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Traveler Indemnity Case Summary

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WHEREAS, this case has been established for an injury to the right shoulder; and

WHEREAS, the average weekly wage has been set at $420.00, inclusive of wage-expectancy; and

WHEREAS, the claimant has been found to have an 80% schedule loss of use of the right arm, which the schedule has been fully paid as of 01/26/2012; and

WHEREAS, the parties have reached an agreement to resolve all outstanding issues and to bring this case to fully and final conclusion.

THEREFORE, subject to the approval of the Workers’ Compensation Board, the parties stipulate and agree as follows:

1. Upon final approval of this Agreement by the Workers’ Compensation Board, Travelers Indemnity Company, will make a one-time payment to the claimant of $130,000.00. From this amount, $ …show more content…
v Ifco Systems North America WCB# 5060 3948

3. Traveler Indemnity Company, is continuing to pay for all causally related medical expenses pursuant to the Workers Compensation Board Medical Treatment Guidelines. Travelers Indemnity Company, will continue to pay for any causally related medical treatment under the Board Guidelines incurred through the date of the Section 32 settlement hearing but will not pay for any treatment incurred after the dater of the Section 32 hearing.

4.. Upon final approval of this Agreement by the Workers’ Compensation Board, the claimant, Primitivo Vazquez Jr., hereby waives any and all claims he has arising out of this case whether for lost time, medical treatment or other.

5. It is understood and agreed by and between the parties that this is a full and final settlement of this matter and that upon final approval of this Agreement by the Workers’ Compensation Board, all of Primitivo Vazques Jr’s rights with regard to this claim will be extinguished forever.

6. It is understood and agreed by and between the parties upon final approval of this Agreement by the Workers’ Compensation Board, this case will be closed finally and

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