Claim Settlement - FitzgibbonsBarry A. Lindaltl, Esq.
Corporation Counsel
Suite 330, Harbor View Place
300 Mai~ Street
Dubuque, Iowa 52001-6944
(563) 5834113 office
(563) 583-1040 fax
balesq~mwci.net
December 10, 2002
Mayor Terrance Duggan and
Members of the City Council
City Hall - City Clerk's Office
50 West 13th Street
Dubuque, IA 52001
RE: Workers, Compensafi(~n Claim
Dear Mayor and Council Members:
John Fitzgibbons worked for the City of Dubuque Operations & Maintenance
Department from approximately 1978 until October 19, 1998 when he was injured while
shoveling blacktop. He underwent su~ery and Mr. Fitzgibbons was given a ten percent
permanent impairment rating by Dr. Stenberg.
Subsequent to the surgery, Mr. Fitzgibbons has had an extensive amount of treatment.
Mr. Fitzgibbons filed a Petition with the Workers Compensation Commissioner
requesting that he be considered permanently and totally disabled. The Commissioner
has approved the attached proposed settlement agreement.
I recommend that the City Council approve the proposed settlement agreement for a
final settlement of this claim.
Ba/ry A. Lindahl, Esq.
Ctrporation Counsel
BAL:tls
Attachment
cc: Michael Van Milligen, City Manager
BEFORE THE IOWA WORKERS'
JOHN P. FITZGIBBONS,
Claimant,
CITY OF DUBUQUE,
Employer/Self-Insured,
COMPENSATION COMM
DWC NO. 1283291
DWC NO. 1283290
F LED
~S IONER
DEC 05 2002
WORKERS'COMPENSA ON
(D/I: 10/19/1998)
(D/I: 01/25/2000)
Defendant.
JOINT APPLICATION FOR SETTLEMENT
PURSUANT TO SECTION 85.35 OF THE CODE OF IOWA
The undersigned parties make application for authorization and
approval of a CONTESTED CASE SETTLEMENT pursuant to section 85.35
of the Code of Iowa.
1. A bon~ fide dis~ exists between the parties under Iowa
Code subsections 85.35 (8). See attached medical reports.
2. PAYMENT TERMS: Employer/Insurance Carrier will pay to
Claimant the amount of $90,757.50. This payment will be made in a
lump sum.
3. RELEASE: In consideration of this payment, Claimant
releases and discharges the above Employer and Insurance Carrier
from all liability under the Iowa Worker's Compensation Law for the
above injury.
4. It is further agreed by and between the parties that this
settlement was entered into with the understanding that the lump-
sum payment of Ninety Thousand Seven Hundred Fifty-Seven & 50/100
($90,757.50) Dollars represents the final and only award the
Claimant, John P. Fitzgibbons, will ever receive from his former
Employer and its Carrier with respect to the contested injuries he
sustained to his back as the result of his workplace activities and
is, therefore, to be allocated to that period of time extending
from the date this agreement is approved by the Iowa Worker's
Compensation Commissioner through the period of his life
expectancy. According to the table set out in Chapter 6 of the
administrative rules promulgated bythe Iowa Worker's Compensation
Commissioner, see 876 I.A.C. rule 6.3(1) ("Life Expectancy table"~,
Claimant, who has a birthdate of February 1, 1951 and is presently
51 years of age, has a remaining life expectancy of 1,310 weeks.
Dividing this number of weeks into the settlement amount of
$90,757.50 produces the weekly settlement rate of $69.28, a weekly
settlement rate which has been ~ envisioned by and is herein
stipulated toby each of the parties.
STATEMENT OF AWARENESS OF CLAIMANT: Claimant states that he has
read the Contested Case Settlement and all attachments thereto and
that all statements therein are true to the best of my belief. I
further state that I am aware upon receipt of the payment and
approval by the Workers' Compensation Commissioner, I am barred
from future claims or benefits under the Iowa Workers' Compensation
Law for the injury(ies) and the payment shall not be construed as
payment of weekly compensation. I understand I have the rights to
(1) consult with an attorney of my own choosing and (2) to call the
office of the Workers' Compensation Commissioner at (515) 281-5934
for a full explanation of the terms of this document and my rights
under the Iowa Workers' Compensation Laws, and that I have either
exercised the rights .or wish not to do so.
SJ. ROT~ DATE //~! · ITZ~BONS DATE
Claimant's Attorney '/Claimant ~
Subscribed and sworn to before me this /_~_ day of
~ 2002.
I__ i,,, ,'' ota
~- . ry quo±mc, State of Iowa
The Employer/Insurance Carrier consents to the contested case
settlement.
BY:
T~e contDsted case settlement is approved on this b~ day
of
~ ~ - % ~ IOWA WORKERS' COMPENSATION COMMISSIONER
T~~f~i~rfvided will be open for public inspection under
I~£[~e §22.11.