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Erin Westvang 10/12/2023
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Erin Westvang 10/12/2023
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Last modified
10/13/2023 10:32:23 AM
Creation date
10/13/2023 10:30:46 AM
Metadata
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Template:
Contracts
Contractor's Name
Erin Westvang
Approval Date
10/12/2023
Council Approval Date
9/13/2023
Department
Human Resources
Department Project Manager
Marcy Hammer
Subject / Project Title
Claim Resolution Settlement Agreement Between Erin Westvang and the City of Everett
Tracking Number
0003982
Total Compensation
$170,000.00
Contract Type
Agreement
Contract Subtype
Settlement Agreements
Retention Period
6 Years Then Destroy
Imported from EPIC
No
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Page ( 4 <br />3 <br />CLAIM <br />Claim <br />Number <br />SC-70786 <br />Date <br />of <br />Industrial <br />Injury <br />02/27/2008 <br />of Accident <br />The <br />Claimant <br />injured <br />her left <br />shoulder <br />at <br />work. <br />Description <br />Nature <br />Condition <br />and <br />and <br />Extent <br />Disability <br />of <br />The <br />permanent <br />p <br />Claimant <br />eviously <br />impairment <br />paid <br />s <br />at <br />industrial <br />claim <br />of <br />closure. <br />the <br />injury <br />left <br />resulted <br />upper <br />in <br />extremity, <br />a 3% <br />Date <br />Claim <br />Received <br />The <br />claim <br />was received <br />on or about <br />03/13/2008. <br />Date <br />of <br />Claim <br />Allowance <br />The <br />claim <br />was allowed <br />by order <br />dated <br />06/10/2008. <br />Date <br />Became <br />Allowance <br />Final <br />Order <br />On <br />the <br />or <br />Claimant's <br />about <br />08/15/2008, <br />receipt <br />of <br />approximately <br />the <br />order. <br />60 <br />days <br />after <br />Claim <br />Status <br />The <br />03/03/09 <br />agreement. <br />claim <br />was <br />and <br />closed <br />will <br />remain <br />by <br />Department <br />closed <br />order <br />part <br />dated <br />of <br />this <br />as <br />Closing <br />Order <br />The <br />03/03/09, <br />disability <br />closed <br />claim <br />as <br />with <br />of <br />part <br />was <br />the <br />of <br />an <br />left <br />this <br />closed <br />award <br />upper <br />agreement. <br />by <br />for <br />extremity <br />Department <br />3% <br />permanent <br />and <br />order <br />will <br />remain <br />dated <br />partial <br />Condition <br />(s) <br />Accepted <br />Conditions <br />conditions <br />injury <br />tendonitis/tendonopathy <br />thickness <br />claim. <br />There <br />of <br />are <br />the <br />bursa' <br />no <br />but <br />left <br />the <br />shoulder <br />Department <br />tear <br />Claimant <br />of <br />and <br />the <br />with <br />was <br />MRI <br />supraspinatus <br />orders <br />subsequent <br />treated <br />evidence <br />accepting <br />for <br />a <br />rotator <br />of <br />straining <br />under <br />a <br />any <br />cuff <br />partial <br />the <br />Denied <br />Conditions <br />conditions <br />There <br />are no <br />in <br />this <br />orders <br />claim. <br />denying or segregating <br />any <br />CLAIM <br />4 <br />Claim <br />Number <br />SB-12211 <br />Date <br />of <br />Industrial <br />Injury <br />11/22/2005 <br />of Accident <br />The <br />Claimant <br />sustained <br />a right <br />injury at work. <br />knee <br />Description <br />Nature <br />Condition <br />and <br />Disability <br />of <br />The <br />condition <br />permanent <br />Claimant <br />returned <br />impairment. <br />received <br />to <br />conservative <br />status <br />care <br />without <br />and <br />any <br />her <br />and <br />Extent <br />preinjury <br />Date <br />Claim <br />Received <br />The <br />claim <br />was received <br />on or about <br />11/22/2005. <br />
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