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Chris Guluarte 1/3/2022
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6 Years Then Destroy
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Chris Guluarte 1/3/2022
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Entry Properties
Last modified
3/11/2022 11:29:28 AM
Creation date
3/11/2022 11:29:01 AM
Metadata
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Contracts
Contractor's Name
Chris Guluarte
Approval Date
1/3/2022
Council Approval Date
12/22/2022
End Date
1/3/2022
Department
Legal
Department Project Manager
David Hall
Subject / Project Title
Workers' Compensation Settlement Agreement
Tracking Number
0003226
Total Compensation
$300,000.00
Contract Type
Agreement
Retention Period
6 Years Then Destroy
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$32,278.02 however this sum is being paid as part of the <br /> lump sum CRSA. <br /> Attending Physician Dr. Robert Handel <br /> Claim Status The claim is currently open at the Department. <br /> The claimant is currently participating in vocational <br /> rehabilitation, but that will cease upon approval of the <br /> CRSA. <br /> It is the parties understanding that upon approval of <br /> this agreement, the claim will be closed with no <br /> permanent impairment beyond what is being paid in the <br /> CRSA. <br /> Condition(s) <br /> Accepted Conditions Bilateral shoulder rotator cuff tears and bilateral bicep <br /> tears. <br /> Denied Conditions None <br /> jHereafter referred to as Denied Conditions) <br /> Unrelated Conditions Depression and anxiety, right elbow (tennis elbow) <br /> (Hereafter referred to as Unrelated Conditions) <br /> CLAIM#2: SK36367 <br /> Claim Number SK36367 <br /> Date of Injury January 31, 2017 <br /> Description of Accident Was vectoring meters for house and was using a <br /> pressure washer wand which recoiled and caused injury <br /> to right shoulder. <br /> Date Claim Received by On or about January 31, 2017 <br /> Employer <br /> Date of Claim Allowance The Department of Labor & Industries issued an <br /> allowance order on July 12, 2017. <br /> Date Allowance Order The allowance order became final 60 days after it was <br /> Became Final I received, which was on or about September 12, 2017, <br /> Nature and Extent of As a result of the industrial injury, Claimant sustained a <br /> Condition and Disability right shoulder injury/strain. <br /> Claimant underwent conservative treatment for the <br /> condition but the claim was closed after he sustained <br /> further upper extremity/shoulder injuries in the 4/25/17 <br /> incident. <br /> The claimant did not have any permanent partial <br /> _ disability as a result of this industrial injury. <br /> Attending Physician Unknown <br /> Chris Guluarte Page 4 of 14 <br />
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