!^*4^gl_A^.-Lgl ?* */V. | z7.7>l>-r7-~* - OVt^UM OCCWPAtlC tin* im<vs> "TTTITJn P 1 .A/./|fc'fg+-a fcty,Ir j ^!ee ^ ? 4 J.f ^ I - - 8777 7alt.*-**< i 7777 <77777J) ... 1 _ i7J*--.-7j>s*'*-.*.7>-' 4 r --2 . < .aA.* 1 .P' 1 * .a> t *| s 1--<-!) 1 7f ? 17 1 I t. * . * 7 ( ? 1 <7:-<W ><-A *7 I x-<? iisSL. j / - &0 7 7++. t Jo<?ai--S 1 6/l M pr .r 1 1 aa J &"*t +0 fif-rJ},o4oSf*P W?#! al -Vj .J J o.i '^1 **UV*,4.nj <w7U_g, > *91 i-f^0OlCSIk ^dzsssn 4^i mm l*^-<jrs *n ..-J iaa fl a 0 a. f^egjjwg .?ift,.4'j 4* !**%-} -PeI 1 ' 4 ^Witip^iia if' ir._^'-!t_i*-'*L( y c.JI .2r ? ii -0.?.l/ft eaf, /Jt,r diiasuz* fr-V*-** I t^L~.*JV7i . ft oc,__r_/_/_I__*_l_._i_SZ>c/a* |i.<|. +11 3.n.j. <t! ** ^aVI. #<wl 6ioa t^1 tf tt.J*I wU fr., ju .yJn-.uaa.t.*?: ** ^T.tJ ------;________ 1 I 1 1 ' - J.J j1 ~ K - K ' i r.<j.*'Vi:5V- 1f.7w''.9 3><j-t.- ________ *) ^ ^ ^ *< ^ ^ /aJl ,`.J7~V ^ . . .. .*___^ --*Jtr?i r> i__ _ r n n1 s __7; ___ , ^ V - A4( <MCr PAAT ' ACCiftAMT T> UM#( AC MC6M SUIt rUMA. OCPl IU& ^ATKfiT t_fc a2* -ajrma----------- 4/^nf4^' (a) Bay of oel:----------1.----- f-j> Hour of iar (a) Date disability bes^r 4. Naaa of inJure! eanal'-yee r ,'l) HOiM Addiss.. ? / '.' . Vi'/.-Si *7>1|.<k>' i (o) Ae i+) lurried, single, or widowed 1~' a () No. of ohlldred under sixteen fears S. (b) Average dally eernlaps ' (e) Engaged in what went when Injured . t J > (d) In wfcat department (e) Washthls tte regular occupation of injured person *j< 6. Describe In full Sou acoiacnt occurred, stating eeua* clearly. SI -si/ . : . ,t. . (a) Kind cf machine, tael, c r spyi.!ere<* with which :.ce.d.rt cceurrad ib) Par: *f machine or device causing accident ___ (c) Power Driven _ Hand feed or nectar.tee! {,,! Any safeguard raaavcd at ti.ue of accident _____ 3y Whom ' ____ .8 Nature of Injury an definitely as 'cssibic ^ (a) Part of bedy injured (rifht or left) ' 1/ 9 (b) Attending physician or hospital: Nana &+> & uJ ^T- ~ Address -n-.-- (c) Has employee returned to veric (di If .:o, Siva data __________ : fal If ret. state escinat- J M 0.1O.A--IUIl>4t--f ' 'T'C^rk In re Hayoocd Ludwig CUim No. 4042-1373 4-30-42__________ finger.hand Ve acknowledge herewith receipt of the above accident report in duplicate. In all future correspondence concern ing this case, please refer to it by the claim number. In ail EYE CASES, see that the injured employe sets im mediate attention from an eye specialist. Very truly yours. Pennsylvania Manufacturers' Association Casualty Insurance Company or wmmvMM utr (tiio/t o ura amo wawm* EMPLOYER'S REPORT OF INDUSTRIAL INJURY smpkam or wo*a*c* ecu*cmsatiom . r1 KWlIUffl. $A ... r**s (MMQPTAMTi FOLLOW CAJBdPVLLT QgTAlLRD IMQTCUCTJOaK M MVVM **M EsrLOTEM Conrtt* UCT^ t'TT 'TCj STTTvaC* o> MW* of Xy *y .... _ _ , ------- ---- lOlv* **m undaf ardW* bmmemrn <U* ^ 4 4 5tf) Otflda U fM: Xfe Ml nrM( --y Ji*lfte S. . Cmtmif . m rmbn IftuarfactfWCT of Asbsatc ?o*tila________________________ (UM prfalpal pmW*t r btiKh nf tM wiiiw) (*> * inMmi *rmumd-------- . Jfcflhota. ....... - (> 0 rwln> % Pfmimm _ . City ** *'* ' Ulnittag (Two !( . S*l* f AmIObI ... MiM.... --n> fcr. I Ait--. *T3I U) Hu iaj. Mm MOiir'i 49% onia diandtttrr tovsa -*000 . (Id) '*> tH rL oM I* f*ll fur rd# daf tf*u au m) (fl> Ddta adCJdal fvpMtaW tl J/JAi___________ so mot wurrt jm TMIO C9LLMM "AwniOTi* mo. eow4*rv UWfT"4 0*rx' 1 iIRtt cmcus uPLorzx Cli) Mum . Bwsswd (First H**4+> (IflkWurjaittii) """ (UBt RMti MS) Addmaa: Ha. ud firaat --......____________________________________________________ BKdeiai("Tty rtr.tiMainr r IU--) (IS) .)# .. 49 <14- ____ (14) If MOr >*. rau ds*a an flU an Rptormt rvnfSrata (TM 99 *a> conn. cawamoM AMO IIS OtPfMOlHCY oe&u*.rtOM Mi) limtor mi ftnitaata ------- ------------- ---- (1) OtniMt^ f* Meh lauvnd 41?) Cda* (V ) Mnrmd ~*uew - - Mala <* Kamnia.. . U. * CUIMH .. - <U) .V*. HiMrn A<r It m. Mi) (*) *4i lnfora*f Wadaa* (I Vi* fli(# mpiBVMV r*ntir wwim^ .T? ... TlMC iMFwOTte (Jdi >mt )|i )uc amuWyad at 'M*rVlloa at vdlrd InJaraW id) Haw tan* *mpUrH d* fM .* --___- i SM NgmKr nf dVtir vraad imt dar . . JS) XanMwr *f Of* wurdad par ward 'SJt V!i|M I'rr dour f )'* f t**f ffr*k I B*ard *r Trfd*la i CACbz_ar A( < n>r.M i (SO Timc m i4 ^ ^^ 4m(A Lr*n (Ikv KvI4m| irurvTv .^ <rV*n4* hrtfi) Uim4tma<g * KfMradac A drill t**r aCAiOfMT TTFA rtoM-*(l*u Win; M.ntlitr vidi 'p r*4. ntl mr(!. *th<Mr *(*], a fuaat ftUBMiiW wtlPi ID* m*. irMaadi ad? iStfM (* (Mi'#'**, tfc*L *tUam *. ^v Uaui<L tc. vulv*o (21/ If MeRta r vtnieJ*. vuai part >*f it ... ... ..................... ............ (fl*a If vra. pulltf. (#. ate.) <ST> Haw .l.d rha C.M1 m..w Tftsssd itir !acJt cad rLp;t off r4 fall on teal iDtaerifea tha (Cendant fallr. **< vaaiftaa injuraW paraoa f#U ar w atpueA. ate. MICM. OAFACT toa. eerie <TuaC 4 all ramar* r~a*ntwMn in tk arvt4t. Vm odtar ihJb far uUIUmaI i IrCAMOM <tfl> Wm (da naeiina. tMl ar ad)ae lafaativa in any nr? ________ _ ... (St) If an. fenv* ......... (14) Catf tda iMiiait hnra Man prtviBiat?____ __ Ctl) fl*v* rppmtltr dr oinminniiac. rantliatm*. iuolnws. pmMlaf facfln. ado.) CtJ) Wan uwfmiai mMi nr atlar 1 aa/aronrCa (nonfl aa ya<rUa) irartM . CM) Waa tfUomtf otlse tiaaf___ ______ }UTCtl AXD LOCATION OF CTJTST OB 0CCT74TJ0XAL JXSXASC <m> .......... teaa.cf^ri^S a*a8jjd..taa.............................. ..._ ........ ..... ........ ... ............... (Daacrlda ia aatad Ida natara af tiia lajurr r aeaupauvnaJ diaaaaa, aad tda part af tda d*4r atfrataC For asampla IMMllAdCl -sn HWTt Ana'aatatlad af rfydi arm. rroadfnc lajory ta adaai. ifwnl rrrpiratory craef. kfo inf*atlna^ ate.) U) Aftanfllnc pdrUiaa and )ap<f3V 2m...Ia PcfTL** ....................... (Nama and addraaai (St) ff rmpleraa mam+rf m mnrbr ft?) It an, firm data . .. .. (Si) At vdat vdlr. vac** - IS rmplnyaa ; diradlad. prabablr lanctft ><f diaadilliv? ... (ii) Did iaiury raault id d*ath- fl*' If m. fir* data ............................... ........................ nsnu5rt cabriib MS) WtNSYLYANIA MANUFACTUHCJtO* ASSOCIATION CASUALTY ifcSUftANCS COMPANY SrtBen Ort'ra LANCASTCH- PA. .. . i/Wu rMil oirf l.r i. y.'alsa__ _____ occ. ota. ti r.^*gg==~- ACCIDENT REPOST 3. Cate of Accident .(a) Day of Week_ (b) Hour of day _______ (c) Date disab^liiy began, j> a.; 4. Nane of injured amBlovae / J" (b) Hoae addressJ*^ % Age^Ua*tj 1 ^ ^ U&*V, .-r- . k: ` ~- (f)- Harried, single, or widowed. ^svu.u. - (g) No. of children under sixteen years 5. (b) Average daily earrings (c) Engaged in what work when injuied_j (d) In what department*-1 iC -C. -i'*' te) Was this the regular occupation of injured person______ .6 Describe in full how accident occurred, stating cause clearly _A. It. < ** /- A T ' ri /, a- / /, '* "/ t /--,--------- 7--.------- ------------------ r-^r- (a) Kind of aachine, tool, or appliance -with which accident occurred / (b) Part of aachine or device causing accident (c) Power Driven Hand feed or aechanicol_ (d) Any safeguard removed at tine of accident_ ( By whoa ._______ ________________________ _____ Nature of injury as definitely as possible (a) Part of body injured (right or left) ru.a (b) Attending physician or hospital: Naae <. ____ _ .ft'a > ^TT, Address________ __________ ' (c) Hes enployee returned to work (d) If so, give datc __ ,. (a) If not, state estimate of probable length of disability ! I I-`> ~`-a t=i . I * JJ7-0--MM torfafe^t v it Mr* la re: RizaowD Lrora; 1-6-44 Claim No._________ ..404Ar.iJ.____ -------------------- --____ ____ We acknowledge herewith receipt of the above accident report in duplicate. In all future correspondence concern ing this case, please refer to it by the claim number. In all EYE CASES, see that the injured employe gets im mediate attention from an eye specialisr. Verv truly yours. _f Pennsylvania Manuractuiers' Association Casualty Instil ance Company r! t -. -4 ni 'nr riWir. i 1 f >111 PBn^ . T !iarsgt1yi- PB1.1HT H IW S IW IIM S , t l B W ^ - e v rp T T P r^T --^nT. f f i . W'Sg.ee^ ^ w I<tf - -* ` r March 32, ISM. Or. C. U, Pohl, 210 ~est Hih Street, 'lanheis, Penno. Osar Doctor Petil: ft* folioei.v is a eo-y of the rerort o' the cheat x-ray ef_- ..end iud<.l. This ensst x-ray aos t-dcen 7/2^/Ui and read by Dr. Juti. : '2 5 The lunc c-r.i.ics ar.o-.. r- cticdly r.e cU nre fr .. '. t.'.s rev; vj sx-'l ration. . jt -a; \-t sires .1.-.-noo is: TuJr* shu -e l.esioaij, -- ctlx-lly : C.. " e fro- T-rv at nd? nt sines ths revi-us cs. rv.t; r.n, 111rjObert a. je..b, . .. 2/22/45Ths .lilar an.-.aoT.-s re *"1 ryed -`Jid ar.cm :: decided ir.ers se i:i density. A narked fibrosis In the ri^ftt and left lersr lobe arse. The co-tour of the rlfht btse apyerrs fairly nornal. The left lk.se and the hu-.rt outline, especially the left side, is suite fussy in ehamctcr. The iienrt sh-doe shoes scout anlsrrcatnt. Di.Cncsis: The i:ar.sea msont, in riee of this sen's occupr.t;on, Indicate ssbestesis practically of tho third sU-c* Hebert C. Snb, K. 9. ' T*y "truly your*. csrra statss a^k-tos dtttsi h of 3a}bestae-lbnhcttw Inc., ioc-any iiurae ?r.d .-.lay Technician | \ fIrrc. -I S5-1M U Nra) WMWwtuni of xwn.u MmAtmckt i t- -.r. t -r . -t scrunrsre report OF INDUSTRIAL INJURY Ui*. ,o.rMmMomIiIMMCMM`a9 ePeA. rcM* WMMANTi W1U flW CAACTUU.T DgTAiiCS IMOlUMCTfOMO OK A aazoma cnxma tSEITS) STATS3 ASSS?OS C77Ii2Qi . *-- ... - astaltf *a&agg -- SUSTfS: <t> OCk* nm: Ik. ut IMI -------fact CtSMtnrr . Cmtr (4) <> o splayer** a> Osim-KAl W1n**ng TMtS COL bam qt MtefT 4} Ow* f iwU--t Dstt dlaabtllt? k#M () tell Mtliwl repaned M>k J/8&JL ------PH (>l Mr. tel twi no Ml f tel (aM UHlkrlUttr. fWM M4 eddr cucxn xxrwrn <n> OPirst JAum) middle I&IUSl) IfiddLi (ULmt~< Warn*) /NteJessJity *r iui S*iU) AMnh^ (U> A ..att..f9eftj&*setU stmt..______ rAtw., ... (M) If esder if. did yes Hare as Si# a* rmplenseut certificate ____ (Tm #r Sot HO Hunter f rertlfieet* ____ ______ . .- . .. fit) Oempe*lbs fnr wtleh Instil ..._____________________ _____... 4ir> rteek /*) Married* Vnelc .Msle* female .... XL & (.nttse* ____ n*> siutrm water if m . toSSSnwc ESSwTcomI TSTBSt (lb) /el ocvuoetia* * ------------------- .. (b\ We thin employee* regular Acuueatf** -- fje> <a> Hnv long egupjered at wm(te u blaIt lajvrad ---------------- /b) Hmr Jang employed by yau - .ir- <21} N'limte *f hear* vnrked per day ........................... ~ Iff) Number #*f day* work**! per week . <fj) Wage*- I'er h*ur 1 cause or accibest Wr ter I t'rr PVek | |mM r l^lcinr /}) Wkai wt <mpi"r# dt**** when tte arculeti! i>acurr*i <J*errtte briefly a* ruck. i*r*iig * drill pre**. pan t aftciotet MTtl9 din; ptiBimr rul spray sun. eta.) (ft) Wbat mashtse. ibel, whwat er tel. va mom cieaeiy esaseatvd wut the ms. .* (Name tte <M> it llatetue er reticle, wtec pan af it bice. tael appuascs. gar. liquid. etc. faenired) - ^ ^ tftate If rear*. palter. mater, eta.) (JTl Mv did ihe Meiteat teppfi? to report onl\<." asS ilocelcratijW- _ - , (ttencrlte tte aaaidettt fully, atatjag 'eaetftrr injured peraun fell er waa atruas. etr. f ttajpr taa u adriMd to bis tfootor fee ciii-sats. aad all baton mttlNiUf ta tte <(. L*aa atber tide far addiuenai opacoj (SS) Wa# tte maasiaa, taal ar tejeai dafastIra (a say vayf . (ft) If as. tewf (M) Ceutd tte earndeaf bare teas pretested? ..... at) Ra? (Specify by inssiisattsc. rastUaUPS. raplauisc preeidia# ftttm. ate.) (IT) Ware tetehaaleal fttidi ar after i i aa fofflw) provided . rff> W%m txuared satsr tboaa? ........... 5SAirae asd Lociros o?. zsjtxt m occrr.vT:o ju, disease 3n<t ........ teiiHt-j aad acniorstiea -sf rtAt aUd o fla^r /paiisrlte Is detail tte satura ai tie injury ar aaeupatie ai diaaaea. and ttte part ef tit^ body atfaetec Tor rsamplr. Ateps'u4jaa%fVirbt ariiC enitefas lajury ta eaeiat,~iiffoc; odreepirm io ry tract, akin (afpetlans atot) "** /U) A/tending psyM'ian ate kaapital ??... Fosst^........................................ .......................... (./ama ana eddre*o (If) Hae melnyaa returaad ta verb? . (17) If aa, give data .. ---- (SO At vaat ekly. wage * Sf ampler* dmaled. probable lengtb af diasbillty?.................................... (ft) Did injury recall in death? ....................................... (40 If aa. gite data Z3rsrXA5CS C1M21XM. (41) PENNSYLVANIA MANUFACTUPCP5` ASSOCIATION CASUALTY INSURANCE COMPANY BtenrS pyica LANCASTE* J*A. . ACC1D2HT REPORT Date or Accident //V A*z (a) Day of Week (6) Dour of dav i '(e) Data disability began ^ Sane of injure! wculovo* 'S . " /y (b) HoB-e atidraas.o-A,/ (c) Aa* " '-- ' '-,Tj / 2 /f (f) karri ad, single, or widowed ^ \^.e. S (g) So. of children under sixteen years (b) Average daily eernings ______ (e) Engaged in what work when inludud l/J --^ <*.c ^ ^ / (d) In what department i & c ((-.' . -/ .. (e) V.as this tae regular occupation of injured person . t ' Describe in full bow accident occurred, meting cause clearly J : - - f !. , . -*' ' (a) Kind of =a china, tool, o sr^iianc.* vMi.n 'iliac accident occurred (b) Part of .sachins. or device c-.usinp, accldant (c) Power DrivenBend feed or mechanical (d) ny safeguard removed at tine of accident,, { By vAnc ______________________________________________ f\ Mature of injury as definitely as possible ---- (a) Part of body injured (right or loft) - < (b) Attending paysicisn or hospital: Name,, /*, t >/) ` Address (e) Has ut.ploycc returned to work (ft) If so, give ftat<(c) If not, state estimate of orobatie ,l.ar.sta * disutility Ihrcfc 1, 1945 Dr. P. T. Sui*, 1SU South Main Street, Heahaia, Plnaa. Dear Doctor Ouici Die following la a espy of the report of the ehest x-ray of Raysond Ludwig. This x-ray >u taJean 2/20/45 and road by Dr. ^ab. Tha ,iilr.r 3"adorrs ora arlnrrad and anew a decided increase In density, X marked fibrosis in the ritfrt. and laft lower lobe area. The contour of tne right baaa appears fairly nonsal. Tha laft baae and tha heart out Una, especially tha laft side, is cults fU2sy in character. Tha `isnrt snndce hoes soma enlargement. Diagnosis: Tha changes present, in rise of this san'e occupation, indicate Mbestoals, practically of tha third stage. Robert D. Saab, II. D. Tory traly yours. ttlXTID STATS ASSESTCS VT7SSS3 of Saybestoo-Saahattaa Zee. i^eC. Nurse and 1-Say Technician I ( -4-4?. 1 Or. Ub. M. fn--irt ! 136 tut High Street, i Measela, fame. : Dear Doctor r--------- Ret Saysoad ludvi*, South Charlotte Street, Kachala, Poaz. J The falloviag ire copies of the reports of the chest, x-ruya of R.-.ysnd Ludwig. These x-rzy* were tahan $-1-49,3-25-46 ad 2-23-45 all we-* retd by Or. Swab. ; S-l-49 The lung aerielogs are acre prone-need oa this flla by conprrison with the pr-ri-us I film, tucer. >-25-46, -Iso the fce'.r* sh'dow ad the -or'si sr.ow -cae lrerec e in slse I at till* ties too. Cridaoee for soac thickening of tne sleurt 1.tardily la both 1 aides it present uf this exiainatiro. The contour of `he rU:hi tuse pce .-s noral, j the lf" is not outlined. The exi-eosl'il "t the beaes is :llihtly less h*. vis 'la# too. j Dt-.;fipsLi: Third ft'-ge -.-.t rfoul:, erre asrksc - `-.is tine tth; .riron with the prewioua fils .s r. tec e.etre. Rol.-r* 0. Suet., M. 0. : 3-25-46. j The leu a. rsi:uys sn-w r.etieilly ::c er. ag .n.e jI prTi s ex sir...tion. n x-r y ,t nd-uc st jir.ee the ; Diagnosis! Third stage -sbestotia, practically no er.-ege froa ua x-r'./ -t-odroint aiaee the preTiuas exaeinstlea, 2-20-45. Rcfcer- 0. Swab, M. D. ' 2-215-45 The pilar shadows are enlarged aad show a decided increase is sen Jty. A a-.ried fibrosis la the right sod left lever lobe area. The ecato.r of the rirt base . appears fairly =oraol. The left base tad the heart cctliae, especially the left .- side. Is ^aita fussy la character. The heart shadow stevs sees ealorcaset. / Dtagnoelei The changes present, in view of this aan's occurs lion, indicate asbes'osls, practically of the third stage. Robert 0. Swab, M. 0. i * ; i - Veiy truly y-urs, .03ITED 5T..TSS ^fcTTTOS DITISI * of Ruybstos-Jth ttso lac.. t1 ; 'JP t i v .i 5 r * abi rcr \ f r i Cob toy Jur:-e -ad I-.1ty Tecr.n ct--n i i j .-;--o".- Lucrn. ? * Ti -* /.****5e 9Tlm --'. l"r i*.ie'is rri eni'T^eri iriew Beider! J .-rre re 7-->! ''r'sis In *',.i rl.'it --! e"t V.-er fhe r.!- t hare r^,'rs fair' 'reel. The :' 4.snec <..!; V- '.eft jM,, 'j -j< te Tn-r - ; r -*i ,, -. ~.t .-rre i ;e' --t *'f 'r.osis:- r-.* evr.*e. rerert, <n vier; <*:' ``*e -r---i ** j.-trsis r-.ct'=.: -r *.-.e *. ir i :., `.e nanr g * - ;>fV '.* "--Sps; 22 wjfci ! j Ravnond Ludwig ' R 2461 3/25/46 ^SiUKaeahMa^^: >.. -j %-- The lung markings snow rraetier.lljr r.o change from an x-ra;? standpoint sines th previ us exanir.ation. DiaT.csis: Third stage asbestosia, practicall;.- no change irns an x ra;- stand point since the "rsvious exr.nination, 2/..J/4*. fiayaond Ludvig R 3389 8-1-49 The lung sarsirgs are acre orono'Uieed on this fils by cor rison with the orevit.s fils, taken 3-J*-46, alee the heart, shadow and the aorta show son* inere-.se is siae at this tine too- Esideace for soae thickening of the pleum laterally in 'oth sides is present t this extslr.etica . The contour of the riant ti.se spcesr- nora-l, the lef* is not -outlined. The expansion at the bases is slightly less st tr.is tine too. Diagnosis: Third strge asbestosis, acre m-rked at tnis tiae ty coav.rion with the previous fils as noted above. /'T&fsSfJr ,-^Lr-fA- Rober X. owi.t, ft. Z>- ami. :r Sum is. fun Date <* airth. Place of Birth -1 So u-r. PAST DI?L0'SZ3T AJ3 S23ICA1 RTCQ5J JSm /r+* -A B>t; //.* A * iC: 4* ^** Race:. .Present \iirm;T02** J-xr. i JLC began aerie. /3 PFJT7I0C5 HCSa KECOES ___________ 3o. years worltei . 3f. EMPLOYED 3Y i- 2* , 3I 4. 5. 6. i 7. j i 8* V 9* ; io. EXACT IIISSSZ 0? T73P.Y ?C TCTA1 Record periods idle sauxss C^_- - 'fji/j & c&- J)-S -&um* ~SjL, 1-t - i 'iTjgff ': -' V1 .;; t i .:. -iitv ..*" ' 'ihzrLV:' -'. r-Tr-*r.*<''-^-^y.:'^:;" :. * * * V;4;]; ; -.--^ ` . *.-*. T* * i';\-- T'v - '- J5.^'*.*r75' * ' -f k:j,.yJi2&. ' .- - it ^jr. * ..- ; * *>. . . "-"TT?- ` v'., It,. 4./*. '7'l^w ^ cMj. /X ^ /J. 3Jj *-/!(.. ^ . (?*~OJ , ?>. fv f f * UJ>t / S-J ~.. ^ <^2`J---% aadt e-t^a . tL-x? I'tjp j - G a . n j^i "Ax -- - - ./ -. A .-. . c_t--A. rosily Record Father Mother life Children Other Ccstacts Living Age 1 Koalth I 1 TOu. | 1 Ago j Dead ^ /- Y 1 Cause ei" Deaxr. Ees any one of your parents, brothers, lirtin, elie, or children rrer had the. epilepsy, insanity, heart disease, or ne]',.g-*r.cy? If so, give particulars. i TkfC&Jl ^ast>J{edieal_^dates_j2jer^cssiblie^ Tuberculosis, Kiemcsia ___ Heed Colds ______ Pleurisy . Influenza., Chest Colds 41 Shan. . Bronchitis Asthsa^^-^ Syphilis, _ Diseases Rhetsrtisu _______ Typhoid Fever Operations Scarlet FeTer ja-c x Ever is Hospital, .Sxslain. Eyer rejected for life Insurance Mj 9fo Xd**y . sialaria Ace. Injuries 'At* fresgrtChrtBiejrilsessorJ^osoliy^rts (Froq) Cough Sight Sweets _ Peis Appetite, Prodsctire _________ fteedess A-' Location CoBStioatien Char, of Sputa ** Dysunoea *---- Diarrhea Other eessloiats (blood is wise; stones; headaches; sleep; joist pain; occassional . dizziness; palpitatiajsooturia; polyuria) * a-*~ ***~ ~Jl4 a IjXjf &*e*l2si C-- Cate 77 / # y" ~n+-f~ a<;~ a*. ft Becord talccs by 7^ 'fozpa. *4+ . U.C. ` ` anaim guiSHATiQiT Seas: /*et- /ayi'i p / Adare**: .'^i a..J[ ---, fts . sg>g>Ai. AjCTyTLijacT ff rld*jL ^~*HZ Ju~~erLtJ- S4. 4> iLfl _>- Eair: Skis: ss* -- *--* X-->-* - teas#*.Atu^^ri. /3rrua~iify'/1<f ^y^jU-r.n t ao-rjtt^-ZL<; , a^fe^acju. faaff.fiUrTndc . tZtUr~~ c^-^rJr' Tees SaighOZISE Actual v.C. Puis* Weight / f<71 Sersal V.J. . R,*P _____ lbs. Set. Tieight, "TPT JC of Horssal lbs. as. Syes: Lida: ecsJvseti'Ts:. adore*:. Vision: 'Without Glasses Distance St Lt 20/30 20/f Color Iliad Sere: f Cc,A~t. esnal dr*s hearing Rt at Rt /2-J Lt Lt Lt Itoresests: ..pupils: i7r rt*J -~<Vr With Gleseea: 20/le___________ jo^aj F'*dus. 720" 1 J i ( meus seabranea septa __________ turbinates ________________ Sinuses; fratels diaries Rt. Rt Lt. Lt. Lips -- Bues&l liucoea.: ' Teeth: G.a. 87654521 8***4321 u a. TJ.L. *2 S JT 56 *** A-A 7 1 t.L. Gas league Threat: -y^SVC - ^J (a) tonsils Lt/a^rTLf-^r v 3,f / (b) palate. URX1 0 - Restored X - Kissing = - Bed (e) Jharynn, T . 4- CHEST HEART JLbx beat Leeatiasi - SS^TM*. j+-J, ^ Muraura EtEBCXSE j AS BEST Pulse Roan ^i. r*. 1 let* 1 Am i /3/cr "*d. ' j jAFTER 2 nr;, uis 1 EG3CISE i Lit i fc" 1 JA 1 /A, ! /t a/4 s" ^ 9-^ ^ &4fce 2. y &-*U4 Etiological Class Asatsadeal Class Fractional Cap. Pulse: Character t*Associated Teasels, Ede Petechias LUNGS Expansion \3d * J/ Tactile Freedtus ITT - KF Percussion SI. lap. Ill Mod. lap. /// Dullness Breath Sounds Broacho-ves 3.7.3. Bronchial 3.1. Foable F.3. Sarah Insp. S.l.B. Prolonged asp. ?.E. Vocal Sea enaseo I.7.E. - D.T.T. Mhlsp. Pee. tt.P. Friotiea Bun. Files Sub Creb...Bibos o Creb ooooSoa 960 Course OOOCKeachua$S@ GLANDS 8 cervical dadllary epltroehlear inguinal thyroid (a) palpable (b) diffuse eniarjeyeni Signs of Hyperthyroidism - Hypothyroidism (1) oye tipi (2) tremor (3) tachycardia. ... (4) flushing ABDOMEN (e) sadalar Blags-1*^-* St a* -*<*/, GENITALIA-^ RECTUM #r Diselars Scrotsi Testicles Sphincter,-- ProstateS-**-------- Vesicles f crr^rr-TT<; ,-d Z7TSL Pcsture Mobility Spelling Tenderness SPBE HA2DS n2T 1 1 1 1 | oTsss joists 1 J f ! REFLEXES: Rhoabcrg CIRCULATION Varicose Velas /(g- behavior/ - General Speech y~i_ _ Pupils Jkrterio-oelerosis % Gelt Personality Type U^v * LABRATORY- DATA URINE: Boaetlaa Sugar ' ' ' Sp. Gr. Usreaoepie JUfeisln BLOOD* Z.Z.C. *-?***+ Bb. f* f* *'f*-**TM* v C Index t.b.c^*mp r. z Jr u B/ Itartholoey d RecarJu: Ssdinantation Saatt B Serology for U*es FLUCROSCOPE Honsal Breathing Dlaphra^is Excursion Tercoi Breathinc A.-". Heart: Lateral Sion P.C.2cno Shapo Loft Auricle St Lt Position Aorta HiO fWl-lW -RAY READING '4 Escmass&sicrs (jy X */ I 'raiihg : ,. '; \rW" \. I;vf - * f* ^MUiaS&tS^SSIk v fr EM?LOYi>SZN7-MZDICAl CA2D . * ^iif*Tir : .* iir - . ~ ; ' ;:. . "V" ... - V - ' * * . *- j* .T ..-kLL. --1--'---*r 'ji tjl^2LAAli- m< s$? t .1 2J4 7/* f^tiu SiJfSj. 1. :-h. A. S iS" *.T ' C" --/-r-a---i.--r-*74 -. *4 # ^ .f2^* * * A A /+ JJ E*.f < M 0*s Ow. -'.-'i.'-ij A ^17-iV ^ ' X-> - ^ r-y.-:r b-iJt.A; fj7-6-36 j3-it. *-37 u- i. VV / Owwiiwi s/'-'jZ' jSt -J 7~S`* -L*s >*' yj' .fb *1** jL flru-Jlsl) UkLi_________ 1 WQS 1HWHD JUra D j7 ,, 7 *<J 1 A //. *, Si . ji. j p**~ 1 | I *62 If! u KtHM >W .W*MI . - r .. H- ....... -v,'-, ' ' "' ` : tp^; * $tC**0riarjy\^L. I *v. : it; iLviiLili -4 t. /?- *7- <itlL3 Application For Employment vtmrs trxnu ajixjtoi htm I 1T* I III till I Mill hfc -!/ 3~3 i Qmw Lufj *f- m..A*J Ji r J _ ^ // hi _{ztu Tfto. Tote. ha--rr | /4 V if 1 fXIMit Saaamwr j I jam u 1 Utwr^ fu Un Imtm VlMW Dmmo \a taiuiwn T*m ^ fa .\*iMun a ftain _______ ILA__________ 1 >**U a W | Om Tmm* 1 9i.r--*9 I //* 1 1 1 ** Mn>--r--* Vur Utfwtn C* Yw Oruxi1 Srr l>` j On Nm^* Imm j tta U WWa Rat. | Yum 1 laiim ! Li / ^ J >.***** It# 1 Oiuw^. M> Tm^iiiii b< Iumc OtminHu AMunn. Caa k4f tea Ua u \M~ Cw> >wi a* flimnwit, Owe. iaru* a Onia 0at**M--w Warn Xm A** * Miaa lni Lai bu`w Ja --./^a aj Jft~A_________ lu.tZJU;, Pt. hiwdci anonnr Fanwi Khj ftf //at/ &** m >!!--! taara Anmm Lh taaw - ~a famai Ha* in Dn fama Ktu ** Dnw Pm-- Ho* *n awu ( Pm j Ta ./arJg* lUw m fat ir Ta tn m hi In Unr Fa-- . iI Ta | Raw r fx* Te t 4 c  "j . ..t , i JMBI B. No Tmm v* i / r. ukic -* *rV tt ... *. t . ; v--r-v - tf Jv - I * Z. * -**"*** r*ri t vr* ' , t* * fc. *' `.'-kU frr;* vj.* ... e. ri;. '&* 4^>a. MSTKOPOUTMi UFE IN5UHANCE CD.MPA.Vr FlMnilbaaMiaVhM Tas 1* NY. Gk 3'360c H A'j: 27 49 65778 LUO4(1 G RAYMOND 7*10 ELVA LUC4iI S is RAYcESTOS-.-ANHATT AN I NC UNITED STATES A'iSESTCS DIVISION VR A K "AH.N PER 5 0R AiANHEI" PA *SP80C HOT A CSXCX Gentlemen: Enclosed is a cheek for claim under this certificate. Please deliver this check to the payee <v to hi? attorney./ r.evpprreesseciitid bv counsel. If an assimment nr notice of assienmtnl has Ixrn reveii etl `inn the claim was `tilmi.lled, please rv with the assignment or notice immediately. If for any reason the check is n-t riche, ml j r-.iu; tly. ple... many till* Pivi` V**tir< truly. f.i;.C- MvJ >i ".-AM. > `p>rri>,->r C -- Pf\7V * Iffp" 1 I'JT, ." . CvL ... w ,*" GHOUP INSUHAKCZ MEDfCAI <a* ^- ^Zc<^ / <zb**l^J ^2* 'Jb+iJf. i < *7' ______ _^-*T^s^__-r7 . i, : _____ !y I U!*./^------- -- ------------ .----- --- ... | / a--Si ,. 7. -- uUBSlL. r 77 - 'i ? *ff ? *.- ./r.* T` \>-'rk , * - /*. --a. - - * ? i*tr5n* v* -- ,j,,-, DUP INSU2ANCE ftm dad. At* _ MEDICAL RETORT NATURE QT ILLNESS ___A^fL-Ss'L? -Vyj * Li^Ti -Sana! No__ . .1^ . ~...---.. Lsyg J-S- d hr V'Sril ij c*. lirj=-r? IUot |r`r;.' 3 ? ' Vv <r>* /. -^.3*rr r- P!l;> /J --L. V-\ .._ O&^Z****-^- I^HC / 7, /f iff -- 6rz^~ - ^ /<U lJU- V; , I-.: ..- *: ' t- f; r  .* **; 4 v .>77' r**'*'- . .. t f . %: -* ^ i-> *> W. >| Xk.lU w . -SL: r'tv'Ti'" f-MMuag- -1 -*-'- ~>TM---= - GROUP INSURANCE *H ^ 3b Art " ' A^ium ' Pmta si . De4 -S' f"/ ^7/( J-.vijfcte;?-/?.! Jjb r4A.ti^ '? *e MU.-ykit meeic J^e/f A - it'Tf. y< '*' ' /"-i ,/ /sre Ju4 J </?>/<: zi --------------- & & k^ >*vi % j/j. w< , ^ ^ --As '/"^` r" ~ / e** ? *.i ;,rvi ^7X*- * v i ^., . . , - .t **".** 1 ty-* ' - ' - J *V * r .. *-- N .* - -*TisSsif --" ~~"rl l '. t.# ---} ----------*----------4. t ,, * -: ............... : . ., GROUP INSURANCE MEDICAL REPOHT NAT21KL er iumss Sar-il No-. .* --ti *****>>* j yp.. jifrc* wt--;.1oZ i*- S Z ` ?*" r! f: r - v --* J p- -rs-r^. .. . J ^<>r /</ ? Hr r /;/,_ _l-LLLL'- V t c'- . '' A .-. j- *** ................ '/* /- 7 t^v'rtt _ .*,. *,v ^ _ ? vV"'-1 tJjr >- < :'-C a --:.r:ff'-*_..'. T l~ < s 7, /? / ^ ^ K3f A/-J~-^ S- l-< <rz ^r.nm | />** A? *rr:,-..: .A. t''V - . -- - ** . -.1t.* c * \ Geodames; Saeiosed is a cheek for ciaim under this certificate. ?!ease deliver this check to the payee unless the payee attorney. If represented, deliver to the ittcmey. If an assignment cr notice s: assignment has seen received since the pissue return ths cheek trith the a-ttfimact or notice imaieriiateiy. if for any reason the check is cot delivered pr this Givnina. Yuurs trui Gaoaoa C. hIcGcio>iM, uup. 1 S' n cf iissrj^iAi7 ;r. sir's.. sr . : .'s is a.-.j S' o> a; '.uicx. sss`.3v. .in. trgaSMfiS juwm. I I I 1 Sw.v.-: iviiadca V--; . ><lt. , i-~Jr.-l;- FcaitiTv .... jf i;-c?cy--'.<J7 in ijroij-'-v ** rsr-ta;:wj t > s.fia Sy s^ic: JiBieal trtatawui v./.'- J * U*. u- *. v:*ca. n?..-. s* 3h* ilA. sr.iizan *"8, earaci.il - i;- iw-.jiir e ri.-ni r** *.s ?;* t^.a ' Si .**.* `e i3* crrsis: Csrcric vllitia \nc trcrev.iia, erre *r increaa<i dsrsit; # especially tits rirr.t, re- lose, a.-.c ?: i;ce for seas fitresis is ir.dicstiT* ;'cr a f: ti cr seccai ai- ?a astsslcsis. ...it i VZ CS=L^3R?3iI53 C7 73JJIS3X7JLSU.* * ,, j~. - - * --* r' -- -- ` T . ; C * .... i X frft'iS'TTi* totaS7 &sjsUi as tis r=s=s o.f lA-is.-,S..-s;c>ia "I JVOa A cs7r. . laW... ri zzi I isrra ises as capfo' 'i fa tbs Casssssrsc.'th sf s?assasse7ssl?r=pasisoaitclaaatast;f=aro j}xzzis'iLa --- -r*_~J1 :ba yaaT a.1 (Ncasv tic i*U cf >j--I;iat7 as : xaas at SsaWw ia Asa. 3s3toiCSCfiS9 3S.TC21Z3 * ; >- V---., ;_-^ iii &t; -- va J 4. &or assd d<frrriant waa sy en?Joyer wi*s I vaa bst ctposal *.GSj h~aari iStfl na a tbs tatsaisKU capJoy ircza 5. Xiacs th* date of Uariaa the ii/iiaaifs inpfoysaint, I cave bees sapioysd u follows: * -2za Isa zjrtis t ss sx> zz? vi-i wvrs yscu*5fl ;v ****^2.... ~j *^ -- . -- ~j +j --T-C " -' * :___; ** JiiQ zsUa cs zvjzd ^cr scci csyi. >3 ls =27* i*"1 '^-':,B' jr^ ."?*?' r*'.1 "* ^vTj; - . ' w- r/.* j; -4vC fr t2TV..a>-y ' **. j?y* 5:,v " JL~ y 7,_^. Subur4d azd ttos to jafsro sfr'-iafr U-- .day of. r > A.**-. A A *. * Sty Gcmmlssasn Scioee'an -.'________ -day of .'iCTTCC: Tils yli'T'rai may ho tiarad and sworn to by sat dependent for hi 1 and all other de- Fleaee ester ay appearance for pecaioae? * .#"jr- "- -- * 1 -7^T .IS --j fl-A - TOXICS: This petition abonld bo filed is original aad Art exact copice either typed or printed. The party lacart asih reunited to type or prist fall nue tod complete addres o/ Petiiisser rigs* lag this pott^TL It is sataaesrr to maha aSdnrit to oaiy the original copy 0/ the petition. Tab 41. An aagicyoe. shall bo if--eri to have bad an aggregate caployaent of two yean la the Corn- mcnwasiHi ci ^.-rsv+e--^-i rccS. th. eieht yMn am pracabing disability ia- as -occupation msnhrsg a-aiira.er aaatao iaaard: tel TTz^i'Czcsc 2=7 two rt'.rtdar Tears is the preceding eight yean he haa bees employed ia =if~S*t JW--V*e=blji ^4: ::. i 1-j': ' 't 'A -1 `Tj) v-trris has iaen employed b--eh.an occupation during the eight yean period for a total troTT-jeT-cf 'tcbc_.'-dayi equal to srica tiwatsascr af ttavi the men employed ia that induas? merir darire aa groan ywrvor GO Sfi'.vnii or ssthrscliooei3 ia ray occupation involving direct contact with h.m'tiup of, or ezposare to dust of tillcon dies'It (S20,). Q) .laaestojia ia ray occupation involving direct contact with, handling of, or exposure to the dost of asbestos. The tin "Tinarcn-a Occupation" ea seed is Paragraph 3 of this claim petition is defined ia 3ule (2 cf the 'JVcr'csen's Crsp--jation Board as follows .- Tale 1Z -~7T? 'xstits involving, entesure to an occupational disease hazard enumerated in Sec. ids 2 at Tcsngsssa Tiseaae Compensation Act shall be deemed a "'arardoua ocrupe- tisa" as *.haa tsa ia: t-iia h ^tia 8 (hi and Section 9- . *WT :t treturned to be an occupation having a silica hazard. . that ml:teals, lathrsco-.ilicosia ~aab ashestoala are ci* ~ifj ta'a _:: : if 2'* Via sat cai7 aftsr aa exposure or five or more year:. ___rirt,. htr--r.i hia:a.`hr the. State Torisnen's larmaoa P'rad, may pro- ' ` - t * -v *.rr-.-__ Imr irrin-s the cloasse i.i in lira aorslep is .; . W.7., C^_rijs zh&i-.'ix- ,9 i PEIHi. MrnS ACS'IJ. CA&. EJ5. CO., Per - 3.0 .aweet 'W r" -I -- 1 fl */f CaiSaliy Zus Cti.-i.ta S. Shuarcr Claia Bsitar! M13-2733 Saar SiraJ Tha folleariajj ij copy of the report of its cheat s~--7 ef 2hU cscat a-ray *as Uiata 7-2-42 add read by I?. Ssab 3-12-12. 2, .usrsr. Tho alia snodrrs after seas r arr--r-~. ircr^.se ie dsssity, tea ftroacsiai o.ciia--,:, copsei-tlly iftj rir ler^r, shea an icerssao is dassity. 4 5-57 1aersssad caasitr la tfta rijjtt aad lift lsssr lob*, i 7cry slight flat tea: ft; 0.* iftj ri jtt iaaa, ifto esAtcir of tbs left bass 4,-Ta--3 r.onsal. Ths sisa iftd outiina ef tha ftaari and aorta appear norsal. Thsrs la ao deviation of ta-t trachea or rtttlcmal toaor. Btagnoaia: Cftrseic ftiiitia a-d trcr.cftitia, sera ao tfta ri&ct side. The ftazy iceraa-'ed dassitr, sspeelaliy tfts right lever lobe, and svidasea for eeae fltrcala la indicative for a first or 3-esr.d stag* aateateals. Bobo* 0. Sarah, d. 9. 7cs7 truly yours, C2I72B S7A72S 1S3Z.7K3 0171310 of Eaybestca-Sanbattan lac., Caopesy -ur00 aaa i-iay Tecanieiaa r If r frt ' r: 1 t ? ia i l < 1 ***. /f'J- jV" -l-*00 t;-h . . -. 7 r'-_. ---------r*, 'T* -i * '7 < . *s --rls -- 3 ~SZ~~. . i 1 . ...: 1 ,_______ 1_______ ,__ '- ' ---' i-i^- - '.jy -A-f i.a-io - 1 aj-!j..:.-io SI-7-.J/ ' / .. // `L *r ... a->- _,,:)? ..*6 : .. r- 7-i/ -ij A- / - * , > -/ - *.* // . JJ--3 7' : s '-J. //.J'.J? ,..j .i.? ^ _ __; /** * . -*.. ` t. /->? +& / ^i <_ '/ a J i.it -------_/ * -> U ,j <. r.i'V 1 ' r. iuj. .*ar. i i - - *y 3? A/ GO j. *v 1 / 2 o a ** 7 2. *4 - - . T' , iVV*.......... t ./ * _. ^ 'I 1 ^//. . . -r '.at x'.' o* ..J-: <ijJ Hour c-j day_ .(ej u:zc diziOillty -=,:-.J ' i. ycri or iziuz-J (b) ivczr * ddrear *7 -- .'- <LS. 4. . /,.... !_____________________ /'..- ^. is) -..*?> - - ' *' c v: (r) i-arriid, aiasit, or ?l.&?v.`d >-n- j. '><.. i~i So. of abildreu uzd-r 3drt&a yeara_ (aj **1X8,53 toil? e&rnlmta (eJ -a^s^sd is aSat *ock *iec laiured ---./*... ..... : -. V (d) la wtat dcyartseat. u; >*. < xt il "as tils tie r:-*;ul:r ccsaritic.-, or iz'ur-.d -c.3=:._ -cicribu ic ful.1 fee-* ccldsst oiourrra, s- tiar siuse ____ </ . glcRrli' <gt- ' " fa --.i.r i ^ -* ' * * A / tL--'X*.'- J. _<3-S'i.aa J--cf*-{.. \ lc) -lad or uiokize, tool, or i-.rl/ax.ca witl szisz sccid.az occurred '\ ;b) ?uxt of acalc; or trvic,. c: usian 1 coldest ic) "oner U.ivaali-ad f--ed or Lzezi.aiOi.1. (ii --; i-fc^uard r!r-.c-sd it tluc of i cold:.M fly *ios_ irc cr injury oe dtrialtly cs rot. siblt, Krt or cody lajur-.d iri^bt or i'.-rt;______________ ttszdisg pJiyslclus or fcoTit:l: lxar /jUs. i.aiiros g . /t>*> _______ / (e) ru.a i.tplcye returned to work (d) If sc, riv. dr t. ____________________ _ U) -r rot, atat trtli-ttt cr orcbablc 1-uetz cr risibility 2 C7 Petition Mo. V3. ______19_____ To ??9 .->2S9* XJ3 - - J-- - '-.I - If you fail to appear. the petition will b* dis posed of. in your absence. All witnesses whose testimony you desire to present must also be present at the hearing to gether with such records as you desire to offer. 1/ it is necessary to subpoena any of your wit nesses, subpoenas may be bed upon application at this office. X hereby notify you that the shore claim petition win be heard by me on gegtaato 7, 12*9, 20i3O a.v ?ly.f cccrt iicess. * JL 7* r^_ 4 rw I J -r- 1. 1------ -- ---wti ------ -- . - -J 0 J>-- '.. --- ' v. _J il i * * * , - - i| t^-7 "= -j. *..., # . S.U.1 ...*../ ,, _> -- -_. *' --. , > JJ i +* ~i i -T - '-1-JS ^ .'.tf 'j.i'/ --_ %,, ,\ tf '---^--7/ ,'..ir- -5 / >y fy m\ * m. s*. <> .*1 /-/ i - -/ 1! r/ . y.!> /- 0 1 7'*! * <> f ^ 'vi TZ,' 4 1 9 *<!*'*, ? * ' /! 7%( ***r**/H4 . Jy j '**, i?v"'.7U *,.UA-fr.o. i v1 1.4 < m. * rC'- ? ./- J-/.L ?J<r >' s>.' , -- i im *" J" / I j ,j | ' :...'* *' V's/VlSVv *' Vi-'-j'/-**'*. Til* -. r '7-> '. *_? * ^ 7 + * 'J t :- ,\ ' 'm + -*v ..-. V- .............-.-j;--Ji- _. ^-1. "V/J'r*-! 1 a i7*<? 'i'l...',-,,1', )7 : -yV^v* --^ I CZ-U *> , O Jr -? j -.< r.i--i 7n ---- n *--. ,y--/ 'f.:? rfsm&fc'i 3i !t^~i3c/f --57;;t JL.l_ --i.* . ! 1 ; 1 ! i 1 1 NO. j Cuo' ..... ...... 7 """ ...... .. .......................... rTviglwwi '" ^ oiiiial'iaiMt) ~ t-u exclld zi cz: :.-Lr:iz a>z> :zz to txi l'clt-axce cc.._vxy p.;c,,..-tly. a: t;-_: zz..~-z-:za~z>i Azr.ZL..zr: cax.yct ox ?,-.z- ?A.UO, NC.I CO.'--'d.'.jAVU.'i P.-i-O --'jT-- ..-Li L\.rCiUriAT*C.\ IS SUPPLIED. If r--iyloye waa paid a friar! uai'ily. msstbly. or n--tal tisj*. bow ascb? ........................................................ Owl Dad* of bat* of employ* ...7?---- S' TKZ EOSLOVS "7AS fXT PAID CN A FK2D SALARY BASIS. COMPLETE THE FCLLOOTNC VACS SC-ISDLLSt y,,x'b * psd J.-..P...S!...'^7^!!--TM:........ ..... Nssfencfboo* eossdsi a soisal work day . Nsmbar of day* is a aormal won wood .. ........ -......... Woo aaala or Sbow data of air* d iajtsud baa boa is your employ loa tbas tbrao soalha (Saw :o*lo7e4) TTA623 rOB 752 SB WiZZ3 ECE2SUI21I PSICIDEfS ACCT2.TX OS 70S TS2 722I0D ESTIOISD Skew total aaretam of iaa ualoya a <acS of Ika 11 w*ak parlodj. Pat do ooc isclod* spa or grtaUlaa. 1st pcxiod of 13 eeMoarc ~nfimff*T wmk Total 'Vacua Farsorf From "- -- ~ ^ To '*/t* - , 7 7/3 /3_ ;;OTS' Wkao to* ;lsy'i w**a mala la as kmrly rat*. dally rau. ar Or tk* output (9lae* work), tka Act retain* that tka a week* --m...h prwcadlas tk* lacldast are to Pa dlTided' Isis i ^rloda o< 11 csBaaeatlr* weak* rack, tad ika weakly wa* eoapatak Jy dindln* sy 15 tk* aaralaia a tkat period mom Sterna ta tka Island. It la tkia promtoa at ika Lav wkiak aakaa run 117 Ika waft detail reaatatad karoo*. | *v 55' . u* &^ov acci: ru.ure ccrrsctcac^nw ccxic* ; cii* .^uc rcrer to it oy .{ huslost. .: --I 171 CAiZi, *&5 LUt Ui6 ir.^u.'eo employe jeu Jn from aa y jpec^aiuf- Very truly youra. *1tL J W in* it .'UwvUrtiU1 c^iuirr ssir^G r Mrs. This is the Tins.l psynsnt on this esse - $3600.00 piss interest of oii.32 side st hiae of first j*yaat. 303 J--* it Juii, sfZ- ?1^CJ ' Sir-thi '--- - . . ///**> , ijat ** 9 2atJt .Srssast lldrset: CL--*, . iis begas wwk. IS'IOEO 3T ^2? r~ *-- 2 is/'. JSS720SS -233 7CZZZ3 _______ Se. years *ariad SSAC7 '"-TZ2 C? T7^*?~ *r^CiI TO *TCTLi 4. .: 5. 6. _ T._ 8. .. 9. .10 fieecrd periods idle satmss ^ :ZLt_sj^ _ f I/. 4 *d 4 A 4 *. liLd *r, r. n __ 3 > - 4*^- Osx ^.TSta SSS jA^22y*C c/uZLi*, ..--4. 1&-S' `"v"' I0O qo i!^ >0 ? j ^lt htjL*iAsl ^v. Jl4p JLr^U X--^ ^ctli4. (!,4au>f> : _ '-ril/'Hi^ - ^ w>/r-tn*,nj - a*+Jy$LC V/<< ^'i*. </ ^ feat Uedieal (dates There eessible) Tubereslosis_ 2ssuss=i.i Zthld Colds 9 ;I/,i}-'A -- Syphilis______________ Pleurisy ---------, (ggy /-. Cust Colds . Skis. Diseases. .Ircseitis. oaeveasisa. Scarlet "erer Operatises ________ 2rer is Hospital. .Ssplaia. Srer rejected Tar LLTe Issurasee ~^yui^Crjvaii (J92o \ ------ "p yt zr? n isc. la.-juruea - -jin' _____________ -f=E3^' (??eqj Cough Hight S*aata_ rmis__________ Appetite. K'eeerrtChrords^lliesso^Cgrolsirts ft-edactlTt Char, oS Sputm. Weakness ___________.Dysssoea ________ I<soatlea___________________ . CoastipatiaB 'Tlsr-- Diarrhea "*%U> ! Other ccsplaihls (blood is urire; etcsse; headaches| sleep; joist pais; cccassioBal diseisesa; palpitatica; nocturia; polyuria) (/)_ 0-9 i m ytxh Jt_________ { -tor VM ^LLt/ *"*f m-- .2*^^ l. Date a*j -& ' /6CZTj&iL *hasT` tv*CL*f~ As*4< ^uc**r^ trf lu&t . T '' _ Record taicaa by / n&_ ..sua. ad.gtt r> S Vu TLrtj=rt i/-/ 13s. Zst. V.'aitht Actual v.C.ScTtal 7.5. or Sami /> t laa. eesjiccttta: ilia :iarW! IMtMtlOUt 3iataace Cal or 31iad st_________ 23/ / >' Lt '0/i- a _,, n a- - h ~2Z drj=a he&risg at at 5ea>j =ucua tnsfcraaaa /20 Lt Lt SfaTBsassa: ttttlia: Hth gltsift; ________ 20/ _______ 20/ ~icd.ua /20 Taaths 3.2* ------------ *7* 5/t !! XX*5*3 2 1 l. a. Staa y?-~ Taaeca Throat: *6. (a) tonaiia US23 O.L. 4vJf 3 4 5 > X 8 12 1#L* 0 - Seatarad Z - Ittaaia* r - Sad .* a. I Sythya and Sensda <*'/**--r/ r* r=2CS3 i Sis* Sees 31. ?r. IS H2SJ ! i f^r 1 tzzrso 3^czrz 12 :an. lissa t TTO 5^ i .< < "* i I :+*!& Stiologieai Class Asatssieal Class Functional Cap. Paisa: Ctamstar Associated Signs, -- Dyspnea*, Cyanosis, Satie Veins, Vassals, Idsna, Pataehiaa Percxaalsn SI* Isa. Ill ifed. lap. /// Dullness Foabla F.3. Sarah Insp. E.l.B. Prolsngad lisp. ?.S. Voestl Fes ceaaco I*7*K* * D.Vili Sub Cr*b...Sib,tsd Crab oeooSaa 064 Course OCOCgowchaa QG6 .v:voi(i) Cjitabij > (1) u>* Jii (2) trees' S3} tachycardia. 4) flushing A3DO.V;N >) ii-J3a isrj;s;sss " * *<"c*'** (s} :dciar lisgs His lft GENITALIAS Sears Discijarga Serstiss Testicles ^Ai^<-c-e-s2^. -- 2E32ET22S asd 5?ZE Posture Mobility S7EZE Swelling Teademess Drri rvCC * Jerics i\Cr{.LALO * SfccEberg CIRCULATION Varicose Velas ' 1 IAA WIY I Eeacrrhoids Schiaetar Prostate Vesicles iaots ' rssr CTaaH JCST3 e-- 3aoixaiei rtX^l Pupils Arterlo-ecierosis *^4*' BEHAVIQR General Speech Ca4i 4- in - S j 3, (jy, A*// liuraees;sic '-%--!--*. ^ 3 ` /">, ^fN . V*A^ ?Xf^_ ILartholocr esi Scarves: Sedisestaiiss Test: Sarotosy ?//*/ Llcs ?/,/vA T 7 Vi / * <iy c. Isdcs > 'J Jf'l X- 3 Dlasi Sear- FLUQ&QSCQPc L'ersa.' jeathlas lea "creed areaihiag Size Lateral P.C.lcne Shape Left Auricle S- Position Aorta X-RAY READING 1 ' -v-> . aXisis t i' I i i i i / \ I I I I i 4 I i i i 1 1 1 ' v ; /; i rj i 4 *f * * .ittlUAS- i I I 1 aarri ~ ftn- 1 1 i I i *4 -i r'arasui*. : 1 I l 4-,y~ r\ V / V J> <* & <?. J' ' 7" /? ^ j _ / * 3 -I I J J 1 * ) .icier, a- -------- t w---------- --...-1+*..*^-- .11 > *' * "* ** ' ^ : . \ >r? r .1a'.c-jvcj -aa;-:a77.u,. J* Ajj.iiTCi JJV AA--JU, AA. ATT: JJ5 A. S. J!A>3i L PZ=3=3. CS3. 1 -1 -- - - Escxamcs ., j ~zh-i *- 4/23 A3 0 1. This claim has beca approved under the: D Coitiaoed promotion oa accost at* total disability provision at the policy. H2 Death benefit in the event jjtal disability pro> moo of the policy. O 2. Please scad the employee's certificate to the Total and Permanent Disability Section tor endorsement. 2 3. The employee's certificam properly endorsed is retained. 3 4. The attached copy os' this approval ootice may he seat to the employee. F. G. DRESS, fiapereuar Total, atm PsBsixstr Daasaar I I i | ! t i I l --JvsJ y.ta 'iat 3r 2. % lpplaj'-ta Sarlal ';9 Saar Sir* Sitaeied jr '*'122. flii a Statist of Cals far tha airra Raisysar. Sjarr has is= flaMd siiiJ 3*7 12iS, lft',3. 21= Ilfj eartifie&ie Is rsaisssd =s i=='i proper earlifisstiss i-ii is t-? if tie elaia is >sasrai ht. Zco*t~t wished ts i=rr the (pendant ccreraja asd ia peracaal fcorrilr- * _=J aurjicai esssalsd If tie proaiuaa on tts Ufa i^. cg?.sea is '-lived. 2r. uwarer was "rsstad tats* H-uiZitr by ear isauroasa csrrltr as of Oetstsr Ii9. Tery trni7 yewa, BITS SZTZZ ITTITCJ ST<ZZ31 of fa, . ds \ >fa 1 Cs oP3-= =7 7 2QQm9 02-00 14_~~3 *f ti7rcid msrcy not -o2 j-:ci bj rsooval ------r~-- t^jteUi Coo ct sere az ate op^nrinn..;_____ foes Ttaocrgosos^ jres=oa....~... ;7S-eo Biri.t'., a s be irrpzri os cno cjeipta)' an# hssn. '^'.r^yooo :vr:-7T-co isso (sspi&g astpas} ZfXO -t opCB&BB.. s`ef tcadooa; ........... ^sak........... M-oo > V X^TIT ' ' ' -v .4000 tia)........................................................................... loao Bg-daso. b;. '.-<;. jeer cc rrs.~.. . tooo SLot-ou Cosing cpestipa 3 mjeodoa c.-ament for ndSet ago a .-vr-.r.--l-r-ii (esojici* pr.-r.'jHir)............. C--tin; eyas-.'--- In; p.-d.py_l .-ar_m a in SS9........................`................... ................ . Cutting cpeodca for uuat..................................... oi-oo OT-38 icloo Scuu. Cuaing iroo cnnsil avity....................................... o-oo SlTMl 00 SrOtAL Cou Opcnscn ohsh removil at portion of vertebra 3 vertebrae (acapt eoeaya).............. ... i ra-oo Usaoval d put acillaf coccyx............................... foao Tatum Sec Paracrateau Tsnioo, Zzhcvai t nadcrGics Towna, Reuovai Of--Ja coda Sir. Noro, or TTsraet Taygo' - ^ ' Raaowi orT by h-.tt g c^-irar.'.v: ' I/laligmot rnogi (ra.--t tias*c/isca,up| 3 ikin) isoloo JvuSgnast team a' aco, lip, 3 wsi....................... 2-ao Beiign nsnora, one a mare: Sequinng hospital midst*............................. 11-30 Not requrring hcaptnl riiidmr:, ............ iaao Vajuocs Vbm Oirbng opcncoe at ir.ieedoB scrrjnt (complete procedure on sil veins).......................................... *0l90 * * /*y .a us r--rstnt ------is tea ! . :r! so repretent wiis is riTbehx'c cr bis.--: -sill cr itr.p'.s 7 Aaaeaaai `---hi;-jus-V--*-1!<mvtT7fordia;rssicr mm. ., sent or cr^irj Hess, (uslsi otherwise -iparfari a this.avTj-.ri................................ ...... .. ,,.3iaiaa Ahermcs raciasj hrepnl resdenee (fstr <ca o c^wftcatcaCT........................................ 15.00 Aii7VT.ua: Hugh........................................................................................................ Arm, fora. entse hand, leg. at ssshs&ot. Fageacr too, ech.................................................................. 75-00 5000 tooo A-windix. Rciuovai. or. ioo.cc Blood 1 Rempier.t, sob sasauian (sot acre baa ax). 15x0 Btwr Ampumaon..................................................... Tffpm Abseosws. dap (fimgrira "*?--0 one or mow . C*rrw So Mak^nat nwvw oder Toon Cost Complete rhcracnplaety. or removal af gcroon of lung....................................................................... IJOO Other anting mm cbtac cavity for daymen or set' +n m fnriurrrn of irescal pnejmetbsax. M-fiO OnLDsutrw--!s Obstemiol Dblocahom, Rzsucnow cr Hip or knee joint (patella eserpted)............................................ Shoulder, elbwv, or ankle jeanx................. ....... ......... Leweriaw........................................................................................... ... Caihr boos or whs.................................................. 35x0 15x0 15x0 Per disircanrns requiring an esei openbon the mTh*TM payiseua anil be ranee the abown above. Sas^sal CtTTiin ZZiz Bax, Nea, oa Tdoat Removal of naiaid 'Vi.itHig far reoval ofdisaeed boBKGReade................................................... Syyxo both sides.......................................................... too.ee Bgnaval c! rwall artgr_r,s r--I->--^V..................... 1JXO Sanaa operation by cutting r-.--------------- gf i.r~m exmpted)........................................................................................................... 35x0 Suhrminrau rusemaa of nasal scpnmi........................................... 35.00 Z.-errbsu.-07 for rssovti or'fo-tega body or bfo.=7- SJ- Cutting into the oaesa........................................................................... 35.00 Any other cuts.-.; crerttton (puncture of antrum and tapping eseptzd)...................................................................... 10.00 Ft.-uu* (Fxmoval) Shsulder or hip joint................................................................................. 100.r0 Kneejoair............................................................................................................... Elbow, wan, or ankle joint.................................................................. Oiamaed portion orbone, inr'ndi-g curemgr (alveolar 75.00 50x0 processes esepted)................................................................................. 50x0 En Any anting cperacon into die tyebsll (chrougb the coma or testa).................................................... Raoval of eyeball.................................................... Caring operation on eye suada..................................... 90.OB 15-ao a&oo Faecmnis. TjUAraoxr =7 Thigh, lag, kneecap, upper arm, or palria................. Vertebra or vertebra* (eseept coccyx or vertebral pnxtasea)............................................................... Lowe jaw (alveolar processes esepted). collar beat. ihnuirirr blade, or forearm.................................... Wrist, hand, ankle, or foot, each............................... Fingers or toes, one cr more...................................... Nose, rib, or riba....................................................... face face Sf.co If.00 laoo taco The amouno shown above arc fcr Simple Fracases. For Compound Fractures die T*vmm payment will be one and one-half ones the amamn thown above for die cor responding Simple Fracas. Far fractures requiring an opes epeaaon (i-nciisdmg bone grafting or bone spliang) the payments will b: twice tac amounts soown above ibr the axrespondinj Simpit Fractures. la aWa's* a 1 -uroi zsscz es i i'; .: 1: jrv-t a Jj Is i . . ' tjmjcer/ lay-c-f.hi. ospjymroc may. fa asro.-ps~s 7 tau_: t_nm tu.T~jr _.aJ au Employe in r.v ~ bir/cdi the icraamcn of uxh^lsarted peied as SS7 be pr~ r--hrri in ten Croup ?aiay. a. Tic_ jap3tml_Ctmtdcn >.tar*re shall autcmatiroE'/ error -- Ir-arinas Company rcsmvre such -**** ---- bad ire rVrrpri ts lavearcttl'jd wnh cot >-.- ----- of tbs Group ?elx7 aa to proofi- claim upon -uimJiti whist proof evera- the escuroreos. fV~ap sod cu; or tbs curbed e;n ~gn fa which dmm is --~dr ^in^BKa^^aesBs proof * hia too time pro> p-eyfeio a faruah sues nca or proof and mat auen nonce I cr proof was furnished it soon u was reasonably jraahla s. No art*on as law or m eqiity shall be brought a recove on tbs Croup Policy for a dan for beea reared a a this eetrosas supolentnt star a the espasnon c: afay. .days afar proof of dan has been died in accordance end: the reqtsrronents of die Group Policy, cor shall such assoc be brought at all wiles brought within .. .rwP years from die ejcuutxn c/ tie cae wuha whxh proof of dan u required by as Poixy. Sacnow U. ?Arson or Ciam i AH besets provided under at Croup Policy wcl be paid to the Employee mmsdatriy arts receipt of due proof. Simon m. CimaTaM or Inatnuuss j a. Tbs Surgmal Cpeacon Insurance ihaB autcaocoally ceaas 1 ..c: the das of sraciacai of die Esplsyors u=o!c7bsr. - ~--hits of notime, fef the pnrpgn* m c-_t~I C assess Insurance. means ernwnen of serve wore u an Employee as dfaied in the Group Policy, eezpt that - (a>3 the Employee ia absent from active week at , srhnrw ar injury, hia employment may, for the purposes of his Suipol Operation Insurance, be ArrmmA con- tinue until tenunated by the employs m !wviii with the terms of the Group Policy, or ere Erne p^e barerf, It may ec ainuareri etdy if acds-ha ~i Employee mass s aesve work fa the Employs on 1- If tic Sropleyee Suia to malm tS7 ccncabucon required by the Employe; to tit seat of his mtunny under tea Grocp ?aiiO\rroSror"l Cpaada l-.-jrasa dell luromororoEy earn ca the dcs of the smphattoa of toe las: prrind 5sr which such ~ woo mode by the Employes. 4. The cmplsyea's Surgical Operation Insurance shall auto mat; *~ii/ r.'a.ai im-rn'mly upon the dauentetuancs of aba Group Polity or cf tha previmroai tiemrida ia Surreal Cpcratton Intunra y. (a) If tha Employes, at the cate of die cessation of his Surgical Oatracxn Insurance unde the Group Policy, is totally rtiiahlni aa a rtauit sf injury or udptesa and. while rod! so totally din bird and within . thi,-tyyaie days , after such creation, undrogcre any iiargiesl cperetien specified in the Schedule of Surgical Opeitions hereof, kit shall be traded to whatever benefit would have been payable unde the Group Policy for such surgical opera tion had his Surgical Operation insurance ben in tore* on the date of sjdt surgial operation. (a) If a female Employee ia pregnant at the date of the ctaaean of her ourgtal Cperaaon fcsurants under the Group Poiic7 and, re a result cf roch proyiarcp trod within tact rr-ya aits such creaecn. ucccrgta any surgxal ecensca spnrarl in 6e Sshrriuic cf Stcgial Ccrastss vrtof, sir will be aetlcd to whotrver berodt wcold have hoso payable ucds the Group Policy (a such surreal np-rara bad be Surrmi Cperetien Injurancx been in face aa the das cf web surgial cpmtim. & Tbs cessation tS the Employee's Surgical Opearion Inturact shall aoc acet any clsa reeuortd before such matian . i. i' l 4 .'sar No.. .irrrawrs^awsa To -a Mot Past c? CssscAg, auu. Ma, , .7-wSL .*; u?: 2 --'-'-'.^3 AZZ'-Z-JZZZpZZlOi (' i a c.us= ruTLJsvljj"~ . ---d :--'ur rh* rhtrmg--m Prlirv gn t.-'gBiiiinlage --I r~---s. t-i------ -- S3 1 c* .ssaissahca: -.. 'at) tar/aj'S7. set adds; outcf-cr in ia count of ha esslcysesx. cr ,T --/ a saa .adir* ban a jv.'-'n sis 2=7 .-- -----------. rr ------'--; A---. --TS 2XGLOV22, ri;~ a da t=a and Isisdcrj cf tit Craa? ?auer, nr tie aerial jurrial fa ,darned far ash aurpel opeadan, piovtdad (s) iaa asi asr^ni cpaadcn *a.-oscaaended and pafansd by a ?hy==n or ar^ea 'famed a pnaia -edit--, end fa) itf is asxunr ef asah esyaant aball in no event ea=d it assent 7---*-' far ass aurjisai opeaaca in too Smadii/ of Smy: Oy-erarnni hereof. Zf mro or acre staryenl epesdssa gasified ia ie Sciedtiie of Ssx^icai Gjvaeatu hereof an per- tapea dte "-apasrea ~~~"7 aar sns cssancsoa perted ef diasbiiirr, wherecr from oeu or mere cauaee, a.- an perfaraed jassaiva period-. of sirsiiliry duo is i* asms cr reisad cssac or das >"*-1 . under is Grasp ?niis7 far n2 rush optssdaca isii net rrsenf 9 Eaploveefa Msdmua Surreal - rii--1 2--afe r-or-'ad faainrtg- Taev'ded inn. !f ane two or =a of snahenr-ial orc.-rrinw are 0; any ess t= and ia ia ssa oes=dr* Seii ia teal payment tar,eg i Group Paiiey for all epeeadooe _.arjr~Trlg eaa iss and ia ie earns opeadre said ahaii use "* iwriwoi Jwnr jn ^ a -_d rn-3rr:e far ini one of ia opoatioea perfanaad far which is iarjert aaton.n U . . .1, . i ia w.d " ZZs nayr-jr-t dial am sods ones ia Group Pcnrr far say aarpieal openrioa which U dais a prep. ___ .-- :r ~rr-:aat; ci-.i'r. hiri cr esaplicsasca if ia pr=c~.-.nc? 1--'-.tr! oa i* euantra dsta cf is Zsjioyaa'i f^ryssl Cjantfaa iTvsmnra _' '' ': '* ' T^sSspisyea'ahicsBaSisiaiOpeaaaoSsediaBtbe r^n--. hGsaHisdnd Tk* heeegjhv rfiit rj-T-'.-rire ini m eAjiVm fa ery -J----- etj-j-girg mwM- S. h!^.j. The fn.asrr-r evidnrsd by iie cor: ifirts sappbsest, the faCcana* pagee, ie provided under end ie eubjes the prsviame of ie Gtei^ Poiisp. .^aa.3>awT'trt Ci ;-t:p--Mali 194a ^ .euar.s a ua. IdETKCPClfTAN UJE IN3LTL\NC2 CGhiPAMT, *.' *1 * iy -_ij ~>V- a: a w' ihj Cizu? ?a^r/, m! us rs sat i." -.. cpssa o> j-ah baud asud u cay bs i Crcup Polity. a. (a) Ti! Sapiayos a Idotpud iaai Imass on iu ewa ?*rr? zn?r-" irgTbT^r^i IIfa a=jHsjby-ucrBradsap^^sat sdatef c=M*a cf t=a Ho--=1 =? on tor 33 3^01 ss*,*i!!iw * ^.-/^fa =ad --P^ysjaXyis^ .-. -~..--r-^-K- .....` 1 --U .-. V ttrnr-u-a. (3) Tbs asrsisytt'; '.iutrsl ~br~-- Tkssuis er vro. -Tt~-- or---- ___:.'a. so--:------- ----. '. ------ ;-< cr any Char-da* uul autoroeally sa-* en du dots - aa his a fort: ts tit data e: ~ --'------r--z sf =3 trio. a u; =-.\Js --eLr as Group f ./ on --~ such hotticl corintaanc ft aa^r bo i cast asd upon .-savory of the Dependent from bmiy mmr7 cr rc'^rr^ wtocb oud such hotptui ccftinement, ir.d ^*Jr TM-iai e r.?isy a then insured cn Sa r * T V TieHas!svajHrrsaI2snirfTiuufsas3cai3-*tsrf>i7,ll.`.^. '? j^-ascaU/ c=s cn J ds? ---jTjtfi--a * ~ 4^ If tie 2=tL -iirtD salt any ccotabwcao reomnd by the ^-=--i ; v------nrr ucder the Qroa rdic7 4 GP fuiCV^dCNd Cf TEE C.~ ' .-ZU52 ZLDiCBALLY AFFECTING THE 2i.t?LCYZ3 , <T I i .--.-m/H. Dccansa-cymi naL/w2usB.'S Sicnaa IV. Nona avb Pacer or Claws u .s a ii Cross FcEcy ' Vbsss sa cf hrapml csrdcsrams ea which ^sa srr ca --S (i) '-A f-J- avar-SLSi .'. -*,="= ia=4;t* jia a as liaunr.se Company wndj yesrc of i;:ci e a._ .................. days afar tbs < SSSt. ?TOef of XCO bcTKsi 7cf tsycf its tpacdad C ?acf Spsshl act tar tbsn[._......... =r"7.................... day. afar tts. I------filter, sf tic prtd cf cccpital caafrasme fcr wi bsitdts ~~~ v1"* under tbs Cross ?idisi y. F37.iT hscyitsl----of the Erortlcycs " '.rede is caused by any one pregtaricy or residim- dciiihirth or eomalications. the Daily Benoit chad l ex be aiid /or more chan fourteen days and cns a of the payments for all Special Hospital "irvicm 'inch thin- delivery room) shall not etc red _-re times the Daily Benent in force on account of ate Emaloyea; provided, however, that no payment cf any land shall be made for such hospital con- Toe insurance C , ipaay. upon rrcapt of the rati, tequbeb by tie Croup Pcccy. wul f--rash such terms as c-_ roi-.iiiy nrrrsaed by it ter ciir.g precis of cam. if >uac fbnas an not rtenved by toe rLiirrinc within train days arcs the inscrertc Gcxyany rceer-es iueh nonce, da dssact dull be bersed to oave ccmpiiuii with da requiresesta cf tac Group Poucy is to proof or dura upon submitting, wsa dc tree seed in ebe Poiicy toe lung proofs of dam wntt_i proof covenng the occurrmce. character and exant at the hospital csasncEent for wJucb data is auric Cate of the Employee's Hospital Expense insurance. Fxiurr to remish none: or proof within the use pro* ndtd is the Greas Pcbcy chad cot icvaiidirr nor reduce Foe all hospital confinement of a Dependent, ' any ciua if 3 shall be shown not a have best resmnaHy inch is caused by any one pregnancy or resulting peeobie to furnish such nonce or proof and that such nets fldhjth or campliasticns. the total of the pay- cc proof w furnished as acoo as was reasonably pradhlt .md beth Daily Bncadss and ail Special .to*- sal Scp/tcea acmhanad not exceed ten time* * Dudiy Scnaac in. dorse on account at such - a. No acaon at law or in eouiry shall be brought a recover no the Group Policy tex a dura hr -- /g'ertai to a d_ iprctc-mt; provided, however, that no payment . any rfr.d shall be made for such hospital conar-tasa if the pregiancy emsted on the effective do of the Hospital Expanse Insurance on account cerebrate pnet to the tapinocn of.. ..^!tT... daya after piece , of claim has bees tied in accordance with the requirements cf ` the Group Policy, ncr shall such acacn be brought at ail i .' auah Dependent. brought widan...TM?.....tears from ths expiraaon of tbs as: withm wbacb proof of dura is required by the Policy. a :.-/'Ll/. L..h . -H 'I . Section V. Patuimt or Claim fTe6jrr.......... v- '-_ -.-.-Ii^ rtL 7y*c`j4i& I Suejeet to cue proa a ax t Eapbys wiS bt * *4188^*0^ serins iny period a ! .^sTtieR^sesanc fer wt-. nw '* J sa ZZ.7 bi. it u.* lli 'Cmxal Pftosflwont ,,,a,^tantfi-(rKirpiBod wQoepajdioaocategr^oB rtca ..No Ajtnt-iai ZTOcsRty co ww dc fgjjirctf'nooeg^br" \*- *' ' (`l'J`., proa cf a ciaaa. nor co extend the sse witbia. nonce '" ' es pass abas<oe^^ n;., ^.A; i . .... ,, \ . xu conicatf j iuc tc insurance %ac boast 02 2"^n^m^asic pna to !c. Tbe inAunrxe does not u 27' prsvicj pvd'up inaunncs* or ion or cud vMucl StcnoM VI. Cmatiom or [jaL'&Aica 8t. .`Ml Hoipiai "rprriic t iw -* r* oa the due cf tenac^can of vr?^fV^J aya espioyacaft. STiO- --- . j --; 0.--t .-cjri'sati tliaa as rtsysinr ef cea ceia cf --- - -->7. ' '' -i~-- '~^ tv,--. . .. j~ ,~j r; st _=st =?tsa cr-aigw caa, V--m-- ; -7 foal PAV TO TK2foWPLOYEi. wbjcsi to the teassad ias.;.,. , cf tin Gran Peter: {:) for Oil7 Oats: a fees a ss tea ef mrstsBt of ess csssest ea , -x.- sea ay a tuea essszseic. as a so cx sr =s r ef 2 yraa ef aaesa foerpd for sil Spas! TMp:sl Ssvea of etbsr sr best ef focfoilrs- Trw ofSntvia Majjuuv Paimctt Type (A)--Aiy-foaia and for arfmtns- . Pivc amra foc..0fuy nr-xff . ngia fosraf, sad us ef caraang f Typ* (B>--AB otter isviea charged for by tbc bespits! ocept ievta a pby liusi or irma1 ouati Five does tbe Dady Beefe Sa Section 2 hereef fer nstxectisaa applicable to Pagsssy end Maternity. Thesssassa peried for payment cf Daily Serfs and tbc maiirmn payeati for Srrr-al Hcarata! Scrveti bd sieve see!! be foe for any one ccccnucua perad of bespits! coefraratt wicsie dss a esc cs csxzsA cf rTT smccssaivc pccccii c hcisi&l cscscscnt dus co ebe occ Cf silted CUSS Of c Tbc --irti--r rvidaad by tbs errataa. --irfing for fcUecaj peps, a pavfosd r-f.-r sad asuajaa. eslcf foepravcaaaef focGtsapPebey. - iwHT^CPCLITAN LIFE 3JS3iiANC3 CCfoPASCf, Ei*~>it sj, 154* fsra jfofo. ji->--, 194a :. . . .. ^Vii , Arritmi - t // ./ 1 //?- X,* '/,/ r/... /> , .*/- . // y / -.. > i . ,, .* _ . __ .. -- . ...... ......... ---- ; : - / // . / /" / / ' ' . /__ / -- " /f,',-/ * / - i- 11i *: ~/SH /: w-'~d/,. * \J '/Z.sfUt*:. &U _________ --If*, U JT P2! ,x< J 44 a a4, 1 4 r/ dir-/ '*\ v ! 1 / /7 * /yv * ^ //7 * tDijjLJ rl. -- - '\ 'a<3 1 ?-} 4 i_J . - /' -' T-' i t i *r - - // <V~ i a '? ^ ; --/* l11 7 iU* -.J f r *-r ' --.'V* ' 'i 1 ' I J j i-i > 1 #- ! / -*//- . , ** <7 ^ ' > A .-/ f: .. * ` j . * i L,dLj -- 1 w 7. a 1 \ i Joi* i s: \ *X'. \ 71? za \ 3 ! , . i-z Jjrti *rr i gr*s rd^~f ra/^/ro J/ /^-~- jJ-M t* /-T / --' C fcrt *_ - polid7. ssi to =2 It a paid up ; <? ^sr:=3 ' scsaucs asa: sszs asancasasoa ? a/: 77-/>' ^ Cato Cortificato .Krraadorad Couatomigtod tyi J - i"<3 ajeoi-rod :': the certificate esaabor&tod Tor trsassisslcn to the 3oo or Hoad Offieo ef the .".ctrecclitaa Life Issursaes Ccrpar? with the data for total disabiitiy and the the application to haro the incurarea prcsies* vaivod. Sot tSsri^s 3s Ecsr Sin (Gpoap) .tAx^ jn^*n*e**A* y** *">-- ted 'tdl Gftfc C-3 m4 &1V# --.p^tfyn dcea&Md. 1?. Saigar died ?oStj^ 12, 1955 Very 7oars, C3S3 STASiS jir~ .".X3 S^3XC3 e _''-_v--`---> ~i) r--n eaU / ** * ***"* !> jwi 3 a--. SGf3?53 ggyi E?K*sf *ri SE*aW-CJ ssatfM A5&4pr*; **SS* s*?K*-r. i t ! i J-*' -r Am U-i.-,r fUmt ^iu M. r smu fl <e> m *. I 37 sM-rti . / c/ejL-/ /j. -,/- S ? 7 x&t.rJi C/- # srid &<*+***, ~d : cT t. vi ........ -f * iS3 L J*^-skJT'-'tSs+i.Wt***.< Jsr ;W**>4p---!.r:*:* <^*s^~!*?USas^'S3K*^^^ ---< -5^-^v v - ..': :' "*M I *)C S3 4- * , i . - I r,-I *-1. ,--rtr 'ii-t T .-; s^g>gSgagtf^l - h!I?CWytcri>maMifa^^""*>` s&Bs&ss&Sf --- 1 T _SU rrxwixw-Ai.rn >r ne\HTt.v*M.* nr.'Arn^xr * i^nrw *.xn ixtwm*T . (Tisrrr<s*nox mult ffAUttULTK .... - J* 1 - 'l ,, _?*-.s;v> ____ _ *vi -: ,--rc2Sa ma ?. . vj. N--ylinli Mtctwi1 liwIiUa ?imai*r Tw iw &R-M7, ot Cfwei 1. 3. Oi 9*r SLm a*-fU*iac am mow tb wpMi f Um < *? f 8m InMfi y 13 tl. tda alia wtf Ua taiiiajtl uaoa m riipUy griliit ia >-**.' tu*. ;n U wtiiail * mm fttmti !i IA* rt-ft ai rfft im- :U, un m fljttf filflM Lx a IHK tf 1U1? is Ua * *" * 4 S---%--iy r MM OU1 MMl. ****** *' *-*- -* - ^ !* WM4 f*M? MtUM. ft i**-'' fU. ..r** ; i*m n^l aift* ttt MA da MTU ** i imu at >i<iln ia M*4 alm> Sa darUCM *f to* imaai p mu ) fiUfciUi N nueaa ta taa im MaiU a wl u, w Mtw far av aaainty it Uia Um ?b* tUftft fi3mia u VIM rifft* mm laft !m Um, mm m id* naatt 2 mUm, Mp* f mMMIi dm U aliw 4 alio* Ouiln f m rlftBft Oft* af MM SmaM ar aim 11 1* mm aaalMU/ Imui uua U MMl OlsafcM a*rt. ImaM a M-nrla af U-U m 4 antha latar. feMM ft. Jmft, I. 9* IMMft. Jma aa ium a tda prmiaaa murimaim, ma faa fam M LM f#r mpawviM itaay. hW 9. JMM, t ft. da 1m* Mdiip *m ^1U firm! mi, data ttay am MlalUiy Ixm m Uaa pnaal um jfanaaa flla, um da Imam uam la ly mrr aUcMOr turaiM U tfa a Uttft 83i r mraM. Mklaf iMIUmiL W4i Mftaiila* ft wry alio: Haaa tft* ?m*lma ma far familm taft bawl 9. ftMft, s. a. tby Waif tmtb. i- -fi-i v Itt ***** Sm*-** it-ia **" *' x s**s*art, 7*. :* tw hear. n. era MM, U. tt, a. hui. *fr*. iaa. Salinity ia*. tt, ~i *. On** a., Wuur, hat. at Ua ft Or. Avar 0*_n^ * -- * ** -^.1 -i to i*.-r,-1* a`*etir.i f"ui* a. .nui*. ... * aa *n* Oi*t**y *y Oaruo mom * to* ?. t. i.naut 3*. ft* at jtwt uniat * ** M at to* lin. b iuw< Oa M la* *** ts** SR* Ola an* *wm yarn* a**, oa ui a a* Oa* all* la at** anil Otaai so, tom. * toa tia* o* at *nuui? irn> t toa sue* B to* iftinia. Haw to** a a* Ml* a yrOiuti, a1--rtr an tam anijti a ia a>la tt tana* a* IU# tf iut ttibaa **> tm traattu It a* Oats trata* fi> St aaagt tt 3* nail. Oi am tatt ttry Itpuo artac a aaaialaa* aawla. 7!y*0aal Malania tlaia* oa la a la aaarrat* nMamit BMraaa tali* a* ran. Ba nummary tat* aa* a ytr man*. I mala* at 00a Matt *M B-'-rin t* 0* tarn* am taaUm. rtmiaw at* > tm nnr tt St* *at warn mu* la o**0 e'-W. a* laaiHiln m toa at aauooaai** aaa aaanlta. la aaa 0S*m n marain taat am mm akl* t* f**a tat 11*** nta Maal aka** to* ran. !Ma aaaa at natalaa aanm* 01* nt|iliain an* ta laataaa* la 4 am 10a non t* n. Bay i mat t* 0* am *0 Satan**, a attal aa*a*00y anmnalm OK nm IS t* 0a 1.7 loom. A matt S-aay, to* taaaro *7 aSleO *0U Oa toraama*, I*nm a t kalian too* am ia lata'.ly Batkin aa nr aa 4aln >*7 nyatnl E ia nnatrt. Sa la aat Oattait, km tt** nan* 0ta ilfftaalty. J<uji Tarn* a*rr ta*ly, /i/iMliU IA .. --,-i \ isa **J5m PL^inivAm^^^ CASUALTY INSUHA.NCE COMPANY ri .] J2C&r^ n r>*u * *%*> mu *m. 3f!ai lutAftAvr !Uti tf K"SdU, 7*ia*. MlUl Ua. b MMrtitM viiii v mrhwi canmin f Wli af.iwa I i^u ienw* ww \Sm AU a tte >Ti. mm earn X-rmy ?i an, ie* 2r. t*U *n b -i ,*ai U 1M, aii tfi )mk raiTv4. hiwii, >tn a4* siuila u firwt jam l* naiim it Itti r tnlr rwi, fr-~ JTU / :<r >KWT r iurtA ? :4 c*,vi' ^y:rs-~:- r- _ ' r Sis****V= Ug'r.-M >* - ; 4"' -, - - ;rs4j*?^'3 ; li'teiut -r-yitM, ba JaSj&_2=22i2s- ......... -juRsnjt 4 1km *> i I ** L mm *+41 mm m mmimrm mm I mm km Mb taw ------- B jea^ik. * Bf . !U. B tB faflMni nr n m.v -.sir yn srtUXa *fM > ,,r**Z5m m ^'ZmXmm. gggggti ^-3 **<-*"*! -jrtSSiS Xr Com MmnL tmMitei ,, K B, O, . uu . .y**- 4J W ___ ^ - ._ * 3-MW .... IS *0 jwwtUkTBf *P^Mt for ><* 1*1 *0 MlMT 4* , F--i obott r far pattttaMr ___ _ JWTKSi TWi ttitiaa Ml b flM ta iftgiOTl itf Jr* sort < Mkr trW r griBlot SW nr UMM a * mmmmm to im or amt fnf i_________ ot Pmjummt o*b tt ta > , -w/t U mo otadom to oafr U* < oorr o< tta* qtmo (fcl kr 4ot b-- ^pta>OT t ao to *nr ransr ob >rwm jotar. or M Wfrai ao a--Sbot twniM i# at Tlta ftrs of Cota Neao iiuto nk for dboMUtt nmtnzg fan U fdtavtar fbrnooiiOToi 2b mmm !taood ob Uta OmM Rjobot Gmm--nua A. fk) STuoboio v iBiarw niam io a*r oBcrtoa^ taiBtaat* drat ooBtaot OTt4 hoadUof ot or IWWI to root or cutaon jMr (SiOj- <D uwwni io f oottboboo iiwmar atrm nrin rocai fcaadfaf at. or iiponw to ttao lw 7%o tom 'Hiarasai CWmoum* m otbT is himni 4 of t&i dotat podttaB d ddtaoo m fata 4t rf '-Sr Trtaoii Cioihowhob Boon! o fuflioi; fata O. vt argraoooo mwn to as i--art wl dtooooo baud wiwoto4 <* Sot- do* t of tbo OmiBiduo ftooooo Ctandoondoo Art noil bo dMl * -kottrmo otoobot ttaB* m U tnn 4 Md ta SotSbb 4 (41 o* HorrinB 1 fata <L jUttadCto noJ feme MB ktaRM to ta oonpoaoB kootatr i cBe* kowt fata 44. Tbf otaoA ta a grOTOapBOT of foot Uut dM. aatnnw Vroaij no wanno* or* 4b boot vtaeO ta**tap to guat of dloofiitOTOTt o*flr iftor a utuww it tfo* or soot f*or^ Acr partr ta morOTt. ta ooOTT. toejBO/ar ttaSuu Piirf oi Jbibiiibi faM. av 4bot iwiiot to ooov '.hot s ic OTrteBiv -^otobot 4jootot eat sa fort past r dtaBBtaMB tarav bb OTSBoom or tan tfai fl* fOTri. .... ms* 'in i in~ i .i \ \ 1. -jn? Umm mu*..** _L * _ . * i * T t *** .rt4 4:.*v`;tr wi .r. : w. J is.Itr-- uMr airua uw ______ f, (9< rHrWJS Jlt*7 - -- - - --- ii'i Is +*> itf* U;i IsJarcd -- (:> la wu t "T- + _ *';; Si. . **J.r oist\blsi .* j*u^ *"... >. ria- is *..1 n< %. 9r*rrrr**t, ?* * _ ;-.) *1^ cr :*c-....., ...i. n . v ! r.*w *ii~ *.. i.r csciiwsc. sisurr*^ ,'s) ?c*; cr i+esm ?' isJ ?0k*r ^ c- V; > ssi-ais " s." -i'-Wilc*!,. " . ..1* ; * f I".. ' ' ` ________________ ..s x J : .*X rr.L^vA^.wg^dae 4 -7 ' --; -.2.=S I-r* ;' -3' '-*? *se * ^*5 +U IM A0 A* to ooeertUclr --rtd " jt hvwTi toft fUla--U % m* ** ' ? f <71.20 (ittf ii m*w of Wt tA Aft*} #r-- r*O0r -fl, ]3J tal U CMtlftl* Uftf--ftor *0 l^*Jt A tbft cl ft t Ml ti total:? iioftto-- *tuu vi lUitfttiftM of un ?oo--yiNsto o*t--u--1 :1mni Act of I4i$: p--ndtot Nwnt, uni u total ilirt U*7 ftf - o*f--d--t, **.o (ii mua of ffta&ftrl*--to to all pMnii lira--d u- -- of <4*000CO. ftii --ftpaft--Uoi pU4 Jolatly, 9B r tti mi Uw 9. 3 , Ab--to* Dir., of Soy-tt it rtiahottoa Pa--rioa*i --foe--* i--cLiti-- Comal*? Iwvuu of t-- dofo*--at, mA Ul p n tf WM yir ml to to e--tmiit of r<ttri*ttu ni of mm of 91-- ftto emtai la th* Suu nom/ Uknati f--d. u > m * iad/0r too iorara-- sarrlftr totUml TSo inn enu. U to tear lato--o% r i$v*u; w *--it-- of too ie%. 1 all tofrj-r^d tor*--to Tio 9. S. Aotootoo P----ylftasto Ho-foe* of too dofo--t, tad eradlt of too Iteu Vq too fflit--nt to* ;* ... . dofiadaat, --d/or too oaX^y lljntaeo Co., laftoroe-- earrlor oX^taia --t of to* a-lao to too " -r 90f ttantff too siaAl23,^ to -- paid Sy too 0. S. iotoui &!., of attofi* tt v ii inn~. lid/er too P-aiylo-la Ka--f--r* jCoBalty latorafl^ft Co--y, tojaraaeo earAor of to* Oof--rtirt, tad 101 or IJ.cbktootoof toyift told by *.N C--atlto of ?--ftyl--aia oat of ---- to to* BftUtV atOABtotisoU Slftftftoo faaa er--tod la : luto Voraa'i fa ~m,- i ,K Vic 7,1* !__-- - _ _ t fr* 1"12Z .I~"sfl:fz?i tj! * ^`f J ^rtnrr'7J ^---- . _ -f-j':*^.`i. .u: -! j.jf;-j-v//j '::^ -ij.'.-'u1 -M i1 4 -Uiilti ri K<ri St: 2i_ v?tf } i w/fi ..I--__C '''>> ,. ** -'^r* n1 ;.n >(//. ?i- *-3^. J? _<*/! ~-L J J *- t/y St UTj >- >_?_ ijul A?) --^/7</ Jf ?>**' in: JSL.i_-___i>_"f_r_.j_iV__j_r._1i_n1_7_f_i_w__w. ;7, 't,-^'V ijg** . wit i^.i ai.a.jr.m.ff{fry* g i'^^.,.24tgltt'zr,7' ^st ig** _ AiA3 I.TL*. !. gjttrfAa --`i*Tl |~ yrr scxt^lii-rr__ T-:wr i >/ j-4 I. I II ii ii i fi ii I -y* \ ; 44'trj TVT -!"'c>44* -*&v T? * -r-i * - .: ss^sssSSIr'; I ) > r^Sn 3 1 .xmtaua Mcr-rvsi v> cctuuirtb ams trerc "' glands urusxs : -- ---- - ------------- cacio-kTio.N s,#i_ EEHAVtOl J. -1 ` LABORATORY -- DATA (.RCfC BLOOD tar UC V.LC. " r" C Ita P............... L............. L............. t........... .... SEXOLOGY far LCD SUMMARY diagnosis UCOUXSfDATlOKB RAtCVC .. r '*= t.. _?; -.. J * --- a W1 pm4 fsjj|j pi |lp^ B 5SJ5:--`-`' Esp--. . \ I \ - *&Ur&F&*icfir.7n*tea,*g y; h:^i j^-J<rf^aeity:>iii!i|iB'- TIP .mSmkiesi Kno 7. Imir 326LI T/12/U -v, sia aao uvAj&i^ t*.,jo o*lieAr tn tots uim> ^r* U I*un for SOM fibrooia U tfto rlt ooa i** ?f ~ ^ rt^it. ffcor* i* * aU<at oocust of aettlla* la ** ftp* *'* ^4 e*nt*sf,Tf tti Witt inn ftomal, uaP Mi Irfi mi* pmiou * "*" f#l^ wl^-a*. * iUpt if ta ftp*. iu f tA i*n mm w*w* aotm* a mill of soealoa la teu iMn. So Wrtitia of Mi t.ne r namml SUftMlat &ftoo aovii la vm rieit iadiooto * J V * *Ti?2!* for ifty MtlTlt? tf taia ilu. tfco aLLiftt fiSrooJ* jsl**o iso loft imp .ofco, aort *o ta# ripn, 1 baiioro, lo ** tJ 4 4mrr* ti uMPmM. Tloro U oit&or i lUpt of Ifea asA *iAa a: att ma or oiJo It la aoio eontrai.7 Misiii taoa tao ovoaL lt\td ftoort. ianiwnani a p^yla* of tai* tamt 4 --orm Ut*r. ____ SWs^`.r '* fewygfts>fr^^af4 Ill*  r* i i I If tt* :94t. Sr. C. Sla, flMftlt {&* f Jfinii1, S3 MU aurialt* Mm*. UMU, Nw, a ftiiMtu w mpim at uw at ua imm i-~rt at urn t. traaaf. fta*a --rata Mr* Ma DOM* m T-U-U, M*a aart raa* V Sr, M. M1KU? " *<**;* fmt a* r-rv T-* '*. tlaaa taa **Raa inmiluT* w, Tiamlii Smw > wink at taa wMai mlauai. CaaamaM nxv m w fw aatai Mar tar aaaaamira auatt- T-U-tf. fta alia ana Uu amwnial mam r* tlMtlr malaaat la uu nam. Am X* aaUanaa far mm fltraal* ta taa rim ana laft laaar laaa, aaa* m taa rttst. Start U a aUft* taatait. at aattilag la t M Rata apaa. Ra aa*> taar at Ua taaaa arraan aaaua, u*aa# taa lafl taa* araaaata a aaaaatM taaar aaaUaa. 1 aU<tt OMatia* at Ua ritftl lUa at Ua laart. Aa iu apaaaan aaattlra. a aaaala at aaaaiaa U Mtft alarm, la main la* at Ula Uwaaaa ar aa*at~ - 1 1 aair. IWlTirUt Rp awacaa la tta rt*at araa laaiaata a atwlaal 11, a mamma tar matt aatlmr at Ula tiaa. Ra aUM Rama* U U* R# ami lat* laaar taka, Mr* aa Ua rtaat, : bwUaaa, 1* at* U * Mirw at tMaatMU. Rat* la alUar a aUR* aiMatia* at ta* rl/Bt Raa at la* Mart ar ala* 1* 1* aara taatrtlir laaata* Ua* taa aaaal attaata* Saar*. tammaama a nwraRa* at tau aaami 4 aaatM laaar. Mar* 9. M, . B. Taar tralr jaw*, *ra runs itsratc sxnsoi at Igtaatat Warn ttaa laa.. ...2am*? tan, maa^^ 'iamSZSa r 1 ,n *- in* |W> itn w 1< I r: - - a.'i ' t ,' -1i ! "'.L.*** * V7' csec? S65IA.1CZ K . i L.i> 1 >> 4 I 4 fin mi--.j11 j iwi h -- 11 in mvmi ^cw si?7.' :,v:r fc *$*=*'- rkWr^ i^S^*.-;S2;-:sr._ ' -:?>: Fs* , . -A **>!: V.#M` `""'if`~-*f-;---A ~~ -- - :------------------- - -- - -=- 1---.- ---^ **^-~ ----- - .- 7-sgr ; ------ ^-^"--^ --'^- -~ ---t" T~- - .' V, 'zzglM ^-V*k3 .,*^| . * i^^':j^3 * a--..- _ -, -- T1U| Mt;Tntfii irw lirr N*t m %m r C`mmi*> * % r-..r....... I <pif * i(VU- <#*** ;a, |4 \ ~`** *'p-^-",,^vr*' Mm itMm ar:u M UtMUM Malta, UtamiMM MtU, it. tttatl it . t. L Ml, ............. Hat St BIB f. *b*zt iarlti iU - *' ' '^jt.-'W.***- =i.. ..*.^iGS |/Pft/S'*l^aJ br. >NH7'i ilaia /ae UrJ^Uiitin Wtti u W irrnM ei ti w tMi / UJ4.M r*?ratae:iB| ala jr ?f Aaa,i:a; iaa* fl&aaam rt ,J J*r 4*y, fUa tSi.tt aym aarriaa Nm, am 4100 trd*l taa/lu. toarltal litileataa tL*t *f. Spam* iu emLa fra* -aesm k) nJRii o^JT 1*, 19*4. 8aawf, tiay etor<a *?' --**--pTl 1tttt taunlsi tto nmit fartea af ur^ttl etfl'n M set: .j # tJat w Mr M tamrto mtr rail UUllitr tea bam Taw mptfilm * ba rrr*ii*to. Tam trulr, Sa ? las r brwiiiruiaUtlkfitromi*mSMtowM , ;^gse: s/ut -w 7 ( >n>BRrnnxn.a*ti E^LOYZIZIT-ZOZ'Z-J. C33> Mo. _2J. s _o5crts-it -- rl^ , r?" . Rp^graasi Ccca/J / ~ Oaawrw, tat < <j"*7VJ i* f.- *tetfij - TIa>: Oesupcis / .. . s** s V. * lei Serosa Dw* * Sum , . *7----f4 m 1 . * n , , to-2*-:--;f->/^<' . <--- 1 *k a_1/:.*T . =^l*- - G**f . \ ffi ~ 1 & '.'/* ,>.-__ 1/ -.-- jwiJ *rfc Ai* 1"*_ n 'r ^-rv V . w .c?/ u' . C*i-i . >4. . / , . ^ata^+AUri -jssrt. -vVi. r-}` <T. a^..-. 0 &<..*.a?.X.-yA~ A .... aA.: iT*+^M. - i-' /1 ^*T>^-------= ''*/ ** ;.'v? If no c'* " 'r7 C31 r- *__ cr .no coi-vir/ Vr-------------- .w *'*** ~~'~ i* 1 ' rr.t=lC9 *lica Gclis?^ I -, ...si- cjf - -^a . t . fS.i Kffte S$< KCS23 C7 BEAUD* ratios No,222S22_ _ ^ - . rcrrv _______ t -: % fr.sj ;--n?-. SrJ -- -- r-- If roa fail to appear. ths petition wC posed of in jaat rtwrrsx. AO wrtaesses whose fial'-iimy yoa present onst *la> ts present at the sssz. gether with reeoxos as 700 desire j- To ..-n. S3 Gxjr^ ft.-, KzSZzsr -lij.j' ~ r~ trs. :e., ^h^v~.r/,v^wCaag) .f- -*- ~ If it is necessary to cnlipcrwa any cf ?w scssBi ccbpoflsu my be btfd i this < I haebj notify job that the above tiatia petition wfll be beard by ns T~.~r-^.- 1 _________________9a30 ,-- ;.^T l.f *??.. Ccsrt % I^saaato?. <r*"` JEM J. f-'ATdS ecu wc_ ...;.. :... : ?srccJ2r7z:3A-- ____: ____________/ CwCil'CY ' -' vaLs.V.vl'J BOARD .;. ^^--assa ' 4SZS3. CC"iCS W. V cl c?a C7 5ZAS2KG Petition No.____ GsT-aieixScs^EJe cJ E17ja-i-3 *..> -L ,, j ---I- . , STRUTS To I V* !r< JS5ulc%s --(* * . V " ' * *i; If yon fail to appear, tSaa petition wSl be C # --T 1 _________ posed of in yoor absence -,.. _ AO witnesses whoa* testimony you dssire . present meat tUo fcs preatnt at Ca bearing gether with sacb records as yon desire to or-- t_-'ii W.U may be bod open 1 --\ - '* y .^ I hereby notify yen that the abort riaan prtftio yd be beard by me on__ ___6. ica*:fiZJLU*. qa*--~>~^a gap *> Prrrgi ff ca . *fc3 rvwr~; Jfeadri 4 i. is --- -^*T-c/y *4<<* (M44 -,*; f " *v hKS<-p*M j.* i^.. t*. ^--%* ?/<A. -w.4 '^U.'s . br~-t^X<& S--~* 7* a-**~L*.*. -TWUiWCm*' **: O.* L-** .*! >,*. :>.-** *c.: mrTWr^.r m' IIi II ,*4 (J. V p pj rr^ / '- _y ^>/ >i coo i \ r ~5hT^fS^t-cL^. '.%.*' CasrtZUi. C/a -CO- S- Qo`-ct,~~* *p I 't'c___ KC2SDA. % si f ^er I .~ '.X rs n t xCr -c ^ '' ' ~- G^,_j y--^-- Ki ^l*"W 2^-' kC' -1 /, r . JU; --<V- rU n, 19SL. IS*. Goldart c. zsa '**** er jsa, tts Cacroa?4* cbar* of tbs Safarov's fersd as i? 8--!7W ,|< jauffte4arers* o*v<cioiioii Sosursaso Ca~^s >* bo disturbed tist Hr. Geldor4 bus Is eioe os ESdbard 3. St v2^ i rfjxt ta <--'> ---a >* os tiyy oro. I rtVia --* In.<gwo to tjo ear sad It bo corroetad ea yc&r safcovpsnt ftir .i I asp* JOB tro ajer4=5 jest rislt. I ca SSacorely yours. _ . # >'trM i~: - --- rrs.-. - >- .............. -> V _ ' V - ; ' ' -> . . .... : . .'if-' ~.r '** ... i-~ -Tr*'!-' _ - 7*A07-V----T----- *i+ *"?"**77=?? ffn**,*.;.. j&ifZjf-: ^ ia t <.* ft * r PS'CeEPZKSASSCM Z0AC3, C2^3STO2A1SB cr P:2KCTLViKU: day nf - > . to r - prrT>g^ The'daetdaii bad been empioyed ia a hazardous occapatioo haring hazard b the ed Petxzyivania for at least tiro yean is the aggregate doling the eight years next pra_ty as ic-ow3: V* . ^ Kant at taslom *. - > ` tlr W-.'`^--e-^ *--**> emir-- 1ZZ2S& tciaa. Oiui at OspizTSuxt rrem -- ?o - -X3 v W*MW% . ... r;i: r 6. -w3*u v; *. - t'4 . , V 1^ . # ^ : - ' -, . v'; 31 Cla cr7=za-5=ts art ss icZrua: ' V^.',5i'f\c ;'Sabam ' j-Dsiiatmes I/ 3SO -.U;. I -- -u-;-. . -itkHi n&tc-.Tzr^: or.jfr: n: ci-1ri-r vA: S;-1- - ,r r . - W ' if * Aso .is ycl'A-* . >* . rj :f- V*r: ..a. ; VT3I i" 1 1. .-:.-.T ** ' *~bAi o; '.. ' * . .r* *:.r) *i.:. *** .4* Id cbisxrnt b a T.iiow or wl' conm'nn !....... 'js-iffe -Ate.-_____ : rrvr.r.w, ... i . . .. ___ i.-4 ~ ............ ......................... ':*r' :6. -TIi c...ajozst was last esgz -i^ia a Lszarde:*. eci"~ -> br-hq t employ cJ.t Jt#idia;t on _day c'^-J 2lt 6. Ths^dretieat becaae totally, disabled on . --___ -dxjrsL "`I -> ? "!>- '.s i' --:va c;"c '.'u -"lT"-- ir '! ; - . . .7 .. ma . -J ~ h"zrd in the a? ^ 5 . -v l.- 2a* . .19- 4 w . i;. *>" -JL. lie V.-ii'iiCXh^.'.idify */ ***V ^.'lwr ' .-.' ,,-. V* it' - *.- < --.. **/>'- -- --- ' w_ - j C--_ i. ' Ww".tli. _ii * V- S--t2--s-=----*--4-a--=-i------- ` S-7, -----------------d-a-y -e-r-f-. ------------------%-*- ------ . *t: --------------------- ---------* r*.-^ -r -r/. 'A - -- /', / Uir^VJ'/iSTOM *?0 iV/UUVm jl'rrfr.-vF.'V,.:v. ~ -- -w 'V! * ^> V .`... fc. r rjy r s^a, on .i-r-i rv. ;;S ~r.cs. 4 ---.-J ; -- a&TiCZ This sstisaa may ba cizsad sad owora. tailor czyt-->ua>-.t far j r^r---`t -i*. >. Si iZ-CifaxT * si biased :: r^ - ' Ple^M =**-' TM? spy-arancs far patitaGa _ "T^n ' . - exact espies either typed or pri-.iad. 1 M1V piste c___-_i_zrz^n e___d__P_t.-- tZi cmy tfa c^jmsi et;^ erf the Bale CL An employe* shall bt defined to hare had as 033rspsle employent erf two yean fa " f'----.-'zr""-y c PinszTivaaia ccriap the efaht yean seat preeadms dtsaouty fa sa a_ pzifaa favo..-izp a s_ca cr r-nrstna canard. ~ i-rr.-n_\i *2 r ^ cr r-er-yam-M th* preeadfa? efahi-ye2n Eelfzr-bS>=rpr.. -u* *.ta- .t. -. Tvnm_ 1_zt b'jrva=::-lcyed.fa zcca cn oeeapatioB dar-g ep3-.twen^-fcsjr-eaiezhzz: --~ ---------ei^s-7r50ii6ci..-v- ' ` ---------!' " ' -- ------------------- I'll: 2zr~. <. lla~: rtatfaa fa t-i bo ~^d far cfaabHl^ reaaltfai from the folloeiag occupation diaec-: " 4 ' :- -~ ___ ; a-w- t:.aCcca.--Ifaaal ^faoa~* Coapjgaatiaa Act." i -- ------------------------- (fa> 5- -~-ii .-17 --* "------i- fa aa7 occupation favohnsj dinct cantact with, -- ex.-acens to da. t erf silicon ci~Tfa1'* (10;). i ............................... L 0) ^ - fa ay occupation favohrirg direct contact with, b-in/ninj of, or to tl -Tfarfaafa *1 - ar l. r.,,-.lfaa". ra rz:i 'ttT-'r rra-.h'2 rf the Claim Fefatfan is' dafasd L: Hale -. or t_> v/r - -- --- Com.tcas-Sfaa Eoarsi ta -a_ows: '.T Cafe 42. Zv.- - :---ptfaa cavolriaj erpcairr to an campaiiopal cfaaarj hmari taasaat*i Ssct: .- , . .'_ ___^-.atiaaal Cc*a; Jtzatfaa Act shall be aeusad a "t~ ~arfi~ji Occupation W tla- -fara fa cut fa LS 6 ft) am Section i. ' .'-!^ale 43. ,*.nf~*;tc real mfaiaj iaii be "'named to be as oerepatkn having a nilla hazard. Hair -14. .'-sac :' Hi bs a '-`ra Let that ia: i-e #4050-1028 2=1135 SATIS AScZSTCS DXV., 0. Gaidar, Dec'd. ORDER A80 AWARD Sea; -nsttlou la, accordingly, aaardec to Boatrice Alice Gelcer vidov of Mchard 2. Solder, dacaastd, at the rate of vl5.00 per veek (442 of*C>5 00 beiag la excess of the --'-t-1 ---- uader tha Act) free April 11, 1950 to JanuaryJlp. 19 -6. the ead of the 300 veek p. period, in tin total sa of v45C0.CC. This eeapens*>vion'*Ss4;a d Jointly, TCS or tae sua of $11..*" --r week to be'paid by tt 0. S. '-Diajtcs Div' ,\of Aaybaatoe fcqiKotta.-. Inc.. dr.'uideat, and/or the Peansyltaaia MasufaS^asap 1 association Casualty Zasarcace Coapcry, <~~--** carrier of the defendant, ead IC'Ji ^ tcSysua of bl.50 per veea to be paid by the Cr.cmavealth of laaasytpaaia out of sn.',s3/to the credit ef the Occupational Disease Fuad, created>o thj SiUte ioriccaa'a Inb^raace Fuad. t score order is to bear interest at ccrding to 410 of the Act. on all deferred payaeats Dated `larch 9, 1951 JCdS B GEATBIH, SUZKii FOURTH CgggSATXOH DISTRICT /fU^c. if. 4- s-- s'/ /gf*SC' ipra a, 1990. Prcacylrcnio Ksaafactsrors' ,/Lmoc-latloc Cr r.t * 3 ty Tv- nappe Ccupcay, 5c LV-st Crsrie Street, T tn-e^", Saar Sirs* The '-'lawiag are copies of the reports of the chert *.rsys of Bichard 9. 3aid These rrt x-rays were ViLts 1-4-50 aad 7-11-47, both ver* road by Br. Sutb. 1-4-50. &s charges ia both aides are slightly son proplacat by cooaarlaca vith the previews -'.la, takes 7-11-47. Zifcgaoaia: Third st.ge ..-be.`asia the ?rerir'-.s file. Silgitly acre s-rlcsd ty coir..fcriaoo with Robert Z. Zvat, >1. C. *-11-4?. Harked fibrosis la taa right sad left lover lobe area, ouch leas as oao t-ceadto the epicas. Toe br.saa e*e eat be veil eutiizod, eridtally ehrcaic basal pleurisy la preseat, laterally la the lover lebao aad the laterlcbar plesrs ca the rlytt side. The heart appears to be rihractsd tcsaijq the ricit to a certai. dcjrea, the ri^ht aide of the heart hhoua scsa dilotsriea. Thera cppearp to a. ecaa brsadsaisj of tho aortic chtdro ss re.-31jottr.in. to deiatica of the tr*c. or aubatorasl tear, so boss pstaolosp. Magaoalsi Asbastosls, Z bailees, a thif-katigo.. lirippbirs- ihijetiy acre ear:, than presort ea the -rrerious fils, takes 1/14/42. Sotort 9. tab, M. 0. Tory truly years. 0SXT72) S74TZS A32SST0S DJ7ISZ03 of Beybestos-Xsahatta, Ire., Coapoay b'urae aad X-?-ay Tecr^ielea i I i fi * s - J - * *' 4J*: a jr * 4* 5" u 4 v* {. if J* ?j- U w vJ' V /. iir 7 a. a : * Jv c <44 /J Jj. ' n ? J. 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V :i-r- XSStiX vv^;^ TJ&iZK ./ V/ >i> r's'r>r.'P /,r*V/jV/Ti ?-/ & TV* *f 0* f yv ,' * rv j > / X/ **; __ 5<x o ^ ^ wr l4^ *, a ,rf ^i. . -o JV ^ 5 / S 1 _________ L__ tN i. i ~i-:-~"r T'-' . .*?./) i 1 f ;:-i 33 ** ,'3?/.-. > .--/*-.V '.' ;jrs -f\ rv ^/ i ' 3 i 7 ^ ` 7~ - > * i 1 Xr *=- (V sM / -- 7*-'L*a.- - ?;^'i X'.' !"=" ] 5. U.'?s'~---- r " - *rz*iJ*<'F!*!1 ' 1 ;a * JV U 3 ? X ".'t//;.-' *> / `-TO i"1/ - ,C 9 % .* *J' -) J//?' -r* 7-Jl l'J I ./ -/* J*5 ! 2X5 5 si -j1- i* i"4l XV ; i r-=n1 iC.27^' *-y V2 iI/O'** *,T.J I :,. n ' y> -i-i i-?rr7 -- --4-*a/-jT] * !.-vn rv i i bU? r^'. ...... f/VT-O i r i - /i**1' ' rv' " '.``'.`ivl* ; r/ j-i*i ' f ^ ! i T 0; t* *t' jv S'* iji '-?i. tv' *2. v : ,*>. iV t JL2JL2JT" y 'z ;/ . * '* * J *4 . __ j f - ' `V */ *-* .s* '*y JI .'.< * *'1 <-y ri:' \rrTE- v-:- .'-/c .i; 7 ' ' \ " . . 4U. .* r'.i t> " Xi -- j"-' a 7 -- r * * v --1 '5 - ; -*'! V r- r-o*'V \ y* i ** /} J *> t??. 4Kg '"TtCM nrr^j 1 Sum i- fnil^ ^ yr^JL^rsf 3 Bafcot /y fcjyL'tJ._____ ___________ Dot* Of Blrtiu >?'---- " sm FUm of Birth; /? . -6u- 7TvJ </! - '(/ kr*i 3 Eaca. ft-woat IdfrWi -* g/~ /** Mr*/? aesnoss css ssccaa ip iapa *Brk___ ' * I year* gli eza.c? vjsz-s c? rrr: ?cr*i 7L, S^s--T- T sZ*_t 8. ~lf_'rL. -S--^ <2 . - /<v, __ .. ^ sf. r /?*<-/* Z. c b / JL* > -71. <-r* i'/zti 2 aLt^c_ r / - jr^ 7. yf - 1. .9. 10 Record period* idle pympqg +/n/->y- -(, M/jL/,r "fa/*s 4. /-/*/*'* -A-**7. ?/"/V 7. 71-^ 9? . hSL^, UJ*t - .rv^r<Zty jL^U-'iS&U no CO, _ 04* yL* y---tf. 4+*.*%--**. ft**"****). .Am. ............... ~~ feat tlsdical (drtea tiara possible^ Tubereulesi*__ Pleuriav temcceia Tuflawa Head ColdsChart Cold; Astisa. gtaa arer.eh' tie Synhilis SlSs Diseases Typhcid rarer_ Scarlet rarer Operation _______________ Srer in Soanital Ever rejected for Life Insurance SrVslre~ifn. i r.t Rhounatisa Valeria._____ ice. Injuria*.. J ydttd <^<g/ . Present Chrcnlt Illness or Ccsalaista 'A r (Freq) Cough Sight Sreata . Protective TBsaisess __ .Char, of . Dyspnoea SS5-/**.**-*. ^LcJ 351Appetite. Location ~SWr Const!potion, Diarrhea Other ecplaints (blood in urine) stone*) headache*; aleep; joist pair.; oocoational dinslaea*) palpitation; nocturia; polyuria) JLl-C~J <-r&) Record tahon by .1US. Ssa>i28i2~tL bklltl_ aelomat VSsice^ IHthcat Glasses Distance St Lt 2o/;>~ 20/; Cclcr 3Iind h-Si' gars; ncsilas. gth Slmti: _______Z0/2*> 20/2 F=d=s. tot: bbsus rffihranas. wptu * turbinates______ Slaaaea: ftcnbala St___ naaiV! arias St___ tt Lt tits -- Buccal 'jcnasat "teeth; bi.s/uL<I -------- 8 7 2 5 4 3 2 1 fsgsn tovSf1 B* Guns -6-Zu Tongue ~~~W ; .:wV= threat: (a) tensile Si it. ri.u yU&+. 1 2 5/4 5 G 7 S 1 2345 L.L. / SrT-r'tr (b ) palate. UT23 /20 0 - Sectored 2 - UBiudne = - Bad "7(c) Bai Astr beat Xocatica 1. Eaxxs* -'/J-. . ?slsa T. A2222 i I 2_CJ2CHISrL2 *1 2 233. 13322 i >' | // 5 7 .;> : Sm9 <9 ! i A# >.< >> 9 ! / ----- ----- ----- >11#5/rr------- Etiological Clara ina'fa--ical Class tactic^ Csa. Poise; Gasastar Associate. Si^ss,-- Cyspsoea, Cyeaosi*, Seek Vetaa, Tassels, lisa, Fcteaaiae LUNGS &qa=ics ^7 tactile Freita * r7? i Parcassia SI. 1=9. Ill fed. i=s. /// Ml sea* saaars . Hrcaaso-s 5.7.3. iftacMil Em5. Feeble F.S. n. is *p ...3. Prolcs^-i Eso. p.2. Tocal Bes cs -sce I.7.E. - .7.3. Frictica 2ob. Bales Sob Creb...SIbeeA Creb ossaScs 39 Coarse CCCScacLaa 900 y av <^/iiw4 -G w; . ; ..? uvlul ' JbdUary gitmcAW.ar inyrtnal i Xtgxcld- ....- (a) palpable ' ' ' fb) diffuse ealsrgepasfc ' - ... (s) gcdnTsa* Si^s of Z:~---i - ggpctayroidla (1) C-.VJ (2) trcasr (5; tacaya-.rtia (*) asiisj ABDOMSN** Slags fit utt Seers DiscJjtrge Serotm Testicles grn?p.rr?TTS and gpnra Posture Mobility | SP2H2 j - Swelling Tenderness j REFLEXES: CIRCULATION Varicose Veins BEHAVIOR General Speeoh CK- ) RECTUM^- Hemorrhoids Sphincter Prostate Vesicles suras nzz 0XHE2 JODIS Irterio-eclarosis *** Geit-^M>k~^ Personality Type * URINE: U LABS-;r. ;V- D-"A 9p.<r'. *'+'& ` iXbs&a. Hlcroacopie iX-a-a-a^ BLOOD: R.a.C.#-7f>* *- B. ? r Z*'-*"/ C. Index a# V.3.C. Pt l*S ri**> Morphology and aoarkai aSB_j Sodicsntatiea Teat* Serology for Lues PLUOR.OSCQrE Horsxl Breathing Diapiira^: Excursion Forced Breathing A.?. Heart: Lateral Sise P.C.Zsne Shape Left Auricle St Lt Position Aorta X-RAY READING  " ...... ? *- - S-r*^' V ' > r* *A *.-.Cl - - /V i.. - --^...-'.2/. .` Visas Pi*. --cal EiJset Kkjr rl^'aacal Soa'oct (UM* ^ i ! puscsisG #* =cai '"J .. \ . A fjj? O 1 RAJIKS **' "-----------, -t | lichard 0. Gelder & 7A1/47 Verged fibrosis in tbs rirht sad left loser lobe area, such less as cae eauehds to the arices. The oases can r.ct be sell outlined, evidently chronic basal pleur isy is ."resent, laterally in the lower lobes and the interlobar pleura OR~,the ripht aids. The heart appears to be retractea toward the rirht to a certain decree, the rirht side of t.ie heart snows sane dilatation. "here appears to be sorae broadening of the aortic shadow and aediastinua. Co deviation of the 1 traenea cr substerr.nl tuner, no tone pathology. 3ignosis: isbestosis, I believe, a third stage. It appears slightly aore narked than present on the previous filn, taxes 3Ait/12. Biehard 2. Gslder ' H 3922 1-4-50 The changes 1 -wia sides re slightly aors pmalrsat ty caapsrisca vith the previous Is, tiran 7-ii-47. Dltgnosls: Third stage sabestosia. Slightly sors narked tjr comparison with ths previous fils. Or. fca. X. Kusewr, 13S East Bich trwt, lUnhela, Penan. Dear Sector Cesser) Jnas7 5, 1990 1*1 lleherd D. Seller, 235 Zest Sigh Street, Mabels, Pence. Th- fellowlag \re copies of the rtrpor' of tho chest s-reya of Sich*rd 9. welder. That* i-reyi were t -fcan 1-4-50 cad 7-11-47 both were reed b7 Cr. Such. 1-4-50 The ehtnee In -u sldea ere alVsbtl? aore crcainant by eoBCurlssn with the prevlt.* fij_( tdtea 7-11-47. Marked !T. rosis Is the rlgk end left lower lobe ree, seen lees a> roe ascends to the aricss. The tises esn cot he veil outlined, evidently chronic heed pleurisy Is crs.ent, laterally is th lover lobes ssd the interlobar ,-leure on the ri*ht side. The --art t-tpowo to he retracted tev&rd the ri$tt tr a certain decree, the right side of the heart *howa acne dilate tloo. There appears to be soss broedening of the aortic shadow ana. sediastisss. So derlttlca of the trachea, sobeternsl tuner- or bone pstbolog. Dlagnoeist isbestoels, X believe, e third stage. It appears slightly aore narked thaw .reseat on the paeviocs Kin, tchch 3-14-42. Sokert D. Swab, M. S XTEC STATES JS223T0S 9I7XSXC3 of Baybeatoa-Menhsttan, loo. Coepcy Worse and X-Esy Technician r JmcaSU, 1S47. &. r. r. cai, li 2x1* iiia S&xoat, Bmt Sbeter Osin Btfart 2. Cdisr, Els* El> Causi, ftaalij fea. &a falXsacLfi^, __ *-77 of tba re.agt of tia cita* of Mcrt 0. Colder, fils sk: x -xj aaa teisa 7-11-17 aad rroi by Sr. Sab* lorsat Tii.-0J.Lt It voa ri&t ud loft Ivor lobe uii, &ea loss u sao ifo-fiti to too 071003. Tio bocos coo act bo aail tllied, erii.siij dorzs-o bcsol pletrisy 1> Laterally la too lacor lebsa aod tic 1-trietar plcara ea too rlit Tic aoart appo^ra to bo reirtsaesi trd tu ri^tt *- * car- tala dorres, toe ri-xt aloe of tie Mart sicss a.o dilaictioa. tesro 0770070 to bo 3sso ireedania; of tie aortic r-iorino ari oodiaottris. So dcvLatioa of too trocOao ar ctctrsal t-anr, os beao patbeioty. BLo^cela: Aabootoole, Z believe, o third stc-go. It 0770070 oli^tly aero oaricod than prcMot ca. tbo previoto fils, tolca 2/li/iJU fibbori 0. Sab, JU 0. Tc7 trely ^ca, aiTiu stirs irrirs rmsnc * 6007037 ocroo 00a X-xejr Yoceairuo vy .1* t i m> TV x m-L. '-a-a*- SJs? ~7TJL--Jx -/> 3 Tri.. g J V i^ . /**. -r/Tfj' CUUm ^ W*fet ,,________ t ** - naBimun ._____ ___ifft-- C*at //!!* ! 7m. Item Bw y-/f-Aji jll1 1 1 /-/? jj' <l-f7-2.i* III; i.^J 1 CZJJ-UZ__________________________:____!____1____: 'hduC.C^UJULAAtU *j*.-*?*>!**1*AS *;!?- %rXTtr ' *S* 0A a*,-X r>-r i ^ t ! # // iJo- /-Ze-Jg.i4-J7-3/ ia at'v-27.it /-(-Jt 1/7^1 /- /- J3 L-if:JJ.. '.h>\S-1.PJ3 J-/r-J7.\ -*' d 1 fit 'l/ivt-ra 1. .1 -4- 1 l I 4^Lv-:r-. \1>C- S* 1 0+y *'fe C4*e*+t*B iI 1 ;' f lit !1 11 ` ;:v 1 I , &Wmi jI oOmwnwrap**rtto'/ a,m_t , 8VO0JX' UIB I . \ /- *1 , ______ : U It*. 3--*~! % Vo->7- if 1 . ., ilV- J/0 -JL :'//%! l/f 1' iiJ JjiC' it/- r-<-o\ . to ,. i/isi 3 - a *r v i---------------------------1l 1! ' \{ ; r l . : .. . . I i . w-> /*! + . AJ " . - |. .. -.. . j"V /-/ fc r * /- - ----j_ ,-r. I 1 _ __ - i! T i -1 r! ! . 1 ' .v C-l* J. A . iwJ.. ? ! / 5-v lit- 1 4.-3 -4i . II!1'- p-.-.ll bri'.-U- L. ^-`/-4<.i F-.slJ -- k* . * n-u*e . T7L 1 *- f- ft jT-!4 -4i | t'-'-.Of,,,', hT>o>T 1 ' 111 1- 1 1 T 'll' . -t laa^a . .v- - r-J \j Captor--' Sip--n [ ______________________________.' Uaiwp Smwi Au*m Daviaw ferx No. ilMMC i %