Workers' Compensation Compromise Settlement_Karen Pins Copyrighted
September 5, 2017
City of Dubuque Consent Items # 10.
ITEM TITLE: Workers' Compensation Compromise Settlement
Agreement
SUMMARY: City Attorney recommending approval of a Compromise
Settlement Agreement regarding a Workers' Compensation
claim by Karen Pins.
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Approve
ATTACHMENTS:
Description Type
Staff Memo Staff Memo
Reddick Letter Supporting Documentation
Compromise Settlement Agreement Supporting Documentation
THS CITY OF
DUB E MEMORANDUM
Masterpiece on the Mississippi
CRENNA M . BRUMWELL , ESQ.
CITY ATTORNEY
To: Mayor Roy D. Buol and
Members of the City Council
DATE: August 24, 2017
RE: Karen Pins Workers' Compensation Settlement
Attorney Les Reddick, representing the City of Dubuque, is recommending approval of
the attached Compromise Settlement Agreement regarding a Workers' Compensation
claim that was filed against the City of Dubuque by Karen Pins. Ms. Pins is an
employee of the City of Dubuque Finance Department and filed this claim arising from a
work-related shoulder injury occurring on June 4, 2013. Although the injury was
accepted as work-related, an issue arose regarding whether or not Ms. Pins needed
additional treatment.
The case was mediated, and the parties settled the matter for a lump sum payment of
$30,648 which includes a release from Ms. Pins, releasing the City for any future
responsibility for the work injury.
Funds are available in the Workers' Compensation reserve to pay the settlement.
I recommend approval of the Compromise Settlement Agreement.
BAL:tls
cc: Michael C. Van Milligen, City Manager
Randy Peck, Personnel Manager
Jean Nachtman, Finance Director
Les Reddick, Esq.
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OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA
SUITE 330,HARBOR VIEWPLACE,300 MAIN STREET DUBUQUE, IA 52001-6944
TELEPHONE (563)589-4381 /FAA (563)583-1040/EMAIL cbrumwel@cityofdubuque.org
THE CITY OF
U` E MEMORANDUM
Mciste ece on the Mississippi
TRACEY STECKLEIN
PARALEGAL
MEMO
To: Kevin Firnstahl
City Clerk
DATE: August 24, 2017
RE: Item for 09/05/17 Council Agenda — Karen Pins Workers' Comp Claim
Settlement
Kevin:
Attached for the September 5, 2017 City Council meeting is the original Compromise
Settlement Agreement for regarding the Karen Pins Workers' Comp claim. Once it is
approved by the City Council and signed by the City Manager, I would appreciate it if
you would forward the original executed Agreement to me.
Thanks. O
F:\Users\tsteckle\Workers Comp - Reddick Cases\Pins Karen\Firnstahl_OriginalAgreement_082417.docx
OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA
SUITE 330, HARBOR VIEW PLACE, 300 MAIN STREET DUBUQUE, IA 52001-6944
TELEPHONE (563) 583-4113 / FAX (563) 583-1040 / EMAIL tsteckle@cityofdubuque.org
KANE,NOR13Y& REDDICK, P.C.
ATTORNEYS
Brian J.Kane 2100 ASBURY ROAD,SUITE 2
Les V.Reddick* DUBUQUE,IOWA 52001-3091
Brad J.Heying
Todd L.Stevenson* Retired:
Kevin T.Deeny** Gary K.Norby
Bradley B.Kane
Joseph P.Kane
Nicholas J.Kane
David J.Kane
All admitted in Iowa Phone: (563)582-7980
*Also admitted in Illinois Facsimile: (563)582-5312
**Also admitted in Wisconsin E-mail:lreddick@lcanenorbylaw.com
August 24, 2017
Crenna M. Brumwell
City Attorney
Harbor View Place, Suite 330
300 Main Street
Dubuque, Iowa 52001-6944
RE: KAREN PINS WORKERS COMPENSATION SETTLEMENT
Dear Crenna:
Karen Pins is an employee of the City of Dubuque who filed a workers compensation claim
arising from a shoulder injury occurring on June 4, 2013. The injury was accepted as work related,
but an issue arose regarding whether or not Pins needed additional treatment. Through a private
mediator, the parties settled the matter for a lump sum payment of$30,648 and Pins is releasing
the City for any future responsibility for the work injury.
I have enclosed a Compromise Settlement Agreement which will be presented to the Iowa
Workers' Compensation Commissioner's office. I would ask that this be submitted to the City
Council for approval for Mike to sign. I believe the settlement amount reflects a reasonable
payment based upon the injury incurred and the statutory requirements of payment related to that
injury.
Very truly yours,
KANE, NORBY & REDDICK,P.C.
By
Les V. Reddick
LVR/bmo
Enc.
BEFORE THE IOWA WORKERS COMPENSATION COMMISSIONER
KAREN S. PINS )
Claimant, ) Contested Case File No.: 5057024
Compliance File No.: 1571434
Injury date: 6/4/2013
VS. )
CITY OF DUBUQUE, )
COMPROMISE SETTLEMENT
Employer. ) [Iowa Code Section 85.35(3)]
The undersigned parties submit this Compromise Settlement pursuant to Iowa Code section
85.35(3).
A. A dispute exists under the Iowa Workers' Compensation Law, which the parties
seek to resolve by a full and final compromise disposition of claimant's claim for benefits. The
subject and nature of the dispute is Employer disputes that any current complaints of right shoulder
pain or problems are causally related to the June 4, 2013 incident. (See attached medical reports).
B. If claimant is not represented by an attorney; a claimant's statement and evidence
of the dispute is attached. Rule 876 IAC 6.1.
C. Employer will pay Claimant a lump sum of $30,648.00 upon approval of this
agreement. Of this amount, $10,336.17 is for attorney fees and expenses; thereby leaving
$20,311.83 as the net settlement amount Claimant will receive. This settlement was entered into
with the understanding that it represents the final award Claimant will ever receive in relation to
the work injury alleged herein and,therefore, should be allocated to that period of time extending
from the date this agreement is approved by the Iowa Industrial Commissioner through the period
of Claimant's life expectancy. According to the table set out in Chapter 6 of the Administrative
rules promulgated by the Iowa Industrial Commissioner, Claimant, who has a birth date of
05/09/1964 and is presently 53 years of age, has a remaining life expectancy of 1,487
weeks. Dividing this number of weeks into the net settlement amount produces a weekly rate of
$13.66, which is the weekly settlement rate stipulated to and envisioned by the parties as the
weekly offset amount to Claimant's social security entitlement.
D. Release: In consideration of this payment, claimant releases and discharges the
above employer and insurance carrier from all liability under the Iowa Workers' Compensation
Law for the above compromised claim.
E. Statement of Awareness of Claimant: I have read the compromise settlement and
attached page(s). I understand that the money I receive under this settlement is the total amount I
will receive from my claim and that there will not be a hearing and decision on my claim. I am
aware that if the Workers'Compensation Commissioner approves this compromise settlement and
the employer/insurance carrier pays me the agreed sum, then I am barred from future claims or
benefits under the Iowa Workers' Compensation Law for the injury(ies) compromised. I
understand I may: 1)consult with an attorney of my own choosing, or 2)call the Iowa Division of
Workers' Compensation at (515) 281-5387, or both in order to receive a full explanation of the
terms of this document and of my rights under the Iowa Workers'Compensation Law.I have either
done so or freely waive my right to do so.
Claimant's Attorney Date Claimant Date
Subscribed and sworn to by claimant before me on thisKe day of IPcu
2017
Notary Public
s EMILIE J.ROTHRfCHARDSQN
Commission Number 733684
M�( ommissi n Expires
� r. S '2.a2t,
Emnlover/Insurance Carrier: The employer/insurance carrier consents to the compromise
settlement.
Employer/Insurance ier's Attorney
Employer/Insurance Carrier
Date
a c
ORDER
I find that substantial evidence supports the terms of the foregoing settlement, the
employee knowingly waives hearing, decision, and resulting statutory benefits and the settlement
is a reasonable and informed compromise of the competing interests of the parties. The foregoing
settlement is therefore approved this day of 2017.
Iowa WorkersCompensation Commissioner
The information provided will be open for public inspection under Iowa Code §§ 22.11 and
86,45(1).
14-0025 (7/(15)