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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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Nature <br />Condition <br />and <br />and <br />Extent <br />Disability <br />of <br />The <br />returned <br />permanent <br />Claimant <br />to <br />impairment. <br />received <br />preinjury <br />status <br />treatment <br />without <br />and <br />her condition <br />any resulting <br />Date <br />Claim <br />Received <br />The <br />claim <br />was received <br />on <br />11/12/1998, <br />Date <br />of <br />Claire <br />Allowance <br />The <br />12/09/1999, <br />claim <br />was allowed <br />by <br />Department <br />order <br />dated <br />Date <br />Became <br />Allowance <br />Order <br />Final <br />Claim <br />sixty <br />of <br />der. <br />days <br />allowance <br />after <br />the <br />became <br />Claimant's <br />final <br />on or <br />receipt <br />about <br />of <br />the <br />02/15/2000, <br />allowance <br />Claim <br />Status <br />The <br />will <br />claim <br />remain <br />was <br />closed <br />closed <br />as <br />part <br />by <br />order <br />of <br />this <br />dated <br />agreement. <br />04/1 <br />9/2000, <br />and <br />Closing <br />Order <br />The <br />will <br />claim <br />remain <br />was <br />closed <br />closed <br />as <br />part <br />by <br />order <br />of <br />dated <br />this <br />agreement. <br />04/19/2000, <br />and <br />Condition(s): <br />Accepted <br />Conditions <br />but <br />claim <br />Mete <br />the <br />is <br />condition <br />no information <br />of <br />about <br />neck <br />strain <br />any accepted <br />was treated <br />conditions, <br />under <br />the <br />Denied <br />Conditions <br />The <br />segregating <br />file <br />does <br />not <br />any conditions <br />contain <br />in <br />any <br />this <br />claim. <br />orders <br />denying <br />or <br />3. Claims Not Impacted <br />The parties agree the scope of this agreement is limited to the Claims outlined above and no other <br />claims are impacted by this agreement. <br />4. No Further Disability Entitlement <br />In consideration for the lump sum amount listed in Section 6—Lump Sum, the Claimant <br />relinquishes any further Washington Industrial Insurance Act disability benefits or payments to <br />which the Claimant may be entitled resulting from the Claims. Disability benefits include payment <br />of time loss compensation (wage loss), loss of earning power (partial wage toss), permanent <br />partial disability and or pension benefits. <br />5. Vocational Entitlement <br />In consideration for the lump sum amount set forth in Section 6— Lump Sum, the Claimant <br />relinquishes any further Washington Industrial Insurance Act vocational benefits and services to <br />which the Claimant may be entitled under the Claims. The Claimant understands that vocational <br />benefits and services include vocational assessment, vocational plan development and job <br />retraining. <br />6. Lump Sum Payment <br />In consideration of the release above, and for this agreement, the Self insured Employer agrees <br />to pay the Claimant the sum of $170,000.00. <br />Pagel 7 <br />
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