Workers' Compensation Settlement Agreement_DeMossMasterpiece on the Mississippi
TO: The Honorable Mayor and City Council Members
FROM: Michael C. Van Milligen, City Manager
SUBJECT: Randall A. DeMoss v. City of Dubuque
DATE: March 31, 2011
Attorney Les Reddick is recommending approval of Agreements of Settlement with
respect to two workers' compensation claims filed by City employee Randall A.
DeMoss.
I concur with the recommendation and respectfully request Mayor and City Council
approval.
MCVM:jh
Attachment
cc: Barry Lindahl, City Attorney
Cindy Steinhauser, Assistant City Manager
Crenna Brumwell, Assistant City Attorney
Les Reddick, Kane, Norby & Reddick, P.C.
Michael C. Van Milligen
Dubuque
beitti
AII•America City
1
2007
Brian J. Kane
Les V. Reddick*
Brad J. Heying
Todd L. Stevenson*
Kevin T. Deeny **
Bradley B. Kane
Joseph P. Kane
Nicholas J. Kane
All admitted in Iowa
*Also admitted in Illinois
* *Also admitted in Wisconsin
Mayor Buol and Council Members
City Hall - City of Dubuque
50 W 13t Street
Dubuque, Iowa 52001
LVR/bmo
Encs.
KANE, NORBY & REDDICK, P.C.
ATTORNEYS
2100 ASBURY ROAD, SUITE 2
DUBUQUE, IOWA 52001 -3091
March 23, 2011
RE: RANDALL A. DEMOSS V. CITY OF DUBUQUE
Dear Mayor Buol and Council Members:
Retired:
Gary K. Norby
Phone: (563) 582 -7980
Facsimile: (563) 582 -5312
E-mail. ireddick @kanenorbylaw.com
Enclosed please find Agreements for Settlement with respect to two workers'
compensation claims filed by Randall A. DeMoss against the City of Dubuque. These
Agreements reflect settlements within the authority granted by the City Council and at this point
we need your authority for City Manager Van Milligen to sign them. After the Agreements are
returned to me, I will sign them and forward to the Workers' Compensation Commissioner for
approval.
Very truly yours,
KANE, NORBY & REDDICK, P.C.
By v' L
Les V. Reddick
Randall A. DeMoss
BEFORE THE IOWA WORKERS' COMPENSATION COMMISSIONER
Claimant,
vs.
City of Dubuque
and
Employer,
Self— Insured
Insurance Carrier,
Defendants.
The undersigned parties submit this Agreement for Settlement to the Workers'
Compensation Commissioner for approval. The parties agree:
1. Claimant sustained an injury arising out of and in the course of employment
with Employer on 4/21 /08 (date).
2. Jurisdiction exists because the injury occurre
85.71( ) applies. (Circle one.)
3. Claimant is married/ .ingl- (circle one), entitled to 1 exemption(s) and gross
weekly earnings are ', 862.15 using Iowa Code section 85.36( ).
The rate of weekly compensation is $ 511.15 . (If the rate for PPD
differs it is $ per week.)
: Contested Case File No. 5032615
: Compliance File No.
Injury Date: 4/21/08
AGREEMENT FOR SETTLEMENT
Iowa Code Section 85.35(2)
R Iowa Code section
4. The injury caused Claimant to sustain the following disability and resulting
entitlement to compensation:
a. Temporary total disability /temporary partial disability /healing period
compensation for 39 weeks from 10/9/08 (date) thru
7/1/09 (date). Iowa Code sections 85.33, 85.34(1). (A detailed
description may be attached.)
b. Permanent partial disability for 28 % loss of whole body
(member or earning capacity) resulting in 140 weeks of compensation
under Iowa Code Section 85.34(2)C u ) payable commencing
7/9/09 (date).
c. Other compensation or benefits consisting of IME expense of
$3,243.
5. Benefits that accrued and were paid are shown in the attached
payment activity report (PAR), dated
Benefits that remain to be paid are 19% or 95 weeks.
6. The employer /insurance carrier shall file a final electronic Subsequent
Report of Injury [SROI (FN)] and mail Claimant a PAR that contains the
information in the final SRO!, including the date that weekly
compensation was last paid. Rules 876 IAC 2.6, 3.1(2), and 11.7.
7. This settlement waives a hearing, decision, and resulting statutory benefits. It
is subject tc review- reopening for three years following the last date that
weekly compensation is paid. Iowa Code sections 85.25(2) and 86.14.
8. Claimant is entitled to medical care for the injury, including care in the future.
Iowa Code sections 85.26(2) and 85.27. (A detailed description may be attached.)
9. Evidence that corroborates this settlement is attached. A Claimant's
Statement is attached if claimant is not represented by an attorney.
WHEREFORE, the parties request that this ttllement b
_.111 A Al ' kV 2,
Claimant Date /
e (//(
Empl er /Insurer Vit
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 , 20
Iowa Workers' Compensation Commissioner
The information provided will be open for public inspection under lowa Code §§
22.11 and 86.45(1).
14 -0021 (7 -05)
IOWA,.
W0RKF0RcE
DEVELOPMENT
Smart RcsLeis.
ORDER
Claimant's orne
roved.
c
7//
Date
Employer /Insurer's Attorney Date