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Home My WebLink About09/02/2025 07.I. Resolution authorizing settlement of workers compensation claims filed by Claimant Sam Masters `y � ljlt i! 'I!I, (7A r : s . BUSINESS OF THE CITY COUNCIL YAKIMA, WASHINGTON AGENDA STATEMENT Item No. 7.1. For Meeting of: September 2, 2025 ITEM TITLE: Resolution authorizing settlement of workers compensation claims filed by Claimant Sam Masters SUBMITTED BY: Connie Mendoza, Director of Human Resources SUMMARY EXPLANATION: Settlement agreement with Sam Masters agreement pursuant to RCW 51.04.063 to resolve all issues within worker's compensation claim numbers SY16436, W582435, W582525, W919408, SE06672, SE06771, and SZ63149. ITEM BUDGETED: N/A STRATEGIC PRIORITY 24-25: A Resilient Yakima RECOMMENDATION: Adopt Resolution. ATTACHMENTS: Resolution_settlement_Sam Masters Masters Multi-CRA Council_Redacted.pdf 170 RESOLUTION NO. R-2025- A RESOLUTION authorizing settlement of workers compensation claims filed by Claimant Sam Masters. WHEREAS, Claimant has filed multiple workers compensation claims since 2001, all of which are identified in the Claim Resolution Agreement; and WHEREAS, the City's third-party claims administrator investigated the claim, engaged the services of private counsel to evaluate the claimed damages, and negotiated settlement with the claimant contingent on City Council approval; and WHEREAS, the City Council of the City of Yakima deems it to be in the interest of the City of Yakima to authorize the City Manager to settle the above-mentioned claims; now, therefore, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF YAKIMA: The City Manager is hereby authorized to execute all documents necessary to settle claim numbers SY16436, W582435, W582525, W919408, SE06672, SE06771, and SZ63149 and for $225,000. ADOPTED BY THE CITY COUNCIL this 2nd day of September, 2025. ATTEST: Patricia Byers, Mayor Rosalinda Ibarra, City Clerk 171 CLAIM RESOLUTION AGREEMENT BETWEEN THE SELF-INSURED EMPLOYER, CITY OF YAKIMA,AND THE CLAIMANT, SAM MASTERS The Self-Insured Employer, CITY OF YAKIMA(Employer),represented by attorney Brett B. Schoepper, and SAM MASTERS (Claimant),represented by Dustin J. Dailey, enter into this agreement pursuant to RCW 51.04.063 to resolve all issues within claim numbers SY16436, W582435,W582525, W919408, SE06672, SE06771, and SZ63149 (Claims),and to seek approval of this agreement from the Board of Industrial Insurance Appeals (Board). 1. Parties to the Agreement Pursuant to RCW 51.04.063, the parties to this agreement are: a. Claimant Name SAM MASTERS Claimant Address Represented by Dustin J. Dailey PUTNAM LIEB POTVIN DAILEY PO BOX 337 Olympia, WA 98507 (360) 754-7707 dustind(a�putnamlieb.com WSBA#: 39369 b. Employer CITY OF YAKIMA Address c/o Penser North America, Inc. PO BOX 4047 West Richland,WA 99353 Represented by Brett B. Schoepper Gress-Clark-Young& Schoepper 8705 SW Nimbus Avenue, Suite 240 Beaverton,Oregon 97008 (971) 232-5247 Email: Brett@GressandClarkLaw.com WSBA#: 42177 Page 1of12 172 No other employer is subject to any responsibility or burden under the Claims. 2. Criteria to Settle the Impacted Claims The parties agree that the following information is true and correct. Claimant Criteria to Settle Date of Birth and 13,Age of Claimant Claimant is 55 years of age. Gender Male Life Expectancy of 82.7 years pursuant to the tables provided by the Social Claimant Security Administration. Claimant is expected to live an additional 26.9 years. Marital Status Married Dependents 0 Other Benefits None CLAIM SY16436 Claim Number SY16436 Date of Injury January 20, 2020 Date Claim Received by April 24, 2020 the Employer _ Date of Claim Allowance Unknown. Pursuant to WAC 263-12-052, the parties agree that this claim has been filed longer than one hundred eighty days. Date Allowance Order Unknown. Pursuant to WAC 263-12-052, the parties Became Final agree that claim allowance has become final. Claim Status This claim is closed with a Category 2 impairment. _ Closing Order The Department closed this claim on August 12, 2024 Board Appeal The Claimant's appeal within Docket No. 24 23855 will be dismissed when this agreement becomes enforceable. Page 2 of 12 173 CLAIM W582435 Claim Number W582435 Date of Injury December 21, 2001 Date Claim Received by On or about December 21, 2001 the Employer Date of Claim Allowance Unknown. Pursuant to WAC 263-12-052, the parties agree that this claim has been filed longer than one hundred eighty days. Date Allowance Order Unknown. Pursuant to WAC 263-12-052, the parties Became Final agree that claim allowance has become fmal. Claim Status Closed Closing Order This Claim was previously closed by the Department, which order has become final. CLAIM W582525 Claim Number W582525 Date of Injury April 19,2003 Date Claim Received by On or about April 19, 2003 the Employer Date of Claim Allowance Unknown. Pursuant to WAC 263-12-052, the parties agree that this claim has been filed longer than one hundred eighty days. Date Allowance Order Unknown. Pursuant to WAC 263-12-052, the parties Became Final agree that claim allowance has become fmal. Claim Status Closed Closing Order This Claim was previously closed by the Department, which order has become fmal. CLAIM W919408 Claim Number W919408 Date of Injury December 3, 2004 Date Claim Received by On or about December 3, 2004 the Employer Date of Claim Allowance Unknown. Pursuant to WAC 263-12-052, the parties agree that this claim has been filed longer than one hundred eighty days. Date Allowance Order Unknown. Pursuant to WAC 263-12-052, the parties Became Final agree that claim allowance has become final. Page 3 of 12 174 Claim Status Closed Closing Order This Claim was previously closed by the Department, which order has become final. CLAIM SE06672 Claim Number SE06672 Date of Injury December 5, 2009 Date Claim Received by On or about December 5, 2009 the Employer Date of Claim Allowance Unknown. Pursuant to WAC 263-12-052, the parties agree that this claim has been filed longer than one hundred eighty days. Date Allowance Order Unknown. Pursuant to WAC 263-12-052, the parties Became Final agree that claim allowance has become final. Claim Status Closed Closing Order This Claim was previously closed by the Department, which order has become final. CLAIM SE06771 Claim Number SE06771 Date of Injury January 3, 2011 Date Claim Received by On or about January 3, 2011 the Employer Date of Claim Allowance Unknown. Pursuant to WAC 263-12-052, the parties agree that this claim has been filed longer than one hundred eighty days. Date Allowance Order Unknown. Pursuant to WAC 263-12-052, the parties Became Final agree that claim allowance has become final. Claim Status Closed Closing Order This Claim was previously closed by the Department, which order has become final. Page 4 of 12 175 CLAIM SZ63149 Claim Number SZ63149 Date of Injury _September 13, 2017 Date Claim Received by On or about September 13, 2017 the Employer Date of Claim Allowance Unknown. Pursuant to WAC 263-12-052, the parties agree that this claim has been filed longer than one hundred eighty days. Date Allowance Order Unknown. Pursuant to WAC 263-12-052, the parties Became Final agree that claim allowance has become fmal. Claim Status _Closed Closing Order This Claim was previously closed by the Department, which order has become final. 3. Claims Not Impacted The parties agree the scope of this agreement is limited to the Claims outlined above and no other claims are impacted by this agreement. 4. No Further Disability Entitlement In consideration for the lump sum amount listed in Section 6—Lump Sum Payment,the Claimant relinquishes any further Washington Industrial Insurance Act disability benefits or payments to which the Claimant may be entitled under the Claims. Disability benefits include payment of time loss compensation(wage loss),loss of earning power(partial wage loss), permanent partial disability and/or pension benefits. 5. Vocational Entitlement In consideration for the lump sum amount set forth in Section 6—Lump Sum Payment, the Claimant relinquishes any further Washington Industrial Insurance Act vocational benefits/services to which the Claimant may be entitled under the Claims. The Claimant understands that vocational benefits/services include vocational assessment,vocational plan development and job retraining. 6. Lump Sum Payment In consideration of the release above, and for this Agreement,the Employer agrees to pay the Claimant a lump sum of two-hundred and twenty five thousand dollars ($225,000). This lump sum is being paid to the Claimant for disabilities related to the Claimant's work-related Page 5 of 12 176 condition 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. Pursuant to RCW 51.32.040 and RCW 74.20A.260, the lump sum amount is subject to collection action by the Division of Child Support(DCS). If the Claimant becomes indebted to the Department or the DCS in the future, the Claimant agrees that such future debt will be deducted from any remaining payments but the payment will not be above the statutory maximum or below the statutory minimum. 7. Discharge of Payment The obligation of the Employer to make payments outlined in Section 6—Lump Sum Payment, shall be discharged when a valid check is mailed for the required amount to the Putnam Lieb Potvin Dailey. If the check is lost or otherwise not received, the Employer, upon prompt notification of non-receipt, will reissue the check, subject to verification that the check has not been negotiated or otherwise cashed. The Claimant or Claimant's attorney must promptly notify the Employer of any address change. 8. Claim Closure CLAIM SY16436 It is the intent of the parties that at the time this Agreement becomes final that Claim SY16436 will remain closed. The Claimant understands other than the payments provided in this Agreement the Claimant will not receive any other benefits, including medical treatment, unless the Claimant's Claim SY16436 is reopened under Section 10—Reopening. CLAIM W582435: It is the intent of the parties that at the time this Agreement becomes final that Claim W582435 will remain closed. The Claimant understands other than the payments provided in this Agreement the Claimant will not receive any other benefits, including medical treatment, unless the Claimant's Claim W582435 is reopened under Section 10—Reopening. CLAIM W582525: It is the intent of the parties that at the time this Agreement becomes final that Claim W582525 will remain closed. The Claimant understands other than the payments provided in this Agreement the Claimant will not receive any other benefits, including medical treatment, unless the Claimant's Claim W582525 is reopened under Section 10—Reopening. Page 6 of 12 177 CLAIM W919408: It is the intent of the parties that at the time this Agreement becomes final that Claim W919408 will remain closed. The Claimant understands other than the payments provided in this Agreement the Claimant will not receive any other benefits, including medical treatment, unless the Claimant's Claim W919408 is reopened under Section 10—Reopening. CLAIM SE06672: It is the intent of the parties that at the time this Agreement becomes final that Claim SE06672 will remain closed. The Claimant understands other than the payments provided in this Agreement the Claimant will not receive any other benefits, including medical treatment, unless the Claimant's Claim SE06672 is reopened under Section 10—Reopening. CLAIM SE06771: It is the intent of the parties that at the time this Agreement becomes final that Claim SE06771 will remain closed. The Claimant understands other than the payments provided in this Agreement the Claimant will not receive any other benefits, including medical treatment, unless the Claimant's Claim SE06771 is reopened under Section 10—Reopening. CLAIM SZ63149: It is the intent of the parties that at the time this Agreement becomes final that Claim SZ63149 will remain closed. The Claimant understands other than the payments provided in this Agreement the Claimant will not receive any other benefits, including medical treatment, unless the Claimant's Claim SZ63149 is reopened under Section 10—Reopening. 9. Medical Treatment The parties stipulate that the Claimant is not in need of further medically necessary and proper treatment and that all conditions related to the industrial injuries/exposures under Claims SY16436, W582435, W582525, W919408, SE06672, SE06771, and SZ63149 have reached maximum medical improvement. 10. Reopening Pursuant to RCW 51.04.063 and RCW 51.32.160, the Claimant retains the right to file an application to reopen the Claims should the Claimant's condition related to the Claimant's industrial injury and/or occupational disease worsen. The Claimant understands that the Claimant will be required to demonstrate aggravation of the condition in the Claims as contemplated by RCW 51.32.160 if the Claimant applies to reopen the Claims. Reopening is not guaranteed and the Department retains the right to deny the aggravation application should it determine there was no worsening of the Claimant's conditions, within the meaning of RCW Page 7 of 12 178 51.32.160. In the event the Department denies the aggravation application, the Claimant may appeal that decision pursuant to RCW 51.52.060. The Claimant further understands that any reopening will be limited to medical benefits only, and that even if the Claims are reopened, no further disability benefits will be paid. 11. Administration of Claims During Board Approval Process The Employer agrees to continue to administer and provide benefits due to the Claimant under the Claims until the date this agreement becomes final. Any unpaid bills for treatment provided under the Claims prior to the date of claim closure should be submitted to the Employer within forty-five (45) days of claim closure, but in no case later than one (1)year following the date of the treatment or service. 12. Ability to Work Nothing in this agreement will prevent the Claimant from returning to work full-time or part time, paid or unpaid. 13. Future Claims If the Claimant returns to work, and suffers a further industrial injury or occupational disease, the Claimant may file a new claim and receive appropriate benefits if the claim is allowed. 14. Parties' Understandings The parties acknowledge and agree that each understands and agrees to the terms of this agreement and has entered into this agreement knowingly and willingly. No party has been harassed or coerced to participate in this agreement. The parties have represented the facts and the law to each other to the best of their knowledge. The parties state that this agreement is not the result of a material misrepresentation of law or fact and that the agreement is reasonable under the circumstances. Finally, the parties acknowledge and agree that this agreement will bind each to all aspects of the Claims except for medical benefits. In addition: a) Claimant i) Industrial Insurance Benefits: The Claimant acknowledges, agrees and understands that by entering into this agreement the Claimant will receive no other benefits related to the Claims except as outlined in this Agreement. The Claimant acknowledges that the Claimant could have continued to pursue additional benefits under the Claims (benefits Page 8 of 12 179 such as financial disability payments or additional vocational services), but instead opted to enter into this agreement. The Claimant understands his rights under RCW 51.04.063. ii) Other Benefits Potentially Impacted: The Claimant acknowledges, agrees and understands that by entering into this agreement there is a chance that other government benefits that the Claimant is receiving, or may be entitled to receive in the future, may be impacted. iii) Ombudsman: The claimant was informed that he may request that the office of the ombudsman for self-insured injured workers provide assistance or be present during the negotiations in the event claimant is unrepresented. The claimant here is represented. b) Allowance Order: The Claimant and Employer acknowledge, agree and understand that this agreement does not set aside or reverse the allowance order on the Claims. c) No Employer Affected: This agreement does not subject any other employer to any responsibility or burden under these or any other claims. d) Department Funds: The agreement does not subject any department funds covered under the title to any responsibility or burden without prior approval from the director or his/her designee. 15. Medicare Coverage The parties acknowledge and warrant that it is not the purpose of this agreement to shift to Medicare, Medicaid or any other government program the responsibility for payment of medical expenses for the treatment of industrial injury or occupational disease related conditions. To the best of the parties' abilities, they have tried to be clear that this agreement covers only the medical conditions accepted and covered under the Claims, as outlined in this agreement. Other medical conditions are not covered except as provided in Section 10-Reopening. If the accepted medical conditions outlined in this agreement should worsen and require treatment, the Claimant understands and accepts responsibility to seek treatment for those conditions by following the process outlined in Section10—Reopening. The Claimant's right to future treatment for the industrial injury and/or occupational disease is not being compromised by this agreement; therefore, the Claimant and the Employer do not expect that there will be any impact to the Claimant's Medicare benefits. Nevertheless, the Claimant knowingly and voluntarily accepts responsibility for this risk and waives any and all claims of any nature and/or damages against the Employer should Medicare take such action, including but not limited to a Private Cause of Action against the Employer under the Medicare Secondary Payer Act(MSP)pursuant to 42 USC § 1395y(b)(3)(A). If the Claimant decides to Page 9 of 12 180 seek treatment for the accepted medical conditions outlined in this agreement without going through the Claim and Medicare finds it covered and provided for treatment that should have been paid for by funds associated with the worker's industrial insurance claim, the Claimant agrees to accept responsibility for all costs and penalties for that treatment assessed by Medicare, Medicare Secondary Payer Recovery Contractor, CMS, Collection agencies, or any other governmental entity's claims, actions,judgments or settlements. 16. Assignability The Claimant will not and has not already agreed to sell, mortgage, encumber or otherwise assign any part of the payments. All payments will be made to the Claimant except in the event of the Claimant's death. In the event of the Claimant's death prior to the final payment, payment will be made in accordance with Section 17—Claimant's Beneficiaries. 17. Claimant's Beneficiaries In the event of the Claimant's death prior to final payment, remaining payments will be made in accordance with the schedule in Section 6—Lump Sum Payment to such person or entity as designated in writing on a form acceptable to the Employer. If no such designation has been made, or the person is not living at the time, such payment will be made to the Claimant's estate. 18. Attorney Fees Each party shall pay, to the extent that party incurs any, all attorney's fees and costs arising from the actions of its own counsel in connection with the administration of the Claims and this agreement up to the date this agreement becomes final. This provision is not intended to affect any rights the Claimant may have under RCW 51.52.130 to obtain attorney fees in any future superior court appeal regarding the Claims. Pursuant to RCW 51.52.120, fees for attorney services are limited to 15% of the total payments made under Section 6—Lump Sum Payment as compensation for work done in connection with this agreement. It is important to note that the calculation of attorney fees attached to the Section 6-Lump Sum Payment is wholly independent of the benefits that had been previously paid within this industrial claim. 19. Filing for Approval The parties acknowledge that this agreement must be approved by the Board and that the Employer will be responsible for filing for such approval pursuant to Board rules. The Page 10 of 12 181 Employer will file for approval no later than ten (10) days after receiving signed copies from all parties and will send notification to all other parties upon filing. 20. Revocation Any party may revoke this agreement by providing written notice to the other parties and to the Board (if the agreement has been submitted to the Board for approval). A party may revoke this agreement no later than thirty days after the date that the agreement is approved by the Board regardless of the date a party receives the Board's approval of this agreement. 21. Governing Law This agreement will be construed and interpreted in accord with the laws of the State of Washington, specifically the Washington Industrial Insurance Act. Pursuant to RCW 51.04.063 the parties acknowledge and agree that if aggrieved by the failure of any other party to comply with the terms of this agreement, the aggrieved party has one (1)year from the date of failure to petition to the Board. Furthermore, the parties acknowledge and agree that should the Board find a party has failed to comply with the agreement; the Board will impose a penalty of up to 25% of the monetary amount unpaid at the time the petition for noncompliance is filed. The Superior Courts of Washington will have no original jurisdiction to hear claims or disputes arising from failure to comply with this agreement, and the parties acknowledge that the Board has exclusive jurisdiction to hear any and all disputes regarding compliance with this agreement. The Board will also decide any disputes related to attorney's fees for services related to this agreement. 22. Comprehensive Document All parties acknowledge that before entering into this agreement, each has had the opportunity to discuss this agreement with an attorney of their choosing and to obtain legal and income tax advice regarding the possible consequences of this agreement. The terms of this agreement have been completely read and are fully understood and voluntarily accepted. This agreement consists of 12 pages and sets forth in full all the terms and conditions agreed upon by the parties. There are not any other agreements, representations or promises, verbal or otherwise, regarding the subject matter of this agreement. Page 11 of 12 182 23. Good Faith and Fair Dealing The parties agree that Employer has complied with the duty of good faith and fair dealing contained within RCW 51.14.180. 24. Best Interests of the Claimant After considering all the factors outlined above, the Claimant believes that this agreement is in the Claimant's best interest. Parties to the Agreement: SAM MASTERS Date Claimant Dustin J. Dailey WSBA 39369 Date Attorney for Claimant Victoria Baker Date Yakima City Manager Brett B. Schoepper WSBA 42177 Date Attorney for Employer Page 12 of 12 183