Workers' Compensation Settlement Agreements Copyright 2014
City of Dubuque Consent Items # 12.
ITEM TITLE: Workers' Compensation Settlement Agreements
SUMMARY: City Manager recommending approval of two agreements
for Settlement regarding the Workers' Compensation
Claims that were filed against the City of Dubuque by Arthur
Hedley Jr.
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Approve
ATTACHMENTS:
Description Type
Arthur Hedley Jr Workers' Comp Settlements-MVM City Manager Memo
Memo
Staff Memo Staff Memo
Reddick Letter Supporting Documentation
Agreement for Settlement DOI 06/24/09 Supporting Documentation
Agreement for Settlement DOI 09/27/12 Supporting Documentation
THE CITY OF Dubuque
UBE I
erica .i
Masterpiece on the Mississippi 2007-2012-2013
TO: The Honorable Mayor and City Council Members
FROM: Michael C. Van Milligen, City Manager
SUBJECT: Arthur Hedley Jr. vs. City of Dubuque —Workers' Compensation Claims
DATE: February 23, 2016
City Attorney Barry Lindahl recommends City Council approval of two agreements for
Settlement regarding the Workers' Compensation Claims that were filed against the City
of Dubuque by Arthur Hedley Jr. Mr. Hedley was injured on the job on two separate
occasions, the first in 2009, and the second in 2012. The settlement for the first injury
totals $17,336.70 and $25,052.00 for the second injury.
I concur with the recommendation and respectfully request Mayor and City Council
approval.
Micliael C. Van Milligen
MCVM:jh
Attachment
cc: Barry Lindahl, City Attorney
Cindy Steinhauser, Assistant City Manager
Teri Goodmann, Assistant City Manager
HE CITY OF
DUB
E MEMORANDUM
Masterpiece on the Mississippi
BARRY LINDAHL
CITY ATTORNEY
To: Mayor Roy D. Buol and
Members of the City Council
DATE: February 22, 2016
RE: Arthur Hedley Jr. vs. City of Dubuque —Workers' Compensation Claims
Attorney Les Reddick, representing the City of Dubuque, is recommending approval of
two Agreements for Settlement regarding the Workers' Compensation claims that were
filed against the City of Dubuque by Arthur Hedley Jr. The City Manager has approved
the Agreements.
Mr. Hedley has been an employee of the City of Dubuque since 1977 and currently
works in the Leisure Services Department. He was injured on the job on two separate
occasions and those injuries are compensable under Iowa's Workers' Compensation
Statute. Mr. Hedley sustained a 13% whole body impairment from one injury that
occurred in 2009 and a 17% loss of whole body impairment in the 2012 injury. The
settlement for the first injury totals $17,336.70 and $25,052.00 for the second injury.
These settlements reflect the amounts payable under the Workers' Compensation
Statute for industrial disability. They are fair and reasonable and we would not expect a
Workers' Compensation Hearing Deputy to award any less.
I recommend approval of the attached Agreements for Settlement.
BAL:tIs
Attachment
cc: Michael C. Van Milligen, City Manager
Cindy Steinhauser, Assistant City Manager
Randy Peck, Personnel Manager
Marie Ware, Leisure Services Manager
Les Reddick, Esq.
F:\USERS\tsteckle\Workers Comp-Reddick Cases\Hedley Art\MayorCouncil_HedleySettlements_022216.doc
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 balesq@cityofdubuque.org
KANE, NORBY& 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
All admitted in Iowa Phone: (563)582-7980
*Also admitted in Illinois Facsimile: (563)582-5312
**Also admitted in Wisconsin E-mail:lreddick@kanenorbylaw.com
February 18, 2016
Mr. Barry A. Lindahl
City Attorney
Harbor View Place, Suite 330
300 Main Street
Dubuque, Iowa 52001-6944
RE: ARTHUR HEDLEY WORKERS' COMPENSATION SETTLEMENTS
Dear Barry:
Enclosed please find Agreements for settlement of two injuries sustained by employee
Arthur Hedley. I am asking the City Council to approve these Agreements for signature by Mike.
They will then be forwarded to the Iowa Workers' Compensation Commissioner for approval.
Arthur Hedley is a long time City employee, starting in 1977. He was injured on the job on
two separate occasions and those injuries have been accepted as compensable under Iowa's
Workers' Compensation Statute. According to his medical providers,Mr. Hedley sustained a 13%
whole body impairment from one injury and a 17% loss of whole body in the other one. The
settlements are $17,336.70 for the first injury and $25,052 for the second injury. These amounts
are intended to reflect the amounts payable under the Workers' Compensation Statute for industrial
disability that the Commissioner adds to any permanent impairment injury affecting the whole
body.These settlements are fair and reasonable and we would not expect a hearing deputy to award
any less,thus the request for approval.
Very truly yours,
KANE, NORBY & REDDICK, P.C.
By�
Les V. Reddick
LVR/bmo
Enc.
BEFORE THE IOWA WORKERSCOMPENSATION COMMISSIONER
ART HEDLEY JR.
Claimant, Contested Case File No, 5060061
VS,1516790
: Compliance File No,
CITY OF DUBUQUE Injury Date: 6-24-09
Employer,
•
and : AGREEMENT FOR SETTLEMENT
Iowa Code Section 85.35(2)
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 June 24, 2009 (date).
2. Jurisdiction exists because the injury occurred in
85.71( )applies. (Circle one.)
OR Iowa Code section
3. Claimant is arrie single (circle one), entitled to 4 exemption(s) and gross
weekly earnings are $ 881.85 using Iowa Code section 85,36( ).
The rate of weekly compensation is S 577.89 . (If the rate for PPD
differs it is $ N/A per week.)
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 weeks from (date) thru
(date), lowa Code sections 85.33, 85.34(1). (A detailed
description may be attached.) see attached
b. Permanent partial disability for 17 % loss of whole body
(member or earning capacity) resulting in 85 weeks of compensation
under Iowa Code Section 85.34(2)( u ) payable commencing
8/26/10 (date).
c. Other compensation or benefits consisting of
5. Benefits that accrued and were paid are shown in the attached
payment activity report (PAR), dated
Benefits that remain to be paid are $17,336.70
6. The employer/insurance carrier shall file a final electronic Subsequent
Report of Injury [SROI (FN)1 and mail Claimant a PAR that contains the
information in the final SROI, 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 to review -reopening for three years following the last date that
weekly compensation is paid. lowa Code sections 85.26(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 at ny.
WHEREFORE, the parties request that this Settlement be approved.
Claimant Date
Art Hedley, Jr.
Employer/Insurer's Attorney Date
Nick J. Avgerinos
Employer/Insurer
Michael C. Van Milligen, City Manager
Employer/Insurer's Attorney Date
Les V. Reddick
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 , 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 (02/15)
IOWA
ORK ORCE
DEVELOPMENT
BEFORE THE IOWA WORKERSCOMPENSATION COMMISSIONER
ART HEDLEY, JR,
Claimant,
vs.
CITY OF DUBUQUE
Employer,
and
Insurance Carrier,
Defendants.
: Contested Case File No. 5060060
Compliance File No. 1571288
Injury Date: 9-27-12
AGREEMENT FOR SETTLEMENT
Iowa Code Section 85.35(2)
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 September 27 , 2012 (date).
2. Jurisdiction exists because the injury occurred in lowa)OR Iowa Code section
85.71( ) applies. (Circle one.)
3. Claimant 1 marrie./single (circle one), entitled to 2 exemption(s) and gross
weekly earnings are S 963,51 using Iowa Code section 85,36( 2 ),
The rate of weekly compensation is $ 626.30 . (If the rate for PPD
differs it is S N/A per week.)
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 weeks from (date) thru
(date). Iowa Code sections 85.33, 85.34(1). (A detailed
description may be attached) see attached
b. Permanent partial disability for L3
% joss of whole body
(member or earning capacity) resulting in 65 weeks of compensation
under Iowa Code Section 85.34(2)( u ) payable commencing
7/6/15 (date),
c. Other compensation or benefits consisting of
5. Benefits that accrued and were paid are shown in the attached
payment activity report (PAR), dated
Benefits that remain to be paid are .$25,052.00
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 SROI, 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 to review -reopening for three years following the last date that
weekly compensation is paid. lowa Code sections 85.26(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 repre ented by an attorn
WHE
A
Clai n Date
Art Hedl
parties request that thi larriVnt
(L 1(7'
Iaimant's Atto
Nick J. Avger
Employ r/Insurer at Employer/Insurer's Attorney Date
Michael C. Van Milligen, City Mnager Les V. Reddick
ORDER
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
lowa Workers' Compensation Commissioner
The information provided will be open for public inspection under Iowa Code §§
22.11 and 86,45(1).
14-0021 (02/15)
IOWA
WORKFORCE
DEVELOPMENT