Document xd52q4kXLqpBymGk8LOe9p7Q1

LAW OFFICES OF HANNA, BROPHY, MACLEAN, MC ALEER & JENSEN OAKLAND, CALIFORNIA 94612 1970 BROADWAY, SUITE 1225 415 - 339-1180 RICHARD BROPHY CHARLES M. McMlLLAN * CARL J, WEBER* Ro b er t l . Mc Ca r t n e y * MICHAEL H. YOUNG JAMES ft. LIBIEN* ROBERT G, HEYWOOD * PATRICIA A. NOLAN FELIX ALFRED AYCOCK JEFFREY A. GRANT CRIST1NE E. GONDAK FRESNO, CALIFORNIA 93721 2310 TULARE STREET, SUITE 330 P. 0. BOX 1312 193715) 209 - 266-9823 IRVING H, HIRSCH* HOWARD L. WILSON* DANIEL P. O'BRIEN* JOSEPH A. IGOA* REXFORD M. THOMAS TERRENCE J. BYRNE BAKERSFIELD, CALIFORNIA 93309 200 NEW STINE ROAD, SUITE 220 P.O.BOX 11019 (93389) 805 - 397-1212 ROY O. BAEHR* IRVING H. HIRSCH* KENNETH J. DORMAN PROFESSIONAL CORPORATION SAN FRANCISCO. CALIFORNIA 94105 595 MARKET STREET, SUITE 900 415 - 543-9110 WARREN L. HANNA OONALD R. BROPHY ROBERT N. Mac LEAN* JAMES V. BURCHELL* ALBERT H. SENNETT* MICHAEL G. LOWE* JOHN W. MOORE* RICHARD C. KELLEY* THOMAS J. BRINOLE KERMIT N. SPRANG JOHN L. ARMANINO W. DENNIS BREWER DIANE E. 2AG0RITES SANTA ROSA. CALIFORNIA 95404 900 COLLEGE AVENUE 707 - 576-0331 RICHARO C. KELLEY* ROBERT J. KANE REPLY TO OAKLAND OFFICE February 21, 1984 Taoinia Crockett E.S.I.S. 39510 Paseo Padre Parkway Fremont, CA 94537 REDACTED SACRAMENTO, CALIF. 95825-6380 99 SCRIPPS DRIVE BOX 255267 (95865-5267) 916 - 929-9411 DONALD V. MITCHELL* FLOYD C. CARRICO* GERALD M. KENNEDY * JAMES C. CUNEO* JOHN H. BLACK* MICHAEL K. WARD* JAMES R. MISSLER* MICHAEL S. BALAVAGE R. CRAIG LUSIANI CHRIS ELLEN WILLMON HELEN C. BERGER ELIZABETH S. SWANBERG WILLIAM E. SIGNER HERBERT C. JENSEN.* o f c o u n s el SAN JOSE, CALIF. 95126-2262 1671 THE ALAMEDA 408 - 298*2393 WILLIAM C. CARR* JERRY C. DUSTHIMER* MARTIN S. WEINSTEIN* WALT AYLWARD* CARLENE J. KAHN* H. ANNE POTTER REDOING. CALIFORNIA 96002 300 KNOLLCREST DRIVE, SUITE 1 916 - 223-6010 t FIL8 10 O. PAT McALEER ITE Jo s e p h r . Mo n t g o me r y EDWARD P. llALEER,* o f c o u n s el * so pv C FEB % I V i M a i WCAB Case Nos. s. Sherwin-Williams Co. staal OAK 105568, 116383, 116384^~~ M Dear Ms. Crockett: We are in receipt of your letter of 1/3/84, Please accept my apologies for .the tardy response. In your letter you requested that we discuss settlement as between Mb and Aetna by way of a Compromise and Release per Dr. Lipton's 10/14/83 report. Unfortunately, the applicant's attorney is unwilling to discuss settlement with the defendants, individually or otherwise. This is because the applicant, as you know, has continued to work and has had subsequent injuries. Mr. Furtado, the applicant's attorney, has made arrangements for the applicant to be examined by Dr. Sigurdson on February 24, 1984. He will not be in any position to discuss settlement of this matter until he sees what Dr. Sigurdson has to say. I enclose a copy of two applications for your file. They are OAK 116384 alleging a date of injury of 10/26/83 to the right shoulder and back (off wort 10/27/83 - 11/15/83), and OAK 116383 alleging injury to the right shoulder and back as a result of an 8/26/83 incident (lost time unknown, if any). We note that Dr. Lipton found the applicant's condition to be permanent and stationary and the applicant is not in need of any further medical treatment or chiropractic treatment as a result of the 8/28/82 specific injury. He precludes the applicant 0007-SWP-005805353 CONFIDENTIAL E.S.I.S. 2/21/84 Page 2 Re: REDACTED vs. Sherwin-Williams, et al. from heavy lifting (20% standard) and apportions the applicant's disability as follows: 80% to the pre 1981 industrial and non-industrial injuries & conditions 4% to a 5/27/81 injury 8% to our 8/28/82 specific injury 8% to cumulative trauma at least up to the date of his examination (10/14/82 - 10/14/83) We will keep you advised as to any further developments. Very truly yours, JAG/pm P.S.: Enclosed please find Dr. Greengard's bill in the amount of $205.00. This was originally forwarded to you for payment on 10/5/83. If you have not already done so, please forward your remittance to Dr. Greengard directly. 0007-SWP-005805354 CONFIDENTIAL ..STATE OF CALIF ORNIA DEPARTMENT OF INDUSTRIAL RELATIONS WORKERS* COMPENSATION APPLICATION FOR ADJUDICATION OF CLAIM (PRINT OR TYPE NAMES AND ADDRESSES) APPEAs BOARD SEE REVERSE SIDE FOR INSTRUCTIONS CASE No.________ otimmsT M X- Social Security No.. 441 Viebrock, Hayward, CA 94544 (INJURED EMPLOYEE'S ADDRESS AND ZIP COOE) REDACTED (Ap p l ic a n t , ip o t h e r t h a n in j u r e d e mp l o y e e } vs. Sherwin Williams Company (Emp l o y e r -- s t a t e if s e l f -in s u r ed ) Self-Insured/ESIS Oiv. *'Ok (Emp l o y e r 's in s u r a n c e c a r r ie r o r . if s e l f -in s u r e d , a d j u s t in g a g e n c y } (Ap p l ic a n t s a d d r e s s a n d ZIP CODE} 2756 Alvarado St... San Leandro, CA (EMPLOYER'S ADDRESS AND ZIP CODE) FOB 5025, Fremont. CA 94537 (INSURANCE CARRIER OR ADJUSTING AGENCY'S ADDRESS] ^rs 94577 IT IS CLAIMED THAT: Forklift Driver/Box Car Loader/ 1. The injured employee, bom 3/16/35 while employed as a Unloader/Assembly Line Worker___ on 10/26/83 (Da t e o p in j u r y ) (DATE OF BIRTH) "* (OCCUPATION AT TIME OP INJURY) at. 2756 .AlvaxadQ. St. g. ^San Leandro, G&__ 94577 (Ad d r e s s ) (Cmr) By the employer sustained injury arising out of and in the course of employment to Right Shoulder & Back________ (STATE WHAT PARTS OF BODY WERE INJURED) 2. The injury occurred as follows:____ gifting heavy objects (Ex p l a in w h a t e mp l o y e e w a s d o in g a t t ime o f in j u r y a n d mo w in j u r y w a s r e c e iv e d ) 3. Actual earnings at time of injury were: Maximum (Giv e w e e k l y o r mo n t h l y s a l a r y o f h o u r l y r a t e a n d n u mb e r o f h o u r s w o r k e d p e r w e e k ) _________4_________________________________________________________________ __________________________- (SEPARATELY STATE VALUE PER WEEK OR MONTH OF TIPS, MEALS. LODGING OR OTHER ADVANTAGES REGULARLY RECEIVED) 4. The injury caused disability as follows: 10/27/83 -- 11/15/83..................................................... .................... ....... .................... . (Sp e c if y l a s t d a y o f f w o r k d u e t o t h is in j u r y a n d b e g in n in g a n d e n d in g d a t e s o f a l l p e r io d s o f f d u e t o t h is tNJLY) - 5. Compensation was paid Chunking $ $ .--.---------------------------------------------------------------------------------------------------------------- (YES) (NO) (TOTAL PAID) (WEEKLY RATE) (DATE OF LAST PAYMENT) 6. Unemployment insurance or unemployment compensation disability benefits have been received since the date of injury _X_ (YES) JNO) 7. Medical treatment was received (YES) (NO) CQPt.inm (Da t e o f Ta s t t r e a t me n t ) . All treatment was furnished by the Employer or Insurance Company X Other treatment was provided or paid for by . (YES) (NO) (NAME OF PERSON OR AGENCY PROVIDING OR PAVING FOR MEDICAL CARE) . Did Medi-Cal pay for any health care related to this claim_____ X___doctors not provided or paid for by employer or insurance company who treated or examined (YES) (NO) for this injury are. (St a t e n a me s a n d a o o r e s s e s o f s u c h d o c t o r s a n d n a me s o f h o s p it a l s t o w h ic h s u c h d o c t o r s a d mit t e d in j u r e d ) 8. Other cases have been filed for industrial injuries by this employee as follows:______OAK 87417. OAK 101780. QRK 10556 (Sp e c if y c a s e n u mb e r a n d c it y w h e r e f il e d ) 9. This application is filed because of a disagreement regarding liability for: Temporary disability indemnity___ 2L. Permanent disability indemnity__X_ Reimbursement for medical expense . Medical treatment X Compensation at proper rate Rehabilitation. Other (Specify) AND APPLICANT REQUESTS A HEARING AND AWARD OF THE SAME. AND FOR ALL OTHER APPROPRIATE BENEFITS PROVIDED BY LAW. Dated at ...... Hayward ROBERT A. FUREADO (APPUCANTS ATTORNEY) 22274 Main St., Hayward, CA 94541 (ADDRESS AND TELEPHONE NUMBER OF ATTORNEY) 415/582-1080 or 351-6111 12/1/83 California,. N40054.01 "! A VVC* a *3 ee 0007-SWP-005805355 CONFIDENTIAL WORKERS STATE OF CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS & COMPENSATION APPEAtS BOARD APPLICATION FOR ADJUDICATION OF CLAIM (PRINT OR TYPE NAMES AND ADDRESSES) CASE No.. -MK1 16-3-&3 M JE Social Security No.: r edac t ed 441 Vlebrock, Hayward. CA 94544 (INJURED EMPLOYEE'S ADDRESS AND ZIP COO) {Ap p l ic a n t , if o t h e r t h a n in j u r e d e mp l o y e e ) vs. Sherwin Williams Company__________ (Emp l o y e r --- s t a t e if s e l f -in s u r e d ) Self-Insured/ESIS _______ (EMPLOYER'S INSURANCE CARRIER OR. IP SELF-INSURED. ADJUSTING AGENCY) *"'<* o a. (APPLICANT'S ADDRESS AND ZIP CODE) 2756 Alvarado St,, San Leandro, CA (EMPLOYER'S ADDRESS AND ZIP CODE) FOB 5025. Fremont. CA 94537 (INSURANCE CARRIER OR ADJUSTING AGENCY'S ADDRESS) '-ClOSHTs 94577 IT IS CLAIMED THAT: Forklift Driver/Box Car Loader/ 1. The injured employee, born . on. 8/26/83 3/16/35 (DATE OP BIRTH) _________ at , while employed as a Unloader/Assembly Line Worker (OCCUPATION a T TIME OP INJURY) 2756 Alvarado St:., San Leandro, CA______ 94577 (DATE OF INJURY) (ADDRESS) (CITY) By the employer sustained injury arising out of and in the course of employment to Right Shoulder, Back___________________________________________ (STATE WHAT PARTS OF BODY WERE INJURED) 2. The injury occurred as follows: Bushing & Pulling on door (Ex p l a in w h a t e mp l o y e e w a s d o in g a t t ime o f in j u r y a n d h o w in j u r y w a s r e c e iv e d ) 3. Actual earnings at time of injury were: Maximum (Giv e w e e k l y o r mo n t h l y s a l a r y o f h o u r l y r a t e a n d n u mb e r o f h o u r s w o r k e d p e r w e e k ) !__________________________________ ____ ______________________________ . _________________ _ *__________________ ____________ -- (Se p a r a t e l y s t a t e v a l u e p e r w e e k o r mo n t h o f t ip s , me a l s , l o d g in g o r o t h e r a d v a n t a g e s r e g u l a r l y r e c e iv e d ) 4. The injury caused disability as follows:__Checking: Check! na ,SPEC,F1,LASrTDri(SPECIFY LAST D*Y OFF WORK DUE TO THIS INJURY AND BEGINNING AND ENDING OATES OF ALL PERIODS OFF DUE TO THIS INJURY) 5. Compensation was paid_________ _ $. ________ .$_ (YEsi (No) (To t a l p a id ) (We e k l y r a t e ) (Da t e o p l a s t p a y me n t ) 6. Unemployment insurance or unemployment compensation disability benefits have been received since the date of injury (YES) _X_ (NO) 7. Medical treatment was received jL_ (YES) (NO) rnnHruaIrKx (DATE OF LAST TREATMENT) . All treatment was furnished by the Employer or Insurance Company_X. Other treatment was provided or paid for by . Ofe (No) _________________________Did Medi-Cal pay for any health care (NAME OF PERSON OR AGENCY PROVIDING OR PAYING FOR MEDICAL CARE) related to this claim ___3jL_ doctors not provided or paid-for by employer or insurance company who treated or examined for this injury are_________________________________ ;______________ - __________ (STATE NAMES AND ADDRESSES OF SUCH DOCTORS ANO NAMES OF HOSPITALS TO WHICH SUCH DOCTORS ADMITTED INJURED) 8. Other cases have been filed for industrial injuries by this employee as follows: 87417, OAK 101780 f OAK 105568 (SPECIFY CASE NUMBER AND ClTY WHERE FILED) 9. This application is filed because of a disagreement regarding liability for: Temporary disability indemnity. Permanent disability indemnity X Reimbursement for medical expense ________ Medical treatment _J?is_ Compensation at proper rate_______ Attorneys Fees. Rehabilitation_______ Other (Specify)__Meciic^--Legal ..CostSj^ AND APPLICANT REQUESTS A HEARING AND AWARD OF THE SAME. ANO FOR ALL OTHER APPROPRIATE BENEFITS PROVIDED BY LAW. Dated at_Hayward;____________________________________ California, December 1, 1983 (OATS) ROBERT A. FURTADO (Ap p l ic a n t s a t t o r n e y ) 22274 Main Street, Hayward, CA 94541 (ADDRESS ANO TELEPHONE NUMBER OF ATTORNEY) 415/582-1080 or 351-6111 N40054.02 0007-SWP-005805356 CONFIDENTIAL