Document mBd6NRr5ymezNaZQLLdVqeRk0
FILE NAME: Mobil (MOB) DATE: 1968 DOC#: MOB101 DOCUMENT DESCRIPTION: Tyler, John - Worker's Comp Claim
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'7i L*O7 f f i c e ^OMMUNiCAJlON
7 F. L. Gardner, Lancaster
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November 1 , 1968
From V, A. Haggle, Los Angeles
Sub act
Order Approving Compromise and Release
Case No. 67 LB 36087
Workmen's Compensation Appeals Board
John Tyler
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Attached fo r your information Is the October 24, 1968 award In th is c a s e .
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FORM 1901 P r i n t s U.S,A.
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nnrA R T M nN T o f iN n u n rn rA t. r e l a t io n 3
'VISION o r INOUSTftfAt ACCIDCNT0
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'ORKMEN'S COM PENSATION APPEALS BOARD
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join; tyler (rtc c a n c d ),
Dorothy r r u :n a n d ro ::o n rY ty ler
no G u ard ian ad L ite n and T ru a te o
f r CLAUDIA KAY TYLER and
TERR1K LUgJTYLU ;
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The part/ to the above-entitled acrion have filed a Compromise and Release hereto, oa
O ctober 24, 1963
smling this ease for $ 2 0 ,0 0 0 .0 0
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in addition to all sums wliich may have been paid previously, and requestin/phat it be ipprortdf .
and this Board having considered the entire record, including id Compromise and Release, now
finds that it should be approved; and,
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IT JS ORDERED chac said Compromise and Release is approved. .
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eorotuy tyler and G uardian od Litom
. CLAUDIA KAY TYLER
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' ro nonrY TYT/BI 08 end Truotoo fop
ond TERRIS LEB TYLER
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" . r " i . T'.7; AETilA CASUALTY & SURETY CONTAIfY '
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INDUSTRIAL INDEMNITY COUPAMY
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' Payable aa follow oi
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BY AETNA CA3UALTY AND RIRETY COMPANY!
TOI DOROTHY TYLMR and DOI.OTir T/JiRR o a G u a rd ia n nJ L ltc m i ml T ru o to a f o r CLAUDIA KAY TYL1H an d TERME
LEE l'YLER a p p l J c a n t a . ...................................$ 5 * 3 2 8 .0 0 ROSE, KLEIN Ci MARIAS,
Ab a t t o r n e y fc o o .............. ................ . . . . . . . 2 , 000. 00
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BY ARCCNAUT INSURANCE COMl'AfY........................ ..
400.00
BY PIREMAN'S FUND INSURANCE COMTANY...................................................... 81(8.00
by Pa c i f i c employers insurance company. , . . . . . ..................... ..
2 ,0 6 4 .0 0
BY AMERICAN MOTORISTS INSURANCE C O M P A N Y ................................... 1 ,4 6 6 .0 0
BY FIERCE CARD CORPORATION AI PLANT nUBBER AND
ASBESTOS NORiC.j. . . . .
# 060.00
BY/TltE TRAVELERS INSURANCE COMPANY................................................... N^ T . P aO.QOB
BY/STATE COMPENSATION INSURANCE FUND..................... .................... ../2 .00
INDUSTRIAL INDEMNITY COMPANY. ..................................................
684.00
>' D CITIERAL ACCIDENT GROUP........................................... *.......................
9 0 2 .0 0
TO I DOROTHY TYLER an d DOROTHY TYLER a a >r
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G u ard ian ad Llt:om and T ru ato o f o r
CLAUDIA KAY TYLER a n d TEHRIE/ .
LEE TYLEn, a p p l l o a n t a , . VV' '
$ 1 2 ,6 7 5 .0 0
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Mr f
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7V Dato 1 10- 30-68
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F ib e rg la s E n g in e e rin g &
S upply Company (now
o d i v i s i o n o f Owens C o rn in g
FI b o r n l.is C o r p o r a tio n )
5933 TeLegraph Road .
toe A ngelos, C a lifo rn ia
C onst I n s u la tio n Company 2604 Lacey S tre e t
Lee A n g e le s , C a l i f o r n i a
Thorpe In su la tio n 2741 So. Y ates Ave.
Los A ngeles, C a lifo rn ia
J . T. T horpe, In c ; 940 E. Second
Los A ngeles, C a lifo rn ia M arine E ngineering & Supply Co. 941 E a st Second S t. Los A ngeles, C a lifo rn ia In su latio n s, Inc. 532, So. M onterey P ass Rd. M onterey P ark , C a lif o r n ia Thorpe In s u la tio n
Flbcrbosrd C orporation
tit P l a n t Rubber & A sbestos 1789 Montgomery S t r e e t San F ran cisco , C a lifo rn ia
''A rm strong C o n tra c tin g & Supply 4340 D is tric t Boulevard
J .o s A ngeles C a lifo rn ia
"Hahn M ansviile S ale Corp. Leonis S tre e t
Vernon, C a lifo rn ia
A ccurate In su la tio n C o ,,
900 South C ypress La H ab ra, C a lif o r n ia Lee R. E kins Company 4933 V olley B oulevard Los A ngeles, C a lifo rn ia
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P la n t A sb esto s Compony 1300 64th S tre e t E m eryville, C alifo rn ia B echtel C orporation
220 Bush S tr e e t Son F ran cisco , C a lifo rn ia
J , T. Thorpe In c.. '
948 E ast Second Los A ngelos, C a lifo rn ia
: ; A1 P h ilip Carey Mfg. Co.
532 So. M onterey P a ss Rd. M onterey P ark , C a lifo rn ia
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..CARRIER A APilRESS *
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A'ktnA" csTau'*'& sure iY Company'-"*. ,
2404 W ilahire Boulevard
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Los A ngeled, C a lifo rn ia
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A rg o n a u t In s u r a n c e Company 443 Shntto Place
Los A ngeles, C a lifo rn ia
F ir e m a n 's Fund I n s u r a n c e Company 3223 West 6 th S tr e e t Los A ngele3, C a lifo rn ia '
P o c if ic Employers In su ran ce
Company
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4050 W ilahire Boulevard 1 . .
Los A ngeles, C a lifo rn ia , .
S elf-Insured
T ra v e le rs In s u ra n c e Company
2600 W ilahire Boulevard
Los A ngeles, C alifo rn ia
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S ta te Compensation In su ran ce
Fund
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600 S o u th L a f a y e tte P a rk P la c e ..
Los A ngeles, C a lifo rn ia .
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: I n r iu a tr io l Indem nity Company 505 South V ir g il Avenue Los A ngeles, C a lifo rn ia
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American M o to rists In su ra n c e
Company
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3545 W ilahire Boulevard
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Los A ngeles, C a lifo rn ia
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G eneral A ccident A L ife A ssurance 3535 West S ix th S tr e e t Los A ngeles, C a lifo rn ia 90005
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Ofltobor 22*, 1968
Mr MUfo Tomeoen CTLaima Roproaontatlvo Aetna L ife St Casualty 2/fiA H ilshlra Boulovard Loa Angoleo, C alifo rn ia 90054
Door S ir i
fla* Claim Ho. ? (M) 33 CC 215709 MR Employer - Armstrong C ontracting and Supply Corporation Claimant - John Tyler D/A - 3/21/66
Ho havo copy of your l e t t e r ot' Soptomber 18 addrooacd to tho Loa , An^oloo O ffice of Armatrong C ontracting and Supply ro tho qbom claim .
On Jby 1 | 1967 vo se n t to your o ffico inform ation rOinrdlng th a
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oarninpa o f Mr, T y ler. Two ciroloa of our l e t t e r o f Kay 1# 1967 and
< a ll Qttachcd inform ation aro nnoloood. Xcu w ill noto a d iffe re n t Aetna ,
claim numbor was aaoignod a t th a t tim o.
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Tho only additional information vo havo now 111 a brecfcdovn of bid oarningo for the year 1966 and two copied of thia data ehoot or* eloo enalosed.
Very truly youro,
Bialosuroa
Mabel E* Damot Znnumnoo Uopartmont
V . A. Mjffgio ACSfi, Loa A n g e le s (w ith finas)
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ha earned 1,029.60 in 'the 'year 19Sv AIbo, I have t h a following brenkdewa which Lea Ang0-' -a-an1t ce -- -i
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JG roan EarIned
N 3/21/66 tttb>33//227/66
3/28/66 to /13/66 4/4/66 to 4/10/66
Jl 4/11/66 to 4/17/66
T r n :T laid off 4/17/66 _
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AS2SSTCSI3 CLAIM
uwttx u tizirn ai Lasuranco Dent 4/25/67 . . . .
ht 0 c - ^ T - - V V
f ^ ^ 9 U o r ^ n 'L C o s'o r.; a t i c n A tp e c ls S o a r j .: D i j r f .8 i c a k t i d v s i r i i a3ic c id s n tn ,! I
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T y le r w orked f c ^ A rm strong Cork Conpanyj and I A rm strong C o n t r a c t i n g en d S u p pllyy CCco r p o r a tio n
d u r i n g t h e p e r io d s L j s t e d b a ic i; an d r e c e iv e d re m u n e ra tio n i n +thUe a__m__o_uin ts*jsIta te d
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Ve a r e a s a s k e d t o s u b s t a n t i a t e t h o s e f a c t s i
I realise* th a t because of our .R e te n tio n " ^ Records schedule ve do n o b " T
have much o f t h i s i n f o n i a t i c a .
However, p le a :a g iv e u s what you lave
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..j.lcyed b y ALLS o r A rm s tr o n g ? ^ ' Can
you d e te rm in e when Mr. Tyler was first
2 and *56?
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Then I f you c o u ld g iv e He a b reakdow n o f h i: 1962, 1964. end 1965 i t w ould b e m o st `
ods Sc num ber o f d a y s w orked f o r t h e y e a r s
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Period, eralag Earned
9/30/51
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much.
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T ra ile rs
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T h is p o s s i b l y i s e r r c a a c u s . ACTS f a r n e i i / i / 5 e 1 t a e r e i s n o p a y r o l l l i s t e d f e r i b i , q u o r t o r o f *60 under ACS
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R equest Foe In fo rm atio n ' Aetna L ife & C asualty C laim Number T IM) 33 CC 215709 MR John T yler
A ttached la Aetna*a Septem ber 10, 1968 l e t t e r re q u e stin g In fo rm atio n In ro g e rd to Mr. T y l e r 's e a rn in g s w h ile In o u r em ploy. Such in fo rm a tio n la requested fo r the insurance claim th a t T yler has processed.
Wc have re v ie w e d .lth e Los A n geles b ra n c h f i l e s a s f a r back ns th e y a r a p re s e n tly a t th is lo c a tio n and fin d th a t any earn in g s T yler had p rio r to 1966 a re not h e re .
Wc h a v e a t t a c h e d a l l o f th e r e c o r d s p e r t a i n i n g to d a te s o f h i r i n g and te rm in a tio n and would hope th a t you con have th e proper deportm ent in L ancaster research the necessary Inform ation fo r A etna.
We h av e in fo rm ed th e l o c a l A etna o f f i c e t h a t t h i s m a tte r i s b e in g r e f e r r e d t o t h e home o f f i c e and you may f e e l f r o c t o an sw er theca d i r e c t l y from L ancaster.
CS M.C. S w eet, Los A ngeles
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CASUALTY
Casualty A Surety Division 2404 Wiishite Boulevard Los Angeles, California 90054
382 5481
September 18, 1968
Armstrong Contracting 5 Supply 4340 District Boulevard Los Angeles, California
Gentlemen:
CLAIM NUMBER: EMPLOYER: CLAIMANT: DATE/ACCIDENT:
T [M] 33 CC 21S709 MR ARMSTRONG CONTRACTING 8 SUPPLY JOHN TYLER 3/21/66
Mr. Tyler has filed an Application, with the Workman's
Compensation Appeals Board, applying for Workman's
.
Compensation benefits.
He alleges that during his employment for you he sus tained a pulmonary disorder, due to his exposure to * asbestos.
To assist us, we would like you to provide information regarding Mr. Tyler's employment. On your Company letter head stationery, would you please provide the following information:
1. Dates of employment during which Mr. Tyler worked for you, and whether he was hired as tem porary or permanent employee.
2. Type of work Mr. Tyler was hired to do, and a detailed description of his duties. Please pay /: . special attention to whether Mr. Tyler was exposed to asbestos fumes or not.
3. We will need a week by week resume of Mr. Tyler's earnings, while in your employ. Please use the wage statements, that are enclosed, for your convenience.
The above information will enable us to properly defend your
firm and determine what benefits, if any, are due Mr, Tyler.
Your prompt response in providing us with this information'
will be greatly appreciated.
Yours very truly,
* .-' 1
'1 ,Mike Tennesen, Claims Representative ..
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' Workman's Compensation Claims
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EMPLOYED RECORD CARD
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EPFECTIYE CAPI RAT 101 APPROVED
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Hi rod Terminale
Reason
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UNION A f f H i A l
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EMPLOYEE RECORD CARD
Telephon#
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wire ^ J J i a h w c i d -- ije.k e viOQd.
Address ---- -- --- ---------------------------
Address
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HOURLY RATE
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EETECTIYf EXPIRATION approycd
DATE
DATE
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CLASS
DATE
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DEDUCTIONS
TYPE
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7o m e s COMMUNICATION
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To F .L . G a rd n e r, L a n c a s te r ,
From M.C. Sweet ,^j,os Angeles.
3ub{t J o hn T yler Cose tio ,68 LB 36087
August 19, 1968
Attached Is a copy o f a N otice o f Hearing and A pplication for Adjudication o f Claim from the Workmen's Compensation Appeals Board for the subject former employee
FORM 1M1 Rrti>tj I U.S.A.
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* DCPAKTMCNT OF INDUSTRIAL RELATIONS
DIVISION o r INIjUUTJHM. ACC1DLNT3
WORKMEN'S' COMPENSATION APPEALS SOARD
STATC o r CALJroRNM
j o :m tvler z z i (so:i)
I S S S 3I ( BSCSSiD) soROSinr sylsr ( widow)
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SEE ATTACHED LIST
Applicant--
C u e No. 68 LB 36087 n o t ic e o f H ea rin g
ONE FULL DAY
Defendant.... j
YfU> arc hereby notified that an application for compensation hai been filed with the Workmen* Compenntroa Appeal* Board of the $ u u of California You arc further notified that takj Application ha* been jet lor hearing >1
230 EAST FOURTH STREET, ROOM 3 0 2 , LONG BEACH, CALIFORNIA 90812
OCTOBER 3 j 1 9 6 3 , AT 9 :0 0 A.M.
and th a t a t aid time and place the W orkmen * C o m p ila tio n Appeal board will proceed ta hear and dispot* o f the cud application in the manner prescribed by law.
WORKMEN'S COMPENSATION APPEALS BOARD
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LONG BEACH, CALIFORNIA
ny JO HIT L . DTJIU3TT
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meN 1* JiMwr ,1 ik' Wari r.ONTlMJANtrr.V V|| I. nr. CKAMT.I) ONt.Y UI'ON A CI.KAA Ml U V I N G OK CLKW) C'AUlK- * n # n i fw
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utuwM c a m p in g
$ERVEDIIY MAH. ON' POISON'S SHOWN
ON THE OH ICIAL ADDRESS RECORD
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wtiii'jsr? corporation \ . AETNA CASUALTY U SURETY CO.
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E. s . KCKITTRICIC COMP A NY
J . v . THORPE, INCORPORATED
'SELF INSURED
ROYAL INDEMNITY COMPANY AMERICAN MOTORISTS INSURANCE COMPANY PACIFIC EMPLOYERS INSURANCE COMPANY
K 03IL OIL CORPORATION SELF INSURED
MARINS ENGINEERING 6 SUPPLY COMPANY PACIFIC EMPLOYERS INSURANCE COMPANY
PLANT RUSHER 4 ASBESTOS WORKS SELF INSURED
FIDREEOARD CORPORATION' SELF INSURED
HUGH A, ELSDON
PLANT ASBESTOS COMPANY INDUSTRIAL INDEMNITY COMPANY
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KULDOON COMPANY, INC. SELF INSURED
INSULATIONS INCORPORATED PACIFIC EMPLOYERS INSURANCE CO.
TINRMAL ENGINEERING INCORPORATED
HOFFMAN & SON
INDUSTRIAL INDEMNITY COMPANY
*
.
DAI DWIN-EHRET-HILL, INCORPORATED
INSURANCE COMPANY OF NORTH AMERICA
TOE PHILLIP CAREY MFC. COMPANY GENERAL ACCIDENT FIRE 4 LIFE ASSURANCE CORP.
.
SUBSEQUENT INJURIES FUND
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BECHTEL CORPORATION INDUSTRIAL INDEMNITY COMPANY
THORPS INSULATION COMPANY SELF INSURED FIREMANS FUND INSURANCE COMPANY PACIFIC EMPLOYERS INSURANCE COMPANY
ARMSTRONG CONTRACTING is SUPPLY COMPANY TRAVELERS INSURANCE COMPANY AETNA CASUALTY is SURETY COMPANY
FIBERGLASS ENGINEERING 4 SUPPLY COMPANY, A DIV, OF OWENS CORNING FIBERGLASS CORP. AETNA CASUALTY & SURETY COMPANY
RELIANCE INSURANCE -COMPANY
JOHN MANSVILLE.SALES CORPORATION TRAVELERS INSURANCE COMPANY
COAST INSULATING PRODUCTS PACIFIC EMPLOYERS INSURANCE COMPANY SELF INSURED GUARANTEE INSURANCE COMPANY ARGONAUT INSURANCE COMPANY
\
LEE R. ENINS COMPANY STATE COMPENSATION INSURANCE FUND
ACCURATE INSULATION COMPANY, INC. SELF INSURED STATE COMPENSATION INSURANCE FUND
CiOOW C M t s r , APPEARING
T lw a p p lic a tio n Ihtvm
'n ijLrn oti ciL'n J jr,
D ep artm en t of IinliiitrU J Rclrttintie ' UivjiMin of Im JiiK riil A ccident!
Workmen' Coinjiensaij'on Appeal Board
Slate of California
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APPLICATION A O JU C iC A lJC N O f
(Dcolh Com)
CLAIM
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IT IS CLAIMED T H A T;
J. Deceased employee born -- 2 / 2 !?2.9.15 , ,, while employed h a --- ^ S l ? 5 5 i Q 5 --
-- - . ....
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on - . . 2 / . ? / )SJ2._________ , at
V a rio u s ..
of and in the course of employment to ,
2. The injury occurred a# followi;
- C& j .i.4. ._______ ( by the employer uicained injury aruing out IMtUl
?ulr.;o:iary,,D lgordc
llltll air Mill 4 Mil 11| !!
I;^5.^V5B-Ja3LAsUan.t.o.3_
irilll t i l MIM at fiat oa taiwaa no
t *1 ; )
resulting in death on - lT-UPCI--NIlIiHl j*--44111119 6 S -- lfc (
I. Actual earnings at time of* injury were:
Mill Mil U ll l l mt M ill MiMI MI *4141
4. The injury caused dUability aa followei
_l/ICy_5.7_=_5^X9/C-
4i n t i n l i i t m i ora a n out io m d la iH ii m b i m i m i m mom i t i t t m m m i w h i n i n t i *4
f . Compcniation wai
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I I M I u t |
. T i m r n ? I g f i S _________ '
IM II If u l l M iaian
4. Medical treatment wai received J X L iu#
s /iopa,
All treatment w** furnhhed by the employer or uwaranct , .
INI H ill OP lair m iT kiifi
com pany___
other treatm ent wai provided or paid for by
Doctor* nor provided or paid for by employer or iniurance company., who treated or ciamincd for ihia injury a m
(*414 n a il a iim im ii * Mil M ilan ana anil *4 M inm i ti imcmMmMiiaM im iITU MMMI),.
7 Dc/endanu Have paid burial expense. , ____
TOTAL PAID
-
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|, The employee left surviving him the following dependents:
hTAUX
DATE Of PIHTH (if under 21)
RELATIONS!* TCI T/IE EUrLUYEE
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WMEIULFGftE, applicant request! a lieirlng and an award af: Death bcncliuC l-- Burial expente a u l Comptruatioa accrued
and unpaid 1HI Unpaid Medical bills_ULL Q iKct
5pei
and all other appropriate bene Hu provided by law.
Hearing queued it . 2iTT.tr1. *P.?.
, Dxed *<___Sijnifl-kac__cjufn'pi. Juno ?,7. la&S-
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Number of witness.
rt-crial v .a tcd ------ -------
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C ilim jud iim o l ...V
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Sec now
See Uccr en wncujt rcquc*( -------
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52701
T elep h o n e: 5.11-4123 '
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f. address
EARMItrcs
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;h<:idet Cor!: C o r p o r a tio n 116 i.'nL'icr /.venue
ayvood, C alifo rn ia
A etn a -C a s u a lty o .'Surety Company 2404 K ils h ir c boulevard Los A ngeles, C a lif o r n ia 90054
$ 19,976.60
tv b e r g la s E n g in e e r in g & S upply C o ir'a n y , V.ou a d i v i s io n o f Cticr.s" C o rn in g F ib e r glaa C orporation 99 33 'ic lc g r o p n ..sa d
, Los A ngelas, C a lifo rn ia
A etna C a s u a lty & Surety Company
16,669.02
C o n s t I n s u l a t i o n Company
2!>34 Laocy S t r e e t Loo A n g e le s, C a lif o r n ia
A rg o n a u t In su ra n c e ) Company 443 G hntto P la c e Los A n g eles, C a lif o r n ia 9000S
2 ,0 3 2 .2 0
.Thorpe I n s u l a t i o n Company 2741 South Y ates '.venue Los A ngeles, C a lifo rn ia
J. T. T hom -, Inc. 9-18-C a s t S econd S t r e e t Los in g a le a , C a lifo rn ia
F ire m a n *3 Fun 1 I n s u r a n c e Companies 3223' W est S ix th S tr e e t Los A ngeles, C a lifo rn ia
P a c i f i c ILv.oloycrs In su ra n c e Company . 4050 w ils h ir c b o u lev ard Los A ngeles, C a lifo rn ia
4,246.75 700.00
*
;;arir.c en g in eerin g & Supply Company
941 C a st Second s t r e e t las. A ngeles, C alifo rn ia
Thorpe I n s u l a t i o n Company 2741 South Yeses Avsnus Loc A n g eles, C a l i f o r n i a
P a c i f i c E m ployers I n s u ra n c e Company P a c i f i c E m ployers In su ra n c e Company
5 ,1 8 6 .0 7 2 ,0 5 7 .3 8
i
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In su latio n s, Inc. 5 32 S o u th o n ta re y P a s s Road U nteray 'Farm , C a lif o r n ia
P a c i f i c E m ployers In su ra n c e Company
v. 6 ,3 6 6 .3 0
Fibreboard C orporation * 1703 Fontcom ary s t r e e t
Can F r a n c is c o , C a lif o r n ia
S elf-In su ro d
P le a t Rubber u A sb esto s Works
1300 - G/.th S t r e e t
S elf-Incured
. Em eryville, C a lifo rn ia
Armstrong C o n tra c tin g S Supply Company
4340 d i s t r i c t b o u le v a rd
Los A ngeles, C a lifo rn ia
T r a v e l e r s I n s u r a n c e Company 3600 W ile h ire bo u lev ard
Los A ngeles, C a lifo rn ia
John tln n sv illa Sales
C orporation Leonia b o u lev ard Vornon, C a lifo rn ia
T r a v e l e r s I n s u r a n c e Company '
3 , 352.'00
,1,466.00
*. i C, f*'' 4
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U >* 19,117.00
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3 ,0 5 8 .5 0
to il O il C orporation' 12 S o u th V ie w e r s t r e e t Los A ngeles, C a lifo rn ia
A c c u ra te I n s u l a t i o n Con"'
pr.ny, In c .
900 S o u th C y p re ss.
*
La tiab rn , C a lif o r n ia
11
S elf-Insured
S ta te Com pensation Insuranco Fund 600 South L a fa y e tte P a rk 'P la c e Loa A n g e le s, C a lif o r n ia
100.0 0 '
3,730.20
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c o n ti ii he n m v i attachmkht 31
2 ,T .ilr'/^ r K ,A ddress
C a r r i e r s Acidr e ns
P la n t A sbestos company 13CJ - 6 `rt h S t r e e t 3 Jcryvilla , C alifo rn ia
E schtel C orporation
220 DUii t r e _ t
San F ra n c isc o , C a lifo rn ia
Thermal L n g in e c rin g , In c . Hoffman t S outh lO tii S tr e e t Richmond, C a lif o r n ia
J . T. Thorpe, I n c .' 943 P a st. Second S tr e e t Los A ngeles, C a lifo rn ia
i *-.
j . T. Thorpe, In c ."
The P h i l i p C a re y MSg. Company
B32 S o u th M o n terey P a s s Road M onterey P a ri:, C a lif o r n ia
I n d u s t r i a l In d e m n ity Company S05 Souti; V ir g il Avenue Los A ngelos, C a lifo rn ia 90005
I n d u s t r i a l In d em n ity Company
I n d u s t r i a l In d e m n ity Company
Ameri can M o to ris ts 3545 n i l s h ir e .oulevard Los A ngeles, C a lifo rn ia 90005
R o y al G lobe In s u ra n c e Company 210 VJeot S ev en th S t r e e t Los A ngelos, C a lifo rn ia
G eneral A ccident F ire s L ife A ssurance C orporation L im ited
3535 W est S ix th S tre e t Los A ngeles, C a lifo rn ia 90005
Earning '
| * ..
5 3,366.00 , ;
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5 2 . 5 0
, I ` ; ,>'
1 ,2 3 7 .0 0 I.
7,327.00 , !
6 9 0.00'
' M 2 ,2 5 0 .0 0 .
.*
J jh U '
Jo hn T v 'e x ----Case No. 67 LB 360B7
Attached fo r your information i s the subject appeals board n o tice.
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attachment,
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D EPA R T M C N T o r IN O u S T m A l. R ELA TIO N S
DIVISION o r 'NOO'jTftlAL. ACCIUCNF
WORKMEN'S COM PENSATION APPEALS
S T A T E O F C A L IF O R N IA
BOARD
JOHN T Y L E R
n. SEE ATTACHED SKEET
Cat* No. 67 LB 36087
Applicant...
N otice o Tim e and Place of
Further Hearing
NORMAL ONLY ONE FULL ( 1 ) DAY
DtjcnJant.... .1
NOTICE TO ALL PARTIES You ire hereby notified chat further hearing will be held in the above-entitled action at Z30 EAST FOURTH STREET, ROOM 3 0 2 , LONG BEACH, CALIFORNIA 90312
APRIL 15, 1968 at 9:00 A.M.
V O R K M EN 'S COMPENSATION APPEALS BOARD
By
JOHN L . STRUETT 1
JUrjW*
N OTEi CONTINUANCES AND FURTHER HEARINGS ARE N O T FA VOREO.
/
SERVED BY m a il o n p e r s o n s s h o v n o n
THE OFFICIAL ADDRESS RECORD
D i:
2-8-U 68
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1 9 . in s u l a t io n :: im c . PACIFIC EMPLOYERS IN S. CO,
20, therm al cn ln eertn , In c.
1 t>*
3.
J . T . THORPE, INC. ( 0) SELF INSURED
HOFFMAN U CO.
( b ) ROYAL INDEMNITY CO.
INDUSTRIAL INDEMNITY CO. i
( c ) AMERICAN MOTORISTS INS. CO.
2 1 . BALDWIN-El (RET-HILL
I
MOBILE OIL CORP.
,
IN S . CO. OF NO. AMERICAN
SELF INSURED
2 2 . THE PHILIP CAREY MFO. CO.
5. MARINE ENGINEERING it SUPPLY CO.
GENERAL ACCIDENT FIRE 4 LIFE
I
ASSURANCE COHP.
' I
6 . PLANT RUBBER & ASBESTOS WORKS
SELF INSURED'
' 7 . FIBREBOARD CORP. SELF INSURED
*
I
8 . HUGH A. ELSBON 9 . BECHTEL CORP.
INDUSTRIAL INDSWITY CO.
#
10. THORPE INSULATION CO.' SELF INSURED FIREMAN*S FUND IN S. CO.
* '
*
1
. *
1 1 . ARMSTRONG CONTRACTING & SUPPLY CO.
*
TRAVELERS IN S. CO.
-
AETNA CASUALTY & SURETY CO.
1 2 . FIBERGLASS ENGINEERING & SUPPLY CO. now a DIV. OF OWENS CORNINO FIBERGLASS CORP.
AETNA CASUALTY & SURETY CO.
RELIANCE IN S. CO.
13 . JOHN MANSVILLE SALES CORP.
I I
TRAVELERS INS. CO.
t
14. -
COAST INSULATING PRODUCTS ( a ) PACIFIC EMPLOYERS INS. CO.
( b ) SELF INSURED
( c ) GUARANTEE INS. CO. (d ) ARGONAUT IN S. CO.
' 1 5 . LEE R. EKINS CO. STATE COMPENSATION IN S. FUND
1 6 . ACCURATE INSULATION'C O ., INC. ( a ) SELF INSURED ( b ) STATE COMPENSATION IN S. FUND
1 7 . PLANT ASBESTOS CO. INDUSTRIAL INDEMNITY CO.
1 8 . MULDOON CO. INC. SELF INSURED
1
fi, r.
u ie z -
eefo ee TizK jiorjC E JT , r i : .? :- ariosi appeals eoard o? tub
1
s t a v e Ov* Ca l i f o r n i a
2
CASI HO. 67 i o 360Q7
3 JOUl TXIER;
)
4
A pplicant,
)
fi
>
6
T i r : ? n i L i p c A ir _ * m * r j p / .C 'j l i ::s
)
c o r io n :;
7
a c c z 7z :u! f il e
l it i
)
ASSCSAHCS CORPORATIO::, L IO ., e t a l .
8
)
D efe n d a n ts.
9
J
FUOIRCS AMD AWARD A.D
o ren t p srrrn o
pettaic:; i o c k im ss
10
U ose, Klein : !I a r ia a , t y Howard A. Gcblcr, a tto r n e y s f o r ' ,*
applicant
11
B r i l l , H u n t, DeBuys <- D a rb y , b y R ic h a rd L. I'o o rn u , a t t o r n e y s
f o r C en erai A ccident P ire and L ira . Assurance: C o rp ., L td.
12
R o b e rt iUe.T.pusr, a tto r n e y f o r S tateofC orpcnsation In c u r anco
Fund
l \
13
J , D. IJendcrcon, ro p rc e c n ta tlv o ^ S fiJ r^ x c ric a n n o to r ie t
In s u ra n c e Cornany
^ \\
14
I v e s , Ilirt.-sn Ct L i t t l e , by JchvrTV^F ra n a is , a tto m o y s f o r
A m erican M utual In ai.?.:tte^Cfsnii/iy
Ifi
Clop to n Poruiy, by F.ofc'jpfc^L^rijyi a tto rn e y s f o r P a c i f i c
la
17
A rg o n a u t In su re;-.'.-' c _ . .;a.;y
18
llo r lU iy , lio r l il i y i V v v ^ ^ / s i'ai
attorneys
f o r The `ir e voir-
19
A l l e n , P ctci'csiV u i l r u c a i i , toy Dawlir.*, a t t o m e y o f o r
I n d u s t r i a l Xndczu-.ity Company, and I n d u o t r i a l In d em n ity
20
Exchange
K r. H s c in , r e p r e s e n t a t i v e f o r F lr c r m n 1a Fund I n s u r a n c e Company <
21
S a n u e lc o n , B a le e n C: i.1;i te h e e d , by Donald G o n z a le s , a t t o r n e y s
f o r C u a ra n te a In s u ra n c e Company
v ..
22
Brobeclc, P n lc ^ n r H H a rris o n , by ninaldo R claro n l, J r . ,
a t t o r n e y s f o r P l a n t .".ulibar C: A sb e sto s Wastes, s e l f - i n s u r e d ;
23
and Piberfeoard C o rp o ra tio n , form erly Fiber-board Papor
Products C orporation, G ulf-insured
24
Jam es W. H o c K a c ra tts n , by C h a rle s fi. I b o i d , J r . , a t t o m a y s . *.
f o r R o yal In d e m n ity .Company
.!
S ir.3 iIar.-d.lton, a tto r n e y f o r tJo b ll O il C o rp o ra tio n , B o lf-
i
inauved
29
27
An A p p lic a tio n h av in g te e n f i l e d h e r e in ; a l l p a r t i e s hav in g t>
2 0 . appeared, and th e m a tte r having been r o c u la r ly su b m itted , the.. .
29 Bono-.-ablo RAl'.'iOMD LEAVER, D e fo rce , now f i n d s , aw ards end o rd e rs
i
3 0 ' as fo ilo v /a i
.V
f intuiti mtnim
tim i 1 1*4Wtl'lll
I'.'w:anvC` .m.* - A ^ u u U
im
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W, i ,
**>* i f '
* I
y
1
FIM DIKG2 op fact
2
1,
John T y ler, born February 25, 1918, oucfcalned a compcnsablo
3 Injury t o h ia lu n gs, a r isin g out o f and occurring in tho coursa
4 o f hin employment aa an a sb e sto s vrorlicr in C alifornia from 1943
5 through January 9, 19^7 and whilo .-pacifical l y co employed from 6 January 1, 2957 through Jsr.-.-.-.ry 9 , 19^7 by P h ilip Caray Manufacturing
7 Company, which -was then insured by General Accident, Firo and' e L ife Assurance Corporation, Ltd.
9
2 A pplicant has e le c te d to proceed against P h ilip Carey
10 Manufacturing Company under Labor Coda s e c tio n 5900. 5,-
11
3. A p p lica n t's earning a wore maximum at tho timo o f in ju ry .
12
4 . Tho in ju ry caused temporary d i s a b il i t y from January 10,
13 1957 through March 3,' 1257, when sppltoaaV 'c condition bocaca
14 permanent and sta tio n a r y , c n titliW ^ /s r m ic a n t to $70.00 a wao!e
IB during said period,
IS
5. A pplicant i s totaliy^ d iT u rn ed , and Co o f sa id d i s a b il i t y
17 was caused by the inJu r^ b iib r-i^ _^ en titlin g applicant to 240 week3
18 a t $52.50 a tcele or
19
6', A pplicant i s e n t it le d to be furnished with suoh llfa tim a
20 n od ical treatment as may reasonably bo noccasary to cure or r e lie v o
21 tho e ffe o ta o f the Injury.
22
7. Applicant I d e n title d to m edical-legal coots o f $362.00
23 payablo as fo llo w s : $132. CO to Dr. Morton K rltsar; $100,00 to
24 Dr.. .Merborti Shubin; $20.00 to Dr. Charloa Wolnstcin; and $50*^0
25 to ap p lican t ( f o r h is p a r t ia l payment to Dr. ICritEor).
26
8. Subject to c o r re c tio n fo r c le r ic a l error, ap p lican t 18
27 allowed a d d itio n a l m e d ic a l-le g a l costa o f $50.00 fo r rep orts from
8 Dr. Dalwr and Dr. T alarca, payable to Do d o , K lein and M arias.
29
9 . Applicant i s e n t it le d to reimbursement fo r tho reasonable
'30 valu o f self-p roou rod m sdicul treflitmont in 2966 and 1967 r e la te d
ifitiUl!:
foil) *A
37 LD ; 007
-2 -
I iiUlu
MMUS
<Jm74711^ U
. :r i-
*
#* I
1 53 provided by law;
'..-11. llfctlna radical tmotirant
2 pursuant to Finding Ko. C; together with mcdical-lesa! costa as
3 cot'forth in Findings ho, 7 L C; to;"athor with roimbursetnent for
4 oclf-procurod ;.:s<Ileal treatment as sot forth In Findinca lio, g,
5 10 and 12; less lien clad:.; of the Department of Er.ploynent at th e
rato of y70.CO a week for the period January 17> 1967 through
7 March 3 , 1267 in the dsau.'.t of :`,iC0.00; leas :U9.25 payable
8
to Rose, K le in !i .'.arias f o r c o o t s ; l e s s $ 1 ,5 0 0 ,0 0 payable t o
!
.
9 note, K le in Si Marine, applicant's attorneys, aa l i e n for their
f
10 fOO.
f'' .
V;
11
ORDER
* ' '`
12
GOOD CAUSE APPEARS & TliETdiFOr;
13
IT IS HEBEEf CEEDEEB t h a t th e P. S g n V fo r Com m utation b e
14
and i t Is hereby denied.
s /-
s
1
18
16
17
(SEAL)
18
/> *
/ f / rA T'lU D rx tc tt? .___________
J i a i - d i ' 5
jU 'P x l A I f i E o iiu ij)
19
Dated a t Lons Soach, C a lifo rn ia
20 OCT 8 1367
21' Sorved by n a i l on a l l p e r tic a l i a t e d on th o o f f ic ia i addrcna rocord
22 By; a /C , In rjh aa
23
24
ri-
26 26. 27 28
29
30
67
26067
-U -
J
UHI Al
ITill*
} ,
I
J . t . Z eller U n cU U f
August 23, 1967
H ig jlo - Branch H anager-L.A.
John T y le r ' Workmen1l C om pensation Appeals Board * N otice o f H earing
A ttached f o r you r In fo rm a tio n 1* a Workmen'* Com pensation A p p eals Board N o tic e o f Hearing fo r John Tyler on O ctober 3 , 1967
OEPAnTMI-NT o r INnUSTRJAL RELATIONS DIVISION o r INDUSTRIAL ACCIDENTS
W ORKMEN'S (COMPENSATION APPEALS BOARD
I
S T A T E O F C A LIFO R N IA
, 'j y
Case No. 67 U3 36007 No tice o f Hearing
THREE-FOURTHS DAY
S . 9 . ;' 3 - / 0 -< 3/
,, PLAINTIFFS
m
,
You jr* hereby notified t h : v Board of ihe S u tt t>i Cfctiiofvf Cm* .i
. ' pcrt^ium h*f bn filed with tlx Workmen'i Oxtiperuitioa Appeal -.Quutd t u td application hm been act far hej/anf el . .
230 EAST FOURTH STREET, ROOM 3 0 2 , LONO BEACH, CALIFORNIA
OCTOBER 3, 1967 a t 9s00 A.M.
and that at laid time.and plac the Workmen'a Cajnpttmtion Appeal) Hoard will proceed to heat and dispoe* a t th* aaid
application in tha manner prctcribed by law.
1.1.
WORKMEN'S COMPENSATION APPEALS BOARD
Dtud ati WN0 BEACH, CALIFORNIA
Of JOHN L. STREET?
Aa/rrnr
N O TEt Tbe p u M i an n p M d i u eeAnu. .11 di.gv.t-d inner fur drri* w i . . thii hauling. All wi.naetee, teidrer*. pwdiral H f o f . , , t .r e il l i * i atbed | . l d n u n ba ie .ii.b le .t the tieuing. C O N T iN LtA N C LS 1 U Bf. OH A N T t O 0 N L T UPON A C l t A A SH OW ING O f C O O O C A U i l . I reeaa. Im aaeiitivaneai are 1 ba tnade nubia a data e l aba date el the neuca.
N O T E T O IN S V K tD L M tL O Y E A S : Year auindanee at abla beaaieg ataf area be niaiaaeft. Aab jreee Uanraaee
SERVED BY MAIL ON PERSONS SHOWN ON T ^ m c ^ l ADOl^KS r e c o r d
B U W tA t ppiw lUV,
4 '*
'
` 'EMPLOYEES
INSURANCE COS. '*
! i . Mundet Cork Corp. 2. . S. M cX lttrlck Co. 3. J . T. Thorpe, Inc.
i,, ,,
1.
2.
;;
3. S elf-Insured Hoyal Indem nity
^American M o to rists
Am erican M utual I n s . -Co.
\/' r
4. M obil o i l C orp.'
4 . S elf-Insured
' 5 . M arine E n g in e e r in g & S u p p ly Co.
5.
v * 6 - P la n t Rubber & A sb e sto s Works
6. S elf-Insured
'{,7, F ire b o a rd Corp.
7,, S e lf-In s u re d
;/
8 . Hugh A. E lsd o n
8,.
' 9 . B echtel
9,, I n d u s tr ia l Indem nity (
,
10, Thorpe I n s u la tio n Co.
10,, S e lf-In s u re d XFireman Fund I n s . Co,
11. Armstrong C o n tra c tin g & Supply
llX T ra v e le rs In s . Co. X A etna C a s u a lty (t S u re ty C o .
, !' * 1 2 . F i b e r g l a s s E n g in e e r in g h S u p p ly Co. 12y< A etna C a s u a lty tc S u r e ty Co. D lv , o f Owens C o rn in g F i b e r g l a s C o rp . R e lia n c e In s u ra n c e -Co.
13. Johns M anvtlle S a le s Corp 14. Coast In su la tin g Products
13. X Travelcrs insurance
. ' I1'
1 4 . / P a c l f i o E m ployers I n s . -Co. '' Self-InourecI
"O uarontoe Insurance
Co.
.^Argonaut Insurance Co.
15. Leo R. E kins Co. 16. A ccurate In su la tio n C o ., In c.
17. P la n t A sbestos Co. 18 . Muldoon Co. I n c . 1?. In su latio n s Inc 20. Thermal E n g in eerin g , In c.
Hoffman t: Co.
1 5 . < S ta te C om pensation In su ra n c e Fund
16. S elf-Insured
'
S t a t e C om pensation I n s . Fund *"
'. V
17.X ln d u strla l Indem nity
'
18. S elf-Insured
. I.
19. P a c ific Employers In # . Co.
20. In d u stria l Indem nity
21. B aldw in-E hret-H ill, Inc. 2 2 . The P h ilip C arey Mfg. Co.
21. Ip s . Co. o f N orth America
2 2 ^ 0 e n c r a l A c c id e n t F ir e t* L ife Assurance Corp, lim ite d , a corp.
(U a *'14' y* 4
'
I*
l
.
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rO^KAVSN'S CO.V.KMCATOK AATAIS 0OARP. , INDUSTRIAL ACCID ZN T COMMISSION
STATE OF CALIFORNIA
67 LB 36087
JOHN I . TyiEH , JR. HUNPET CO R ? C O R ?., a t 1
Applicant
ssmg Defendant
DefenJonh
J
Good Came Appearing Therefor:
t is HEREBY/QSJQESJIP/THAT t/O c r.sriii P e tro le u m C a v ;/, Incom e & E s c ia e Tax p t . , The 'JLzr.r, n a il/L u is b e r C o. , 'S ts r .d a r d Asbe3<Ci4 HTg. ; I n s u l a t i n g Co. o orns Roger C o rp , V in c u s tria l --'urnccos ,, Xnc. , L r.iu stri c l I n s u l a t o r s , Ino.. o t t e r '/ - C o . i In<vi, c / o John J . C onnor P r o a ., 3 it 3 E r .^ ^ ie e r in g 4 jjp ly "o . , I i i c , , (^!'he .A sb e sto s i: K a.rr.osis iIa to iiri s l 3 (5 ^ J a c k s o n In au -* '' tio n , I n c . / d u lle r AGotin I n s u la tio n s Co. ^C cna In o u ir.tio n C o ., e A n g eles 'o r lc C o ,/ .Recce I n s u l a tit-.-, v'oG, M innesota M ining & M fg ., Co.
| Am a t r o n s C o rk C o . .V T ocotaa A s b e s t o s C o , ] / P l a n t A s b e s to s C o ., T h e rm a l I
Engineering, Inc.
be dismissed as a party defendant in tbe above-entitled case.
Hrfirtt INDUSTRIAL ACCIDENT COMMISSION
vcriKMEN's cokp:7j :i -;.;'' -t appeals Diu 5 -2 L -6 7 LONG BEACH
board
i ,,
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fc '... y,, :.* ' '.^...v. v ft
*
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'
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A ll p e rn '-.a e e rv e d aa l i s t e d bn th a O f f i c i a l a d d re sa s h o o t by a n i l
V
<419] 341*091
0 4 9 t a A O D R E I I AVCftOAMO
ALEXANDER A G EN CY, INC.
..
INSURANCE* WORLD WIDE SINCE 1 0 9 3
U N IO N B A N K B LD P . P IT T B U U R Q H , PA* 111393
June .1, 1967
Y/allace 0 , H offerth ,In su ran ce Manager Armstrong Cork Company Lancaster, Pa.
Dear Mr, H o fferth s
. 1
I wish to and order
S u b je c t: John T y le r v s F ib e r g la s s E ngin eering and 1
SuppX'-Coinpany, e t a l Cal i f or ni a Workmen' s Compensation Case 67"LBj i
Aetna Claim R (D) 33 CC 156S31 MR
`' ,
i
acknowledge copy o f your l e t t e r and N o tic e of Hearing' ; * i
d ism issing party defendant..
I have forwarded t h is to the Standard Accident In3.Co.
ter 31, 196T
i*
1
ATH t SO L
Zip, Dcn Sheltaa Claim Rcprcncntatlvo 53io teina, Casualty and Surety Company !jO!f V/ilehIre Boulevard Boa Anemico, C alifo rn ia 9005*1
. -
Dear Mr* Sieltoni
*
-r
1 1: v ' , '
. `
f
Ex&joctJ Jo!m lyier vs. Fbsrclaaa EncJneering /Ind. "iTcqjpiy c<ETpGny, et al
C aliforn ia Vtorimcn'a Canpcnoatlnn Omo 67 IS 3O&7 Aetna COndm R (D) 33 CC 156U3I MR
Via Junt received the enclosed Kctice of Hearing and Order Pinnrloslpg Party Defendant.
Very truly youra,
dub '
W allace B . ffo ffcrth
Inaurunco liunser
Enclomiree
!5r. D, R, Chriver Alaxcniior Agency, lac. 316 Fourth Avenue Pittsburgh, I'cnnaylmnia 15222
I/0D8 Deportanen t
Alexander & Alexander, Ino. 2225 North Charles Street Baltimore, Maryland 22 PI 3
V >!_.' ,
^ ; / ,, *:, vt . r
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0 *
tu re /tf / Q fH C f COM M UNiCAHON
To from
Subject
J.E . Z eller L ancaster
W.A. M aggio, Loo A n g e la !
Workmen's C om pensation A ppeals B oard John T yler C ase No. 67 LB 36087
Hay 2 6 , 1967
A ttach ed ; p le a s f i n d th e W orkmen's C om pensation N o tic e o f H earing on th e s u b je c t form er employee.
l" 1 . :*. i
` : . I ii * W,
i " . ' `
r o w IJ01 FrtfiiW to U.S.A.
) I
or DEPARTMENT OP INHUOTmAL nf!LA riO N 3
D IV IS IO N
IN D U rjT H lA L A C CID EN T-
WORKMEN'S COMPENSATION APPEALS
STATE o r C A U fO R N IA
BOARD
joua men
vs.
uuTOET come coRponmoH, i
i i.
Applicant
Defendant_
C<ir Wo. <J7 LB 26G 07 Notice o f Hearing
ONE PULL HIT
JOLT 31, 1967 at 9iOO .o . CIO FULL BAT
' Yea ire hereby notified (hit on application for cnmptiuaiaon bi< been filed with the Vo/kmea'l Corapomtian A p ftd i hoard of the State 0i California. You are further notified that raid application haa been act for hcarinf 11
230 x ,
Fcrrcrra stjujet,
loho hsach,
302 c A L i P o n if i A - c o c a
.,
..-.---I.' 1
<A iAA\
, f.'-n- J .. /*. Wt'.-IVA
T, ^ -f'l
{T fy?, ltd Uiit at n id tirm aod pUc* the Workman'* C ooipenm ioa Appeal* Board wdl proceed to Star tod dirpao* v i tbo mH'
*pplication m dw manner prescribed by Law.
:V
WORKMEN'S COMPENSATION APPEAU BOARD
`-a ,'j
johw Rr/.rnrrooisTT
" -v*.
Diced at
lobo bzach, ca u ruralia
. * Y. * .
NOTE/ Tk p a n t am a p u d r# wfcmH il 4**d<*4 wh*n lor dccm>n n Hi* fw arinr Atl
nrp*rt **
**d#*Har
tc i H U niikf* M Ha kaann. C O N T IN U A N C E S W |U T>E G R A N T E D O N t V U f O N A CLEAR S H O W IN G O F G O O D CAUSE. Aa^*<a fa*
ttstU im a n k ara W mad ilk* I, 71 of ik* at* a i ki* Mite*.
N O T T O JN5UA&D Z U fL Q T H A li Y m * u * 4 t c a i h i k *M | m * j mt* ba a f u n t r r . A*k
Uaarttai t ia f iiy .
SERVED BY MAIL ON PERSONS SHOWN
ON THE OFFICIAL ADDRESS RECORD/
Dite
Bjn
5-fi4-7
1 *
flA WCA9 FtHTm$ <w*y, M r) ; '
'i
J ohn m s a s . s j 500- 09-4525 lakaw ood,C alifornia
iu:;urur;ce U ept.
A/25/67
ACCS e n p lo y e a an d f o n a a r l y ACCo em ployee
SB2ST0SIS CLAIM
\
A ncordlag t o a l i s t i n g v a r e c e iv e d from the W orfessn's C o rp en 3 aticr A ppeals B o ard , D iv is io n o f I n d u s t r i a l A c c id e n ta , Long B e a c h , CALIFORNIA, J ch n T y l a r v c c k e d f o r A rm strong Cork jC oppany a n d ' A x a s tr eng C o n tr a c tin g ar.d S u p p ly C orp e r o t i c a
d u rin g th e p e rio d s l i s t e ^ below and re c e iv e d rem uneration in jtlia a c c e n ts s t a t e d .
| :
y
A f - .
We a x e new a s k e d t o s u b s t a n t i a t e t h e s e f a c t a i
I r e a l i s o t h a t b e c a u s e , o f o u r R e t e n t i o n os' R ecords s c h e d u le we do n o t
h a v e e u c h o f t h i s i n f o r m t i c n . , H ow ever, p l e a s e g iv e u s w h a t you h a v e , ! Con yeas d e t o m i n e whsn Mr. T y le r was f i r
1 - A :o j ? - I
1 !. i I:
`
f*/o
p loyed by AGLS o r A rm stro n g ? ' 1 Gan y o u t e l l u s i f h a w orked f o r u s i n *51, 52 mid *567 j -
rfh'c
Thon i f you c o u ld g iv e u s a.^ b reak d o w n o f b ig .e a rn in g s b y v e q k ly p ay p e r i o d s & nurdber o f d a y s w orked f o r t h e y e a ;
1962, 1964 and 1965 i t ucM ldjbe m ost helpful^ ^
I I
t
I I
` !
A lso, co u ld you t e l l jus f o r th ese) 3 y b a rs th ^ re a s o n -fo r 1
K'ETR3::i CORK COMPANY |i
pt
.. n a m e d
9/3C/51 12/31/51
$ 1 ,1 5 8 . :
_______ _
'i S ta n d a rd ' A c c id e n t
'
i
r
Timnk you v e ry much.
I
lib e l
ARMSTROTO CONTRACTING Al) SUPPLY CCPPDR.
F e ria d e n d in g Earned
Insured by
3/31/60 i i- $ 952.
6/30/60
(1,471.50
9/30/60
2,183.80
Travelers I n
11
3/31/52 6/30/52
v 1,359.75 uTravelers |.
.J
i*
*
143.75
9/30/52
308.85
12/31/52 3/31/56
961.35 J ,B
I
jj 2S6,
6/30/56
I 2,24C.^3 .J 11
9/30/56
572.
12/31/60
:: j :
` 187.7)0 1 a U --
r- j
- I - iT h is p o s s i b l y i s e r r o n e o u s . ACCS fo rm ed 1/H /5 &
th e r e i s no p a y r o ll l i s t e d f o r 4 t h q u a r te r o f *60
union t u o
Itt -
3/31/61. 6/30/61 9/30/61 12/31/61
3/31/62 6/30/62
T
I 1 9/30/64
j
9/30/65
2,120.80 2,059.20
366.40 253.60
735.69
869.23 /,& 0 t > `
I
1,972.40
1,519.73
t1 * a 1 a
i , 0i
f
II n :
I Aetsa. C. k
I
toy 1 , 1967
Aotna Cnoualty end Surety Company 0/ Wllohiro Daulnvnrd Lon Angola*)t California 90054
Attention* I-ir, Don Shelton, (Haim HoprooontatiTO VarksaM Compensation Unit
Oentlemsn*
OAEJAHT*
John Tyler- WCAB CAS"' % C7 - M 36007
Insured! Jtrrotrang Cardt Coripsny/Annotrang Contracting
and Sunply Corporaticl
, .
Aetna Claim R (D) 33 OC 156031 HR
In roapenao to your latter of April 11 iro cnoloao tiro shoots giving you all tho infoimticn ua lava bom nbla to obtain f*am our Payroll Dcportioant on tho abovo claim, Under our Hntcnttoa of iocanlo Schedule all infaxtuiticn prior to ''coven yearn and currant* la destroyed.
Ha aro conding a copy af thin latter and tho informAti.cn ohaota to Jiolinnco Inmimneo Caxconioa (Standard Accident) and Tmvoloro .. * Innurcnco Coi-pany (tiirouidi our broJeom, Alcxnruior St Aloxandar) CO they will bo oppriaod of tho available information.
Very truly yourd,
/ Enclosures
Mabel E. Dornat Incuraaca Department
Hotlnnco rhcuranco CorapimtaB
5/;6 South ffingaloy Drivo, JLon Angaloo, Calif, 9COD5
-
Ur, J, D, licGaugiioy, Claim Supervisor -- Zaur filoi 3uoponoo 7116
(Eaaloaurofl)
" '
1r J
travolorn Iwruranaa Company, o/o Alomndor & Alaxnnder, Ino.
2225 IK Charles St.
.. ,
Snltif.uro, Maryland 21210
, 1' '
*
(Enalocncrcs)
V rj
CO O ) CA JSC APPEARING!
11k jpplicifirtn herein ii u i n o/f tiU oJrr.
Drpnnmnit of Icdultfinl lUlituuM Diritinn of Inilumirl Accident
Workmen's Comptmiiion A|i|>eits BosrJ
* Sent* o f C ilifornia
. . k. . ' V " 7
U
AFFIICATION
FOR ADJUDICATION OF C U IM
1
v r
T i t t i t f i t t lg tu J origin*! OmJ i i r cef+ct o n J p r in t or ty p e n s m u 4md o d tir ttu o
AtsnnJED
CASE NO. 67 LB 36087 1
ur. x m u -Ia"
____
6333 Daahwood
iv N iit i Atom i
Sod11Security No__ 00* Q 9 * `4 5 2 5
Lakewood, C a lifo rn ia
. i
is'
u ir u f i ir t iM iilif
SEE ATTACHED L IS T S
SEE ATTACHES LISTS
t r W M ftiia CMNII. a Mt*
r r IS CLAIMED THAT;
1. The injured employee, hue* 2 - 2 6 - 1 9 1 8 ______,
1941 Co 1 -9 ?1 9 6 7
v a rio u e
" employed it > J l J S ? b e s 0 8 W < ?rkeT -_
iUj' iikm if fisi *r mu*rvi __ CtO,l_f_?___ ,, by tJhe employer fu iu in td injury juiting mit
of and m the course o f employttnutt t o ________ 3 ? J i j L 3 i i I = ^ L O ^ j U f l --------- .......
-- -
i . t v Injury oceurred ,, folio* e tc
E x p o su re 'a n d in h a a t'l n 'of s i l i c o n s, a a b e s tP B , -
m i s a n t i i n i i i l * ii Mien it tisi or isiw i woe ismri s u m i m t i
3. Actual earning! it time of injury were; -_ _ ^ 3 5 _ p e r h r . . AO h r 3 . p e r T k.
sSamf UUI
VMMFtl *IU>
i t i m i r n r ( i n i i u i st I s i n < M i n * i f fiM n s lp. l M is t M i i N i i i f n i r t i i i iia u l m iv i l c t m s t
4 The injury atraed liability u follow i: ---- Hill MU a
-- Z & J p--3 l.
**f H I f t n a '1111
1 Compenu cion w u paid .
,
inn
fS4***fi
iH n ifiiii nnu*f)
4. Medical treatment n received .
All treatment wai furnished by the employer t r
i'!
company - X . __ S otber irn tm e o t wai provider! or paid for by _ B .f i I t .
m il
M l
)M t U IW I *IM ) H I M M M H II <H tlH U t C U ll
Doctors not provided or paid for by employer or insurance company who treated or examined for this injury a r e .................-
IL. A . Hnflpi c a l , Long Boflch___
i > s i i u i m u n i i * iuim ioctoii is* *** at u w i n n i l i t * u n i **im i )*itu* iMHi
7% Unemployment Innm nceor Unemployment Compensation Disability benefit! hare been received since the date o f injury. itill *>
I. Other cases have been filed for industrial injuries by this employee it follows; - - K o n i*--
1 ( H l l flUSI
t , This application 1 filed because of * dluyrrem ent rrgardinx liability for; Temporary Inability indemnity-- L . Potmnent dis
ability indemnity T Reimbursement for medical <xpense_X-- Medical treatment--X-- Compeniatjon at propif f its
Other-- . Specify:
------------------------------
. .. ------- .
-
*
-- *
r and applicant rtqwm i a hearing and award of the wm, and for ail other appropmte benefits provided by law, .
' f
N,rin, , lt
J"
t '
Number of wit coirs .
i- Estimated time of * .
lo n g Be a c h ________ Umd M _J.ong_J o a c h _c ,Wliniil> llay 1 2 , 1967 urn
, Pre-trial w anted. m u '**
a x i m roEs i n n .L q"a'^jt: ^ I i f i i l ^ ' t E i t i t w r
pr?r/i7rn & address . r < w m w c 3 for, quarter ktpep
annum
JlundcC Cork Corp. 6116 W alker Avc. Jlayvood, C a lifo rn ia
. *
v
6/30/43 9/30/43 12-31-43 3-31-44 6-30-44 4-30-43 12-31-53 3-31-54 6-30-54 9-30-54 3-31-55 6-30-55 12-31-55 3-31-56 9-30-56 12-31-56 9-30-57 12-31-57 3-31-50 3-31-59 6-30-59 9-30-59 -
$658.90
628.77 769.69 1.002.63
166.50 768.00
2,200.00 1,569.76 1,787.00
243.24 1,734.00
795.60 1,350.50
104.00 1,086.36
1,420.40 653.70
1,610.00 1,411.25 1,616.00 2,006.00
196.80
SELF-INSURED OUT OF BUSINESS
i 1
f J*. . '1 1
*
V
*
E. S. JfcK lttrick Company
7039 South Santa Fe
$-30-44 -
H untington- Park, C a lif.
73.20
SELF-INSURED OUT OF BUSINESS .*
J . T. Thorp, Zne. 948 E a st Second F t. Loo A n g eles, C a lif .
6-30-44 - 505.30 9-30-44 - 328.75
$-30-48 - 334.13 12-31-50 - 78$.25 9-30-53 - 690.00 1 2 -3 1 -5 6 - 321C60 3-31-57 - 1,675.00 6-30-57 - 281.40 3-31-58 - 532.80 6-30-58 - 1,095.20 12-31-58 - 426.60 12-31-63 - 2,055.40 3-31-64 - 1,129.68
SELF-INSURED Royal Indem nity Co. 210 Heat 7th Sc. Los A ngeles'. C a lif . tfRCS-944480 (1-1-52 /53)
American M otorists In s u ra n c e Company 3545 W ilahire Loa A ngeles, C a lif. #6CM-431-B90 (1-1-56/59) 3CM-431-898 (1-1-63/65) Anar lean >iutual In s 8929 Sepulveda Los Angel.ee, C a lif. VSCH 431-898 ; (1-1-56/57) ft: 011-431-898 (1-1-64/65)
Mobil O il C orporation
612 So. Flower Loo A n g e le s , C a l i f . . 90054
6-30-44
100.00
l!arino Engineering & Supply Company 941 E a st Second'SC. Los A ngeles, C a lif.
' . *-
9-30-44 3-31-46 6-30-66 " 9-30-46 -
342.25 378.00 826.00
42.00
12-31-46
966.57
3-31-47 - 394.50
3-31-51 1,168.25
6-30-51 1,068.50 .
P la n t Rubber & Asbescoa Vforka 475 Brannon S tre e t San Franc:.-;ac, C a lif.
3-31-46 3-31-47 6 -3 0 -4 7 9-30-47 w
52.00
305.00 ' 648.00
361.00
SELF-INSURED
SELF-INSURED " ,.
,t
. ... , . *
, . j {
CUT OF BUSINESS
i f,
">
i.
` SELF-INSURED
D robeck, F h lc c a r 6*
Ila rric o n , 111 Sutc
.
S t . , San F ra n cises
(......... . .iTVi-frt-,:Ar-rrrn/.irrinTn n iu ciy A v u tuu;yK H 5ir 75 Drinr.sn S tr e e t, Caa F ran ciaco , C alif*
ft :
j . w n r o o ^ i\.,nyAHTm w iped
12-31-47 3-31-40
6-3(7-40
1 ,0 5 5 ,0 0
902.25 402.00
jCA nnim ^
'.''''V
, BL-Yit'URn' l:
Brohcck, P hleger
& llurrioon
'
111 S u tte r Sc,.
Bon F r a n c is c o !'
f u g h A. UlfldoD 32o2 Enoc Cage
H untington Pock, C a lif.
6-30-46
126.00
SELF- IHS17DFD . CUT OF EUSX1IESS
D echtel C orporation 2.20 Eueh S t r e e t Ban F ran cisco , C alifornia
6-30-48
5 2 .5 0
Tliorpo In s u la tio n Co.
2741 So. Y atea Ave. Lo A ngele, C a lif.
6-30-40 9-30-48 9-30-50
12-31*50 3-31-51
6-30-51 9-30-51 6-30-52 9-30-52 3-31-53
9-30-55 12-31-55
6-30-57 9-30-57
9-30-59
169.00
479.13 752.50
198.75 160,00
198.00 110,00 1 ,0 8 7 .5 0
C 0 3 .3 0 513.3(7 1 ,5 5 0 .2 5
70.00 26.80
187.60
442.80
SELF-INSURED
p rio r to 3-1-57'. In d u strial
Indem nity Co.
505 So. V irg il-
Los Angeles
CC100228
:./
(3-1-57/67)
?
BELF-HISURED
F irem an 's Fund :
In su ra n c e Cocpasr
1616 E. 17th
Canta Ana, C a lif
(1-1-52/53)
F ire m a n 's Fund,, ,
In e . Co.
3223 W, 6 th
Los A ngele#
VC188757
(1 -1 -5 3 /5 5 )
i
fUCI* 3843
1
<10-1-56 v i t h
continuous cover
age WPI20360
:
1 0 -1 -6 0 /6 1 ) j!S
A rm strong C ontracting
9-30-51
-
& S u p p ly Company
12-31-51 -
4340 D la tric c Boulevard
3-31-52
Los A ngeles, C alifo rn ia
6-30-52
<8
9-30-52 12-31-52
3-31-56
6-30-56
,, 9-30-56 .
T2-31-6
3-31-60
6-30-60
9-30-60
3-31-61
6-30-61
9-30-61
12-31-61
3*31-62
6-30-62
9-30-64
.9 -3 0 -6 5
1966
$ 1 ,1 5 8 .0 0
1 ,6 0 4 .2 5 1 ,3 3 9 .7 5
143.75
308.85 961.35 286.00 2 ,2 4 0 .8 8
572.00
187.70 952.00
1 ,4 7 1 .5 0
2 ,1 8 8 .8 0 2,120.80 2 ,0 5 9 .2 0
366.40 253.60 735.69 869.23 1 ,9 7 2 .4 0 1 ,5 1 9 .7 3 1 ,0 2 9 .6 0
fib e rg la s s Engineering &
Suc-ly C o ., tlow A O iv. o f Cucna Com ing P ib o rg laa C orporation
5933 T eleg rap h Rd. Los A ngeles, C a lif.
9-30-52 12-31-52 3-31-53
9-30-57 6-30-59 12-31-62 -
3-31-63 6-30-63 9-30-63 v3 -3 1 -6 4
6-30-64
72.60 567.20 . 379.40
89.40 65.60 '
309.12 2 ,3 0 3 .6 3
2 ,1 2 4 .2 4 367.03
1 ,1 9 0 .6 4 2 ,4^5f 5**.3 4
/ T r a v e le r s I n . " '
Company
. '
3600 W iltshire />*
Loo A ngeles
#2047243 -
(1-1-52/53) .V
fflUB-4991518
<2
(1-1-56/57) ,
vj,:^#llUB-8659227
^
(1-1-60/63), ,
A etna C asualty &
S u re ty Company
2404 w ilo h ire
Los A ngeles, C alif,
798-C2001-C3
1 -1 -6 3 /5 -1 -6 7
M 4
if* >H* -M
A etna C asualty & [
S u rety Co.
C31C-585-RR .
(9 -1 -5 0 /6 7 )
2C-3250-SR (PT)
tf02C*004191 SR-iT .
r e lia n c e Zucurstictt Ccr.7:Cuy
5i0 So. R ingoio/ . A ngelco, C alif*
(p a ric e la uuVr.ovr)
-i t rv
ry
\
^i
I.
b ?j ottr ft^Anoprqft '________
f_iir-irgiiT # t n g i n e e r i n g (cor.tir.ucd) . irca Tacs 2
John M onoville Salea Corp. Lconio Eoulcvrcl . V err.oa, C a lifo rn ia
f-Afln nr-3 12-31-04
3-31-63 1965
3-31-53 6-30-53
ru n trjjnm myorn 798.80
- 1,198.80 4 ,3 0 6 .9 0
6 3 2 .2 0 -L ,l;426.30
-G SEIEL
T ra v e le rs In su ra n c e Co, 0^*78249- 5145 1010 llo rth Main S t. F'.r.''i:*Jlr.3, C a lif o r n ia (7 -1 -5 2 /5 4 )
Coaot In n u latin g Product 2G4 L e e ry S t r e e t Loi A ngelot, C alifo rn ia
6-30-55 3-31-56 12-31-61 -
3-31*02 -
381.20 1 ,6 5 1 .0 0
293.12 1 ,3 6 8 .4 8
Lfift R. E k ln s Company 4933 V cllcy boulevard
Lot A scalofl, C a lifo rn ia
12-31-58
61.60
P n c if ic Employer
In su ran ce Coqpony
4H30 V Jllsh lro B lvdl *
Lofl A n g elao , C a l i f o r n i a
vV'CC-55592 (9 -1 1 -5 1 /5 3 ) ; s::i.p-ii;ciiRE0
O'/T 1)1' EtJSIH :ss
C.nnrantce Insurance
1671 W ilo h ira , Los Angel
V206329, 1 0 -1 -5 3 to
5-1-55 , ' .
A rgonaut IiiEuronce Co.
44J nhntto Place
Lon A n g eles. C a lif .
i
CC67'16 (5 -1 -5 5 /5 6 )
i
Star;;'. Coir.penafltion In . F'I"d
(?7L!7325-58
(10-1-58/1-1-59)
$00 On. C y p rcee St* La H abra, C a lifo rn ia
P la n t A cbesto* Co. 120 6 6 t h S t r e e t E i-sryvilie, C alif.
Ilild o o n Company, In c . 6557 E. Chaw Ave. C lovie, C alifo rn ia iR D u lc tio o s , Tnc. 532 So* M onterey P a s s Rd. M onterey F o rk , C a lif.
T herral E ngineering, In c. Hoffman & So. 10th S t. . Richmond, C a lifo rn ia
E aldvin-E hrct-H lll, Inc. 4800 F.sat 2 6 th S tr e e t Los A ngolea, C a lifo rn ia
12-31-50 6-30-62
12-31-62
9-30-59 12-31-59 3-31-60 6-30-61 9-30-61
3-31-65 6-30-65 12-31-65 1966 12-31-65
12-31-65
-
221.20
- 1,721.24
1 ,7 9 6 .7 6
1,496.00
- 1,768.00
-
102.00
-
109.44
- 1,630.80
799.20
2,911.20
- 690.30
* 1,965.60
1 ,2 3 7 .0 0
-
257.40
Th F h ilip Carey Kfg. Co. 532 So. M onterey P ate Rd. llonterey Perlt, C alif.
1966 1967
1 ,8 2 5 .0 0 ?
'
SFI.F-IISURED S ta te Compensation l o t . Fun d (140046-66 (1 -1 -6 2 /6 3 )
In d u o tria t Indes. Co, CF-C06056 (1-1-59/61)
SKLF-inCTIRED OUI OF EUSINESS ..
s - '' *r( . P a c ifie Earoloyers In a . < , 01-FEC-24319 (4-6-64/67) :
' " ** " I n d u s t r i a l In d e m n lty Co iCC-103031 (6-1 -6 4 /6 6 )
I m u r a n e o Company o i
r**rth America
621 So. V ir g il Ava.
,
Log A ngeles, C a lif.
(V'C -483328 (1 -1 -6 5 /6 6
General A ccident Inour*m
Group
* ''
3535 Went 6 th S tre e t
" Loa A n g elea, C a l i f .
.- -
v, - i
.! , **,ij *
a I
"*. t . `i **
, ) !
1FCL CASUALTY
Casuaify & Surety Divisigli
2404 Wilshlre Boulevard Los Angeles, California 90054 302-5481
Aprii 11, 1967
Armstrong Cork Company Lancaster, Pennsylvania
A ttention: Wallace B. Hofferth, f . Insurance Manager
Gentlemen:
CLAIM H (D) 33 CC 156831 MR - INSURED: ARMSTRONG CORK CORPORATION
CLAIMANT: JOHN TILER - UCAD CADE N0,, 67 - LB 3607
" -v '
CROSS REFERENCE: JOHN TYIZH VS FIBRE CUSS ENQ11ERING AND SUPPLY, ET AL'"
In response to your l e t t e r of March 21, 1967, we have e sta b lish ed tho above claim number and have forwarded a le g a l f i l e to our attorn ey's o f f i c e in case i t i s necessary t o make an appearance before the Los Ancelee Workmens Compensation Appeals Board on your b eh alf. Since our attorneys are p r e sen tly defending Gibre G lass Engineering and Supply Company against Mr. T y le r 's a lle g a t io n s , wo a r e , o f course, being kept advised o f a l l current developments.
In your l e t t e r o f March 2 1 , 1967, you mentioned th at Mr. ^ l e r 1o--employment with Armstrong Cork Company and amount o f wages earned have not y et been 1 substantiated* Since th ese are th e two most important fa cto rs in determin in g the exten t o f exposure, in continuous trauma c a se s, we ask th a t you 1 , b egin an immediate in v e s tig a tio n o f th ese two points and forward your fin d in g s to our o f f i c e , so th a t we can be prepared in case Armstrong Cork
Company i s joined aB a party defendant in t h is m atter.
V e w i l l keep in touch w ith you regarding a l l developments in th is case* :
I,
Very truly yours,
! !
Don S h elton , Claim R epresentative
/<
Workmens Compensation Unit
=J
!,
April Ik , 1967
Ain m i l
Mr. J . D , McCaughey .
'
Claim Supervisor
Reliance Insurance Companies"
5^0 Couth Kingsley Drive
loo Angeles, California 90005
Dear Mr. McCaugheyi
Cdbjeetl John Tyler ve. FlV.crgIo.ca Engineering & Simply, Si;A1 California W. C. Coca 67L230067 Your File - Suspense 7116
Standard. Accident Insurance Company Insured Armstrong Cork Company In California
in 1951 under workmen's compensation Policy A2.71&4GO. Your company did not
Insure us in 1952 as. stated In my letter of March 21; this van an error on cy ' :
part and 1952 should have "been listed as one of She Travelers1 years.
, v
: I *Vi
Armstrong Contracting and Supply Corporation came Into existence on January 1, .
1958 and was formed from the former contracting operation of Armstrong Cork
,
Company. It is a wholly-owned cuboidiary of Armstrong Cork Company and obviously
van not an insured of your company.
- /
Tills case was originally scheduled for hearing on April 6 but it was removed freoj the calendar by the Referee who ruled that It was not in trialable condition* Wo assume that this Information is part of your file even though it vaa not
received and forwarded by us until March 29
Any further correspondence will bo sent directly to your attention.
Vciy truly yours*
' Dl 1
* .
:
*>
*t t
Wallace E. Rofferth Insurance Manager
CERTIFIED
RETUP.IT R E C E IP T R E Q U ES T ED
igfe
.* R .IO T _ iI^ 3 S rO E J
'
i2 s r s x m - A .2 s r o E 3 `
COMPANIES
fM a M OUTH KIH QSLCV D 0IV U C 9 AHC3CLCS* C > L J^ O * N fA 0 0 0 0 5 TC LRFH O N K i (2 1 3 ) O B S -T m
,
'April 10, 1967
RE LIA N C E IN SU RA N CE c o m p a n y R E LIA N C E STANDARD LIRE IN SU R A N C E CO M RA flrr PLANET INSU RAN CE CO M PAN V
Armstrong Cork company Lancaster, Pa. 17604
Attention: Wallace B. Hofforth Insurance Manager
Rc: Our Pile Insured
Claimant D/lnjury
Suspense 7116 Fiberglass Engineering < Supply John Tyler Various
Dear Mr. Hofferth:
A carbon copy of your letter with attachments has. been .directed to this office by our Pittsburgh office.
We will very shortly have litigation in Los Angeles.
In your letter you indicate coverage by^Standard Accident.
Insurance company for the years 1951 and
Could you
supply us with policy numbers or copies of the policies
for those years? You also indicate that either Reliance:'
or Standard Accident Insurance Company covered Armstrong- -
Contracting and Supply corporation and I would appreciate
_ your confirming this, if possible, with policy numbers.
I can appreciate the difficulties in establishing this coverage
and appreciate very much your cooperation. Inasmuch as further
litigation is anticipated at an early date I would appreciate
hearing from you at your earliest convenience.
,
.' v
Very truly yours,
1
RELIANCE INSURANCE CtDMEANISS
JDMc: mg
A *i i
. V"-*
3 .3
J. D. McGaughcy claim. Supervisor OTirr. 1D o t h YtlAR
f ./ r. >:1
'
D EPA RTM CN T o r IN D U IjTHIAL r e l a t io n s
WORKMEN'S COM PENSATION APPEALS
STATU o r CA LIFO R N IA
DOARD (X
J it*
ANSWER ^ H O U R O H CORPORATIOH
\)P
C aio No. L 3 .1 M .(L Z . Dolo c l ottcocd Injuryi L-9AJL , t p , 1 / 3 / 6 7
HOE I I O I L C O R P O R A T I ON
issnstCTfl
Scif - Insured itOBHlt ANI tf IN
!> 1 2 -S. n o w i- S t r i c t. 1 0 5 A n g u i e l
*
(WlVUlttl WI'IN I
_______ 9 ? f> ( F o r m e r l y W o , itim titi *** i# un.twu*fr
397)
AMSWnr/NO DEFENDANTS deny f t ePegafmnt' el ihe Applicolion e i Indicated below with such expfaomlon oi expccnly icl lorili and admit all elh.1 mcteiiol allegations.
DENIALS 1H*1I it muti* il <
J ! ___
Employment
EXPLAIN E L O W
X
O ccupai ion
JL_
tfliury
001 lirtun. I iru d mu
AX
X ,,--_ J C ___
fnmranc* coverage
procured (realm* L(ability for fuiure medical treatment ModlcaMega/ cast*
(E|CRHIlfLatCI Ml IllB MflriH ItllMII 11Ifriflll
JU_
Corning
J ! ____
Periodi of disability
JL_
Permononl driobllity
rr is r u R 7HR a i u g e o
ipr tNHiMiiiiNt it -mitt.*, i imiti
t. Defender!* hqve paid dliebllity Indemnity in fhe total omourrt of 1 V n n n
nt iho rate of $.
f
a wwtk
beginning____________
.threrngk_______
plm
__ _____________
----*
2. Aflirmolive defont** an d olhrr mollarti
ttioM T . Q < 1 r o m o r a t i o n . f o r r u i r 1 y -- k n o w n a s S n r n n y U n h i l . fill f nmf i a n t t , . I n c . *
- S u c c i l i n r .hy . fnftjQ-p_r.-..fl G e n & r a J . . ft,c.tr.n L e . u m C n r . n o c a t i n n
:f
Do/endant* do noi waive ih jighl lo r a in additional ijiuoi In ccuardanco wjih tho provision of law and lb# Rufw a # * . *
Gaelico If odiar iiiuc develop,
r ';
filfmoted time for irfab-------_--_,____, _,________
. All defendant medkoJ report fvov boon filed____________ Additional report will bo filed before
trial--
fri-trfol vankdi . r S ' l
Doled M I ds Annej_c_s__ ColUcmh, J / J 0 / .1 1 ------ '
MOBIL O i l CORPORATION . -t .v*- * tiRPkcii. e I1IVIIBCI aid U i
sg
Stanley Roller 612 5. Flower S t . .
l.A.
9D054
.. 6 2 6 - 5 7 11
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to rc h S9j ler
Am turn,
Tho Aetna C ham lty and Surety Caqpony
Wllshlye Boulevard Los Angola* C a lifo rn ia 905T
Ogrtlmai
Dijbjccti
Jofca Tyler yb.
F ib e r o Ulsu j_ninc^rlr.-{ & S u p p ly , e t a l
C o lif a n ilA W a rta c a 's C c c p c c s a tlc n Cana Bo. 67 IS 36007
This mwi rtlich van nchsduled Tar hearing an Anrll 6, 1967 lo t 'been ordered ct t calendar hjr tbo HcTcrce vlw decided tha r ila von not In a trlalohle condition. A eerjy o f the fleTerco'a notice in unclosed.
Very truly yours,
Wallace 3 . IbiT crth
Insurance Manager DUD
Btclnsuree
Hr. 3 . R. Bhriver
A lexander Agency* I n c .
3l6 Fourth Avenro Pittaburgh, Pennsylvania
15222
Loos D epartment
A lexander A Alexander* In a .
2225 Worth Chari0 s t r e e t Soltizoore, Maryland 21210
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DEPARTMENT OF INDUSTRIAL, RELATIONS
DIVISION OF INDUSTRIAL a c c id e n t s
WORKMEN'S COMPENSATION APPEALS
TATS o r CALIFORNIA
BOARD
JOHN TYLER
v*. FIBERGLASS ENGINEERING AMD SUPPLY INSULATION lifCOLFOSAiCSD AETNA CASUALTY E: SURETY COMPANY
Case N o fy 1,3 36087
Applicant Dcj andanti
Order Joining Party
D efendant
! { i- i-,
G ood Cause A ppearing:
IT IS ORDERED THAT
SEE ATTACH32D LIST
be Joined si i party defendant herein.
JOHN L . STRUETT
Reltic. WORXMEN-S COWENSATTOnT a PPEALS BOARD
SERVED ON' A U . PARTIES USTED
,
O N THE OFFICIAL ADDRESS RECORD C y 0 3 1
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Howard A. G o b ler, E sq . Robert C. W reisner, Esq.' March 23i 1967 Page 2
When th e amended A p p lic a tio n i s fu r n is h e d u s , in th a t c o n d itio n ,, w ith s u f f ic ie n t co p ies to serve upon a l l p a r tie s , the m atter w ill then be r e - s e t fo r h earin g and t r i a l on a l l is s u e s .
I t is noted th at th e a p p lic a n t had sim ila r omplo^.cnt in th is c a s e , as an A sb esto s Worker, a s i n th e c a s e o f OLI-IE \ \ ROGERS
v s . FIBERGLASS ENGINEERING, e t . a l . , Case Humber 64 IP 26779.
I t i s recommended th a t a p p lic a n t 's C ounsel review th a t record to expedite inform ation concerning coverage.
ER:kJb
cc: cc:
BORIS HAYNES
R eferee
^ rt
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March 16,1967
Workmen's Compensation Appeals Board 230 East Fourth Street Long Beach, C a l i f o r n i a
o& r
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Re il John Ty l e r / v s . Fiberglass Engineering & Supply
Case No. 67 LB 36087
Gentlemen:
t h e a b o v e - c a p tio n e d m a t t e r i s now s e t f o r b e a r in g on
Ap r il 6. 1967, P u rsu a n t to in fo rm a tio n re c e iv e d
"From t h e D e p a r t m e n t o f H e a l t h , E d u c a t i o n a n d WeLfare,
A i t i s r e s p e c tf u lly re q u e s te d th a t th e em ployers l i s t e d o n t h e a t t a c h e d s h e e t s h e j o i n e d as p a r t i e s defendant in t h e a b o v e - c a p t i o n e d m a t t e r .
i ;r
Along with a copy of this letter, we are serving the
-i ' "
newly joined defendants with a copy of the Application
previously filed with your Board on January L8, 1967. ' : .
We h a v e requested i n f o r m a t i o n fro m the C a l i f o r n i a In spection Rating Bureau n a t o t h e carriers for these named defendants b u t have n o t y e t r e c e i v e d this infor
mation. As soon ns these carriers are ascertained we will notify them accordingly.
Very truly yours, /
HAG ftnv
IT ) U UpwarcF'/r. Ce bier
ROSE, KLEIN & MARIAS
,
C cployer Haoe r.nd A d d re ss
1* llundet Cork Corp.
/ / 65 South 11th S t. E rc o k iy d , New York
llundet Cork Corp.
E . S'. K c K l t t r l c k C o ., I n c . 7039 S . S a n ts Fe A ve. A . H untington P ark, C a lifo rn ia
J . T. Thorpe, Inc. 943 E. Second S t. J . Los A n g eles, C a lifo rn ia
G eneral' Tetrolevt^3orp. Income b E x cise'T ax D ept. 612 S. Flow er S t. Los A n g e le s, 'C a lifo rn ia
lin rin e E ngineering k Supply Co. 941 E. Second S t. Lot A ngeles, C alifo rn ia
N arine E ngineering k Supply Co.
P la n t Rubber k A jb e jto a Works
g
537 Drannou S t. San F ran cisco , C a lifo rn ia
Tho Lbng IBell Lusher Co.
7.
Weed / \ C alifornia
N arine E ngineering k Supply Co.
F la n t Rubber k A abaatos Works j.
P e rio d Ended 6 /3 0 /4 3 9 /3 0 /4 3
12/31/43 3 /3 1 /4 4 6 /3 0 /4 4 6 /3 0 /4 4
6 /3 0 /4 4 9 /3 0 /4 4
6 /3 0 /4 4
A M in e * 658.90
628.77 . 769.69 $ 1,002.63 166.50 7 3 .5 0
505.50 328.75
100.00
9 /3 0 /4 4
3 /3 1 /4 6 6 /3 0 /4 6 9 /3 0 /4 6 12/31/46 3 /3 1 /4 6
9 /3 0 /4 6
3/31/47 3/31/47 6/30/47 9 /3 0 /4 7
342.25
7 l
i
$ i
3 7 8 .0 0 626.00 ' 4 2 .0 0 966.57
5 2 .0 0
$ .4 0
*
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fl*.
3 9 4 .5 0
3 8 5 .0 0 648.00 3 6 1 .0 0
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Str.cdaTd^Ar:6cotoB H fg. 4 iDCliiPflilR Co.
410 H y ^ l've S t. Kanono C ity , /U so o u ri
F ib r e b o c r d P a p e r P ro d u c t# CwTp. 1709 Kcncguaicry S tr e e t San F rcocloco, C a lifo rn ia
J . T. Thorpe, In c.
Pibrebocrd Paper Product Corp.
Hugh A. E lodon 3262 B. Cage A va. /O . U unclngton P ark , C a lifo rn ia
B echtel Corp.
220 Cush S t. / / Can P rh n c io c o . C a lif o r n ia
Thorp I n c u la e lo n Cotroaoy /X - 2741 S. Yccc Ave.
Lob A n g e le s , C a l i f o r n i a
/3.
C tcarno Unger C orporation 660 Earapek S t. Denver,^ C olorado
In fu c tx io l ^Ttirnac, In c . 946 E. Jlcucoo Ava. / 4 > Loa A n g e l a , C a l i f o r n i a
In d u i.trid f In su lato ra, Inc,
&
tax 3308' Hone ta n , T exaa
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S l a t t e r y U Conrpny, c/o John J,\C o n n o r, 101 V a lle J o ^ S t. D enver, Colora
Inc, Pro.
p e rio d Ended
6/30/47 9 /;10/47 12/31/47 9 /3 0 /4 7 12/31/47
6 /3 0 /4 0 3 /3 1 /4 0 6 /3 0 /4 0 6 /3 0 /4 0
6 /3 0 /4 0
6 /3 0 /4 0 9/30/40
9 /3 0 /4 8
9 /3 0 /4 8
12/31/48
9 /3 0 /4 8
3
f r. 'J 1 `JOI
Amount
3 462.00 4 6 0 .9 0 12,65
' 029.00 1 ,0 5 9 .0 0
$ 334.13 9 0 2 .2 5 4 0 2 .0 0 126.00
5 2 .5 0
169.00 ' 4 7 9 .1 3 .*
311.75 .
1\ 8 .0 0
180.60
1 2 9 .0 0
t.
: .* . ' t;
3
Ih ap lo y er tUun* end Addreos
In d u stria l In su la to rs, In.
,
S h 0 E ngineering 4 Supply C o., In c .
P . 0 . no^x<2531
7 ^ Houston, X a u i
The A sbcqto* U >iagtiesl* lla t c r i s i s Co'.
n . C11h9ic-1a2g7o , MI .l)lRi ne ooriUs S t .
J a c k e o n V I n ta f a C io n , I n c . 'i
Ena 689 t l J c c i t i c;ri\ 'M ic h ig a n
0.
P u lle r A uL tla^T coulatlon Co,
Hsx 36305 V ' ' H ouston, T^aas
H undetC ork Carp: 7101 Tonne 11c Ave. ' * / / H o rth B e rg e n , New J e r s e y
J . T. Thorpe, Ine.
T h o rp e i n s u l a t i o n Company
a * }.
B t S E ngineering L Supply C o ., In c . f u lle r A ustin In su la tio n Co.
Acna Id o u la tio n Co. P. 0 . B ^r'4001 Corpus C h rlo ti, Texas
Lot A ngeles c c /a Co. U. D udley1, ,A . B. McMullen it H. tt. Hargrove
365 H. A ve. 22 t t low A n g e le s , C a lif o r n ia
p e rio d Ended 3 /3 1 /4 9 6 /3 0 /4 9 3/31/49 6 /3 0 /4 9
12/31/49
6 /3 0 /4 9 9 /3 0 /4 9 12/31/49 9 /3 0 /4 9 12/31/49
12/31/49
12/31/49
1 2 /3 1 /5 0 9 /3 0 /5 0 1 2 /3 1 /JO 3 /3 1 /5 0 6 /3 0 /5 0 3 /3 1 /5 0 3 /3 1 /5 0 6 /3 0 /5 0
*
9 /3 0 /5 0
, 1-V*
AenunC
$ 131.15 4 0 .8 5
9 J 4 .2 9 199.95
76.00
792.27 748.20 3 2 .4 0 3 9 6 .0 0 659.26
41.56 4
166.23 '{
$ 786.25 / 752.50 198.75 549.82 % 216.94 251.75 ... 93.81 8 5 .5 0 ' .
133.00 l < .5j ' .*1*-1
' 1 .* f
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fit
123
E rp lo y e r Name end A ddress
Johnn K nnvllle S elee Corp. 22 E . 4 0 th S c . Hew Y ork, New York
ttundet Cork Corp.
T horpe I n s u l a t i o n Company ,
JltradeC C ork C o rp . 1
SO *
Cocot In s u la tin g Produces 2C04 haccy SC. Los A n g eles, C a lif o r n ia
J . T. Thorpe, Inc.
Ar=atrS^ng Cork Co,
Mundet Cork Corp,
SJ`
Cosse In su la tin g P roducts
Rocce I n d u i s t i c o Company 4563 V olley Dlvd. Loo A ngele, C a lif o r n ia
J . T. Thorp, lo c .
T horpe I n s o l a t i o n Company
B < B E n g in e e rin g h S u p p ly C o ., I n c . tlundet Cork Corp.
***."*
P erio d Ended 3 /3 J/5 3 6/30/53
3 /3 1 /5 4 (?/30/54 9 /3 0 /5 4 9 /3 0 /5 5 12/31/55 3/31/55 6/30/55 12/31/55 6/30/55
12/31/56 3/31/56 6/30/56 9 /3 0 /5 6 3/31/56 9 /3 0 /5 6
12/31/56 3 /3 1 /5 6 12/31/56
3 /3 1 /5 ? 6 /3 0 /5 7 6/30/57 9 /3 0 /5 7 9/30/57 9 /3 0 /5 7 12/31/57
. *; t
- `V*C
6 * .v * *' \
i *. o i-v! <
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Anoir a t
i
632.20
1,426.30-
/. : 1
$ 1,569.76 1 ,7 6 7 .0 0 243.24
3 1,550.25 7 B .0 0
( b
'' , .s c <
1 ,773945..06 00 1 1 ,3 5 6 .5 0
3 6 1 .2 0 *
$ 321.60
266.00
2 ,2 4 0 .6 8
572.00
;. k
%' f" 1
'?* . '
104.00 1,066.36 1 ,4 2 0 .4 0
1 ,6 5 1 .0 0
uoao
i 1, * nVtf i'" l%! V' .. * /V, %',, :J< 'ji1 `7
VK.,- V
"il ;.i,.j-' t i* i,:
/ c
> 1,675.00 281.40
i 1 I i -*k
26.80 <
' J
167.60
207.67
'l
653.20 . <
1 ,6 1 8 .8 0
.4
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T c p lo /e r H*o< c r '1 Adrtrt?*
Ovens Corning F ib e rg la s Corp. p, 0 . Bex 901 Toledo, Ohio
J . T . T horp, Xnc.
* ,
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Jiundet Cork Corp.
Loe R. Ekfno Company 1.933 V alley B oulevard Loo A n g eles, C a lif o r n ia
Accurate In su la tio n C o., In c . 900 Scudi C ypress S t. 3 / - La H abra, C a l i f o r n i a
Thorp* I n s u l a t i o n Company a
Kndet Cork Corp.
'
Owen C orning F ib e r g la s C o rp .
P ln n t A cced as Co. 1300 Gjif\stre*E E aeryvtllc/' C alifornio
ty 'V S /Vc/jy -Tlrnottong-Gork^-Co-i--
y--y O titi*-
P lan t Aabeotoa Co.
Anastrong C ontraccing & Supply C o rp o raci n
120 N. 1,1=8 3 t . Lancaotcr, Peonarlvanls
Ccaot Iswuleting Products
Arnotrong Contractiog & Supply Corporation
P e rio d Ended
9/30/57
3/31/50 6/30/56 12/31/58 3/31/58 12/31/56
12/31/58
9/30/59 3/31/59 6/30/59 9/30/59 6/30/59 9/30/59 12/31/59 --------- 12/31/60 3/31/60
3/31/60 6/30/60 9/30/60
12/31/61
3/31/61 1730/61 9/30/61 12/31/61
i . ;> tf !
Amrum C
9
09,40
$ 532.80 1,095.20 . 426.60
1,411.25
61.60
221.20
6 442.80 1,616.00 2 ,0 0 6 .6 0 196.80 65.60 1 ,4 9 6 .0 0 1,768.00
9 187.70
102.00
952.00 1,471.50 2,180.60
293.12
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a l ia c i n o
A LEX A N D ER A G EN C Y , INC
INSURANCE-W ORLD WIDE SINCE 1 0 9 3
'u n i o n b a n k b l o p i . - p i T T n a u n a H , p a . i s a a a
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March 22,1967
Wallace B.Hofferth,Insurance Manager Armstrong Cork- Company Lancaster, Pa*
Dear Mr, Hofferth:.
Re; John Tyler Ys Fiberglass Engineering & Supply,et Caliiornia Workmen's Compensation Case N o /6 7 LB3
We wish to acknowledge receipt of copy of letter and papers in connection with the above,
V/c have forwarded them to the Standard Accident Insurance Co,- for attention.
Very truly yours,
`
p
S.A.Huy H.
,,I, -ru-PIThU
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