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" � � . � ' . � � � � iy'; ' . , .; . . �. ' . , , . � ,. ` � � . � , � . . � : ?�' _ �, . , `. '� : . ; Cali to o�der . � � � . 1. 9:�1 a.m. �, � �. , . ; � `�; � � . , : . , � . ' �-�"� •� °'2. Approval of�Mlnutes � . 2. Appraved as submitted. � � � , ..,� �' . 'af915195 � '. � ', � ' � � � , , , . , . . � . . � , 3. � Reque�t for acceptance �' • ' � 3. Appraved. • � ` ' . � � : . . . into.memhership: � .. ' � �. , , ; ��' � . � , � � ai .! ason Briggs ' . - . . , . , ,� • . . . I � . : �. � - bf Tr�cey Davis . � . � . , � � , • . � ; �. � � � ci Nlicha�i Duffey � �. . , � � � ; , � ' ; ; . �� � � di�Charles�Gibsan , ' : ` � � . � �� .� � , j � � � ° ' � e) Ai �Hinson . � . � . , • � � � ` � � � f? Elizabeth Hishmeh � � ' . � � . . , � . � . .,, � . � � � ' . �� , 9}..Wilfred .3anes � . � ' � . � • ' , ; .' , . , h1 Trevar Murray , � . � � . . �j � ; � { ��`' � i}Julie Phiflips � � � . ' . . . .: � , . ' . �• . . , j1 Frank f'isci�attola � � . ; � . :' ' , � k1 R�ginald Rutledge . � ` . � . , . , .� '. . , , � � � � . .Ij D�vid Stewart � ' � � � . ' . � . ' m} Daniel Tupponce . ' ' „ . ` . . . , . ° � ' nl� Glenn Witko � � � ' � . � � � . . � , aj Greg Zinge . ' , � , ;� • . .. � : . � 4. Job-CGnt�ected Disability� Pens9on 4: Granted. ' , � , . � - � to be granted: , . � � � , . . � ' � � � � , , � J�aseph Stanel�lce � . - � 5. . Job-Cor�nect�d Disability Pension 5. Granted. . - � , ', � to .he grantod: . � � ' ` ' . , � � �manuel Hutchinson � : � , 6: � Jo�-Connected Disability Pension 6: Grar�ted. , � � . to b� gra�tad: . , � Thomas P.� Coleman � . �� � • . � . ' � •° 7. Other Business: '7. None. , � , . . , , , .� , 8. Adjournment; � $. ,9:04 a.m, � � . , � . ', .; • � ' ' . • . ,.;�, , 3 = . , , ; � , , ' � � , ", , � .� , �° . , , � . ' • � '� "° TRUSTEES OF TH� EMPL�YEES' pENStDN �UND Item # � ,� �*�,� Agenda Cover Memorandum Meoiing Daca: io12C,�� Subject: , � Mctnbership in Em�ioyce.s' Pension Plan . �� nr��ri�ri�n wun�im�ni�i Recommondat�anlM�tion: Empinyec{s) listcd below bc acccpted into thc Employecs' P�nsian Plan as rccommcndcd by ttie Pensian Ad�isary Committce. ❑ and that the aqoroqriate officials be authoriz�d tn ex�r.�,tp samP. Jason IIriggs, Maintenance Worker I Tracey Davis, Custodinl Worker Michae� Duff�y, � Policc Recruit II Ci�ar�es Gibson, Fire€ighter AI Hinson, SoSic� Waste Workcr �lizubeih Hishmeh, Pofice Com. Oper. tiVilfred 3nnes, Maintenance Worker I Trevor Murray, Firefighter Julie Philiips, Code Enf. Inspector I Frank Fisc�ettol:�, Policc Com, Oper. R�ginald Rutledge, Maint. Warker I D�vid Stewsirt, 5olid Waste ' Worker Da�iel Tu�rpance, Police l2ecruit 11 Glenn 1Vit�:o, Firefi�i�ter • Greg Zinge, Firefighter AeviQwed by: Originating Dept: Human Resourca; l.egal NR Bud�et N�, Putchasing NA User Dept.: Risk Mgmt. NA CtS �� ACM ^ Advert€sed: �iho� NA Oate: t�;i Paper: . � Not required Submittad by: Affected parlfes ❑ Nollfied � Nat req�ired Cltv MAnaner �� � Scnior.ity Ae�, /Div• I�ate Solid Wzste 915/95 Solid Waste • 8/17/94 Police i 012/9S Fire 7/24195 5olid Wastc � 9/5/95 �'olicc 915195 SoIid Waste 4/5195 Fire 7124/95 Community l2espoz�se 8121/95 i'olice 9!Sl�S Solic! Waste 9/5/95 5oiid Waste 915195 Police ] �/2/95 Fi re 7/�4/95 Fire 7/2�/9S sts: �. Tata! Current FY Funding Saurce; ❑ Capt. imp. ❑ �perating ❑ Olher AppropriatEon Code: Pcnsion � Effectiy�; D��te 9/5/9 5 9/5/95 l 0/2/95 7/24195 9/5/95 9/5/95 9/5/95 7/2�/95 8/21l95 915195 9IS/95 9/5195 1 U/2195 7IZ4/9S 7/24/95 Commission Action: ❑ Approved ❑ Approved w/conditidns ❑ Dsnfed ❑ Cont{nued to: Attachments: L�tter(s} ❑ None `��: •, , • , r' � . • ' ' . � � ' . ' • , ; � � , , ,. • � . • ' . � � . ' � � ' . ' , � ' � . . • � • , . � . ' , • . s . • • . , �. ,� , ; , : , , ' . , � . . „ „ . " � „ � , � . i ' . . . S . . . . , . . �in�>l�c;�': -�Il•^}ts; '� ,��.,i ,. , , e. . , , ' • .. , ' , •.� � � , • . , . ., , . ., 'tt'.`',.. .� . .. °.�. '- ..`� �''�-'i,'.� . .. . . .. "�', . . . .> _• , . ..y .. 'i '" • � � . . ' . . ' , ' '! .. , ' . ' ; � , ' - � ' . . ' ' ' ' .� . ' � � , ; ' C�TY UF CLEARWAT�R , � � �� � � ' � ' � . EMPLUY�ES' P�NSYQN PLAN � � � � . � �'ENSI�N ApVIS�RY COMMITTEE , . , � . . ' � ' 'T0: ' � Pensian Trustecs . : ' �R4M:� Pension "Advisory : Cammiue� ' '���� � � �, , � ; SUBJECT: ReCOmmendatian for ACCC�3[RnCC into Pension �Inn � . � UATE: 5eptember 6, I99S � � � � ' . � �. , As Trustees nf tha City of Clcarwatcr Enipinyecs' i'cnsion Fund, you are iiercby notifeed tltiut tl�e • . � employce(s) .tistaci below have been tiuly ex.amined by a local pfiysici�n and ench has bcen .' � ' � dcsignated us � "first cluss risk". . • � � 3 , These cmployees ure cli�ible for �ensian membersl�i� us• r�ated in the Pension Eligibility Datc: , cnlu�nn below, und it is the reco:nmpndution of the Pensian Advisary Carnmittee th�t they Uc , , , i1CC£�tC(� inta membership, . , . , ' , Pcnsion Elig. . , N�me. Jot�. Class. Rc Dcyt./Div. �?� ' j�jre I?s►te D?te � , ]ASOn �3riggs, ss# 59�-14-2779 4/16170 915/95 �. 9I5/95 � ', Mninteziuncc Warkcr i, Solid Waste De�rt. � . . , . , � Trucey. Davis, ss# �2G2-69-9709 � $/1 1 !6 � . 8/ I 7/9� � � 9/S /9 5 ,' . Custadinl �Vorker, Solid Waste Dept. � *Em�loyee �ircd frant perrri�nent pnrt-titnc . � . tn fuli-cimc permanent stntus, Hire d�te � , ', reflects dute hired as pertnancent pnrt-tiine. Mich3el Duffey, ss# 262-29-8998 �17157 14/2/9S 10/2/95 • Palice R�eruit [I, Police Dep�rtment . � � ' � Charl�s Gibsnn, ss# 590-32-77]fl ! 2l2 9172 7/24/95 '7/24/95 ' . � FircYightcr, Firc Depnrtment , � A! Hinson, ss# 593-46-Q8S3 613 D/7 2 9/ S 19 5 915/9 5 " Solitt Wuste Worker, Soli�i t�'usie llept. . �lix�beth Hishrneh, ss# 399-58-1452 1129/54 9/5195 915/95 � �� Faiice Communicutiat� Operutor, Police Dept. �. �Vilfrcd Jancs, ss# 266-23-a�490 I 1 Z 11 S S 9/519 5 � � 9/5/ J S � Maintenance Worker l, 5olid Waste De�t. , I � Trevor Murray, ss# 2b1-97-2�5G 12/1/G5 7124l95 7/24195 � � ' Firc1'ighter, rire Department � J�lie Phi}]i�s, ss# 591-09-35l4 ! U/3157 812! /9S � �/21195 ' Code Enforcement Inspeclor I, � � � Cotnmunity Response Tenni ' ' Fr�iyk Pischettola, ss# 155-8U-3�l8 212/71 9f5195 9J51�5 < Pnlicc CvmEYiu�}ication Operatvr, Falice Dept. � Reginald Rutledge, ss# 264-21-94b3 I/!/5 fi 9/519 5 �, 9/519 5 i Mnintenance Worker i, Sniid Wuste Ue��t. ��;� ' , . . . >4.a��,�.,y ..,��Fr� �'y�,:�e,'��� .i:� . � � ., �.r�. , • , . . . . , .. ,k; �i:ry I- � rZ �.f � ".. . 1= ,1 .j', ;'�i4 �z'^�f,`"?}"�k� .�k,' .y rSt �.''�r}:: lj�i3; , r '��-,�. . . . �`�:: . • . ' . . r �. '� ' x�. ���r%�, r. 'i'i. . �.tl� �' . . - , . . . . , " " .. e . , . ,. '.�"��.� ��t.,rr.. .. iie, .F'.},.,,i�: 'r• . ' 's,' t' , ' , . , , . . . . � . � ' .. . '.. o i f' ' , � (�.i :�'t.: �' �ti� ,� ..'�.: . . •.i , �i, r �7��'1' �l.� tii. �`F� ' . . ' , ' • , .. . . `, . . . i�' � , .. y . , • �pL' � . . ' � . . . . , .' i � . �. ` . _ ' ' � . . • . '�i . 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' � . �' r`, .r. i � �: �� �,�i. •ti ��Ft1. f.i9'� Fe.i^�S�_..L'�•..�.�."t��::u't`���z��..:..e ...:�rSrYi:��Y.'y'SC�SN y�'�r'§a'i..�,.��;fi: ,-c_ .S .�':f�•.=.•�'�'��',t:i-•:��r.r .l.::i(;.��`S:! �) : 4,' .j,r `• '�,� . � , . � . . . , ` , . .. , . ; r .. r ". . . ' t, ., ' � � .� ,• l l: '� , , . , . . ; C J 1 � ` . � . . �'�. � r ' , � ' . , . � . ', ' '' ' ' ' ' . � " � . r' r ' �.. , . . . . ���`r't14. ,.. � . , .' r. .. . .�, '' ., e�.' . ' : ' :li � '. 1 ` , ' .I. • ' ' .. . - . .. . " • +1 � . 1 .� ,;', ��avid Stawurt,';sst� �2b2-8�-8932 � ,.1/4j7.2 . � j� 9/5/,95 - � � � ,,r915/95 � . , '��� ' 5olid W�stc � Workcr, Salid �V�stc Dc�t. . . ' , . : � . . ` � ' ��;:��� �F .. � , � ,. .� . . � ' , ' : ' , .,. 'y , , , • ,., . �;�' � • ,' ..; D�nie[ Tup�once;, 'ss# . D40�76-3i2U � . ° - 8/ i qlb7 . 1 Df2/95 . �.' . �. � :. 1�0/2/�95 �I. . .,,. . . , . , , . r.�; `.. . , ' �. Policc . Recruii I�, Policc�- I�eprertr�ent • � � � . . � . � , � � ' . �. . � � ` ?;=; ' .;,�` G�enn �Wiik� � . � � ..' . . . � , ` , ' , r:;,�� . . a;�"ss�- 265-8t-9688 . . 2/7l65 . , 71241�5. " . � 7/24/9S� � ;�;•�' Fircfighter, Firc Depurtrnent � ' ' . . � ' ,� , � �'�:'� , r, � . . . , , . , � . � .. , � '. - ; ' , '' ~`' ' �' � � ... �Grc� Zangcr. ssii 595-50-9302 . 3/4165 , � .7/24/9S ' ; ' � ' � � � . 7124195' � ' � ..� . , . � , � ' � _ Fire�ghter,• Fire Depurtment � ' ' � . ' ' . , . . . ; - . . ' ; �5,. ; , ,.,. , i.. y , ; � ; : , � 1 . • . . 1 . , . , '1�'?. ' ' ..� � .` . .. . . ' � . .� � . r .. t . ., ' � . � , • , � . . . I � ` � . � . . , .. . •�`,1�.?, . 'r � . •ft' . . � � '�, , ; ' , . . . . . .e � • • . . , • t .. t. . . . ' ' . ' � ' ' • ' • Y� . � �1t� ... ' .�� I . . � '!�' .• � , . . �' � � , .. � , � . ' ' i , ' 1 ' . , `E�� ,.. � o . � . � }. � ' . .. � .., i �. t ��.' . . � . . �' . . . .. ' r � ' ' � ' � ' ' � I � 4 ' �' 1 , i . , . , . . . �. .' . ., .�" '`' � '�� .i ` 1. , , �.. . ...,� ..., . i . . ' . � ' ' . � � . . . . . . � . . , , � i V '� .• . ' 1.r • .. . �rii` '` . ' •• , ' � ' . � . � .. ' . ' ' . • � . ,y ` ` . . . � tt., �l� � . . " .. �v . ' • � . )' ' . .. .� ' � � , . . . . .. � ..,.. . � . � ' � • • , ^5` 1C . .• ' �S � .�,, . ' . . ' ' � � .. ,' . .. . .. . . � :. . , �, r , � ' , ' . ' ' , . 3 � . . . '1 � • ' ' " , .t , i . . . � . . . .• . . . r ' ' 1 � . . 'I '' � � . ' ' . � � . . . � � ' ' . ' . . . . � . , . . , ; �. � ' � � . . • r • , ; .• . � , . r ' . . . � � . . . � . . ' , . . , • ' ' � ' ' . , � ' . ' ''� . � , , - ' ' , . , ' , ' . ` , ' • , � � .. . � ' � � . , ' � �. � , � . . . : p � � . � . � . . . ' , � � ' ' ` . ` � . , . • , y . ' � ' , �� , � 1 ' . . ' • ' • i f � . ' ' • � � � � i, ' . ' ,. i , f , � . � ' � �} ' , . � . , . � . . ' . � . � S � i . ' t.. . _ � . ; , ' . � ' . . � " ' . . ' , e � ' , ' ' ' ' • 1 . . . . t� . . r ' . . . . � � �IS�, ' ` ' '' . . . , � . I � , ' •1 ' . . . • . � 1 I . , 1 . . ; . 1 . ,' [ . ' , I � . t ' ,; � �k'.:l�-en.,kJA'l��r . � � � � .... , . � . . .. . .. .� ! 1 " . . . . . . . . . .> . •I . � 1, . ' � ' . i'' . �I � � ,•;• � • 1• � ' � ���� , �� sub)ect: ( , . . '1 TRU5TEE5 O� �HE EMPLOY�ES' PENSION �ClND Agen�da ' Cover Memo�andum � Fensian to bc Grar�ted RecommendationlMotion: � ���enl � Meeting Qato: �� Joseph 5tor�elake, Marinc Dcpartment, be granted a job-c:annectsd clisability �ension under Scclion(s} 2.397 andlor 2.399 of thc Empioyc�s' Pcnsian Pian as rucommended by tl�e Pensian Advisory Comrnittee. � . , (�artd that the apprapriat� afiicials be a�jkhorized to execute same. BACKGRt�UND: jflsep�� Stonelakc, Marinc Faci�ity . Operator, Ms�rinc Dep�rlmcnt, was crnployed b y ti�e City on April 11, 1978, �nd 6egu�i particip�king in ihe Pension Plan on Octaber 28, 1978. On Februury 2b, 199�, he in�ured his bac4c whiie on ciuty which is t�c f7�l5i5 for izis rcyuesi, for this job-cor�nected disability pension. Mr, Sto�ielake submitted letters from llr. ]oseph M. Sena, Dr. Nelsnn M. Smith, Dr. R. W. 5pringstead, Dr. Wiliium Cubides, �nnd Dr. Rvbert G. Hamiltan. Thc letter frarn Dr. 5mith statcs, "He was i n j u red while working February 2G, 1944...MR[ fsom �ebruary 2, 1995, showed a ccntral disc hcrriiation at LS-S � and bulging �t. L4-S...There is demQnstr�ble cvidence of disc prablems resulting in t h e ��ain...As Izis to�v stress, low lifting , jab is being elirr�in�ted, I see no other remedy otlier th�r� a retiremcnt w�th disabiliry sinc;c chis �vas cicarly reZated to his �vork. Tl�c patiet�t should n o t engagc in� anythin� . requirin� lifting, prolonged walkin�, or bcnding." T�te lettcr from Dr. Springstead st�tes, " This is a...rnafe who wus injureci on his job on February 2G, 1994, whilc working for t�c City of Clear4vater...Hc has �revio�zsly sc:en Dr. Hamilton wha �;uvc him samc Pcrmanent restrictions of no excestiive st�nc�ing, wcyIking, bending, no climbing, no lifting morc than 2S#s,.,I would donbt that he is �aing to be �blc tu rcturR to liis previous e:mployment 1t thc Marina, WI1lCI] r�c�uires �in� to be c�uite activc, �-ie I�as to clo a certain amaunt nf walking, lifting und fueiin� boats, i�spectir►g boats...in ��ddilian, in thc futurc he might be able to do same othcr li�ht duty." EFforts �uve bcen madc to loc�te niternative em�loyment for hlr. Stonela�:e within iyis physical iimitations withouc success. I�evie►Ned hy: L.Qga1 NA . Budget NA Purchasing __�A_�_._ Risk Mgmt. _ NA C15 y NA , _ ACM �.`� � Oitter NA � Su6mltted by: City Manager Origin�ting DQpt: Wuman Resources User Dept.: Advertised: Dale: Papar: � Not required Affact�d partles ❑ Notlffec! � Not rQquirod Co�ts: �u�,A 9. �4� Comm[ssion Actlon: � Tota1 ❑ Appraved ❑ Approvad w/conditlo�s Current FY ❑ Denfed ❑ Cantlnu4d to; �unding So�rce: ❑ Capt.lmp. ❑ Operating � �ther Pension Approprfalior� Code: � -5 � Attachments: Letter(s) ❑ Nane .. �! ! ` " '.`:''+.- � , , . . � .... . , .S. � . . . " • . ° !' ' � ; � . , ' ''i' . ' � ,�R. ��:�1'',H��? .!'� �?�<.�t • .� i� , � ' ' . . ' , ,• ' .. .. ; � . " . � . . . . � .� ` . . . ' . , � ;t`},�• , , . ..t, '�, .'.} 1�� � � .,f . ,. � . . . ' . .; • . ' ' . , .', , . . �i, .... . 4. , . , . . .. . . • . _ . 1�lr . ' .. . . I � ,� : , '. .. 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' ' � � . :{, r ..•` , I• . . . . ... ,� „ ' '�1+ f . i' .I' ,� � :, t.. . � ' � ' . , " a ,.E � :. . ' . � . .,. . . ' '>�il'. '�;' . 3;f: �s� '��+_ e .. — �i � . : . ' . . • � . ' ' � � ,� . . : �' 'r {� `� �. , , r' , � j. `i : �� , -, � � . . , , ' �;. , ' ' t ; ' 3 �; 6... ,' •. . . .t.;- � �:t.,r; ».l ep�.q.s :l�r., ,q�',srt ' "+`` ,j��Y� '(�'4i.r'r!� %"�y,,��.,�}+ i�S�Af'»l3y �t .i �. � . �. ; Z.',•J.' f.i � ' _�' �.;'; ;f��'��`�` r... � �.��.' i.'�s. p�1 :•;tieti.'i:f !1s;�}�.J• ,� I�T'' L'� f �! d"( .f.'"'e:. �i-. :f.'y. �f' . I,�i � ?Idl'`i l�i',J�s. •J°' t..d �'�:�� ���y ts�� ' i1�, . 3 ��t.k:�.. r , i., ..�:� � . . , .w����. r i. i'F;...is.�i8� .!f'�^ �t•�.& . .'�S.I'� .l3sC�1:��..... ,' .'a,i71.1 �. .. � ' � •x � �. , xjV � '�' , � . . �i Yr.:. . . •' tfj�� ' , i . . .� . `,w..a: i' . ' ' . . ,; �. . . {¢4i j}• ' . . . ., . . . � . , ' . . ' . ' . . . . ' � � .. . ��i� . � .. ' , . ' . . " , � , .1: ' . : ' ' . . . . . • �`. . ; .i� ;. , � . . � . . . " . ' . . . . . . • . � . ' ' � � . ' � , 'f , . . ,' ..,. . ,. � ' .` . .. , . . � ' , , ' . �"i , � �r ; ' � , .. ' , '• f.. . � . . . •. � . . , . '�� , .' ' . , ,' � , t' . . �'ts;. ; �Agenda Item-Joseph ..' Stonelake � . . � . � . , ' , � , � ; � ' �, ., ; .� . . >; ' P�gc', 2 ��, .. - .� . ' � .' . ; , , .• ' , . Y,...�, . October� 2. 1995 . �. . � . �. , , , , , , � , , . ,. , , � � . . , ,. , . . . + � :i � � • � : � : � . , . . ' , .' . . ,' . • .. ., . _ . .. - . - , .. . - � :,.. , . . . �. � . ' , . . . � , + , :. , ' ' , .. ` , . . � , � ' . . �" � Mr. : Stanclake's pcnsion� wgs appruved .' by ihe Pension Advisory. Cammittee� at its meetin� .. on . � ..'�, September 5; � 19�5, und will bc efFective an October 3, 1995. � Bused qn an ;�vera�;c ., sttlary , of a= appraximatcly $2$,q37' over the : pa'st five ycars at�d ttie formulu far computing job-connected � ;,�:; ,�� :. dist�biiity pe'nsians, this pensiori will,. np�roxima,te $21,Q27 annually; .� Chttrts from PinAnce whic� " , � t�ke inta ' cor�sideration marta�ity r�ites � and �ge , ref�ect 't�e ."present vulc�� � cost nf financin�" .th�s � - ;; e:�ension will be. .��ipproxim�tely $249,G06. .. The estimated pension cost (cash payout over the lifc , oi '. � • � .. 1he pensior,er und hislher spnuse} is $504,648. , � . , ; , ' . - . ' ', ;.'� � • � , . � ' , � � � , � . ,�j � � , " , ' . � .. �� : � � : � ,' � .• . , " • ,,. ,� ,�� . -�... � • . ' � - ' ' � . ' • ', �.�. �. � ` �. ,� � �. � .' � . , � ' � . �, • � � � � � , � . � z,. , � , , . � . � - , : , � � . . , - � � . ,, �� . . �. .. , , �� ,. �� .,. � . ' , s � .' �. , • . ' , . . . , '. , ,. `,.� .. � . ' . . � , . . . �_'� . � . , ; �, . � . ' �. ' ,. • .. � ' ? . � : � . ., � ' . , ,' _ ... . : . , , ' � . . : • , � . . . . , . ' ' . , : . .. �. , . ' � � - � � . � ' . � . �� , • �. �, . �. � � ; . , , , . . , , „ . , , . " . . � ` - . � � �� , � . � ' � ' . . . ' 1 _ ' . � , . � ' �. � . . , . i I � . . ' . . . . '' ' i . . ` ' . . � ` • , ' . � 1 ' . ' e � � . 1 . !� . . � � . . . . . �� ' . • � , r . . . '' . � ,� . .� ' . � � � ' ` � � . , r ' . . � • . �i', i, ,' . � ; ,. . . < , � � ' � ' . • , ' t. . . ' ' . ; , ' � . ' . ' , . . , • - , , , ` � , , Y< , . , , . � , , . ��� ;' . . , i � ' � . � ' , ' . . . ' . , f S ' r' . . . , i ' � � . � ', . � . � � . ', ` � � , • ' .� e ' � ' . . ` . . � � •� . ' � ' . . `� , ' .. ., .. ' . ' ' ' i' • ' .. �. . . ' ' . . � � . . � ' . �o ' e � 1 . . . ,,' � ' ' . ' � , ' ` ' • ' i _ 1 � . • ' ' . • ' 1 . ,. � ' '. � �' 1 ' � .. � , ' . . . . , . . � � . ' _ ' , . ... • . " � � '�.. ' . ' . ' ' �'t " . o . � ' . . � � ' . . ' . ` „yyr' ,:yi �':i.vi�f- ��. � ,� ' � , , ' . . • . . ,�h„'t3=s,?i�'i ,s1 .i. 'i�P�l,�°�'��°}' - :�:��;i � • � • ,. ' ���'•' � :-�I� . •r` � . - r, cF:. . . .4F .il)'�, , . . � ...r , . . . ,,, �;�r, �i3��'�' . . � . . .. •. , , � ' . . , . , � . . . , i � ; � . � . � � �r• �1 �+rN....j . . - . . /;, L{�'� �', C� I T X O F C L E A R W 1�►. , T E R � ; . '..- , ' �� ' PflBT AFFIC@ BOX 4748 �_�s�� ���j�,``' '. , , CLEARWAI'�H, FLOHIDA 3461$•4748 �__ ���.,����� j liuman Resaurcoe 0@partmenl � 813l4B2�070 � � FItOM; � COPiFS: SUH3ECI': DATE: Honorable Mayar and Merribers oi thc Ci�y Cart�mission us Trutitces of thc Employ�es' Pensipn � Pian Pension Ac�visory Committce � DcbUie Baiiey, Payrql] 5ervices M�:nag'er; Risk M�ns�gemrnt Pensian for Joseph �Staneluke—Job-Cannected Uisability Pension � Se�tember 6� i 995 . Tlic: Pensir�ri r'#dvisary Committee (PAC) rc�eived �n ap�lication for ciisability pcnsian trom Josept� Stonclal�e on At�guSt 4.. I49S. � Mr. Staneiake has bcen deterinined hy thc Pcnsion Advisory �oi�imiuec; ta mcct ttic requirements o#' the �'�nsian Plari for �. joh-connected disability pcnsion. , Hc �vati c�nplayed hy the City on A�ril 11,� l978, ai�c� began partici�atin� in liic Pcz�sion Plaii oi� Octabcr 28, 1978. �urther, lic has subnzitted n�cc�ical documcntation, copies of wt�ic�i ure �tittaci�cd. rel�tivc to ttis ciisability �c�hicl� has k�een reviewcd and approved by thc YAC. By moiion mucle anc� duly carried at its mectin� af .Scptember 6, 1995, tl�c F�nsion Advisc�ry Comn�itie� :�pproveci/recvmmended tl�c granting oF u jab-connectcc� disability pcnsion tn Mr. Sto:i�lake in accorc�ancc: with prnvisions of Section 2.397 of thc City Cc�dc. Tt�is pcnsian is ta bc effcctive on � di�te ta �e dctcrmin�d. Ttic amount ot' Mr. Stonc:�nk�:'� pcnsion w�l� b� c:alculated by thc F'sn�nce Dcpartm�r�t xcarding ta tl�e t'ormula in tlte �ension Plan far. job-conncctcd disability pensian �►t sucli time as � his last tivc yeurs of service anci salary can be computed, I ticrehy certify that the Pension Advis�ry Cpmmittee has ��ypprnvcd the gr�ti�tin� of a job- connectecl disubi�ity pcnsion far lase�h Stonclak� �nd the abc}ve cl��tes :�re correct. � � Chuirman, Pe ^io Ad sory omtnictee ��� "Equel �mployment and Afllrmativ4 Action Employer" , . � . , ' . , ' . < i,` , ' . , ' ., ' , , , , . . � � � ' • . ,:,, ,. t . ' � �� . ., �� � . ' ' � ,' ' . ' '� �.' . ' � ` � . � �` . ,. � ' ., .. . . , ., � , . • ° . : ' . ` F�� ^�;��_ . . .�,. ' � - . . �., ,. . , r � J ' � . . . .� .... , . . � ' `i' , ' ' r , ,... . + . . ' . � . . I � . I. . . . . .. . . . . � � ' . � � . PE�SION RE(�UEST , F4RNi � . Y ��7oseph �. ston�lake •,�o �ercby aavly far rcticcment; from the City of Clcarwater � Genera,l Employces' �'cnsiaa Plan. � - ,�rfy,. beneflts date is �ctnber 28, 3.9`?8 (Entry date into pensi�n• plan) . � , �\r1 y d�t� 0� hira i5 AP��� 11, 1978 . . , ' bIy birthclay is� Maxcit 17, 1938 � - ,� �� . 'l�iy job � cla�ssificatiosz is rlarine Fac�.ii.�y operator znd I, work in� th� • Afarine . � '--... � —, �, Departrnent�� _ � , _,,;.._.,_D[vision. . .��i y. resi�natian date i� '�° b� detertr,ined � . i ne type oc� QenSian for which i arn aaply{n; is {chec�t anty nnc}; , ______,��Re�uI�r �'enst�n bas�d �n ycar5 ot service . � . x �'nb-conneete� Disability Pensian � ��' ��an-jai�-conr�ected i?isability Pension � , ' � �Iy SpOLl5@'5 n�me Ls: _. -- �ery�._.Y. S/I.1 �3� Depe,�dent� chiidren under the age of I3 and •r�sidin, in rny hous�?�aId �re; � LPrinc C:+ila's : uii Vamt) (Cziid's i,zce oi 3irth) i nereay c�rcirv a.11 �r' the .�ouve ;o �e rrue and cor:ecc: , ��_,.�� {.� ���I ..! '�t,: •� .�; - �, , • � ,.: ' ' (SiQn�n:;=t . - � . �ugu,,t 4 , 1�395 � . ' , .� ,`D :tz) � S�:�TE 0� FLORID �. �� T:�� tiore,oi�, µi�str�:m�a� �.was �c: ;a�.v�ed,_� �etore cn� :z:s C�UNTY Or 'PX���,L�iS ` � ' - ' -- -=.r� �y ` . �.��..__. " „ •►..•E- ��:� `�---�.,., „r�� �.vi�ca is .e.san� ll�� . . . � ° � �;�.ct�.i� to :�e �r ��vf�o nas ?radc�c�d ,� as �•id�ntiiic�cion. ;��d ��ho didldid aac ca ;: �rt a�cn. � '�--� . ,! ,,'. `" � � '•�� -�=-.,'. ; . ' �`,:,.(,l � i r` ���i . �! �f,C:! - - — V�{�"�I ?'SQiIC ' � �::���=;:��. ��A:•1'u1 �{st��Tl�iili6) ' I , • � . • �;''� � ;,% A!Y �:�h�Ad.��iS)N A G::t1:.:G ��lr'::� � ' '�� �;" CG�b9f E. 1448 C 0 ff21I11 S 51 D il l O.,_,_,_,_,.�..—�--• ' '�''r, ti r�,'� ' 3ahet� r►tr,� ra:r tuy �astiwu��. ��+e. - . � , ' ' �;�taC3e O[ :`�o[�i;� n'':A[��i �.. . , . E ' . . ��`', .e, � , 1�` 1 F.. . � ;, , ' � ,' . , - . . . • . �', � � � -' , . . ; . . . , . ., . � ! �', ' • ' � ' . . � ' . ' � . . � ' . i . . � ' . . ' ' • . �' . ' . . `.�.: . ' , . ' � . ' . �'i�' ' ' ' F . . . ' . ' . � . • � ;' . . . ! ,� 1. . , . � ' � � ' ' . . , . . . ' . ' , '1 � , ' , , , . , � ' . ' • . � . � . � . . � . , , . . " � , ' ' � � , .. . , . 1 I � � . � � � , . . � , •. � , s • � ' . . . ' ' . . � . � � � i . ' � � . � � � . . � • I ( � 1 : . i , . � � ' l c i . ' . . � . . . . . . , I ' � '' � , ' 1' ' •�•, , "[ • . � � . �.. .r � . � I .. . � ' . . ' , . „ , i . .. . . � . . ii . 4 , 't��, il �r• ` ' ' ' ' f, ! �. • ' r` . . � .. • f ":i t . � . +� ' � � ' , . �,, ' . • '. ..it.rr_wn...,(•. „ � . .� . .. , H ... � .., ._.t., . �iu�,e:.H �..... : 1 .. ' �.• . , . .� ° , . •. • , . , . . '^�t�.. . . . . . . ' ' ' ' � ' . " - 1 " . . � , e '�lii , . .. . ... . . . . .... . . � . , , . - ' .. , . � 1 . � . � � , ' � � CITY OF C�,E�►R�V�TER " . � . � � ' � � GE; I�R�,L E1�IPLOYEES' PENSION PLAN , � ' � � � � QPT�Qi�ES � GLV�R?�L EI�IYLQYEES � � ��� QPTION nI: ` .. Empioycts c�n recaive a IurrEp sum paymtnt for vacatian and .; . haiiday pay �nct I/? �of accrued sicEc iea�� at the time oF • � . ' � � • - sep�ration from the City. 'Fhere �vill b� nn ti�o �dsduction fpr �t, . , � .. ge�tsion : rram " this IurR� sum p.tyment nar wiIi this amoun� c o � n t � ' ' ,' � ��s e.arrtin�;s in �he catcuE�tion of the pe�sion. The last day qF ' �: � , ;'. . wark will �be tt�e termination d�te ar�d pensian benetits will begin , . " che following` day. ' �OPTiO,�i n'�: ' ,� � Employe� c�n extend terminacioa c�ata �.by tEle time du� Eor � ,. • � ' vacarion, holiday �ay,�.,and .12 at accrued sick leav�. ,, Termination. � �, , . .date�will be the tina� day of extended time. Pension benefits will . ' , � . begin the tollfl�rin, day. . . . . f,Or�Iy availab�e to emgloyees hirec� �ri�r to lall/���.) � � ae * +t �M �it * �IC y� r a�c �!t q+ �R Yt r at +k +1� 'k * �e �le �k � !e �e r �+e � ir ,� yr +Ir +Ie �e kr :}r .{� .i� �Ie .M ye �r rir w ie �le w � ,M �M �M �!t 4� �k * � �s �N +e �M +� � �k :it ye , �� '� Jo�e�sh J. 5tonelake ,�� ���(Q��e oF zhe City a� Cfe�rwater, #��reby apply For pensivn benefits un��r' che City's Employe�s'� Pens�on P�an. � I her�by ;,:;rtify �hat , I►ully unde:5t3t1d the �w� aptions atferad ta ,me. i choose to. r:�ire usin; � Opcion �� I snd, wish my benePifs ca be calcuE�ced �nder this option. t untt�rs�snd �t�at' ance tftis :orm is ;i�;�ea, rriv aeei�io� is :rrevocabl�. � . . � .��r=-�� . � � �1�IPLDY��'S SIGN.�Ti1RE: .r .--� �� �� � _ r.•-�'% •�<>_: . , , , , . SDCI�L S�CGRiTY 7: �'� �6z-30-8�8� '',VITV�SSES: • �DDftESS; _ '�25 Viola nrive . '! � � 1 �• , ' Cleanr;atez �'L 3�624 � . f ��,`�.��-..�- ,\ � i�,t . • � � �---- , i , Y�`.�if,�L...-� �. . /�~�'.;���.�'�'�.��/� DA•�, Augus� 4, 1995 � -. .. , ` � i '� t q� �', • .. . r � . . • ' • r� . ' . . ' . , •! ' � . " ' .'� s _____�— - : � �i� if ' . � • .. �,t! ,i :'!'`. . � . . � ; ' �. I , ' ' ' I , ' 1 , ' � i �ti.. � . , • • , . ' �. , , � � ' , . ' . . , � ' , . . , . � G. .. . . . ' � 'f . , .' . � , i ' �. , . � ' . ' � • � y' ' � � � . . . . . ' ''' ' �d� , , , '...,`'� ; ,�� . ' t' , ; ; ' ; ,,. • ' , . , - 1 . � • : - , , , � . ` �.' �,' '3� . . . " . 't . . i.f ' . , i�' , :' .� i ' . ' . .. . , � � . . • . . . , . . . 4 , . . . ' 1 i ' � . . ' o ' . - . • ' . . ' � . �:��. , , �:1�� . . ... .1± ^� • . `t� . . . ' . . � t . ' . .. . ' ' . J' ' � � �:''' -i� �r, ... .i 'tll�� :�' '•1�'�'' 'i' � • � 1 •,i.� .• . . ., .. . �. . . '' , ; ' .. . .. . �' . � . . ,11�,�` ¢ . ''.� . . :'� `i . ., i . � . , . . . . � ., . . . ' � �� t ' � � � . � . , ' . . , .G'4, 'YI` ,s�, �:, . �E , . f . S. . � " . . � ..� • . � ''1_ •' ; "''i.,�' . I: ' . ��1' r . . ..r .. . . A � ... . . . ,:rJ.. ' �s � i 'i� �',. �`r'rt� ' � . . ^,, � ..�r.r;' _ r.�`'=' •.'AV ' , ' .. . � ' , ; • � .. > . . . . , � . . . , . . . .. aR1.,.zL..� � . „ �, o • . : . i . .'� . . � .. : w � . . �... ,.. . . ., .. . .. . . . � . � . .. � . , t,En,t . ,.._ . ..,... � , ,�.ew. ; ( . . , .s.. � . . ., � . . . �.. � .. . . i � . . � ... . ..�... �.u., . � ., . . . . .�m... . . ..w�r+war-... . . , .�— =f � :'i' ' I � , 1 ,f ' .� , ' . `' . • . � . , . . . t' . i. � ' � .. � � : � . . • ' ' ' . . ��' . . . ., „ . ` . � � . . . . . ., �.,. � , . -� ' ' , � ' . . . ' , . . . . , . ; . .. , i' ' , . � . ' . . - . . . ' • . � . , . . . ��`, . , . . , - . . . � . � � . � . .F: ,, . ' • � } �� ' , ' � . , � . - � ,� � � S ; ~ , z . . I ' . ' . . . t . ' 1 . , . ` , i . � � . , , . , SGan�lake:. Joseph , ' � Ju�.y 31, 7.995 . f, . .. � ` : . , . ' ' � . " � ' ' � • ' , �t . . ' . , . ' , � , ' �: ��` ' . Joe �.s not�ng s4m� eontinued `residual ba�k pain. � He reports Chat , if� he w�Zks slower he nates I:ess di.sC�mzort: He is currently � .,' � , . worki.ng• at the Cl��rwa��r bridge . He wi�.� cant,inue � on �hysical � . . � � �herapy and �,�e .�ill reassess this indivzdual � �n� �ne mon�Y�' � time . .. .:`3.` s paCi�nC has. reached� the �oi.nt ci .;tiaxima.� medicai improvem�nt . Hi:� permanen� partia�. a,mpa�.rm�n� �ata.ng accardinq to the F].orida , ',.: �� Gu�deiines wou�.d be on �he order ot �hr�e percent to the body a� a , ,, . wi�ole status 'post uareso�ved strai:� af. �h� low back wi�h Continued � , . , . comp�ain�� � o� low bac3c discomfort. ' � � , . .� . � . , , , � . , , � . , � � .. . . e � � � : � . .Toseph M. 5ena ► M. D . . � � ' � � ., (dic��ted but no� r�ad) �� . ' � JMS / sms . . � ' � � � . . � � ' , . � . . .° . . � � .,� . . , . ' . � . . � ;, .� , • , � �. � , ; ' , ; . , � � . , � �' ' " � �.' � ' . . �. . , � � � � � r . _- � ----,...���� F!'1�'-��V'� ,'?. , }; � , ' , , ,'; .. . , . 1 � . ' . , � . ' 1 ,� ! .. ., � . `' 1_ '' ' . � ' . ; ' ' � , i . • . , . ' � . , , . � , . . . . - ' � ' ' � ' � � ' . � � ' . . . • . �¢ ,� �S' _ . 1 `s� , � , 3' ' ' � . � .. : � . , t , . ' , . 1� ' . • ' ' . , � . • � .. . i . . . , . . ! . . � ' � � � ; • . . . • . � . . , . � � . ;, � t � � . , , , . ' � � , o � • ' � • , � ' � , " _ . . • . � ' . . � ' . . , a , � . e . ' . . , . � ' '�"� ,- ,'�' � 3 .,.` ..�i ' , '� ' ;, � � ` � . - , . , ' ' . ; ' '' ' , ' .. , ' :,., , .. I i . ' , ..: � . .�' . 1 .1 ' . '� . � ' ' •' � � ., � f . . . : � . ' S '., I � . . i � ,. , , : ' � ' ., , � , � � , • ' � ' w..�.,.�._ .,. . • . � ..............�. " .,. .. ...m.,..,�,»,._u_.. • . ,�_ . ., � , - ' ' . . '. � '� . .. . �. . . . .. ... ,.. . ,, .. .. . � .. >. ' . . ,. . , .. ...s �� . . ' � ' � ' • , , � . 1 ;.� ' . ` • , . . . ' , ' , i11{lorton Plan# r���.sorr M. snni�-+, nn.�. . ' . � p1'�ii7ai"y Car� �ip�orr�ate Arrisr�can Baard af Intemal Medicine � � °. � �`. �.� � . ' Physicians �an cortsett 5tr2et, S�ite ZtO, C�earwater, F134616 8'i3-443-Ofi67 Fax: $13-M�3-6231 ;�� , _ '�, ' , � , . . � �;�'. . � , , . �;� ` . � � . ' , � � �,� , . . . . , ., . . , . , "r' � ' . . ►, •r � , . .�u�e 30, �'ss� . � ;�� . �� . .. - �� . . :, . . .� . . . . . . �, t , •.; -�. , � .. � � � , � , � ; ,, . . , , . . �� . � �Yi�Z � i am Yar�ger ' . , ' ,s' � �24 Sou� F� Hyde Park, 5u� t e 21 fl . . . � . ' � � �� ,TamQa, �L 33606 �. . ' . , � 4 S , � ' '' ; � R� : �Ioseph St one� ake � . , . . . . . . . -.� . , . .. . �:� . Dear Mr. Yanger: � . . , . ::: . , „ . . . . , , , ''' T am tt�e attending primary• carp physician �or L�e above patierit:� � Tn �'-' addition to h�s ather medical prablems, I was asked. to cammer�t r�egarding '.�.� his bacit �roblems. He was Snjur�d wh��� woritir�g �ebr�aary 26, 1994, whiie .� puiTing tree a vauTt fr�m the toTl bott� resui,ting in injury Co the back, ' elbow,'K��es and ank7es. The pa#ient contir�ues to camplain af a lot of `' back pain. and continues working generaTiy despite �Fte..pain. Mi�I '�rom �� Februar;� 2, 1955, � showed a cent rai d� sc herr�i at ion at L5--S1 at�d bul gi �g �=;e'. at LQ—� . A CT ,�une 28�, 199�, showed mi 1 d spi nal st er�os� � at L�-5 and disc btalgir�� a�� �.5—S�. fhe patient's main probTems revolve arounr� the " .�ack .'ihere i s demonst rat a� 1 e evi dence o� di sc probl ems res� i� i ng i n t he ..= pain. � .; . As his. i�w stress, 1ow. lifting� jo6 is beina el7minated, I see no other `; remedy oth�r than a retirement with disabil ity S1RC@ R��11S' W35 clearly ..; reiate�i to his vror�c. ih� patien# shoc�id nat engag� in anythfr�g requ��-inc l.ifting, pralonged walki�g ar bending. f. � , . .:' 5incer�iy,. , . , � � ' . ✓ � � � . ' Ne7son , Smith� M.D., . , � � . , °� NMS:dIa ' . ,� .'�• . . L�,� �.. , ..�� k, blplomace Amencan Elaard ' Of Orthcpced:c 5urgery, . .�. • ' • • • ' •• .' 1 • ' . � • ' • � �� � � 1 R.W. Sp�ingstead, M.D., P.A. QRTHOPAEDIC SITRG�OI�I � 7a PONCE OE lE0l� OOULEVAfiD OROOKSVILl.E. FLQI�IDA �d6Qi ' .�une 20, 1995 �, . � Yr�illiam Yanger . 32r�� S. Hyde Park, 5te. 21D Tar�p�, FL 33606. RE : .foseph Stonelake 16z 30 S4$1 Phone� (904) 796�Oa24 Fax� (9�41 544•0$01 Dear Mr. Yange'r, Mr. Joseph Stone(ake was seen� in my office on June 20, t995 far art orti�opedic independent medica[ exam�na�fon. HISTORY OF PRESENT ILLNESS: This is a 57 year 4id male who w�s injured . whiZe warking on his jab on Fe6ruary 26, i99� while working for the City of Ciearwater. He was working an a tol� �Eaza �nd was injured trying ta` puil free the vault fromt he tal� boath. He said he injured his i�ack, elbaw, kne� ahc! ankle, Every,t�ing impraved except far his back, which he says is getting worse, He has previausly seen Dr. Hamitton who gave him s4me permanent restr-ictians of no excessive sta�ding, waiking, bending, na climE�ir�g, no lifting more than 25�s. H� had previous workup incl�ding CT scan, MRi and xrays. His treatment nas ps-imari(iy been through, medications. In the in#erim he also had some vascuEar surgery done nn his Iegs. At the presen� time he continues tp complain of canstant �ain across the lower back. He describes it as a burning pain. �!e atso c�ets pain acrass his sha�Ider blade5. He has to stop and rest when doing cer#ain activitie�. if he does much walking he gets pain down both Iegs. He denies any numE�ness or- weakness in his legs. He says ne can sit oniy abo�rt an haut� at a tim�:, stand about an hour at a time and walk about one block. He has not missed much work. Again, he wor�CS as a toil E�ooth. His job is going to be efiminated once tF�e bridge in Clearwater is completed, then �e wi11 �ave to return to his Previous joE� working in the marina, T�is requires muct� more as far- as activity, waiking and bending and fueling and a certain amount of strenuous activities. PAST M�DiCAL HISTORY: Allergi�s: None. Medication: A+lotrin, Rabaxin, ' Hytrin, Zestril, Calan, Lasix, Proventi! inhaler, nitraglycer•ine. �Ilnesses: Hypertensian. OpPrations: Angic�plasty right ieg, graft inserted an the left leg, appendectomy, hernia repair. � � ,. 1 � . ', . + �une 20, � 995 �ME continued � � STCENELAKE, Joseph 162 30 8+�8i � ,� ,, � . ORTHOPEDIC EXAi411NATI0N: This is a tall, well nourished, male wha is 6'Z" and 205#s. Neck � upper extremities: Normat. � � , � � Back E lower extremitfes : He has sarne tenderness. in the upper back area�, �. . . intrasc�pular r-egion. He complains af pain across ' the lawer back arv�nd L� S1, lower lumbar region. ' � He bends aver sr�w�y to a��ur �a� and pushes up ' " with his hands. He h�s pain witf� extension. He , is able to wa�k an his taes and he�is. In the - ' � . iower extremities refl�xes are decreased in both �� • - , iegs. He has gaod sensat�on, he has an eiastic • support stocking an his �eft feg and it is about , one centimpter iarger than the right. He has no , `. . weakness. Straight leg raising test �s negative, � � � good range af motion of his hips and knees. R�ViE1+v 0� XRAYS: Lumbosacral spine {date� �3--21-9�� : He has s�me ' sput�ring around �� and araund L7-Z. He nas ° calcification of the abdomina� aorta. Thnracic spine: Shows some degen�rative change� . arQUnd T-� tk�rough T-� 2, esp�cially on the right side. • ' MR1 reviewed d�ted 02-Ox-95: Shows sflme centra! � , disc herniatiar� at LS 51, mostly in the epidurat fat. He ha� some buldging at Lu-5. � . MRI af the tharacic spine: Normal. GY scan repor�t af 06-28-9u indicated 5Dl'i't� mild � spina� st�nosis around L�+--5 and some disc buldgin� at L5 S1. IMPR�5510N: ' H�Rf�IATED DiSC l.5 SI CENTRAL. � LUMBOSACRAL STRA�N INJURY. D�GENERATIVE CHANG�S OF THE LUMBAR ' � AS W�LL AS THORACIC Sf'�NE. DlSCUSSION: � This pat.i�nt cor�tinues with symptamatic low bacic pain. lt certainly depends or� his activi#ies. He. is proE�ably not a candidate for any s'urgicai treatrnent at this time. I wauid doubt that tie is � going to be abie to return to i�is �revious employment at the Mai-ina, wFrich requires him to be quite active. He has ta do a certain amount o� walking, iifting and fuefing bc�ats, it�spectir�g boats. He sF�ould be abfe to continue for the time being worktng at the tpl! boath. I do not feel that wauld be toa strenuous for F�im. In additian, in th� future he might be able to do some ather Eight duty. , ��:� � . � � � r ti.,'i.`,�I b�i � ' ':,., o,P: ' �S' ' , �f , � , .. . . . .. .. :k.1,1. 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' � � . , . .. . : ,. . . , , . � . . • , ' Annn i ieretcin ' . , � � � , . . .� ' �, ' ClGy vf. C.I�ar•ratet , ` . . � - N . 4 . � Sax . 4 7�+f3 � , . . , � . Cleettr�ctcr; r1. 34bi8~4141� ' , . '. : ' ' �' � . . , . � , . _ � ' RB. � .tasc�h Stcneinke . . . ' . . � � Ua n r ,1nna : . ' . . � . • , °' � .4ri Juna 2'; 29.95, , I,. Dr.'� �I�A.t�.anr Cubicic� pet�o�med a .. � . physicaZ exe�m on ,Ioaeph �co�telnke. At Ch�.a tit�e,, � �. �� ,: Mr, .' Stanelakc .is un�ble ta perfarm �tse' duriea of hin s' pnsiCion on a rc�uZar arid ,cnntinuaus baefs. ,, � ,� , ', . llu� �o a prr.vious, i3i.�tar� o: c'liri�izic tharacic—iumbar �� . t�train, Mr. �tc�neZake i.s utt,.wei�;ht liftyng resLrictions . ai .�5-,25 'pat�n�s. , � - . . 3if1^O iQ].y l ' D�. ;d�l�iarr. Cuh:,dCS� i4D '�1C : r�l1 � � . , . �, - . l , � . . . � . � .� , �„ �'� -S r ��� . ,.. 2 Noru� IielCtlur Flueu, C:eniw��Kr. r=!nripp 3�925 �Phrsnr {QS31 �d3.Z22d =nx �f313) a�t•d1Q1 �70Q E��1 Ray,�r:ra, �,s:7q, �Iqr+ne 3�=6�1 �hpne (81�1 y,�,0•�a�4 -nx {pt�} ga0•�{15 � tt�g1';rni5ingncm Rvna. La�ga FFnrida 3�1Ga� ?honr {Ot�} �93•22Za rax 5813} 5Q3•7Ba7 112a0 S8m•��ate Beulnvard, ��mkROt�, FtoriCa 3d6;0 =hcno 5313) 3�2•222� Fax (B13j 382•365i t.:at'., _.. .._. . , '. � � . . - .. } � � . � � ' . t' � ' ' ' �. ' . . s� . o .. ' • . . ,� , • ,i ' ' . . � . � � ' . . . � z . ' � '� . ' • . ' . � � i.. ' � ' � i � � . � � ,� 1 ��lir 7r1� ' ' ' f�� �'�:c•r� � . �,� �.�L� ��o�znA o��c�ro��.Enr� �.�soczA�c�� Robert G. Hami�tt�n. M.D, � � � , Lawrence M. Gnagc. M.p. . � ° � , Brcti R, Bo�hoFncr, �ri.D, ' Daie G. Bramlet, ►��I.D. ' . Clinton A. Davis. M.D. . � • � Willtam W, Dadson. M.D. � � . Ivrge A. Rodriguez. 7r.•, M.D. . . . . � .iuly 17, i99i ' � Jon I�{arcir►. Ris�: M�nagement 5pecialis� � Fisk hianagement Diyision ' �� C , !' � �j . Cicy , of Clearwater � ;'�� �C � � � � �C � Post Office Box 4748 11 . �' Clearwater, FL 346IS-�7�� � � JUL 2.1 i995 . Re; Star�elal:e, .�osegn Pt. x: �3t33 T * .A w r �ra ���rn� ��'�ir-+� t��r�i�i ��4�s; � �ixadt'i .• ��l':�Jy,�Y,..+si1� D�sr I�Sr. uarcin: � i hav� bear� studying the various rating manuals reiative to hir. 5tonelake in my letter af �ebruary 9, 1J�5. - The rules as defineti by the various rating �uides can bE ir�zerpreLed either loosely ox . stricily� much as the Supreme Court interprets aur nationai canstitution. My ratin� in Fe�ruary was by racher sL;ict criteria and our c�iseezssion toda)� has {�rompteci �re �a re�val�ate .in terms af more liberal assessment. � . . Mr, Stonelake daes, ind�ed, have a herniated disc and he �as an examination currently showing no neurologic,al findings. �s yau poin�ed aut in yvur .Tune leLter to me, liberal �nterpret8tion of the situati�n coutd call this a herniaL�d int�rvertebral disc at a single level, n�t sura cally treated, with diagnosuc imaging studies sp�cifically positive for herniated disc with resolution of ab jective ne�aralogicai finc�inos. The Florida Guide. 13. Section an Tn�erverte�rak Discs or rat�er. Soft-Tissue Lesians. l�ara�raph �, defines.a lumbar vertebra meecing this candition as pr�duccive of 7� germanenL partial impairmen� oi�' the v�hol� person. You t��ve alsa asl:ed me to rate this ac�ording to the �lfinn�sar� Guid� and i fir�d their Section �??3,4Q�Q. 1,luscul�skeletal Schec�ui�: Hack. _Sub�a c 1. 5e��io D. ite �at cfeiinirt� an x--ray ar com�rue�r� s:�ia! tomagrapny or r�yelooram . specii'i�a�ly posftive for herni�t�d disc with resolution of objecLive neurolooic.�l �'indings �roducinn a 4 � permanent �artia.t impairmenc of t�e whofe persos�. P.O. Hox 7b33Q • Sc. Petersbur�. Florid� � 373Y � �6Q0 -�ch 5ueet �iorth • St. P�:ersburg. Fiorid� ;;?�.� • c,513? �? i •a� ;? • �'sx t S i 3 i �=' • 1=� -' .� rf. . . , r � . , • . 6if'.. � . . � ' • , � �.°a'. �� F i, .t",'i ,e': . . , . :i�l'(}o �'s .,1: . . � . , 17 ' �I�,�r, .�+ .• '4 .•. � , ' . ' , � � r , . , . . ' , ( .. , ' , i . ' • � l ' .. . . . 'E� •� • -.• i ` .. �.. ,� . , . � . 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' . , ,� ;�' • 'i, �' '�^� i . � ��.ti : , , ,r . � '� :r� I r� '� .s� �!�� . ' � � , . .s :' , '' ..� . ' ' . • � ' ' � . � ' � ' ., . . �� ' . ;'�Si ;'. . . :.. ��, . " , , � . , , . , ' � . . . ' . ti�fo;+!hw:�rkl.�r. TSr . . t . . . . ' , . , ,, .. . , . � . . . � , ' ' . . . . ' �.. . .'•Ln .r�..� .. .. _ ��w.....�......_ . - .S.iv.p�i�l';}�:�Yi ' . .'�� ': �i:f(ti'i iy � . i:� .1+:�.•�� '•{ai,�['f?1, � ' '1 • - . . � N! . , - . . , .�i�.�'�'� . . �� ,��t�..,)fl��'. ��I. .1'.. ' - .. . .. ' • ' ' • � � . /�' � � i �w� , .. ���� . . .. ��[ �?.� - ^• ' .�. + i . .. 1 , . � ' S. . . � .. rr' . � / . - .f:, ' , �• � • .IY ' .' � ' '` ' .. . '! .. I /' �' ' . , r , . ,r . . `f . I . . ' ` '. ' ! _ ' . � . . , ' � � I�l�. � . ° � . � . , . • ' l � '? �� � ' . � : Fa�e �Twa. � . . , . ' . ` , .. , �, ' � � . .�.,. . ' , '. :. :, _ . , 3uty , t 7+ 1995 . � . 3 , ` . . . � . . . , , .i . . , . � , . . - . ';�. ., . . �. . ., , , . . ' �. , � • Re: . � Stone4ake, .ioseph � . � � � � � � � .. . . . .. . Pt �: ��#3133 , � � . , � . . �� . . . , . , ;, . . " � Yau .have, told mc today that Mr. Stonelake, is still undergoing treatmenc for his � � .�'back and. thus T re�ract my statement that he was at maximum medicai impro�re- �� ��. . - ment. since. ths:re is. still .som�, hope that he. may �be improved. �but I�,entrusc the ' � , , � � ci��rrent' treating practi�ianer with �he`responsibility. #'ar.making. sratement a#' his ' � � . , . . �ventuai t�hi�. � : ; � �, ` . � , . . � . , � , � Yours szricere�y, � � . . � , . �. � , . �,s � . , . . i- ,. . , ' ', � �.. � '. . . , ' � . ' '. . . � . . . , � �s� ' 1 ; .. ,. _ .,� �. � . • , E � �.i . . .i , . � I �i . , . . . . . ., , . „ �,� , _ ��Gu . � .� , . �,. � � : y . � � , ,�. . ��. ,. . � .. �� .� - ,. � � , .. . � .. Roberti G. Hami3ton.. M.D. ' ' ' � � � � � ' � . � . � �: � . . • . � . . 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NUlAB�R OIATE �NQ T[M� FtRST fiEPOfiT�ti Ciry of CZeax-�atsr � 2D30 59-6Q�l0289 �/2G/9G 3:?4am�. P. C� .,�O:{ 4 74 8 w,C. CQVEF�I.G� BY •� �. PdtICYIMEMB£R NLIMHER C�.earwa�er, Fl 3�b].8 � . , - o ir��ut+�rac� ca. osE�-�r�su�EO • . . _ . . NAME, AODRESS, i'Ei.EPHON� G� 1N5URANCE CO.OR S�F�VICE COMPANY W1LL Y'OlJ CQNTiNIf['i�0 Ps1Y i�l�PHONE �„�,� $i�++�� 462--b954 ,. �..to�ni Easfern Compaay, lae. •- 5A1J1RY? ..[�YES ONO PUaCE �F NCCIflENT {SVeet, Gry, CourRy, 5tate) pos� Offic� 9nx 33l8 LASi I)AY PAID T�ERQUGii �Iear*aater P�ss Sr:.dg� Ta�il. P1.azu S�rn:�t., Ft aazaa _02r �7 i�3� - I- 800-7�i9•30�4 - RATE QF r'AY C�HR � WK • NAME, ADAAESS AN� 7ELEPHONE S,_L_ �.� O p�p ��y p�,,lp dfi PHYS{CIAN �R HOSPITAE, Nupmebar o} houns B [}10 7H� �MpLOYE� KNOWINC3LY HEFIISE i'p USE 11 SAF�7Y � NUmber ol hours � � O MPLIANCE A}i0N4DE0 BY YOIl. THE EMPl.OYF.FI? p YES [,},7V4 HCe� . .. • ., � per xaek �,., � URTE EMPLOt'�D L�ST DATE EMAIAYEE WORKED � . , N�mbor ot days . par v+eek '." - � -�- --- �4 ! L1 ! 7$ Q� 1 '�$ ! g4 PAIDF�f�DAF�OFlN.3URY RENFINED 7� WOR!( C� Y�S � fV0 � . ALfTt�IDRIZED 4lY EMPLOYER �[�YES p HO Y�S p: ND G' IF YES. GiVE QATE d 2/ ?� 9 4 LOCATION AD�RESS w�5iruuriYF�'r�t.� pY�s C3NO 2�e?cne� �d� C3.easwater, Florida �' IF YES. GIVE �AT� qF DEA7H � � (LDCATION i . 1F APPLICASLEI AGFE� WRIi dESCRiI''T10N OF ACCIpENT7 NATl1RE �F HUSINESS ❑ YE$ ❑ NO IF NO ATTACF! EXpLANAT1pN ��h iZ BT�[�LrP Lc1C�I� C�r Arzy ps�raon who, kna+nnQry and with i�tent lo injura, tlefrau� or aoce��� arry emplayor ar employee, �nsuranc� camparry w sa�i-artsured program, files arty etutemenl at �nmi ca�talninq arry Inlso or mia�aadlnq i�tormavan is qu�lty o} a lelorry al tne thkrd degree, I huve qrw�de� tha emdaVea fnmr copy of trrs natrca: • p In Person ;,;�$y Mn�1 / I r . � ���������/�/� ��.i�'��J E1�?LOYE� Si�3NATURE (� �� � W�� WTE �� �1�+PLf7Y�A SI�NA7UF:E WIIE CARRi�R IfVFOiiMAlIU141 Carrier �udil � Lxation # Sorvice Co. +� Carner �I� � C] 1. Car�tmvorring Gasa--DWC-]2, NOT]CE OF i]EMAL ATTACH�p C] 2. L.ost "time Case--�ate at Frst Peyrnant �! AV�1W ..._. Comp R�lo __�___�_�.. Fi�st day ot dlsabitiry � r --�ate af Frst Cantact with Claima�t > > � In PerSpn ❑ 7elepltione � Mail —Nolicu F'�led Que to Multiple Penods of Disa�i{ity. Oates Cavared by �€rst Payrt:ent p T.T.�. Q 7:RD, Oato Farm Ftec'd. �! t] Catnstroph9c r'' P.T.D. � DBa�h !� 3. Medical ^nly which bncame a Lost Tima CasQ. iCemplete a11 InformaGon in �tem 2 above) A�tAARKB: ADJUSTER NAtr1E. CARRIEA NaME, �ppRE$S 3 Te,LEPHOtJE: pATE; + ! ADJl75TE�i SiGNATUR�: � � . _.�r.. . . ! -- �. " � � � ����� :ES Form Gti4C�t �1�7�! � . . ���' � �.�� /�'.��r"�� W .� -*�-••-+� � � � .."�,.`" �� "3 � _ __� -- __ . _...,� �__ � . __. .-n-i� �i�i%..._..���! �►-��-i-��-� . ��-� ;���� _ ������..�-,� - -- . ' � - � r .o.- ._.�,.! 1' � ....a���,�_�1-�-r�—,��-= }'-�-,� _.�-���P �'�-.-�r,��� _ A A 1 � !f r3 A /1 _L._ � , . . , h r + ",1 r � /7 n ✓ f ."� w r � �" 13 _ /. ' A ' _ r� _ i7l �- �---- v--�------------�- - -_ _ __...�,�.� �.. _—�_�----�- ___�—_____�_.._..7,.._,�.�—.__._� �---__-_ _�- ��� � .�c � �r�.����� r_..___.. �' . _. . _ _� i �_ �so �..�l.►��.r.C'_ _ �' . _ �— --_��-�-�-��-e.�..�.._. _ � _ � � �] � .. ... -��:"--•7''"'� - - - �!.�*�^� -..�.r�r�-�__.�Ld�+�.� �f� ./J ...._ , _ .C' �.r?�'1.�r�s--yrs.�_L,���_C���� ��� ` - — - --.—_ ..�^_..� ` :� 0�.,/i7 ��.�.—•�--.�`�!1.Y�.�.�r! . - -- - - --.�J�+�r�Y. T .li�`Zi�'r�—{' '._____... -�---- ��'7 ���_'_._.�-. _. _.____�' �_......�� --�-��`'�-_��--_ .��_ -- __.—�'.��..r� G�%�"_�.�-�_�-��rrn-����'_ _��Ir/�"-...�. _.�__ ._. ____....._.__-___._....__....w��-t�t?� � `��--�*"--- f /�� `j _ _ ..�1�+�� � .�.T �-�cv"'`�+-X —_._.__.__. e r � , . �`� � �._�.�_..----._ . . . . ._. _w�iyj�r��/�'�i! �...� �'11.if�� _.._r�y.+— __.. ..�....._._�.^.. !jl.�.�'7_.r-�t_'_. � .sr�3Rr._.. �__ _ �._ . .�.__ _-._.__._--- - f% � ..._.__� � �.yS_._��r,.•�.r�.r_.%l..t'��_��Q"�`.'�:��.�a:'�_� .1-'�-�— __.._.__� ------�- r'x'� ,ftGr�e.k...-U __ _. ._. � �.�. -_..__ r�rYL7� _� ����.�._GL.-.�����'-'�-"�3+l� --��-. _c3C� � �il-LYr -� G""rL!�f-'� � .�._�.._...._.....__�._!3.?.?-.��Y ��.��_f�c7-�! . _. - - -� �- �--='�-.�1'�..-�.yY�.-. . �-- _ lYi�-w±�.�. _._.____._ ._... __�.�_� �^"'_.�d-�.:✓L�� _ _r..__. ._.__... _...._. _�....�. ._._•- -. _ -�-•-�-�----_-- .- - ---�---- -..,. , `��. _ _...�.__._� . j�".�-y+�]�. � G?�r.� ,'y-I�s'�...���?�{/�r.li P�'u��.yr-Y'- - �--c�-r�!-. ..- - - • j �'`•�� - .____.�...._�--�u.,,�_.��v ��-��..__ __._.---_._. ____.___ ____ _.___.._ . ____.___.�---- - ..Y.. .ti---._.._.��_ . __.. �__ _.._ , ___ ...._�..�_._.._...__^_,�...�� _ . �___ . __ ,w..___.. _. . . . _ . . _.. ___. _. �v�? . .'Irr�r^�.r....q.i�✓�'J � ia+'r-*�rJ""^ � ��/ f �' m �� � � TRUSTEES O� THE EMpLOY��S' PENSIOM FUNp ^ �lgenda Ca�er Memorandum subject: Pensian to bc GrAntcd Item # � Meoting Daia: 1_Q /,� 19 5 Recommendati�n/Moiian: � Emanucl Hutchins�n, Solid Wastc Dcpartment, be �r3nted a job-cannected ciisability pension under Section(s) 2,39'1 andlor 2.349 of .the Em��oyees' Fensian P��n as recammenctecl by the Pcnsion Advisory Cominittee; .!�' _ Q autrioriz�d to oxecute �ame. and that the appraprlate officials �.�.....,.,_�........,,,,,,,, �..�., --- , BACKGRQUND: Etnanuel Hutch�nsun, So�id �Ysrstc �Vorker, Solid K'aste DepArt�nent, was employcd by City on Septer�ybir 27, 1972, and Bcgnn particip�ting in the Pcnsian Plan on Marcli 27, i973. •On Jur�e 3, �994, lte injurcd i;is shouider while on duty z�tiich is t�c 6asis far t�is reqt�est for 'ti�is job- CQf1f1�CiCij disability pes�sion, . Mr. H�tc}�inson subm.itted letters fram Dr. Donaid V. Graharn, br. Robcrt Harris, and Dr. Cr�ig Schwartz. Dr. Grah�m's im�ression was "ccrvacalgia with left up�cr extremity radiGUlopathy." Thc letter from Dr. Hurris stltes, "H� docs say ttiat thc� pain is intcrferir�g with his wor�c aiid ��e cun't usc his up�er extrcmity �5 well as hc used to...the patient is at maximurn mcdical impravemenk...," Dr. Schwartz' impression was "(L) po�terior neck tendcrncss and (L) up�er extre�ziity radici�lar symptoms status posc u wnrk rcluted incident in Junc i994...Hc is �ni�Ulc to do any heavy liftirtg ar any m�inual lubc�r invc�iving cither upper extremity at tl�is time." Mr. �Iu�cttinsan hus been declarecl tot.illy and perm:�nently dis�bied I�y Workers' ComQcnsatiun. Mr. Hutchir�son's �ensiost was approved by thc Pensinn Advisory. Commitice �U its meetin� on Se�tember G, 1995, and will bc cffectivc on October 3, 1943. Bascci an an avcragc sai�ry of ��graximately :�24,54� nvcr the past �1VL' ye�rs and thc formula far coinputing joh-connccted disability gensions, this pcn5ian will ap�roximatc $18,41! ��rinctuliy. C���rts frc�rlt Fi���cc which tsk� into cnnsideration martulity FiltC5 and age ret'lect ti�e "present value cost of financing" this gez�sion will be approximately $255,333. Thc estim��tcd �c.nsion cUSt (casli �ayovt Q�cr liie �ife of t�te pensioner ajid his/her spause) i5 �7G4,057. ReviQwecl hy: Ler�a! NA Btadget HA- Purchasing .._,d��... Fiisk Mgmt. NA Ci5 ACM _� Qthor _�A Suhmltted by: Cfty Manac�er � Orig[ne4ing Dept: Human Resources EJser D�pt.: Ad�ortised: [7ate: Paper: � Not required Affected parti�s ❑ Noti{led � Noi req�lrad Costs: ��.�� Tolai Current FY Funding Source: ❑ Capt.lmp. ❑ Operaling � Other ��nsfon ____ Appraprfation Cade; � S � Commis3foro Actian: Q Approved ❑ Approved w/condilions ❑ Denied ❑ Canllnued to: Attachments; l.ottar(sj ❑ Nane '. �'' �.. � .� � , ,. � , � . ,'' ,�; , • , . ' � � • 1 . � . � ' , . ' f e ' . � . . � k al ' ' ' � . 1 � . . ' . . . . . . .. • . � � t . . . • • � . . . � ' . . . � . . • � .� . ' , • . . ' . . . . . . , , f . ' . . ' ' . . . .; ' � l, �' !'� � i �, , � . . ' ' . , r • . � . ' i. ' , . , . , . , ' . • ' , , , ,.'' - ��� �4 t' , . . '. ..;:P . � . � ' .� . ,. . . . ' , . , � . ' . � " � , .'. ��. -' .. ' ' ' . ; , . ' � � .. . ' � � i . . . � , ' � ' �WYf .1�,'!p... �.�! .'i � ��1 � ! ��'�5 : ,':`� 1��� c.iti � �� . . � ' 1 � ' . ` � . :il� a. ���'i; . .. . � ��• tki.. ��, • �.e .`s1 . � �.fi'7Y�I:�s �:�.. .� , . . . . . ' . . . 6 .I� . '4�z��•.. � � '1�'. . � . E, • i L'1Z�;r1" ...:�.� , Humort Ranourcaa Oopartm�nl • 8131482�l387fl ...� I�r. . , . . � f�RONI: COPIES; SUBJECI': DATE: E . . , � ` • . i. � C I T Y O F C L E A 1� W 1� T E R ' � ' � �os�r OF�ICE �ax �s�a� . CLEARWAT�R, FI.pRI�A 3A81 B•47p8 Honorr�bl� A��yor anc� Ntembers c�f, tl�e City Cornmission as Trustees of the Emgloyces' Pension Plan . Pension Advisory C�mmittec � . Uebhie B��iley, PayroIl Serviccs Managcr; Risk Management 1'ension for Ernanue! Hutchinsan---Job-Conncctcd Disability Pensioci Sc�tember G, 1995 � . � The Pension Advisory Cornmittee (PAC) rcceived an application For disability pensian frviu Emunuet Hutchinson on March 13, 1995, � Mr. �i�tchinson �hus becn detcrinined by thc .�'entiion Advisory CommittGe to rncet the req��irements at' ihe P�nsior� Pl�tn for a job-connectcci disability pcnsian, Hc was emptoyeci 6y the City on 5eptember ?7, 1972, azid be�an participating in the 1'cnsian I'lan o n Marc:h 27, 1973. Furlhcr, i�e has subi�iitled mcdical documentution, co��ics aF which :�rc , attac�cd, rclative to tiis disubi�ity �vhich h�is bccn revicwcd anc! �pprnvcd by thc PAC. 13y motion n�ade un�i duly carricd fit its meeting of Scpte��ibcr G, 1995, the PenSion Advisory Co��imittc�e approvedlrecommended thc �runting of a jab=connected clisabiiity p�nsion to Mr. I-Iutct�inson in �ccordance �vitlti provisions of Sectinrl ?.397 af thc City Code. This pension is to be effective on u d�tite tn bc dctcrmined. TI14' amnunt oi' Mr. Hu�chins�n's ��eritiion wi11 b� c��lculateci by tlie Finuncc Depurtir�cnt �ccording to th� formulu is� tlic I'eiision Plan fnr jab-conr�ected dis�ibility pension �it such � tim� as his lust i'ive ycars of �ervicc and 5ulary c.tn bc can��}utcd, . 1 hcreby ccrtiTy tl�at the Pc�nsion Aclvisory Comn�ittcc tlfi5 a�provcd t�tie grantit�g af a job- cannccicc! r�isability pension fnr I:manUCl Hut��l�inson �nc! t}i�: ,�bnyc dutLS nre corrcct, � — — -- — — -- , Cll,iirman, 'a Ad sory imittcc ��� "Equn! Employmont and A1lirmaliva Actinn Employvr" ,. � . • ', �. ,I '�,. � `. ' „ ; ,' ' , . : . , I ' ` , ; � . ' , �, , .. . • . , . . � . . , ; . , �. . • � . •'._ . , . ^ . , � , � . . , . . . , t. , � ' , • • � '•• ' , � � •i. , • ' .�' I' • . . . , , ' � ' ' . . !• " . ' , F f .. ' . , � � ' � . . 1 ' . ' ' . ' , ' , . _ . i .'� ., � �ti � . . . i, r .t . a• , . , .. ,�, . ' • . . •, , � . , , e , � . . . � t� . „ ' ' . . . � ' . . . . ' ,. ' , , . . • r^ '...... �... _..�......r.� ,� f ' . �.... ...,,. .�� � .�... ....�� ' -- . ... = . 'i� .� � .t' .. �........�� ' ,r ��`� , . .•�....r..,�I • • .�...�-.�.�.�.��..,....�... + . . , ' . ' ' � • . } . � , ,� •. �, , � �� ' � . ' � PENSION R�QUEST FORNi 4n�nue]. Hu�chi.nsor► I, do h�rcby. apply F4r reti,temeni from� thc City of C1enr�yAter General E�nployeas' Perts�on Plan. • , � � �ty bez�eFiis date•is �March 27,� �973 . (Entry, riate into pcnsio�- pla�n}� � YI y d�t� p�' h1r� i5 Sep�embex 27, �972 � �y biXthd�y�i5. � .'larch �3, 195I � ' 1�ty jab ctassifIcation is �o1i.d S�raste� t�lorkex ��d I work in t�tc � • ' Solid S,iaste � ' Department, Dfvisian. � y rssignation date is ._ �O �1e ���erz�ined� ' The type of peresion fac wh�ch I am appiyiQg is (check artly one}: �, �Regutar P�nsian based on years af service . '� J'ab-cannected Dxs�bility Pension �Jnn-,�ob-connected Disa�iiity Pension � " � � .7vktnn Hutchinson �/Z/�7 � ' 1�(y . spause s � name is: _� __. __ . -- -. _ - _.. -_. -..,,, _..,,. : � Depe�der�t ch#3dren tinder . the a;e of z3 �nc� resic�inb in my household are: (Prin� Child's ��ll �I'ame) � (Child's Dace oi Binh) I hereb� �:errify �11 or th� abav� to be true anci carrect: � f /}/�'' � f ' . � � � ..,� r,. / -` I E�C.. .cir!;"'�7 r-r . - , .4azch �3. �995 E.Si;naturej � . , � ( D�t� j ~ — . � .:iT'•:.' `JF F�Citi�� ' i he fore7oin; inscr�ment �.v,� •w; ::: :�.vi���;��' �p:ore me chis CO[1YTY. OF PI�IELL:�� ' .'ii}�'t`� _� t�y `'irltir�r,� �-:._'�t"_�.,,r���;� , wno is p�rsor�aliy known ta me or wtto has �rac�u.ced:'� •� �;': .� ��; �` �C'� r ` `��, � `'1 � � .�. ,..._.._. .. as ic�entiiicaEfon and w�a did�di�i not' ta�:�. a� o�ch. :.�� $l�yf �c'�[. . � -- -, ,_. ___.- � .� � .,. �� �`-+1�w�1—���=--�t..i. +. ;C i `.�.��. ��0[�Tv PLIi]I1C ' • . � � ' Si;naturc) . Y � , , ,, � , � • . . . ,. _:.'... ' , . C�mmissin� �10. . � •. � _ t��r�i►�.{;��r r�n�l �..=�: 1�,���.:�-�'',(;;ame ar �Yotar� PrintecE) � .. � ' �1. . ' � . , . ' � � . . " , .. • � . ' R . . .. . . . . 1 . . . . ' . ' .� " f ' ' , , � , � . ' � � ' ' . � � ' • � . � � ' a � . . 1 � . . . , �'. ' ' ' t , ' , ' � , , • . ' . . f: " . . ' . , r ' • ' �' , . . � � � � , ' . . � � � ' . . � . . ':�' � ' , � . ' ' ' ' , . ' ' ' . � . ' . . ' . ' . , . ' .� ' �, . . � .. ' � , . ��:i� ., . � ", �t1 . . ' • ' . � . . ; , . , ' � . � , . . ' ' , . ' , , 4 �� ' . t . � � f tr , . e - � ' '� ' ' ' . . . . � ' . . . � ' . . •, � � . � . • ' . t. ' t° . ,r � . . � � ,. ' ' ' ' ' . .. � � ' � , ' ' ` 1 ° , 1 ' •'S ' r . � . .. ' ' . ` � .. � . . . • , rw,l�.,. . . � � , � , ' � . � s n . . . . . . .�'. . , , � . ,.s.. . , . , � . .. s. . . . ' .. .. ,,.... . ,r. .. _.. , ,. . . , ,., ���. . . -1: � � . ' � � � •' . , . ., . y ' � , � ' ' , , . � � . • , ' ' •� . � . � . � � CI'I'Y �F CL�A�"tWAT�R �. , , . : ` � , GENERA�, E1r�PLOY�ES' PENSION PLr1�N � � � , , . � . OPTI4NS - GENERAL EI�IPLOY��S . � ' . � ` . . � , , , �� OPTIaN �1: � Empinyees can . receive a lump sum pAyment for vacation and ;,'. ,. ' . ; hoiiday pay and I/?' of accrued sicic � leavc at the tirne of � � '� separation fr�m the Ci.ty. There .sv911� be r�o 5�'a deductiar� for �., � � � � ` pansioa frnm this lump sum payment nor will this amount cn u n t � ,'. ', � ; � as eurnings in the caleulation of the pension. .The last day � of • � � ' : vrorlc will be the tecmination dat� and pension . benefits wil! bagin , � . , � � t�e Following day. ' OPTIQY �2': � , Employee can extend termination r�ate by. the time due t'or �.,, � � v�c�tion,, holiday , pay, and 1/2. af accrueci sick leave. T�rmination .' . � date wi11 be the final day of��xtended time. Pensi�n ber�efits wifl � begin the foliawing ciay. � , � � {Onlv �v�ilable ta employees hired prior t� 10/11�0.) � **.**�x**�*****�a�***�****:���****�uw*�k***��**�M�**�r**�k*�����*�k�x,��w�*�� t' .. . � ' �nmanuel Hutchinsan � ' I� ._ __ _ �.�_ . an �mpEoyee ot �he Cicy of. Clearwater, hereby apply for pznsion benefits under the City'S Employees'� Pensian Plan. I�erebv c�rtify. that I fulIy understa.nd the two optior�s otEered to rr�e. i chpose to retir� iisin� . � Option � ` and wish my benefits to be ;,alcuiated under this option. . � I understanci that once this form is signsd, rny �ecision, is irrevacable, 'I . . . �`'IPLOYEE'S SIG�f�TiIRF��i.'��r�•�;.,��.-s�/�..��Cc. ?�•%'y L-�h�,_ SOCI:�L SECURiTY �: 5�`�-78--5&89 �� W\TESSES: � ?,DDRESS• Zi60 Sunset Point Road . , L. ;� �--� � � t,�: t,,��; r . �` r.'-- ri.r��/ . Clear�sater, FL 3��63.5 ` , � .�,.,' ~ :' r Dr�TE: ' t•iarch 13 , 1995 : ' :�. ;�,s : . � ., r . . , . . . i . . • ' . • � . . . � ' . _ ' ' �. . � � ' . � � • . '' ' ' i. , ' , ' ', , • , �, r , . , , r.�i.. .s . . . . . � � � . . . � , . . . . �, � ' CI'iY.OF.CI.WTR.R2SIC,TIGt1T 81� d62 5T�7 F�.OI ' . ' '� f"' i c�n1t�/ �u� r ' .� 1 FDfi CARHI H'3 DAT� 97AMP . F�.OAIDA D�pAiiiM�hiT �F LA60Fi AtJD �Mpl.OYMEN7 S��IiA(TY R�c'D t�Y CAFi�iI�R 5E�l�' 7a ��Vl5t��f ' � i}IVIS!{�N 0� �M1IQ�iIC�AS' Gi'3MPEN�AT40l� . t•800�42•17;7 (CrJ COfitnG! YplJI' IoGtl� DHiC� IQf II►iitt�C� • , . NQ7iCE OF 1NJURY . . � �. F�et�rt e!} �+Ceths w!lhln 24 hflurb (904� 488-30d4. ' � L� I� Y INfi t ON !tFl�A ( Mat.1�A+pdf�, Csfl� .. SoUlY Sacselty NunWes oa�. arw �tm• o�cc�aem ., F1T�111�3 iit2tC�t,f.T1..�Cili r" ��� 6��/�4 c�� a.x.:00 2m •• O � ncJUd� �v1 M ,.S 4• + i TI ra�►G����� p�� � X�GO �nset Po��, ca.eaxwar.er, �L � a. ,�zs�'�� � t . L ��y �� _ � iilg�L'+1JU R W� 1 I IG P A T � � �.9. AmOW uio� d►igfil 1nEvr'Sn�N at ar[ey��Q �irtl. hfCiN«d �fCl, l�sd ppri0h11fq, �lt.j �ifi ' SEX �� . pID YOU i7EOLJEST Fa�(31CAt CAfiG7 [�'ES C� NQ 3 � ! Z'3 J 5� �i+1 O F 1F Y�S, D14 EMPLO'�Ep PRUIiD� IdEDICAl7 [�'}YE9 Cl NC3 0 CApRIER INFb�MAi1Qt� . �� C�rrier A.s,ai1 �v La:auon E Servtite Ca. s CaErior Fi10 � _..._._ p 1. Car�troverdr� Cessa--D1NC•12. NqTIG� �F OEtiiAl.'ATi'AC1iEQ � 2. Los! Tlme Casn—Date o! Pirst PayrRent � 1 A`YW Comp pata �tst clay 4f di�nb�tity � --DOtv ol Firs� Canfxt wiih Ctn�mant 1 r (] In FBJS3f1 �"7.. ialsphane � �+�ail � —Nnt1Cr1 F�i�d �ua lo Mulliplp Parlods C! Ols�b�l�ty. Qatas Ccvarad �y F�r�! Paymer►t � -,.� -- - Q T.1:U, p tP.D, Datn Form Hacd, f�' .r �.. t7 Ca1�5trophfc ❑ P.%0. {] Daaih ❑�. Maqical pnly u�hich bocamo a�ost 13mo Case. (Ccvnptsin et! lnfoimation In Hom 2 a�riej . ' . 1 AEMI�RKS: � -- . ' �,� ' "' . ��,,. - - . R - J10.11�5TER tEa Fa� a�ioGf (rrot! 1� � • .. , EMpL�Y�A COPY , � i �� ,. ' , , , , , � .� , ... , ., , . .,. ..�. ' ', . . ,_ ., . . . 1 . G . � ,, . � ������� �� . . , � , ,... . . ,, . �. . . . � . , � , AuU 2 8 1995 � . . . � � •�r�� u„�inr���' ' _ . - • . .. - : �1,���c...�XW, �i�d�i�d�� . . � w:. ,� .. ,... . . � � , �:::}�.:�� �. � : ��,�„�� �' � i�A�S�GE1�E�`� � Joi�tt �tl. �1s131�rc 111, ,�l.q. ' ❑OP: � 31�315.� . . ��v �hnit�rs � itinr�h. �I fl � . Ei.�rr��;+cim��a:t. �I.0 � r►GiE: 43 � r�;ar�es ti. ��brai��.ii����s�. �� ry DATG: 8%� 6�g� �4icltael L. Ro�ftib:r�, 51,0. Gar�� G, �inska��iir., ��l.D. Mr. t�utciii�i��an` ��a.s �a �3 yeaz � o E�:, *:.�c�; • na1e,' PNY.ClCrIl..1fEDlCl.1'r � � R) hand domiaant � gentleman; •uho ' previously work�d � R�H.iIil1.1T,lT10.�' . ,. �.,:.. , i.n the recvc?. inr.r 3�.ra�t.:.��.,. MVi�Jy ,,,a:.aQi iabor xor , �rr��;i�cii�►ar�z.�t.lj � �h8 C.ity of Cl�arwater. • H�STORY: Is that of a work-re�.ated i.ncident in �989 w�.th the � resultant (R) C3-C�4 -•di.sc h,erniat�.on r�quiring . semilamin�ctomy and d?.scectamy xn January 3.989, The patzen� states ' � *_hat the � pain .i.n his ( Rj upper ext.� emity impravEd to some �:xtent fallowing the surgery. Then he su�fered an ir��ury back in June of 1994 again while on �he j�b wi�h a resu].t in �he (L) post��iar �?eck and (L) upper extremi�y di.scomfort. ' ' 7{�RAYS : REVEAL �EGE�TERATIVE CHANGES IN THE SPZPiE . A CERVICAL MYELOG�I ON 7/12/9� SHOWED SOME � EXTR.ADURAL DEFECTS AT C3—C4, C�:—05, C5—C6 AIdD A DISG pROTRUSrON AT C6--C7. AN r;f.I ON 6/23/94 REV�ALED A CONGE2�xTAL EFFUSION . OF C2—G3, DEGENERAT3VE SPINAL STENOS�S AT • Mi;LT'IPLE LEVELS . He was seen at �hat time by Donald Grar►am, U.O., a neurosu�geor. in�• Lar• go; - F3.o '�. �-� � ��_' t2'�at �zme �he impression by DL'. Graham :;�!: C(13� of cer:��c�l�.�.a with (L) upper ex�remity radiculopa�hy. Following his visi.t the MRI of the cervical spine was obtained. 'rie v�as � schedu�.ed by p�. Graham to underga an anterior cervical discectomy in Se�tember �yy�, buz due �a alcohol intoxicata.on and som� �KG chang�s the patisnt's procedure was put o�f. He. was �hen seen in. December �.994 by Dr. Rab Fiarris, neurosU=yeo;� �or an IM� and was indPed fel.t to have some cervical spinal ster►osis a� C5-C6 and C6--C7. Cervxcal surg�ry was agaxn considered, but: als� fel� �c be auesGionab�� du� �o the patien�'s history o� drir.king. He �rr�,s �iaced at maximum medical improv�ment at that �im� c:i��: ^.ervica�. spina�. stenosis *�i�h � object�ve neurologiral fi.� d: ngs ��. id no 'a.oss of function with an . im�airment rat�.ng o� 14$ . �ince ':ha� time, obvicticly, !ie has nat undergone any cervica� sura�ry. � � At this pai•,ZC, h� •;nrauid pref�:r to rema�.n � conserva��ve. :�ie continues to complaa�n ot �L) posterior neck �rapeza.us anc; (L) upper extremi.ty pain radi.atinq down inta the hand on occasion, par�a.cu�ar�.y with heavy usage of �he �L) up�er extremity. There is na sign.�ficant numbn�ss noted in th� {L) upper extremi�y however. -Con��.r.wec?- 1�_'!{ (.ki�ih�+�� fd�•1 � l�E..t�.. JiPf. �'f„rie�.l �•�I1��i 1��11 yil�•����Y�1 '�titi i,`{�ii �s�}I.S i�%? �, , '... � . � �i ' , . , • . . :' ' ' ,' , .. ' . , : i.<< ,�.. � � ,-� . " � ' ' .. - ' ' . . �. , , . , , :ti. � ' . .. , . . �; , , � ,' � • . ' . � ' ' . . . , , , . , , , , � � . ` � '� ' '' � . � .. i; , ' : ��; ' , . . , . � ��. �:;. , ._�, . �.. � • � . . . . . � I;. � . '{,,',. ' ,,,1 ..,� '. . . . � . : '�.4:rA;.u::_ ._..,.�.�. � ��.' .' .. ., . ,_. 1 ,. . • .' .... . , , . • � .. � . ' .. ,. � . . .,: , . . � . 4� . ' ' , � . ' � ' ! ' � , ' � ', � � ORTHDP.4EDIC SUI:GER� CENTER OF CLEAR'YriTER� Y.A. , � ' � • � IS.28 Lukcview Road ' ' ; � , � , �Clearwalsr, Flarida' 346t6 � . • ' ,' (81�,�,�61-6U2,¢, _ ,r 18�3} 4d1-1�J4Z . � ' . . � ' . r�r :t . , HUYGHiNSON, ` Emanuei � Account � #: 29287 . 8/16��5 .� ...� . ,� . �'.w.�..ii�'!� :''�., . � , , • . PHYS�CAL' E:'�`M:� He'is �alert and �riented times three. � . � in na acace dist�ess. Deep tendon re�,�exes are 2+ and symmetric, pxcept trace�at the�(L) biceps. .� Strength in th: biXa�eral upper extremity: � �� . � .�el�oid, b?.�.:�.s," tr?.ceps, �,�ist ex�ansor and gr�.p intrin�ic,s 4+ to � i r �' . n:: .:ir n .• r �• .� ' �. .': : .�: w�f: ~'_� ���� . . . ���rp.ni.c.i. �s . �'ai.c . is �.t� �, �� . N a �v�..:,.nc.. of antalgia . No significant pai�n to paipacio*: over. the c�rvical mid].ine. . There i.s '�ome mild pain to pal.pa�ion over the {L) trape�i.us r��ga.on. Distai pulses a�ce intact. The patient is quite �hin, but no 's�,gnifi.cant atraphy was�noted. No assymetry noted. Cervical range o£ motion ''� �.imi�ed by appraxima�ely i0 in f�,exion and extension duA to �he (L} trapezius discom�ort. N�gat�.ve Spurling maneuver i.n the (L) upper extremity. . � µ i� . IMPRESSIGN: (L} pasterior neck��enderness and {Lj upper . extremity radi.cu�.ar symptoms sta�us past a work rela�ed inc�ident in June 1394. In addition, the patient has a histasy o� a(R) sided zadiculopathy ana status post discectomy in �989. The pafi:�.:;_�;,s ���:�..�h� n,ow, d��::� ��t w�.sli �o undergo an�r su�gica�� in�er ;,:_ .�.c�►:., ,s he ��.��es his co�±diz�.on is stable. He thus continues to havs the discomfor� i,n zhe (L) neck and upper extremi�y, and his �i� is as given by Dr. Harris. He is +xnable �o do .any heavy lifting or an,y manual labor invoiving either upper �extremity at this �ime, Dictated b_Y: Craig A. Sctiwar�.x�M.D.1chm. xc: Jon M�rcin. . � � . - - . Ca.ty of Clearwacer, P� Box a748, Clearwater 3�46�6 . • . � � . , , • . ' .�. . ��. .. .. . .. • , . . , � . •saF , ' ! . 1 . i . ' � . . . ' , . � �! � � • � /t . � � ' ' • � � . s � � � ' 1 , ' , , ' . � � I � • . . �� . .� . � ' . , . . i , . � . . • , E , " i . . . . . t` , ' , . , . . . , ' . . ' , i � ' ' � i . . . • S1 , ' ' , / ' . . . . . . +v F. � . , . . _ ..,., . � � rt r a 1' .,!: .. . �, .. •., . t ' f ` ' � � � . � ♦ �' � • � { ' Rob Hanis, M.D,, Ph.D., F.A.C.S. . . � � Dipfamatr, Amrrrcan 8oard af Nturdrvgreut Surgtry i�. � � I � . � . ' , ' . ' . . ' �/� 1 ' . I � . � I r �. ` .� .11� . ' ' . . 'I'i �~ �011 leffords Strcct, Build'sn, A � . � Office (813) 4�i2-7153 Clearwatcr..Elarida 34616 ' ' . �;; , r�;,t� F�X ($13) 4�46-4336 � '� � 1�r,���'^ri�.'.� Dec�mber 2d,• 1994 � . ��� • �.:��,:; ;.:, ��' �•. , < <�„�� L' � : Mz' . Joht't C , Marcin � • � •�' �� `tr .' Tho Ci�t� of Cl.earwatier � �C� 3(� i594 ''° �� .� �. PO Box 47�8 � � � � CI,earwa�ar, F�. �34b�,8-4748 � � ' . � � � � �.� . � Re: Mr. E�anucal Hutch�.nson . , �� y � � ;;y �,j� � � �ear c�ir . r�arcin : � ' . I had �he op�o��uni�y �o do an independent medic��, evaZ�.�ation an �our r,Zie :�, NSr. k?utChinson tOdal. Far thi5 Ii�1E, � ha3 the cansu�.tiations obtained by .Dr, Donald Grahar� and by his �refar��.ng physi.cian, Dr. Mark �Ionica� .�� �evi�wsd a1.1 oi the data tha� is contained �herein and in� �he in�erPst oi ef�icier�cy a�iZl. no� rediG�ate what is already readi].y aQparent, This histary i.s the same as outl.ined. HQ denies any bladder or bdw91 inca�ztiner�cw. He dogs say �ha� the pain is inter£exing wa.�h his wozk and ha.can'� use h.�s upper ex�temi�y as wel.1. as he used to. The VEURO�O�xCAI, ''EXAM�:iATI�N xs as recarded b� Dr. Gxaham. T find no interval. citanr�es. Thers is no Babinski sign today and he can tand�m walk. He cl,aims �'r►a� he has backed a��' on the drinking sign�,�icantl�, bu� he has not qui�. I revi,ewed �he ��elog�cam ana �SR� and i:he pa�ient does havP som� c��-vical sp�,nal s�enosis �� 5, 5 and 5, 7 and partic��sa��.y on t�he �n�relogratn. x wou].d sha�e' Dx. Grahar�'s opinion �hat this shouZd pzob�b�.y be decor��ressed anterior],� i� she i.s �o xece�,ve re�,ie� o� hex symp�ams and piro�ect�.on of the spi.nal, ca�d �ro�u tx-i.vi.al �rauc�atic d.araage down �he raae�. � a2sa agree wi�h Dr. Graham's �aelxng that the= patxert� shoul.d not be ope�ated a� a11 i£ i.t wou].d be �oo dangQraus tt� do so, in ttte ].ight o£ 3.i�rez� d�.sease secondaxy to drinki.ng. Ha woul.d ��vbak�ly ne�d a reassass�en� in �hat ��ga�d. Fo� your �urposes, tiZe pa�,i.anic i.s at maxima� medical im�rovemen� at thi.s poin� and as o� this date, as far as x am conce�ned and his zating ioz cerv%ca], spinal. sten�si.s with ab�ecti.vP n�uro.Loqic finding� 3nd nv I,oss o� �unction is 1�°s. He i,s n�w �eturned to your care. L have suggested +:ha� he, i.ndeed, get squax8d away w�.�h °hi.s' medxca], p�obl.ems and then proceed with the a�gropria�E tr2atmen�C. As yvu know, w� dv no� o}�ez�ate on any pa�ien�s on whom we do independent medical gvalua�xvns. 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Pi1ST StiRC:IC;�ii, �i I�'I'OR Y: [al:,�h r. «i �+? itn t'p�ria z'!c�►�1.� . ' � r��:h�CATi�NS: '1'he p�ri?iil: s�:�l:�s !i^ i, �:�'cfng Ccr� c�i�Peren� , meriiC�tions �or ��Et� �1.1;1�r�i�c�h iti� i� rtok: ce�'�ai.n NElci; they are. - ' �1%F�F:R^TGS: iVQ itn��art r3r.i�,r �ll.r�r.ai��. . . . 54Ci�1L ffiST�RY: 'Cl1e ����ie��; i: n��rri�c� E� h�s second . wiEe. ;�Q fi��s �wa cf�f 1.r1r�n fC�in I�is ,�r�vLous marziag�.lie . admitte:i tn smoktng ���t�r��:rimatnly.tf}res-quar��zs par��c aF. � ciyar�L�es �er d�y�. �1r, a�irtiil:��ci �� dcfnlcitt� a�{��vxim���ly s'tX �i�prs ��C c�ay. 19n i� Prn�l.r�y�c3 k�y L•f�e C{E:y o�' Cie��'�rar�� in recy�iiny area an�i ,��E���r,�nl:�.y ��f1AS a f�ir amaunL• o� . l��a�vy Ii��ir�� assor.i.��:�ri c�it:li hi� jnh. 'F\�•Si1,Y fixST()�t�: i.lnr�m�r;c�l7�.r. .. " . RI;VT�id DP SYS�r�:ris: tI� ,-�rl+iti rl•.?�1 I:� a 1�i.��ory o� sinc � �1 ��� � F �' � � � � � • , . � � � _,�. , .... .�. � i .. �� � � . . . . .. .� . .. - Ji� �! � 9 1�,94 �. . 1�225 Ulmntlan flnad Sui�H 1Q8 L:�Jqo, F}aidn adfi41 j813j 5Q�1•7775 ,6�-`� rJ� `�" ;� . , � �. � • � � �� -r"'�w' ".,:_.'�-'��.. �i = Y . .r,. . ���� ��.���� -...�.. ?�!''i ,���i� ;r`/ i,F , �I1 (,f` ' . . '! � `• .' . `� . .. : . . ' . � ' .1 • , ' . ' � . .� . . ,..1 •'' ' , ' . , . , ° . . 1 . , . • r • , i ' . ` ' ' ' ' . . ' , ' � t' . . . . ' . � . . ' ' ' . i r• � , N . . � . � � � . . � . . . . ' ' . � ' . . �1 . � ... . , . � ' .. . . . � . . � . 11. . , . , ' . , . . � , � . , � ' ��. ' .. . . ' � . ' ' � ' . • ' ' � � . f �; . . . ' . . . . • . �t;' � � . � ` , ' ' ' - � � ' ' , � ' ' � . ' � , • , J. I ,F .`,I.�'�� �.:� ,�alf �-�'' '���1.5 ' .�. '�1 .. • ° . ' '! , , . , 1'1 �.. S , , 1� . .i '� ' . , j, ��� 'i�' `�:i ' .. `.t .,r:� .I , �,�� ' . • �. � , � ,. ' . .. . . � .4 . 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ID� rieni�s �n y r:l�.������ iri ��nwA1. or blzdr.ier t��h��s.� . ;�'. . , . . � rrt�� � t r.+1r, t��(�1t1t r3�1�'ZOM G��lER�1i�:� !{� wa� asra�c�,��.nc•�;.�.�t-i��►;n,l �=�►zr# a�>�ro{�ri��p.Fle � '� �ac�m�i:tpci to beiny �f.p�l: fti,�►irlrsl. n1r�rlci �]Cp«S�.S�:Cp was � 1�J�i� . pU.�S� H�S c1i . . , ° � F��:CtJT.: �ti5 �e�d w�� i�or•�rt�c,r��;���al.i:•. 'I'�ti�.r�! was r�c� �r;ctiycna�[s ,� �� or ddem�.� Na �ia�El.e �i��i��: �r�lrs �?�r���r�n�► .air�ri. �10 �v[�enc� aE , � . � �Caiima. �'upf �.s uere Pr�ii.i i � r�t�n�l �ri�l ►'!?lC1:P_C1 F,o �.i�li�. Fxtr� . ac�iar movem��t;s wet�� ir��;,7r-t;, 'i'i��r� w�r nn r�ys�a�mus , • n��e�. f�is yax� wa's r.rir�jt�':I�I:e.'l�14�rn wa�; rio Farial droo� or •�• . � asymm�try �otwd. Sgp�r_1a �ri�l,m�r�l:7�•.Er�ri cr�re cLear. Tor�g��� an� .. uvula werP r�tdl.ine. �Ts?hnr, w�.� maftl i�1+�. ni,nne showed ai�r � cvnd�c�:[ar�� grpa�er �i�.-�i�, ht��i� c:ai��l+ir_i; ��r� hi.l.aterall.y. ►�ECiC: Sup�1e. [I� haci at i_x��l:ly �lt?C:C�?ritiP,�i fle:cion and � �.x�ension o�' hts cervi.r�1. spinQ :�ncl GO�TI�L�LIlB�J o� �osteriar c�rvica�. pairr aflC'i E7��rti ltii:tJ f�1° t°rf: S�1f7flZ�P�' WIr�] 83C�iE'(?IF? �LQ.`C��7i1 anc� �.ttr�mw �xr����i�n. ��s�ir.l.i.r�i�s ��s� w�s pasttive �i.viny .te�t up�er ex�:rn{nil;� C�riEr'tEl�r: pain. . f���1RT: Exhibt�ed reyul.��r. R-�31;� an�l r.�iytti� wi�hou� aur��t�i.� murm�ar. `I'here w� a c�n��� r��rnl,i�1 iiE�srr.�k� bila�erally.�1� cara�ic� or cr�ni�l. br�ii+�. � LU� �S: CL��r. �1�3F?OZirtV: Sof� witti ho�a1. s�t�i��s. NEiJR�T��3r,tC�r,: Fle was ��+r�IC�, � 1Pr. C,nri�rited and . ap�ro�ariat�., ��� r�C�EpI�I'.F?!i h.n�h�?iiti�J�lpl'F t�ancie�i. [7Pep �enc3on reftexes werp, Z/�1 �?'tc:ri�s ��i I:Eti� ri�;E�h . �/�1 bf.ce�s on tlye .te��. Z/�I .tr�ce�s �i�,i�hQr�z�.Y• '1'r..�::a ��r.�c)�ioraciiails � bilate�a�ly. 3/� ��tell� on k}��; riy�tih, 7.+/� patel.la on �h� l.eft.2/�l achi].les or� �.I�� r.i��il;,l�/�1 �rl�iLies on �he Zeft.f'.lanhar res�aanse sr�� f1.e:c�ar 1�[1.�r.�r.ally. '1'lir�re was �o HoEEman �o�ecl. �ensnry «�� arn�sty irit�r_•� �a . �ain,�em�ez��ture and vihr.��Nar.y s�r�s� ir► C}�e hil�teraL up��r �nd Law�!� ex�cemi.ries. <<l� ��i k, •w�� ��nrinaL. Ile cauLr3 p�rForm heel,toe an�i tandem wn��c wih►�bi�l; �if�f'ir_ti1�y.P,om�er� was ' �` t . , � ' . . .. . . . , , � i.{.�,;.., . , ,r:. � t•i:� ��s•� . . . . `�"4i`v',�; �dA.f;' ��t'., S . ' �1�. . ' +� .. , . ' ' . , '' ' ` � . . t �. .� . � i' . , '��:" . siv F ±��� � ri:'..,�' '1l��!'. ' , i: �� t ' f� k . ' . .. � � ° . ' ��. . '�' .. ' . '� ^ � .. f��.3,� 1.}� '�1�• .�' ' - � �. f . r �� � . � . '' ' � �`. � 1 , ' � � ' ' t ' . '�.' 1�� , .t , r � � . . ' 1 � . � . , . .i . , y . , . � F:: . A�'�',"I;'�' . .er`i . , " � � � . I , .: . ' �' .et . 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' 1 .L` . . �, , r , . , . , ' . . � � � � � � , ' '( . � � '� � . w � � • .' . � • � ,� ' .. • ' . . . . ' ' � ' • .' � � . ' , i . , , � . i ' . � ' ' ' ' . . , � , , � �, ' , . . � � n2ga.�.ive. 'There was no r.��rwhel:,l�r. �I:�x�a no�pd. . ' � , � , ,� � i �� � �}� c�t�v�ca t spine � � .L�1�OR�1TOTiY D�IT� s Tf�e �� r, i pr�L• r�sa�1��� 'w , . � x-r�y� s�n�ch w�re z�v�A��nrl.''1'f�r�y �ii.ci s�in�a evfdence �� . . �;�:;.� : : con��nera'L E�asion a� �f�� r:�-a„ I.r���nL.'P�f4r� w�s �1.90 .�. . . � ,..;, � '� :si�r�t�i��nt evfcl�:r�cP n� •��-�n.rier..�►:iv� �.,���:�n��s a� rri�L�lpl� � . . .�.,. . . leve.�s;mos� 'pronaunc��t 't�C �i�e r�i-�'', 1.av�1. : : � , � • , , � � • , � � . , � • , ;t' . .� IMP.RESS�ONS C�CV�c��.�i.� :wi.,F,f1 .1.�rh, i�pE�n.r ex�remiLy . � , ' �` �.�.".� ' . " rad�cu,Lo7a�hy. Ft�i�.e o,ir, r:Pcvi��.i i �ii ,r: ,tiar.r�iation. it�aLe out . � ' . � s2COl�d��'y ta deyen�rti�t�v'� cl��n.�r�S. ' . . . • � . �� � . � , . , . ' . ; . ' , ; RECOMDf,i;T1��lT�ONS S �T WC)ll I.d r:?c:amm�nrl 1�.�,� I: :J� oh�a�in. an �SRL � of � . . .. . .•hi� eervica� s�airte� a�i� f cli.�ti �r�t j.r.�w->>sa ��r�,Eft� �im a•Er�r �his . • �; �is compie���. ' .` � , • , • , ; � � � : ,� � � � Thanlr Yau, ' . . � � � . , . . � � . � • . . . ,' �nonal.d V. �ra�tam,�.0. . • ' � . � '' � �.' ' D.Vr/pa p ' . � , . ' , . � '• . ,' � . � � �`. � � � �. ; � � . , .nicti��zci G/7_�/�� ,� � ' �, � • , � ' � � , Transcrih�c3 G/23i 9�1 , ' . , � ' � , . . . . , . . .� . . . . . � . , , , � � � . . , �, : � • " �� , . �_ ,�. . . . , , ;� , • �• , •} . � •• � . . ' . , .: . , '.} . , - . . �. , . , . � : ,. � � � . . , , . , . .,. I�' ....i:;.. . , � . � � , •.. ���; �� � . . . . �. : . . � M '`� � � TRUSTEES QF fH� EMPL.OYE�S' PENSION FUND �� � � Agenda Cover Memorandum Subject: Pension to be Granted Itam # Meetfr�g Daie: 19J3..LQ„�_,..,_ Recommendation/Motio�: . � Thomas P. Caleman, Fire Department, be granted a job-connectcd disability pension under Sectian(s) 2.39� �tnd/or 2.399 of the Emp�oyees' 1'ension Plan as recamrnended by the Pcnsion Advisory Cornrnittce. j� and ihat the ap rpprfate officiais be authorized to �xecute same. BACKGROUND: Thomas P. Coleman, F'ire District Chlcf, I'ire Dcpartment, was cinpjayeci by tl�c City on August 27, 1973, aRd be�an participating in the P�nsion Plan on th��t date. �n May 19, 1995, he filcd n Workers' Campens��tion claim �or � blaod condition which is thc basis for his rcyuesl far this j4b-cor�nected disability pension. � Mr. Coleman submiicer� lettcrs f'rom Dr. Luis F. Fcrna�dez �nd Dr. 3effrcy L. Paon�ssa anc� a� IML rcpart from Dr. �'cter L. Kenrtecly, Tl�e letter frorr� Dr. Fcrrtanc�ez states, "Mr. Colcrnan was noted...to have r� markedly elevated red blood cell count in i995...His l�istory oP ct�rc�nic smokc inhllatian reluted ta his employment vzr�s noted, ancf work-up has demonstrated secandary pt}lycytliemia rei�ted to �lironic smnlcc inhalatio�. This candition is dae to his err��loyrr�ent, in my opinit�n us #ang as he continucs in lhis line of employment his eonclilion wi�� persist, anci ever� continue tc� deteriorate, possib�y caiisin� pulmonnry or cardiac cons�qucnccs...Speei!'ic711y, �ny recommendatian is thai Mr. Coleman b� rentoved fro�� his current jo� desc�•iption..,I am :�ware that ll+ir. Coleman is a nonscnol:er; therefore, the c�use of this candition has definitcly becn ascertaincd as smnkc inhalation ciue to his em�loy�nent." Dr. Paoncss:� states, "Secondary erythroeytosis is caused by a variety af agents. The mast carrzman rausc is chronic e;c�asure to smofcc:...The illness is likely rclated directly to his accupatian in that tt�e pa�ient is a fircFight�r s�nd he has ivc:ll documentcd expasure ta firc and smoke over tlie past many years. Thc putient's LIIt1�i10515 wili definitely �revent his continuing in thc position as dcscriUed in tf�e job dcscriptia� �rovidcd to me. He is directly involved in fire fi�hting uctivities which would bc very r3etrim�nta� to his healtli...The condition is expected to �e permancnt...I whoIehcartedIy bclicve this pntient should tre tc�t���ty �nc! perm�znently disabled frorr� !hc fire department. Any continued exp�s��rc t� smoke unri carhon �nonoxidc wauld ccrtainly r�ccelcr:��e ��is death." Tl�e lettc;r from Dr. Ken�icdy states, "i-ie is u nons�z�okcr...Polycytliemia �rresiimed to be sccondary to cl�ranic smokc inttalaiion." Re�iewed by: LegaE NA ___,_ Budgei _ , NA _ _,� Purchasing NA_�, Ris1c Mgmt. NA_, CiS � ACM � Other Ng Submitted by: City Manager �114� Ortginating Dept: Human Resource: User Dept.: Advertised: �ate: Paper: � Not required Aftected parties ❑ Notified � Not requlrerJ osts: 54�1.4_$� I Commissia� Action: Tora! ❑ Approved � ❑ AQ�roved wlconditlons Current FY ❑ ❑eniad ❑ Contlnued ta: Funding Sou�ce: ❑ Capt.lmp. ❑ Operating � �ther P�nsion _ AppraprEation Code: � � .5 S- Attachments: LQtter(s) ❑ None ��,�.•�f'+,'�!?'#�.� .t:�. :rt�.f� :�rr!' ,tr.:r.jt , „ 'i ;,' ' ' �•° - , � • '^' ° , ! y. '��. :, • y`,, ;.tir, t1,S,j �t? ti� .la' �n'i . . .... . . . , ii: • ' . .� � �� . �' � ., !, �,i' ,i.�;ii .l•�' 'S .. �. . � . � , , , � �! t� ' . .t. ,,i. . . � ,i' . , '� ' • ' ,` ..� ' . r . . . . . .. . . . . �q•,. , . � !� �. A1: � , �i: . :'� , i�i1 `t . ,� � . .��� � , . ' . . .. • , . . . . . ..� ' .. .. . 5 '' ��'. �.'c. ej,���: � , ��^' . . 'ii. .e�7 � �+• � r..r . � .. , . . . ' . 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' . _ . lI ' ; .. :' �.. „ . � °F�' :;'.'� "j. �i. t1^; � .ir?•,`�I' •�S. ' ,}� . . , f r .'-r . . ., . ,. ,t.p• x0. ;�4,,i .�..,t:�l'4 , : � .. _ , . , . .1`� ;.i:�ty;,M! '°r �. 'F� '.s!�. F ':e�C �,ii` �'i .�i� �k' . . , . • ' ' , � ' 4 ,. �'1� �N' „ '}'� '�'t.:7'i :`' p'. . . . . . � , . . . . • .'rt:. "' ' . . . . , � . . r ': i .{.. .'�.o ;F'' p''': Sr; �. y'r' �i �°�4,,� ��. ,t,. .. ' . . � ' , ,i ' � . ; r: .t, :) . 3.,j,r'it. ' `'/�� <i i i., . • . ' '.s��. . . . . . . . , . . F'El::'o-•i '�'' ; <� ,lt'. �„' �'�''" - ,'� �� � .'• z . ! , . . • , ' , � , . �s .i: ,`��i>�; i�'':�". r�.� '���:; �,•j, :t'' , � , . � •,' , , ' . . =4�i� �� ':�5: ..;.; E:' 'i' • � � .�.'• .�t ..'r ..i: ,��; I �' , . . , . . � . . — . ' .. {",:r ' iss:�� ,,x.4;' �•r: f� :F, , , , f' 3'.{r`.'c''3F;'F. '1' '�L'r;i,.`}• tr.!^ ••i� /�� •4,� � ' ' � .� . ! .. . � ? � (,�ri:�. �.�' .k.� •.¢�, • � ' ,. , �r' .. .�i� 1�. (' f � , . �7 . . . �z:' .'i., �2. �` { � �'� . :i' . . ;: . . . ' . , i' .� �� .. ' '. �. ;r"��:.� . '.�.''':'": �t �:i:r . � . . . . . i .. � . . i. "�,. •��' .;t' :'�' '^ �; • I ' - l i ��� :i� ,'ty.,�, i �Y: . au��r�..'.� �.Si:!'.%'s��i�:�.• ;'j�� 't�.� .i • i wh�� , -�;3i �'i:�" �'}°�4".., 1'�^. t;; .�.. '31�� �.i� i � 4 � , • �� . .l•� �t`'t:'�. rt `��F " ,. �1, r.. �� '> .t'' �4.; v�r 1�y.'ri%:�n: 'r`.�.�::;, e.i, .'\ ;Il; ;it�r�S�...t:" F t.E� ,e�. t9� �i,� .,. if: :� g ��. i.j. ."''e.-��. :+' R.. r�r. •',.;� . �� ;�i� �'4 ..;�� .,i.�F�, 1�3'NO:•.�� yi..�, i�;i.� r�j. 'f: �.,. 'i:" ��:.i� �'�` c� '�i���.0 �$�lit.J.�. . �.,.«�,'U.:s�,.r »).�.w:.�:'�Ls'r..�i�.'.`£%!{�kSS)t'tR;'�:�?��"'ii:.•t�`�S/�;•t... ,E.. t�. ��,..».. . '.., f...R�#:..ro.'� ..� .° .':�..:'�, „f .. . ... ... . .. . . . .. . , r f. , ,. , �F' Y{y . � � � , , �: • � . ...� ' . .. �; , f . , � , . . ' + l; . . 5 � , ' . . �' ' ' ; . F��f�� •�. , { 1 . , . ., ,• 6 , ' I '.i' r , � , . r. . � i � ' . � � � ' . , . ' , � ,r ' ' �. .i �l ._, ' . . . . , � ' 'a ; . . . . . � . � . � � E . 1�1=. ' � . � . ' `' . � . t.' . , , . '1 .Ii �' , . �. ° • .�. . . ,' . " ..�• , �. � , . . ' , ���i� � , o ' . . , � . . . , . . ; ;.' . , Agendti' item Thom�s: P. Cnlesnari � . .. �. • . . . . . , � � , _ i � Pt�ge ' 2 . , . . . _ ,. � . • . ` , . ':,�: � ,: Octo6er 2: 19�35 ,'� : „ . . : ' ' ..; . . . ' „ ,1 , . . . ,. , , ,. i�1�., ' , r ` ' ' ' ' •' r• � ., E ' ' ' ' ' ' , � . . . . . , • I� . i � 1 . � , . . . .. � . . � ' ' �� . . . I . . ' � .. •' ' ' . �. � ' . . ..�� � , � � . i . . . . , . . � • � . • . � . ' • . . ' ' ' . , � ;�' �' '� '� �•Mr: .Coleman's pension was .. approvcd , by thc � F',ensinn Advisory , Committee ut its rncetin� on ;'._ : :.., �. . I`: :.�._ Scptember 6, 1995, � und is effective on A date �to be determined. Based . nn an ��ver�ge si►ls�ry of :' .�� �� �. `.� `�apProximat+ely $52,407 over tlie past �fi�e ycars and � the formuin for computing jab-. , � connected disability pensions; this Pension, will �pproximatc $39;OdS. a��nuully. � ChArts from , . Fin�tnce .which take . into consideration . mortulity 'rates and age� reflect� t�te "present� �vulue � • - � , ,� cost af firtuncing".�:�this pertsicsn �will be �pproximatcly .$431,�18�. The� estimAted pensian . .� , �. cost (c'ash` �ayout � over the, lifc ,� of� the , pensioner �hd . hislhcr spoUSe) is $997,878. � .. , ' � . . . . . . � . r � , f,, - � r . . . '. 1 ' : . ' ` . . ... , . �t . � ' ' , . • . . , t . . ' 1 . �F. , � .. � . ' , . . . . ry . . • ' . • . . ' • ' � ' :" ' . . , . . . . , . ` . . � . � ' ' . .. , .s � . ' . .t � . � . i' . . ', . . . > , . � . , .. . . . , � ; . ' . ` . ' . ' ; . , , . , . � . i� '. .� . ,P ' ' ; ". . ° . . � . .• ... _ ' .� + � . . � . � �. . ., . • � . � . ' . . ` �i . ` ` � : . �. .� . . . � , . I� .� •� . . � . . � � , � . � . �' „ ' � .; ' , ' . . � ' � �. . r ' ' . . ' . . I,i' � ' , � '� ' ; � . . .., � • . , ' ' . � , . ,, ' , . . � • �� , � � '. ,. , , � , . , . � � . : . • . ' , , , �i � � � , . . . .t , • . , ' ; �. . • , , i 1 ' ' .. . , . . . . , . • . �. ' , �., , . • , , ' . � , ' � � • � . � . � ' . . .. . � , , . . ' � € � . . ' . ' � �_ - ' ' , • , � . � � , ' . � � . . i '�, , � �� . ' . . , . • . . . � • , � : '' . ... . � � , . . . . � . . � . � . , .' , . ' . . ' � . � . � � . . I..J • -• . I , . • � r ' . • ' . . , • ' � • t- ^! ','-''=1,' ''i, , '`' , , ' ' , . ' . ' � . , , ; , ' � . ; . ' . � � ' , . . , . � .� .'' i' . '. ' ,. . . . . , . ' " . , ' . . ' ' , � ' ' ' .. � ' , �� : i .� �.s f� . . � . ' ' . ' . � . , � . e � ' . � . ' . . . � � . . . . . . , , . , ' ` . � , ' ' ' . . ' . . • ' . . . . . . . ' • . . . � . . . . .. � . ' . , , � . . . , . ' , ' ' , • . , � � . . . . � � ' ' ' '� .. , ' , � . � , . ' ' . ' . ' � , , , - � . . ' .�� � } . . : � � . . , . � . . . � . . . . 5 . � i'. 1 � i� .� � . . .. � . i , , � � . . � . � . . � ' .. ' I�'! t�� . �1..� 1 ..�',� 1' V . � ' i�j��� � 1 . .. ,• � ' , ' � ' � ,, . ' ' ' � ' , ' . � . '' ' , . ' , i � I��,f ' �.�1� I . .'11 �.,.nl' , �. , ' . � t• , „ .. � , .. . . . . . • :.�++ �h't.4 t .:.A,, ::��; ;�;.ti� q�;� .'. . , F I �3�'�.r;f�: fi. _�:+ >, , : �� •,s ['. ='7;'31'�. tri,7 •• , . .. , - " '. ' ' • ' . , .'Ir �n .i'. .� S;: . .'P.'a�1'•�la..., . . .. � ...:5�t , . . .. ., . . . '� . . t . , . . . , . � i ' . , � � , . ����r�ir_.�,, � � .� , � • i�+�����,�+':��/'�� , `If+} .�.""' �! /� ti 1L,�,/,f . • � � � ,,i,,� �.„ ; �c� � ... . . -�. ,r,� � : m�; � �+ . �' . :.-T�`,�� . �4,, =.�`� �'�� ��i �� '~�v.ri�N ' Hurnan flesourcea aepariment , 6131A82�8870 C I T Y Q T G lL ��.A :Et W A'r E R . F'OflT nFI�IC� pOx 4748 C#.EAHWAi�R, r��o�i�n �4saa.a�aa � Honnrablc Mayor and . Mem6ers nf tf�e City Commissior� us 1'ru5tcas nf' the , Employ��s' Pension Plun � ' . FROM; . Yension AaviSOry Committec ' C�k�IES: Debbie Sailey, Payroll Sc:r�ices M�n��er; Risk Manu�cment S[1BJECf: DA1�: Pensinn .��r Thomas P. Coleman—Job-Cannected Ditiability �'ensiot� Septembcr G, i 995 The Pension Advisory Committcc {I�AC) receivcd an ap�licatio� #'or c�isuhility ncn�ian I'ra�n Thomas P. Caiem�n on July 28, 1995. � Mr. Col�:jnai� has been ciectrmined by the P�nsion Advisory Cn�nmittec ta �iicci th�: rcr�uir�ment5 �f the Pension Alan for a jab-connccted dis�tibitity �ension. E�3e: Wi14 ciitnloyccl by the City on Au�ust 27, 1973, anci 6ega�� particip�ting in t�ze Fension �'Isri� c�iti that cl.itc. Further, he has su�mittcd medical dorumentntion, co{�ies of which are illilCliCi�, re:lutivc to tiis dis�biiity which hus been revicwed anc� approved by tlle PAC. gy mation rnade and duly carriec! at its rneetins nf Septemt�cr G, 1945, thc �'cnsio�� �lclvitinry Committc'e appravedlrecontimended . tlyc gr�nting of' a joE�-contiectcc! di�at�ility pcntiia�i tn Nir, Colc;mun in accordanc� �vith �rov'tsions of Section '?.397 aC the City Cacie. 'I'hiti ��c�isic►r� iti to be �;ffective on �e date to b� cietcrmined. The amonnt a#' Mr. Colc�»an's pL'i1SICli1 will bc CiilClilBlC(� by thc �in�incc Dep�trlrz�ent uccording to tiie. formula in the ['cnsinn Plan for jab-cannecced diss�bility peri5icfn F�I yuc1� time �5 his last fivc years of scrvica �Znci sala�ry can be cornputed, I liereby eertify th�it the Pension Advisory Cornmittee has ��npro��:ci tfic gr��i�ting c�i' �� j�l�- con�3ected diti�biliiy p�n5ion 1'or Thnn;.is P. Coleman und the abavc dates arc rc�rrcct, . � s� , G� � � � Chairmctin, Pe , n Aci� isory c►t»titiitiuc , . ��a � • "Equal Empluyment a�d Alfirmative Action Employer" � 1., . . .. , . '. : . � , , 9` '1. �J` , '�� ' �. . ���+. ' r. ' � , . . .. ' ' . . � . ... , , I j . ,� �,` . ' � . . � ' ' � . .� . . . ' . . . ' • , . � ' . , . . ' . � , . ,' �' . } , , 1, . . . � � . ' . ' . , . . . � . , i ' . ' 1 � , .. . ' • . • , r . ' ' ' � • , ' � , r . . ' ... r � � ' � ,• ' � • � ' ! . • �' . . ' , ' . � . , � .. , .. � �'f�. . .. , � . . f . , . . . . � . � . . � . . � � . . . � . � . • � q„ . � � ' , � ¢ .. ' . , ' , ' . . � ,. ' . ' . ' • � . . ' . ... .i� . . ' i i, � ' . ' , . , , , ' . . . ' . I. . . . ' i . . � . � . . f . . ' , . . . . , . . . � �� ' e� `� � 1 . . ,, . 1 .� ' , .. .. ' . ' ' , ' . ' . ' .i . , , � ' , rr . '' , ' � �' � ' � . .. .• , . � . � 1 ' � , . . • � ' ' ' . . � . � � � � ' ' I � �' . . � . . . " . ' ... . � � . . , . � , , . " , . 1' � � . . � � ' � ' . . i . . �. .. . i . F' �� � . . ' ' { � . . , ' , ' : t ' � ' . , � . . ' , . .. . ' ' 1 �. '. .`... �. ��•..-�. .,�..w+rwr+....�.a.Yr.+..�' , . . . , ' . . � �. : ,. . ' . , � . , ' . .. i ' ' , ' • . . �.o: . � ' . . . . I � . � . . . � �.�' � ` � � ' � . �. ii �� ��, .. . . . � � .. �. ' � . • , • � . . ' , , . . " . . ' � . • . . , . . . . � , . . ' . ' ' . � ! ' . • . ' ' ' _ � • � , ' ' • PENSZON R�QUES'x' FOR�Y.I ' . �• , j; �. �'�hamas P. coleman � do hnrcby apgty foc retircment fror� the City of Cleazwater � ,. G�nerai �molvy��s' Pensivn PEan. � • , ' . . . . . . , • , . �.�r[y trene[its date is augus� 27, 1373 {Entx�y date into, pet�sian• plan) . , ' � August 27, 1973 � � �4 y � �date o� hire is � . • • � , �fy birthday.is ��G���r ?�, I936 � �. .�y jab classifica�tion is ' Fire Distri.c� Ch�.ef � and i� work in the • ' ' �ire ' Department, ,_Div�sion. • � ' ,�i y resignatian date, �is �� be determina� � � , . �� i ii� ty�e o� pensipn �or wi�ic;� I�fri 3q4LylR� iS (check on�y one}: , � . , �te;u�ar � Pez��ion hased �n ;c�rs oF szrvice - ' . � . , ' x , ,�o�-cortnected c7isability Pension . ' • ' . � � �an-job-connected Disa6iiity Pension. ' � 1�[�' S�?Ql1S��S n�me is: ' �tary�P. 7/1��37 � Dep4ndent chiidren ��zder the a;e oi I3 and �residin; in my ;zousehold are; {�:in� C:�i:��'s ��:il `�ar.t�) [C�i��'s �Jate oc �irthj ' � � . � 12C��DV ,:�:riFy alI or z�� ��ov� :o ae ::u� �nd =or;�c:: � --- � � ' . , �,' � � I J �t' � � ' � �--c �,. :t ��, � . . � � � ;5i�nacu;e) . � ' � July 3$, 1995 . i Dat�) ST:�TE C?F� FLORI��. The far�Qoi � l��t:T1.±Y�Ri . as '^ ��o�vizd;e� c::r�r� ;:�e :�:'S . � COU�tT.Y OF gIItiELLAS ` ��"`•�;�"� �y ��•:^ ���� . 4�'� r-�Y`G �.v�o- :� ?�rsonalty � ' �tinocv�i co :rce �� '.vi:o ii�s �rcciucea` �� .---.- . �.. . : �as id�nciti�cac:on �nd � no �idlgia aoc :ak� �n o�ch. ,, �,� , `�j� , . . �� ��j'i�i �� � `'�'��'� ` � � �iocary ?:�oiic . ,,1 . . (S i;natur�} � ,�, � . � �� C�r�missifln `ro.�— , � ` � \'' ,��ti` t(� �`•.�:.n � � _ , �.�.�•�:,,ti. �:�:':.�. ' �:�ai� ? � tec3 � - � � i ;' t 1 �� �� 1 �� -�l;a.c�� _ Q,t,�ti:�Q..... f � . • '� ' • ' 1j•,,:,. _ :" '�: ,=1':.:; : �: �'.i'ii.��i � ' t; - I• lr4f�:f.'fir4�?i�7 i�:,.`+�+rl�j'J`i� � . . ' „ �• •�.�•, „ :''7s1.'�� : ;i7 4:�.�+�...��r- -r:1;1. . •«..��i t� •�. — --- — .w...�.. �. � . .� , - . • ' ' .. . . ' ' ,r - . i�'' " ' . . . ' . , , � • ' . . ' , . . , ' . . ' , , ' . . , .� ,' , :�' � . • ' • � . , ' ' � ' . .. . , . � � � ' � ' ` ' . . � . � . . � , ' . . , . ' , ' e' , , . • , ' , . , ' - Z.�,. ' • . ' i . � . . . . ' . ,' . . ' . � . . . . � .� ' . . 1 . . ' . � , , � ,; i . . . � .:c � . �' . �. ' ... . . � . ... � „ � . . . ' . • , . . .. . . . , � . � , , .. , , � . . .; ri4 ' ` ,r ``. . .. ; ; ''I�tY,•'S; �� � � . � ' . .. �, ;' . : ' � . . � ' . ' , i . �. ' . . . ' . � . . • . � . ' , � � �• , :i `r l 1 . . ' . � , ��'(' . � � � . � . . ' ' ' ` " . . . • . . . •�'�� ' . i: � 1'4 'i ' ." ` � ��. 'r'1 . . `�. .. ' ' : , ' ' ' ' ` • ' . • ' . . ,F�' S � . ..1 � . , .1 ' . � � . . . � . .1 . . , : 'iky �'T�:t1..1_�.x-....[^.rl>!rl�....t; i' ,..e...v..11�rr..�.... .. . . � ' .,. ,�. . ..6°` . , f .. � �. . ' f.' . , . �'•1 �� . 'I , �. , ' . . . . '"".- � ' � 1 ' . r ' ' . . . . . . • • ' . '1 i . . . ` , . ' , ' CTTY OF , �LEARi�V�TEit � � GE�1ER��: �I�iPL�YEES' PE�ISZON PL�y � . . . s , , OPTIOYS - GE�'ERa.� E;�IPLOYEES � � '_ OPTTQr+i -�i: � , Emptayees c�n receive . a lurr�p sum ' payment far v�cacio� and �, � • - - - ' haliday pa,y and IIZ oE �ccrued sick le�ve at tha time of • � •, 5epataii0�1 fram the�. Ci�y. T'h�re will be� no 6�'o deduction. for •. ' � ; pension from �his lurnp sum payment nor �vi1l this amoant coe��t , as , earnings ,in the calculation af che pension. The last d�y a� ' � .. work will be cne ' terminatio�i dace snd pensian benefits will be;in � � ' � . the follawing day. . I . � . '. �PT�Oy .n2:. ,� . �mploye� can �xeend cerminacion date by the time ciue tor I .. . ° �� vacasion, holiday � pay, anci il3 or �ccrusd sick Iea'v�. 'i'�rminacion : � date wi�l�be� che fir�al� day oc extendecf �ime. Pet7sian ber�erits will � • „ begin the � f��lowin; day. . • � ' ' (Only availahle tq em�lqyees hirerF prior to i�/1/)0.) ' * M a� �t � �M �t k :M +k �M � �M i� K �r x �e K ,Y x a �f * � yt * �e . s �t x « w k yt +w ah # x +k �[ � �M �It x Y� .e �k �e u �R Ye �M M �e iR :�e �ie �+ ;,s �e s� +� ;r :!� �h �it �it I, � Thomas �. �oleman ,�n employee of the City at Ciearw�ter, hereby apply tor .� pensio� ben::tics under che Cit�'S �mpEoy�es'' Pensio� Pi�n. � � I hereby ceccifv that i tu[ly understanci :;�e ewo ontians or€ered �o �e. I ci�onse co :etc;� ccsi�; Qpdon = '- .ir�d' {vish r�y b�nerits to be calculat�d rsnder rhis vption. I. ur�d�rstanc+ th�t �nc� chis �orm is �i;necf, my ��cisian is €rrevocable. ��� • ���' �% ^� � � . � � E��PE.O i'EE'S SIGi r�TL'RE: -` •'f•�� �'��t-:� / : � � � ""�' ;��c. r • SOCT�.I. S�CL'�tiT'f Y:_ o3?�z8-2i�� _.. r ' �tiTiVESS�S: � , :�DDRESS: ��90 19eh Street , . `� �,�. _L�' =:`�1_�� � �' �,i �,'t_c'f � Palm Haz-bn�,FL 3�683 . . � �� . j .� � �ti'�� �.� .� '�. , 1 �� � Dr�TE: 3u7.y 28. I995 ,� . � � , wsa i � �� . . . . . ' . . . . ' .Y. , � , ' ' • . , ' , . ' .� ' . . . .. ' . - . . f . � � � � . , � . ' .I . r ' . ' . � . ` � 5 , i . ' . ' . . • . ' � . . . . . 1 S � . . . . . � �. � i. ' " . . . , . . � . �. . . . . ' i � . 1 . v . : t.. � � i . � . . . . . . , t ' ' . ' . , ' . II . . � ' • ` . . ' E . . :� � ' � j' ' ' . � ' ' . . . , , . , • ' , . . ' •.�f�•. •� .����i.i....�..�. r� .,, .., �. ' � .. . . ...._�. .... . .. ' . . � a.., � . . . � . . . - . . . .� . ' 1 � � . .. ' . . . � �. �� : A�gust 29, �995 . , � , ' �� . � • � � . � FLORlDA , � � : ` � COMMUNfiY � . � CAr�CER .CENTER�. � . � . � , 1 i3G? C�rtez Boulet�ard Broo�stiyltc. �arida 3a613 Ph. j9Q�#i s�lG•t�z6 � F�. {90�1 a�Ji-21�a . , Rirhard R. Ca�adonna. li.�. tlarrc ten�r,cd,n aredfc�r Onrotary Baara Gernfica ir lnrrrnal,llrelrinc Uatid J. 5allneer. ,11,d. R2CUrran Oaccrnbi,a�, Pcter L, henned��.11.D. Bwrrf C�rtrfrrd m 3rnl,car artraroq� • 9atrrt Ctr[rTrd rn�ln+rrnal tfnliaer .�f1en D. Green.11.S. 1lrurtal Yni±rc��� Luis Fernandez� M.D. � DiagnasCic CIinic, Largo Office 1551 Wesc Bay Drive Lar�a, FL 34fi40 � RE: . ii�omas P. Coleman Dear Dr. Fernandez: T�ank yo� v,ery much for reEerring �Ir. Thomas P. .Coleman, whQ is as you know a.56-year-old white male w}�o� has a recent diagnosis of secondary palycythernia. The patient app�rentZy i�ad �een working far a long time as a fire�i�hter with p�cygen deprivation secondary to smoice exposure. Workup by you revealed that the patient had a normal B1? �evel, )eu�cacyte a�kaiine phasphatasc, erythropaietin. He a�so had a normal �ltrasonnd of tt�� abdomen, � The par�enr th�n went on tc� receive phlebotomy to control sympsoms of k�eadache, shortness af breath and nervousness. He cienies any syncop� or any evidence af bleedin�. He h�s had na history of rccurrent infections. Apparently his piate�et count �nd white binod ccll caunt have been within normal limits. PAST AiiEDICAL H�STORY: Remarkable far a histary of diverticulasis, hypertension, �mpatence ancf hypercholesterolamia. F�e has had a hcrnia repa�r on ti�e �e£t side, an appendeccomy done. He has a history of benign prostatic hyperi�ophy and is sca�us post episodes of prostatitis, He has had a biopsy of his prastate which was negative for any eancer. ' SOCIAL HISTORY: Fie is a nonsmoker, non�ririlcer. He has worked fQr t�e £ire department �or over 30 years. He has had multiple episodes of sma�Ce inhaiation. There is no histary of in-haspital treatment nf smoke inhalation. WorI�up for cE�ronic Iung disease is pendin�. �'Al�r1ILY HiSTORY: Ne�ative for any blood disorders or cancer other than cancer of the prastate in �ome remote m�e reiatives. �iEDICATIONS: Salsalate 1500 mg twice daily; Cardizem 280 rng q day. He had baen on Acupril :�nd a dreig calZed �'acon in the gast. He has no knawn drug al�er�ies. I. ... . , . ' . � , �' , � � . 1 ' � . � • ' • � , r' � , . ' � ' r � . . . . �� ,., . ; � . � , • : ' . .. . , � • � . '. � �� ' . . �` .. , � .. � � . . .� ' , ' � �, ,' � �, .� . �� : , , . ' . ' . ' . , ' ' , ' ' . , ' .� . . . . . . . . . . . , . , ' - � '1 ' . ' � � . f ' ' . . . . - . .. . . . . . . . i � . . . � . [ ' r 'i I . j ' � , f � I ' � � . • ' . ' . � . � . ' t . ' � . . ' � . � ' � I . . ' ' � � . I.�! ' � r . ' ' ' ' � . . , ' . , ' . �d,f.s .. , .���...,... . .. .. .r ... � i ' ' .. .,{_ ` , , � ' ' �' . ' , ' .. , • .. ' . �.,1,� � , 1 . COLEMAI�i, THOMAS � ' . . , . PACE� 2 � , , . . � , ' r�tigust� 29, 1995 ° � � ' � , � , � ', i'�-IY�ICAL EXAM: Shows a weII devc�aped, well nourished white male in na acute cfistress. Bloc�d :- pressure: 130/8Q temperature: 97,1 puIse: 80 and regular. HEENT: 5haws�no alo�ecia. He has a �ienign fundascagy exam. PEERLA. Tympanic membranes are intact. Throat is clear withnut any - evidence nf adenapathy or gum bleeding. Neck is su�p�e withc�ut thyromegaly ar palpable a�enag�thy: Chest shows no axillary adenopathy. L�ng fields are clear. Heart sounds s�ow an S1, S� wttho�t inurm�r, rub or gallop. Abdomen is soft �nd nontender without palp�ble organs or masses. H� has no inguinal adenopathy. , External genitaiia �re unr�markabie;. Rectal is deferred. . His recent rectal . � exam regarding ttis prostate and the recent colonascopy were reported as rtegative. Extremities have , na clubbing. He has no bony tendecness. There is no edema nr cyanosis noted. Neurologic e,cam is intact.� � � .� LABORATORIES: Laborataries �vhicit acc:omganzed the patient are remarkable far an upper Gi, which ;� showed a small hiatai hernia. �According to your nate, � the tests for ev�luation of polycythemia werc all within normal limits. WBC today in our office: �.9 HGB: 17.3 HCTt S2 PLT: ?7?. IMPRESSION: Polpcyttiemia presum�d to be secandary to chronic smoke inhalation: I agree with your , assessment that cIinically and to date there is no evidence of polycythemia vera. r�ccording to history, clinically the patient seems ta respond w�ll to ghlebotomy. , REC(�MVIENDATI�NS: In a�dition to t�e tests performed.above, I havc recomrnczded for kurthcr coniirmation, that a tagged red cell mass study be done. Plasma voiume should be measured, The: �atient .is in the process of bein� warked up for puimonary disea�e which should include oxygen satura[ian, biaod gases, and c�rbnxyl�hemo�lobin concentratian. Bone marrow ex�mination with � cytagenetic stuc�ies can a�sn help in ruling out polycythemia vera. In addician, scrum �iscosity may he he�pful. If there are any equivocal resu)ts of this wori��p, then possibIy the �atient can be �valuateci . by a t�rtiary hematology center tor Further confirmation. � I agree wit#� yo�r assessment, however, that if the patient was ex}�ased to ci�ronic smoke inhaIation, , secondary polycytt�emia is a stron; possibility. If you t��ve need of further informacion from aur office, P�ease do na hesitate to cc�ntact me. , Sincere , yours, . � � ' ' �. . /� � � 1/ / r� . , � � ' �••'. r ' �...` / � • . . PETER L. KE�iNEDY, l�f,D. � . PLK/mc . , • , � � .r . � . �I ; � � � � ; . ; � 1., ' � � ' � �i ' � �. t � . 1 . � � �! � � , � ' . :.4. � .. .... . ......... ... ` . ,. � .,.�...1' 'i�•: .f•. ' .� , . .~}'1 E j i ' . . . . l 4 i . , ��stHES►otaar � ' Yunq Ho H�� fN D. J�mfu J. Ud.1Ul). . ' AobeH A Lev�n�on, M O.� �� Andr�.v Peter�, iAp ' � � CA�dpVASC � �tl�A�i11�4WIpC SUFip@AY ' .►+. cn.i�.a c.ewa�. �10 • • . Jaxoh F. Di�Wno„7r,. MD. . . '' OERMA70EOi�Y - , . � Fr�d 8, qutrxv� �1 D. 1.lelartr� ii, Haynes, MO, '_�,ia J tatya, �A 4 w��wn c}. YYaM. M O. EHDOCiifrloLr3CiY � wNyr►, P. c,00rtti 1A n. • FiU�IILY PF1AC7tCB � dan W, Be��1ey ht4. larna E. te+t ri, M D. darwltrn P. Naqy, MD, Edv�rd F. trHarN.l.1.Ci. E. oorany Ntvnka. h1D. c�u,ow�� a. �t � Q. Paul iG 5a+lherd. AA q. aer,�uw�ctn.,� s�e�v remear. Em�,, AAO. lAkfMel E. �l�rney. hlp. � INTEqNA� MEQiCINE � ��mn A. Av�+ry, �a � A. fkary �r f7enton, M.O. '' Y�N Y. Elia M O, � su.ti, E� aib.n,,, M o. � Ks�ina E. K�ilt 1A �. Anlnch F. Mukoy, M a. ' Ooup� F.. P�Sn, M D. Cn�ryt �, Qu4My. AA �. ' Euq�ne 3. ReynoW A4D. FioDUt i4. ShoEe, M�. uklwl .1. 7fiano�on. M O. O�n�el W. Mawn, lII. M i?. Jetiny 3. S�p�r. MO. . s�cpi� o. �urf�ar 1A13. INTERfJAR At@R7CIAl� CiJ�S 7Fi0 E Ni�ROL0f3� Bruao A Selwn. MD. Mictc�e! 5Lnml. M.p. JoiepF� iC Wiomt�n, lAd. �,�,i�.zeG�� �t�. lN7EANALC3�R1Aiii.'C AI�L„CiNE Shsrcx� 1.i Od�M,1.tU. �yru}ra A. Pqyanni. ti! [1 Jamee F. F�v�nUark lil. A1 D. Jamcs N. 5�ep� iN D. '��i[EAF1qL bIE�IClN� -1 �tulA TCLOGYANtO{.qOY tw� F. Fo�nand�s M O. �NTcRWIL M�RtCI��FINEPFkAClCCiY c�m.1a FaruMa, 11k.o. �iYT"�iNAL MEUICIPlEjONCCLQQY a�a E. �«,wa., r�.a �NTERNAL �+�ECIGI!t� PU��FONARY OISEA,iC•S �'Mtis J. AYSr�. M D , �onsks E. Ro,+ren, !�� D. 1IJlism J. i;fef+nrds. lr.. k40. iN7'cFWAL ldEDlCtt�tE�FU4EUMATOL�CsY '�Y�iis^� M. LYason. tA 4. ; ��:::,cr.sociv `dxrxl 9. Evnn� bA 4. CY�r.0 Hunnwn. M D Stwq E Sirotf, M.C}. 'smn A. Slw�napn, lAQ. ^ 3SSCl'FiiCS�C�YtsECCtQGY :umea E. Ccran, tit D. iocnrs ,J 1;cAer� rd o. ::sw•,h u. iCUOGd. td, :d �. �aiisa Ru� M Q. rF-i T'}ULNCLOGY7SLFidEi�Y Jc �15CiiGfr'tS CF 7Nc cYE :�uarC h1 Ceulxher. 1�10. .;amaa A. Roberh. 1.1 O, �a�r,�nCoic su�ccs��r 1S.+r5 J Gtav�s. AA Q ;1�RUm tSc�r, �d O. ��ortfa� A�rmdarfer, tiS D C'CL1RY"SGOLOGY r,sH. �;OSE x 7NRa�1T ]rxqe 5 GL�Me.I�� R .Yarrcn S UufN.lc�n. hi D. �iI1�ClqC�Y � svrr.and P lot, :d Q. . � c.r.• ATRkC$ � Fesnk �urne�, ht C, .t qop�,t l.�ae+�. F.1 p. ' '�ckaY �'uSer. t.t Ei. ,:�lm c; 'lne�rto. 7.1 D . P5C�A7i�CSPEDr�r�ic pr{EUrt�TOLaGY ac:nf'Pf 'I�c1cw.�7n.�r.!.ID. =t,.1STi�, SUi+GERY +ois�xt � '.1cCuno. !.1 D aA:: {7L^.3Y•CIAG�iCST1C lhV1G�Yfl • � !.i-rrv�n f�s�N. 1.1 p '.� ls tan ���x�,xt, !.1 O .� !.tait�n LanCry. ln, �d O. +�n� T lre. !.1 Q. ��,.�m a a�o�,. r.�+� ! }F.^, �f7(iY UfiCiLOGICAL SUPGEF3Y roCni G. ii:eexAlt.'.tD. �ture A SanrI. h! D. .�C �.�� hT5 Tfl.1 rOR CEO aa:urt A R•pF��9 JULY Zb, ].995 TO WHOM IT'MAY CONCERN; � � RE: MR. THOMAS P COLEMAN Si� 149.0 l.9TH ST • . PALM HP.RHOR, FL. 346�i3 ' CL�NZC NU. QL�55L7 ° I am writzng to giv� an overview of the curr�nt situatzon,I have been add�essing with thi.s p�tient. Mr. Col�man was nated ai.ncidenta�.�.y, by his �.nt�rni.st, to have a mark�dly elevated red bl.00d cel� count in 1995. My evaluation demon.strated no evidence of a �ra.mary b�.00d condition. His history o� chronic smoke inHa�.ati.an rPla�ed �o his emp].oyment was noted, and a work-up has demons�raied secandary po�.ycyth�rnia relat�d �� ch�'oni,c smoke inhala�ian. This condition is due ta his empl.ayrnent. � am awar� of his �ob d�scription as a Di�txxc� Chief. ?n�my opinion as long as he cantinues in this lin� oi empl.oyment his condi�ion will.persist, and even continue to deteriar.ate, passi.4�l.y causi.ng pulmanary or �azd.iac consequences. This c4ndit.ion can b� trea�ed and pra.mary tre��m�nt would consist o� remaving the patient from th� environment whxch is causing the abnorma].ity. Speci�ically, my recommenda�ion is `that rir. Co�.�man b� removed fram ha.s cuz=ent jab descripti.an. Stabilization af h�.s dis�ase will la.k�ly nat happen unlsss he i.s removed �rom this positian. z am aware tha� Mr. Coleman is a nonsmoker; th�r�fore, the cause o� this conditian has detinitely been ascertained as smok� a.nhalatinn due to his emplayment. 1!S1 Wosl Bay Urlve, LarQv, Fia�ida iicr�� Phona: (Ri71 S�!-A7h7 3131 N. kcMullnn Baoth Road, Cloanvalnt, Florida ]a621 Phpna; {3E3} 77.6-3�71 1d65 S. Ft. H�rison A�ronuo, 5udo 20a, Clottrwntvr, �lorida 31616 Rhono� i8131.�3-d50Z a0�0 Tampn Aoad, 5uda 9, O�dsmtu, Floi�dn 7-1577 Phonn: 1913) �y-:36S GEiVtER FOR OIfTAATIENT SUIIGEHY ta41 Mresl Bay Q�rvo.Largo,Flnn0�1 It6t0 Phono: (Sl3I 583-93�a ;n'�J't :g ,!' ' �'��'fn; :fi` � � �.� �� �'.' , . ' - ' . •- , , . . , , , . , . � . ;,. '�; 'Yr �' j. °��F: I" ��`' °�; i , . .� :1" . .. ' � � � a . ' �. . . . ' ` ! ) . . � . � � i .� , ' ifl.1""� 'L � . . n�'t . � fs � � . . - i . , . . , fj,s�i,i- iSe: :,;1. '.I•' ' ' i . . • � ' . �� .� ' � , LS� •�' ,.ri�. 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L � , . � . � i � . . ' L = . . . . . . , , , , .. � . � . ' ' .' . ' „ � ' � ' ' , � , � T0. WHOM IT M�1Y CONCERN : ' . . � 1 - 1 • ' . ', t �� , . . �. , , , . , , � ,� � ' : � ; RE : •THOMAS � COL�MAN, 2 8 5 S 2 7 � , , . , . . • � , . J � .. � . . , ' i . . ' , ,�• , . . • , . � , � , � ' ' � ' • � x� � can he of - any �urth�r assi�s�ance, please �ee1 ,free.� � � . . _ • . � to con�act me. � � . � � . .' . , . ' . • � � . � ' . , � . ,. . ' . Respectfu�ly, . , . ' . , - . . � . - ' . �. '.. '�, �.. ,� l `. , .� . '..' . ' ... �, . . . . , ' , ' ' ' � .JY� . r����C//�i�'�% /y'1�/���/ � . . , . , , ' . i . � . . , , ' . , e9 . , . . � � ! . 1 + �� ' . / ! `. �. � ' a . : . � . � . . '� � ' .: LUIS.,'r FERNANDEZ, MD� ' � ,., • � ' , - , . . � .," � � ,' . � .. �, . "'' � � LFF/CZS . . � . . , � , : ' �. . . . � . . ., . . , . . , .. , ': - . � . . ' - �i . . � � . , . �' � . . , , ' . ' ' � . . � ' ' . , ' � . , . ' . . � � S � � . � . � . _ . • ' , ' . , , . ' . . ' . r , . , , � . � . • . � �. � . . ' . ' �. . . , ' . � '� ' • • 1 ' ' . . , ' • 1 ' ' � ' ' . ' ' . ' ' t • ' . I., . . . ' ' ' . � . , ' , . I� . . , . i . . , . . � . i' y , . , . , � r � I' ' . • .. . . . ' ' . � ' i . . • . . . . i. .. � . . . � � ` i . . . �, , . � , . . ' . , ' . ` , . . I . . � . . � , t . � ' ' � . . , . ' . . ,� �. ' ' , � ' ' ' � � ' , � � � • � � .. ' . ' . . ' ' . ' . . . . . 735f Weq Bay Or�v�. Luqo. Flor�da JaBI6 � P O. 80+ 3o0f. �arqp.' FIOnAO ��Bd9 •.. phone i8t3� 5et.d787 ' , , � ` . 2�SA McMWI�n 8patn Ha�C, Swte �09, L'Ienrwalet, Flonaa 3�61fl. ` � �tio�.. �aaa, r:a•aa�, � , � 501 50. L�nr,ofn AwnUr Su�fr it Gle�r.iatrr, F�ontl� S�AtE � Phony.j8f3isa3•ddp; . ,' , . � � . . . . . ��ey..�....W,.. .... , • ' , � • , . . ' � < . . . � . � �'aonessa �k Peterson, IYI.D. . . � MBI3�GiL ONCO[.4GY,wn ��hc,�,ro�.ocv � . JF�'FREY L t'AdNL�'SSrt, �LD. 1. AlVDItEi�P�7'�'RSON, �ND. 1 �Dl Flfth rlutnua .11artli Suirs SDS 5� Paersbu� F7ortda ,�3�73 � ' OJ�ce: (81?j 8?1-0017 1609 Pasniferta�v,enut SautH �„ St Petertburk. Flnrrda 337A7 _ .... _ � _. F�• f8131 8?3•7�F73 Jul.y �,4, 1995 FtE : THOMA,S COLEMAN To Whom It May Concezn: Thomas CoZeinan returns today for disabil.ity evaluation. He has a form tE�at has 5 stateinents that need to be provided a� evidence �or his disabi].ity hearing. 1.. The patient has �he diagnos�.s o� secnndary erythxocytosi.s . This candition is the abnormal accurnu3.ation of red blood cel.3.s wi.ti�in the ci.rcu�.ation. This causes a progr�ss�.ve thickening cr� the b�ood with resultant de�eriora�ion o� the heart as we�.l as the ra.sk o� stroke or haar� a��ack. Th�.s is a very serious coiidi�ion that does u3.timate�.y lead to death wi�hQUt correction. � 2. Secondary �ry�hrocytosis is caused by a variety of aqents. The znost common ca�se is chronic �xposure to . srr�oks. This disease is th�refoze very aamman i.n patients �hat smoke. AJ.so, it is common in peaple who have chroriic exposure to smoke., 3, The .illness is 1.ikely xelated da.r�ctly to his occupation in that th� patient is a f�refighter and he has well documen�ed exposur� to �ire� and smoke aver the past m�ny years. 9. The patien�t'� diagnosis will definitel.y pr�vent his continuing in �he pasitior� as described in the job description pxovided to me. i3e is directly involved in fir� �ightzng activities whi.ch would be very detr.imertta�. �:o his Ytealth. 5. The p�tien� has reached max_ma]. medical. improvemeni ar.d �he condition is �xpected to be p�rman�nt. Thank you for you� considera�ion. z whalehear��dly b�lieve this pati,en� shou�.d be to�al.ly and permanent�.y disab�.ed �rom the �ire depar�.ment. Any c�ntinued e:sposure to smoke and carban monox�de would ceztain],y accel�rate his dEat�. Pl.ease �'ee]. �ree to contact me i� further .itiformation is required. Sincere�.y, � • . .f� . , ,� �' .,...�---�-.��- /I"�----r ' Je���ey L. Paon�ssa, M.D. J�,P / j kh 9 �� aY�.. L � v x...,. „a .. . �, � . • ,� . �'aonessa � Fe�e�rson, M.D. ' M�i3iGtL OlYCOi.OGY,�IVD lIEhG1TOLC3GY • I�FFREI' L PAONF..SS.f, �ND. , l, ,�VAit�I� p�50N, ,1f.D. 1?01 F1/Sh ,�tvenue Narsh Suire SOS 5t Petenburg, F7oridn .�3;03 Ojj'ue; ($!3) 83I.pp17 1609 F'a,rodenR Awnue Soutl� ,_„ SG Prrrrsbur;,, FTortda t.3713T �.,.y� . ._��.,. .�.._�.,,. F'az,_,L8131 S�?•:dT3 Jun� 2 Q, �. 9 9 5 � Jon Marcin Risk Management Specialist City of Clearwatar �ost offic� Hox �748 Clearwa��r, FL 3�5I8-4748 RE ; THOM�iS COLEMAN Dear Mr. Marcin, !11 r� �; ����L�,�����:�: i.,�,•' ',��li � � ��GJ t!,j :1 '.� �1� j'Z � ;i� �z � �� ;�ra;� r .� ti.� �.� i1�dl�t�d :'r ' �:5 ,,z 7,r . . , .; e�'d J ..y ,'.i .��.. . �ti� �t •� �r Thomas Co�eman pzesen�s �aday for �valuatiQn af h,is poZycythemia �nt! �o as�ess , whether hi,s �mp�:o,yment dutie� as a firefigh�er contr?buted to his disea�e. � The patient has an znterss�iag hemata�.ogic history. �ie origi.na�.3.y presented i.n J3nua�r, �,995 when a rou�ine comp�.e�� b�.00d count was perfarmed and revealed ma=ked er�throcytoszs with a hemo�iobin a� 18 grams. He was seen a.n cnnsu�.�at�.on �l�y Dr. Luis Feznande� who is � hemata].ogi.st at the Diagnvs 4zc C�.ini.c . Evaluatian h�:s i��en per�a�.ned which included a narma�. g].? Zeve�., Ieukocyte a3.ka.�itte nhosp►tatase, erythrcapai�t�,n �.eve�., and uZtrasound af the abdom�n. Ha.s ��e].ing was that t:�e patient did have secondart polycytn�mia secondary �o smoke inha].ation. ge has received a�atal of 6 uni.ts a� therapeutic phl,ezao�.omy ov�r �he past 5 man�ns. Th� p�tient has had seri.al, spi.rometry studies n�r�or►ned by the City oz, Cl�arwat�r. He stat�s these have always beer� norma�. b�� the test this year re�realed some "xes�ricta,or�" . I do not have a copy o.� this zepart. The . patient has had an oxygen satura�a.on �erfa�n�d which �,aas borderl�.ne at 92�. i:2 k,��.`..ETIt 4C'G'S COI:Ir�.�1.;: Of ;;o�Gi�r}'�QC. �I'fd ti nrZi t�Zc u?hi C� i 5 re�zever� by the phlebotomy. He a�,so has ac�asional c�ysanea with exe�ctian, �e does have couyhing after f�.r�s. He has never smoked. '?'he patien� daes snore. He does state that his w�.�e has no�ed that h�.s res�ira�ions are intez:nit-�en��y diminished whi�.e s�.eening. The pat�.�nt has no pr�.ar history o� hemataJ.aqic dyscr�si,a. Th� patient's m�dical. history is signiticant far hynert�nsion and gastraesophag�al re�3.ux. It shoul�' be noted that his b�oad pressu�e is better contro,l�ed �,:nmediateZy =o,��owing phlebvtomy and t�nds �o increase un�il his ne�t procadure. � , His current meda.cations include ca�dizem, sa�.sala�e, and pri?osec as needed. .� .� . , , . � . , . r „ „ . Thomas Coleman �Tune 20, �3.995 Page 2 . The pat�.en� is married.` �$e lives wi�h his wi�e� i.n' C3.earwater. He does nnt smake or dri,nk exa�s�ively. He has been a�irefighter for over 30 yea�s. H� i� curz�n�ly �mpI.ayed as a District Chie�. Physica�. exami�t�atian r�veals an anxi,ous, plethoric, middle aged gentlem�n in na acute distress . Weight 1.99. Zbs . HEIVT �xam�.nation i� signi�icant onZy �ar can�unctivaZ i.n�ecti.an. There is no adeno�athy pa�,pated on deta�l.�d exami.nation of Lhe �ezvica7., � suprac�.avicuJ,ar, axa.l�.ary or inguinai. regivns. CardiovascuZar exam is normal. The lungs ar� c�.ear to auscuZta�i.on •.�ithaut rales, wh�ezes or� rhonchs.. Th� abdomen is benign wi�izaut hepatnsp�.eno�ega},y. WBC 6.3k �IG �7g �iCT S1� �LT� 23Sk ASSE551�iENT: 5�tcoud�ry e.�tru�•��z ��a.�:, :� ? ��37 � �,�a3 �'irefiqh�er with no bistory of tvbacco use. it appears tha� this pati�nt dGes [�ave s�candazy ery�hrocy�oszs. There is no eva,dence :�ar a primary h�matologic dyscras�.a such as polycythemia vera. Secondary erythroc�rtosis is generaiZy assocza�ed iaith conditions.ot chronic hXpoxemia or 1�w axyg�n s�a��. This can occur in patients wi�h ch�onic lung di.sea5e� chr�nic cari�an mono;tide expasu�e, or chronic tobacc� use. Ozher rar� causes of �.his canditian wou�d be occu�t ma�,zgnancy vr abnormal h�moc�iob�n states. ' � feel the most �.ikeZy situa�� an foz this patient would �e t!�a� of progzessiv� r:hrcnic �.ung dise�se re�ated ta ren�at�d smoke inha�at,ion, Th� patient did hav� anparet�t res�.ra.ctive xi.ndings noted on recen� spirome�r� pex*ormed by the City af C?earwater. � a�.sQ �ee�, the z�a��,en� may have an e�.ement af s3.eep apn�a wh�.ch is contributing to his inte�itt�nt hygoxia anci ��condar*� �rythrocytosis, � r�commend this patient avaid any si�uatiori which wou�d grovi.de continued smoke expasure. This wauld �.ikely J.ead to. pragressive ��wd? ��u?�o�!�� disease. I also suc}g�st this pata.ent see a pul�nona�,ogis� to �u�.�y evalua�e hi� respira�o�f c���ci�Y .^_'h�.s would inc�,udz �ormal, pulmonarv �unction �es��ng, arterial blood gas testing, assessment Qf carbon monoxid� level.s, and di.��usiun capa�i�y. Se shauld also be consider�d �or a s�.eep study ta s�� �aheth�r this is a signiza.c�nt cantrzbu�ing �.actor. Tha.nk �ou �c�r al�.cwi.ng me to parti.cipate in th� ca�e o� �his g�ntleman. i wi�.I b� happy to s�e h.�m again at yvur requ�st. F�.�ase fee,� �ree to contac� m� if turth�r infor;nation is reau.z.w�d. Sincere?y, , � �� J��tr� L. Paonessa, id. D. _ . . ,.. .. . , . ,.t'. ..';.:; . . , .;-�:.:... ;�, �..�,_ . , . . ... . . .. , . . � ,. �i i e , ,f , . � . , , , , . , ,; . . , , , • 's�t�>.i.. . .. � .. . , .. � .. . . ., ,. ' ' . ' . � ' �. � r t.- . . �r . � � ' . , � � � . . , ' . � �'. CITY.OF.CLLJiI2.}iISK.MGI�fi B13 4&2 iS?3T, P.01 ,. • , • - �..�,,..-.- ., .. ,.. .. , . • . - - r, . , . . . . , ' � • �ost-!t~ brand �ax t�4nam�tlal memo 7'L�7t i a� u•a•► ► � �'lqST F#��' co. —� a, aENr ra ai�i4iok prvEarow A�c'O pA?G tlORtpA OLPT. •VI. ^�^•" �T 7'U DTVTSxC�r aV�a�or� .,�. , . aR� .. . •� •- � ' I�nr JUL, � � IJJ� a+ i R�Onn R11 p���se�R�Nra�avp�OSHr'�� Lld Eb.1FLDY�EIliFOHMA7lDN s , � � . . � : r. r i ; ElAPLQYER INFDRhiAT1QN � � C T O�' CL W R �• r on ey �.r ca+sn►,r r+�,ue: .- -.�,_—......�_,.._. ._. 5 9 6 Q 0 0? S 9 � � Q S/ 1. 9/�. 9 9 5 � � o.aa.e _..... ......�.__.___.� ._..� _ tpt.cpR B�A ;i�L...'lX...' �'.�� .. n y1 ���+ I a�:C�,�:ARWAT�R s,.,,��`L n,� 3�616:�� MUNZC�PALSTY I �C�LrnDNE �e., cdi. �k�..� '~ , 4r1lT�cFxf�CrS'fi � r ! / ! VES ❑ NO " � Eu+'tJ}+��`Oe1� N P �t���� WST OATE E��PL4Y�� YfCRK�p , WI�� YOU GONT{yUL TO PAY YlAGES IN:,fFA t;3.'1' Y U OF wORISEFiS' CdMPT Y�TS E PO BOX • 47,d.8._�.._........_...,...... .............. 07 28 1995 :� , s�..r � ,,_+.........r�_._. �• u�sr oar wnces w��t n� cAiv �r�sT��a nF , r�:CL�e RWA'�'£��..._. ��_».FL _..�....3 �S'6��'_.. .o pETUAHEO Td WdPK ❑ Y�S,[] NO �'lQRXERS' GO'��P ! � �OG+�r� • v{.oru�.r�.� Iy%�• _•••—` •••••••••••••••- 1F YES. GIV£ A�78 1C PATE OF PAY '`�] HR x[� WiS i �u�CE CY �CC�o��+r ISr„�. Citi s�.�., r• �'. � , r � f F'E� �.] �AY ❑ MO ! CITY OF CL�ARWr�T£R _..____,_,�..r._— ..,, ,,. .�._...�......_.r..—..._..._. DA7� QF OEATH (it appue■6�e) r uma�ir o�f aurs nar any _"'$T�- � S*.+t �,,.�.. --__. , .. ,,,..�.,,,_,_�,.,_.._ _ r ! tdum6er al houri pnt w��k ,_t"'J��_ i '�qr: �,,..� _,..,.�! _ sus�: ,.__.. ='a: .,..,�.,_�„_, �oAfE Y�tNaEstA�aild� pF ACC�C�+if Ylumher ol d�yx per w�ek E CDUN17 or' ACGa�Ht� ' � YES C� NO NAMF, AOORE55 AFJb Y�i,��'HO����� ' � „ny ��r� w e,''Fn�winy(y nn wiff� m�i 1-n �r.,� . esu , o� �o"+�v� �ny omp oyw vr amp oyor, OF PµYSIC1AN t?R }IOSFIiA! ! Inwr�ne� corop�ny� or i�1!•In�ur+Q proflr•m, �ilu� � d.l�m.nt nf CIllnt COn1111l11h� ►ny lair� of Ail�l�adlnq I��ix$ �'ERlIAtiD���i �t�.i � i inlorm�l�vn 1� qWqy at • lnny o� Iho Ihlyd d�qr�o. I hpr� �wi�N�J, undn� nd d �ck�l.dg� Ih• i�hav� slal�m�nl. .._.., �. ......._._....... --- L_.���� , , � � � W..._..._.. ; Ew�tovEE Sicr���uat ri.•,a.s�. a yay , D E . � � — ; � ��.__...___..�___. . �...��L � G�1�LOYEIZ SiC✓iA7l;nE ...���. ��... �IF ._.��--� AllTNLWIZ40 BYiHV�(}Y(R `�] Y�! � HO � ' CAARI�R ltIFORh1ATlOt� � ❑ �. C�s� 6enlcd••DWC•�:. Notice ai Oan�d Akioehad Q 2. bSedical On1y'+.hich hseam� �ptt Tlm� Ca�e {COmp4e1� ntik {nla in /]1 , � �. Laii 7im� Ces� -. f st Cny at d��ah�tll�� �g.j��f S�tnry conl�nued In tleu'of camp7,� Y� ; �elary £nd Qate _�1.�_ I,_„ � bnle Rlnt Peymant Mn�Srd ,_�� ! �� Coma Rale „�r�_ � ❑ 7,i, ❑ 7.7'rEG"C � T.p. �j L8. ❑ P,T. {� Oenlh � HEl.tAFiiC3: �` . �.. � � GMR�E�CC�OC � I SCRNCE COrtr� CCqC • • ����-ao � LGi O�m n4•� 1165�1 � CARRI�a ��nr,tE, AODRE55 � �ELE7HqNE �al�rti4niS/.rL�S3cctf �µ�1,�7� R�S�:C�CpG CTxY OF CLEARi'7ATER Po Bo:S a748 ZZ!]3. CL�ARti+�ATER P�'.. 3 R G 18 �A�,t� �� • � ( ) �162-6754 1�. i ,I� empinv�f Crl!•�nfurrd7 '[j '!�5 ❑ ti0 �nftnt: � r,r,nv