Erin Westvang 10/12/2023 - Laserfiche WebLink

This lump sum is being paid to the Claimant for disabilities related to the Claimant's work -related conditions which will interfere with the Claimant's ability to engage in gainful employment for the remainder of the Claimant's life None of this amount should be considered as payment to segregate any condition which may be related to the Claim(s). This agreement is for payment of a single lump sum amount of $170,000.00, which shall be paid as outlined below: Payment Amount aym.ent Schedule of Single Lamp Sum Payment Schedule $170,000.00 Total Single Lump Sum Single Lump Sum Payment: The Single Lump Sum Payment of $170,000.00 will be made within fourteen (14) days after the revocation period has ex ip red $170,000,00 Lifetime Expectancy Award The parties agree the $170,000.00 lump sum is intended to compensate the Claimant for dtmintshed earning capacity during the Claimant's remaining life expectancy which is 26.5 years according to the life tables published by the Social Security Administration. Pursuant to Section 18-Attorney's Fees of this agreement, the Clairant and Claimant's Counsel have agreed to a 15% contingent fee. After deducting the 15% fee of $25,500.00 from the Lump Sum, the Net Lump Sum amount is $144 500.00. The Claimant's life expectancy constitutes a period of 318 months or 1,378 weeks, and the lump sum is intended to compensate the Claimant for lost earning capacity at the rate of about $ $454.40 per month or about $ 104.86 per week. 7. Discharge of Payment The obligation of the Employer to make the single payment outlined in Section 6— Lump Sum Payment, shall be discharged when a valid check is mailed for the required amount to the last known address in the Self -insured Employer's file. That address is presently in care of James R. Walsh Law Office of James R. Walsh, 20201 Cedar Valley Road, Suite 140, Lynnwood, WA 98036.2028 /1/ Page 18