HomeMy WebLinkAboutR-2025-135 Resolution authorizing settlement of workers compensation claims filed by Claimant David CortezRESOLUTION NO. R-2025-135
A RESOLUTION authorizing settlement of workers compensation claims filed by Claimant
David Cortez.
WHEREAS, Claimant has filed multiple workers compensation claims since 1994, 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 SY16560, T894808, T894905, T743293, W201435, and W919418 for $215,000.
ADOPTED BY THE CITY COUNCIL this 2nd day of September, 2025.
ATTEST: • »; "', j Patricia Byer Mayor
nda Ibarra, City Clerk
CLAIM
THESELF-]
0
OF
DAVID CORTEZ
The Self ed Employer, CITY OF Y , re
Schoepper, and DAvin CUR (C by
ag pursuant to RCW 51.04,063 to clue all i with'
T894808, T894905,' T743293, W201435, and W919418 (C1ap
the Board of Industrial A
b.
theA at
o RCW 51.04.063, the parties to
ant
n1player
.Dailey
PUTNAM L POTVIN D Y
PO BOX 337
Olympia, WA 98507
(360) 754-7707
dustin
Mlieb.cc?
WSBA #. 39369
ed by t,r • rrtey
Dailey, enter into tbis
ors SY16560,
proval of this
c/o Pewer North America, Inc.
PO BOX 4047
West Richland, WA 99353
Brett B. Schocpper
-Clark & Scheepper
8705 SW Nimbus Avenue, ite 240
B verton, Oregon 97008
(971) 232-5 47
Email: B dClarkLavi.corn
WSBA 42177
0
2W.
No other employer is subj.L
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Date of Birth
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Age of Claimant
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Date of Injury
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SY16560
March 26, 2021
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On or about Dece 12, 2021
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Claim Number
T894808
Date of Injury
February 12,1994
Date Claim Received by
the Employer
On or about February 12,1994
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
Became Final
Unknown. Pursuant to WAC 263-12-052, the parties
agree that claim allowance has become final.
Claim Status
Closed
Closing Order
This Claim was closed by the Department,
previously
which order has become final.
T894..05 . ... ....... ....
Claim Number
T894905
Date of injury
June 16, 1995
Date Claim Received by
the Employer
On or about June 16, 1995
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
Became Final
Unknown. Pursuant to WAC 263-12-052, the parties
gree 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 Number
T743293
Date of Injury
October 19, 1996
Date Claim Received by
the Employer
On or about October 19, 1996
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
Became Final
Unknown. Pursuant to WAC 263-12-052, the parties
agree that claim allowance has become final.
Page 3 of 1 I
Claim Status
Closed
Closing Order
This Claim was previously closed by the Department,
which order has become final.
CLAIEVI W201435 "
Claim Number
W201435
Date of Injury
October 13, 1997
Date Claim Received by
the Employer
On or about October 13, 1997
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
Became Final
Unknown. Pursuant to WAC 263-12-052, the parties
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 919418
Claim Number
W919418
Date of Injury
March 25, 2005
Date Claim Received by
the Employer
On or about March 25, 2005
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
Became Final
Unknown. Pursuant to WAC 263-12-052, the parties
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.
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.
Page 4 of 11
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 fifteen thousand dollars (S215,000). This lump sum
is being paid to the Claimant for disabilities related to the Claimant's work -related 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.
Page 5 of 11
8. Claim Closure
CLAIM SY16560:
It is the intent of the parties that at the time this Agreement becomes final that Claim
SY16560 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 SY16560 is reopened under Section 10— Reopening.
CLAIM T894808:
It is the intent of the parties that at the time this Agreement becomes final that Claim
T894808 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 T894808 is reopened under Section 10— Reopening.
CLAIM T894905:
It is the intent of the parties that at the time this Agreement becomes final that Claim
T894905 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 T894905 is reopened under Section -10— Reopening.
CLAIM T743293:
It is the intent of the parties that at the time this Agreement becomes final that Claim
T743293 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 T743293 is reopened under Section 10— Reopening.
C iMF'20T43S:
It is the intent of the parties that at the time this Agreement becomes final that Claim
W201435 will remain closed. The Claimant understamds other than the payments provided
in this Agreement the Claimant will not receive any other benefits, including medical
treatment, unless the Claimant's Claim W201435 is reopened under Section 10—Reopening.
CLAIM W919418:
It is the intent of the parties that at the time this Agreement becomes finsil that Claim
W919418 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 W919418 is reopened under Section 10- Reopening.
Page 6 or 11
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
SY16560, T894808, T894905, T743293, W201435, and W919418have 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 Clrtms 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
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.
Page 7 of 11
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
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 Sectionl0—Reopening.
Page8ofll
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
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 attomey'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 attomey 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 9 of 11
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 attomey'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 11 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.
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.
Page 10 of 11
Paris to the Agreement:
Dustin J. Dailey WSBA 393
Attorney •fob airitant
Yakima City Manager '
Date
?//(-/272¶'"
Date
7512,2
rett B. SchoeppWSBA 42177 Date
Attorney for Employer
babas
CITY CONTRACT NO: 2-5- 1441
RESOLUTION NO' 7` 2 1 .. 11, 5
Page II of!!
BUSINESS OF THE CITY COUNCIL
YAKIMA, WASHINGTON
AGENDA STATEMENT
Item No. 7.J.
For Meeting of: September 2, 2025
ITEM TITLE: Resolution authorizing settlement of workers compensation claims
filed by Claimant David Cortez
SUBMITTED BY:
SUMMARY EXPLANATION:
Connie Mendoza, Director of Human Resources
Settlement agreement with David Cortez pursuant to RCW 51.04.063 to resolve all issues within worker's
compensation claim numbers SY16560, T894808, T894905, T743293, W201435, and W919418.
ITEM BUDGETED: N/A
STRATEGIC PRIORITY 24-25: A Resilient Yakima
RECOMMENDATION: Adopt Resolution.
ATTACHMENTS:
Resolution_settlement_David Cortez
Cortez Multi-CRA Council_Redacted.pdf