214468ORIGINAL TO CITY CLERK
�J ` -
PRESENTED BY
COMMISSIONI
W
r CITY OF ST. PAUL COUNCIL NO
OFFICE OF THE CITY CLERK FILE
LOUNCIL RESOLUTION - GENERAL FORM
214468
WHEREAS, Lloyd P. Urbanski, an employee of the Department of
Parks and Recreation, filed a Claim Petition with the Industrial
Commission of Minnesota alleging an injury in the course of his
employment on March 12, 1962, and
WHEREAS, the City disputed the claim of the employee and the
office of the Corporation Counsel recommends settlement of the
claim according to the terms described in the attached Stipula-
tion which is made a part hereof by reference, for compromise
settlement; now, therefore be it
RESOLVED, that the proper City officers are hereby authorized
and directed to enter into and execute such Stipulation and to
abide by the terms of the award of the Industrial Commission issued
in conformity with said Stipulation.
COUNCILMEN
Yeas Nays
Dalglish
Rolland
Loss
Mortinson
Peterson
Rosen
Mr. President, Vavoulis
lOM 6-62
Tn Favor
V
Against
Council File No 1 - -~
Loss— 2T By Frank L.'
Whereas, Lloyd P. Urbanski, an em
Iand Recreation, filed as Claim Petition
with the Industrial Commission of
Minnesota alleging n injury in the
course of his employment on March 12,
1962, and
ofvtheremployee sand the office of the
Corporation Counsel recommends set-
tlement of the claim, according to the
terms described in the attached,,;Stip-
ulation which is made a part hereof i
by reference, for comppromise 'settle-
ment; now, therefore be it
Resolved, That the propel C i t y
officers are hereby authorised • and
directed pon ndrto abid dby the terns
of the award of the Industrial, Com-
mission issued in conformity with said
Stipulation.
Adopted by the Council August 27,
1963.
Approved August 27, 1963.
(August 31, ,1963)
AUG %7 1963
Adopted by the Council 19—
AUG 27 10
Mayor
r �• 214468
STATE OF MINNESOTA
3nburtrial Commi0ion of ,ninnegota
39ibizion of Workmen's CompeiWation
STATE OFFICE BUILDING. ST. PAUL I
FIle N
NOTICE OF FILING
Record No DECISION OF COMMISSION
Employe.
vs.
City of St. Paul, Dept. of x'arks
a rea on c s
and
Self -Insured Insurer.
TO THE ABOVE NAMED PARTIES AND THEIR ATTORNEYS:
PLEASE TAKE NOTICE That attached hereto and herewith served upon
you is a copy of the decision of the Industrial Commission in the
above entitled matter, the original of which was filed in the office
of its secretary on the —day of July , 19.630
INDUSTRIAL COMMISSION OF MINNESOTA,
BY
Dated at St. Paul, Minnesota, Secretary.
/o/ E.D. McKinnon,
u y 19-b�'
/,_
4T.k'( I- OF MINNESOTA
INDUSTRIAL COMMISSION OF MINNESOTA
Division of Workmen's Compensation �1
STATE OFFICE BUILDING, ST. PAUL 1
File No. 30 7663 —Ct. AWARD BASED ON STIPUI -ATION
Lloyd r. Urbanski I?mploye,
-vs-
City of 01aint maul, Dept.
of Parks & Recreation
& Public Bldg.,
and
,;elf- Insured
,r
JUL 9963
I:mF�lu� cr,
Insurer.
The parties hereto having waived their rights to a formal 1e TiTr�d having submitted to the
Industrial Commission of Minnesota a stipulation for settlement; and
The Industrial Commission having considered said stipulation and being fully advised in the
premises, and it appearing that the facts recited in said agreement are true, and that said agreement is
in substantial accord with the terms of the workmen's compensation law of Minnesota;
1q04_ TH.J&R_,6IiUHJ,, IT Ia qNJ DET ;RNIN.e D Ubat Llby4
P. Urbanski, the employee herein, in additi.n to the corupen.3ation '
previously paid is entitled to and. is hereby aNdrded against the Avove
named employer the sum of u4y5.00 representing 11 weeks of permanent
partial compensation with reimbursement to the employee in the sum of
$311.00 for medical exr enae previously paid; payment to Minnelsot... ';o_.-
pital Service Association in the sum. of 3955.55; and payment to Doct.o.L-s
Anderson and Zagaria in the sum of $30.00.
IT IS MUTU,iLLY UtiJZ;_t,,°rO011 tout wher1 the aforesaid
payments have been made thq same sb -rll constitute full, final and complete
settlement of axq aYl all of said employee's claims against the employer
and insurer herein arising out of the j)ersonal injury of March 12, 1962.
IT Ta ';i't3:- TH44 CRJERLt o, that the employer shall pay to the
Special Compensation Fund,the sum of $9.90•
IT I,� FURTHLR that the cl:xia petition filed herein
on October 22, 1962 is aismissed.
Dated at St. Paul, Minn., this
day of mod, 19r>3
JJ -.. c as
INDUSTRIAL. COMMISSION OF MINNESOTA
u /
/ /, m,
o Imissioners
File NO.` 307663
Recoxd Vo. 467 03 C f, -
STATE OF MIMESOTA
•1NUSTR1AL 0015 1SSION CF MINNESdTA'
Dlvisioh of W4rWen's Compensation
State. Offir. Building-, St.' Paul -1
Lloyd P: Urbanski,
_ -Employee,
�s. snPULAMN FOR FINAL
COMP;RU1 #7S E S ETTLUIENT
City of St. Paolo - ept.
of Parks & ,Recreati.on
+ Public Rldgs. ,
Employer, _
Self- Insurer.
The parties hereto,.' being desirous ' of effecting an
smicable, ,permanent and final compromise settlement of the.
matters in controvegl herein, havo negotiated as between
themselves and through their respective counsel a compromise
settlement upon the.. #ollowing terms and condition-*:. -
L That on .and prior to the 12th day of March, .
1962. Lloyd P. Urbanski, employs- herein, was omployed by the
Depatrtment of Parks. and Recreation and Public Buildings of the
City of Saint maul, as .a Playground,Custodialn, at 4 salary of
S467.-per month.
Z That smplOpo aalleoaes that on th • 12th day of
March, -1962, he sustained an injury arising out of and in thW.
course of his #Mploy:n nt with the City of Saint -Paul, when her. -
tell, while on his !irai to -his pl000 bf employments injuring
his left knee, which. Lcame locked in an extended position ,
f ollowiiig the sudden - weakening of` said .knee exile banding-
said knee at his, placb of omploymont.
3. -Thet, omployere alleges he was-disabled becawe
of said: injury from. 14arch 12, '1962 to May 1'3.•;19621 that
esaployyo$ eras; paid full salary during
said .periods charged, tea :
sick 14, Ave. Thai t- -employee - returned._ to' work as of May 13, 1962.
48 What imployei herein had . notice and knowledg.9 - of
said a�ccidont within -the, time limit proscribed by law.. .-
S. That employeo farther alloois that since the
time' of amid injury, cattain tnadical -bills 'fave been incurraed
by ,hiim . rosulti from- alas= oporation.'�whorein- he sustained 'tho =
surfoicol. removal of ruptured cartilage from said left knee. -
The/ date of said surgery was ',arch 26, 1962,- and said operation
iv alleged to haev4 been necessitated es a result of the afore -
ssiid injury arising as hsrai.nabove sot forth. _
60 That the employee has paid Doctor's Lanniin and
14miloy the total sum of $230.-Which is--the full amount of the
,,ohargts by said orthopodic- surgeons:for the .aforesaid operation, -
s and, �furt er, .that the employee. has paid Doctors Fmmorss► Robins
r.� and Nichols` the total stare of $91.00s -as attending. physicians ;
herelnl •further, that the employei -has paid St. Johm Hoe ital,
o that total bill- its the amount-,04 $956.35, the st, of .3.000.
tho balance of said bill or, $993.55 haiving been paid by the "
Minnesota Hospital - Service Associoi on.
- Fes. ,� `• ' lam' • - -- •
70 Thit boat Anderson a.nd, zagasie,. anoothomblo Istri,
_ -
have. presented .the omployee with 4 ' startem�ent in •the mount_ - o
$30.00,. which statements #.s as, o the date hereof unpaid. ;
- �. F.napioy�a cls %s- ho is pe rnent pavtiall.y disablsd
as a result of said-.alleged injury, in that-,he has sustained a
'ten per eorit .p.exinanent partial -disabilit tD the, loft -lag; 'undot
-Minneisots. Statutis,. ^176.101, 80d. 3 (19 1:'
that empioyer'herein
cohtonds, and all000t that _ iaid employes not in need -cf _ modic'41,
surgical, hospitol - os 'othor, :care; and att,6ntlon. to cure, o,r .ralierve-
his' alleged ;condition of - distbil`ity.
.9. That` iii order to .eft'setuata,_ a• ,pexmaneht and 1ina'l
disposition of `-said the - I " ar agrees toi pair and the
•erployee heroin agrees to Accept in fUll, •final a,nd complete
.6ittlement, comprftisa, diopositfonand-,satistaction cif any -and_, -
all' claims which- ampl4yee <now has' or `may. hereinafter havo 4' ainst ;
-the `employer above' na'mllod,= ttie.surm- of 1495.00 .repres+enting 11
weeks of componsalion -at ..the rate of $45.00 per'vieek, for 3 per ".
vent 'permanent partial dlsabil3ty •to _the left leg; that employs, 5
was, di#4bled f or a "Period. of - 0 woeks, and 4 ,days" and sick leave
,will be restored ' to him to ' the extant of X396 therefor. ;
That in addition td said
pa, ymerste, em plover will pay
the outstanding modical�_ bills and .will reimbutse :emPloYe and--
' Annesota Rotpita,l, $arvice Association in the -sums -end amount
shown in Paragraphs 6 +end , 7 hgvOof .:
1Q:. ,' n addi,tic'n' ;to, the sums paid the employee herai'rr,
the employer will •pay to Oie Industrial Commission, of .)Ainnesota,#
fog the- bonefit of-the Special Compensation Fund, the 'imdunt
r. prescribed by -law'. _
i ROXFORE;'' the-., ppaa artlis- - hereto mutually petition the
tr Industrial c0=61
ssioh-of Minnesota to approve the foregolsV
Stipulation for Final•Compro ,p3se settlerent rind pray that a '
Award issue -in. -conf ormity ; v itth. the 4tartns thereof ,
= fatod -this day c( liy,
-In the :presenae' of.: � ^•t
{= ,
�.+-' — --' w.�.�w.w•+.r ,.
Re
Sd J. roe e o d" "7
.ti .. C01JlpQf ati4n Attorn" , _
1P State- df f ice , i1t- ing
Saint' Paul 1;, Minnes4 a
- ' * A, ttor ney for ployao
- � - , I • r • `" • ' • I ,` , • ' r f f �...r r.�+IvAI V , •IM!i/Mr�
_art. Farms;
Rs etant CorOorati on ouns.+al,
316, Cit y 14411 & Court - House
'S.0 lift Paul Min ntosots
Attorna�r f;or Employer insurer
i b. ,