06/17/1999 (2)
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PAC
~ension Advisory Committee
Minutes
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PENSION ADVISORY COMMITTEE MEETING
CITY OF CLEARWATER
June 17, 1999
Present:
Brian Aungst
J. B. Johnson
Pat Greer
Pat Shepler
John ScaccB
Dick Fitzgerald
Ed Hart
Chair/Mayor
Vice Chair/Commissioner
Committee Member
Committee Member
Committee Member
Committee Member
Committee Member/Commissioner
!
I
Also Present:
Leslie Dougall-Sides
Scott Christiansen
Rick Ebelke
Patricia O. Sullivan
Assistant City Attorney
Pension Advisory Committee Attorney
Human Resources Assistant Director
Board Reporter
, The Chair called the meeting to order at 1 :33 p.m. at City Hall.
To provide continuity for research, items are in agenda order although not necessarily
discussed in that order.
ITEM #2 - Aooroval of Minutes
Member Johnson moved to approve the minutes of the joint meeting with the
Pension Trustees of March 26, 1999, and the regular meeting of May 13, 1999, as
recorded and submitted in written summation to each board member. The motion was duly
seconded and carried unanimously.
ITEM #3 - Emolovees to be Heard
Senior Accountant Pat Buzek expressed concern the Pension Plan discriminates
against employees who are older than 45 when hired.
ITEM #4 - Action Items
a} Review and Action on Employee Requests for Years of Service Pensions:
1. William H. Weller - Police Officer, Police Department
Member Johnson moved to approve a Years of Service Pension for William H.
Weller. The motion was duly seconded and carried unanimously.
b) Review and Action on Requests for Survivor's Pensions
1. Jacqueline Pedley, widow of James Pedley - General Support Services
I
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Member Greer moved to approve a Survivor's Pension for James Pedley. The
motion was duly seconded and carried unanimously.
c) Approval of New Hires as Pension Plan Members
It was requested staff continue reporting changes to employee status for those who
move from part-time to full-time positions. As of June 7, 1999, the City has 1,645.4 FTEs
and 1,750 budgeted positions.
Member Greer moved to accept the following employees into membership in the
Pension Plan: '
Date of Pension
Emolovment Ella. Date
Jarred Stiff, Police Aide
Steve Ussery, Tree Trimmer
Shoba, Sridaran, System Analyst Prog.
Florence Reichert, Accounting Clerk
Randy C. Higgins, Sol Waste Equip. Oper
Police Department
Public Works
General Support Svcs.
Planning & Dev. Svcs.
Solid Waste Department
03/01/99
05/22/99
05/24/99
06/01/99
05/24/99
04/24/99
OS/22/99
OS/24/99
06/01/99
OS/24/99
The motion was duly seconded and carried unanimously.
ITEM #5 - PendinalNew Business
",,#.)
a) Lester Rent - Hearing for Job-connected Disability Pension
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Jeffrey Lebo, representative, said Lester Rent has requested a job-connected
disability based on the injury to Mr. Rent's right knee on October 21,1996. He said Mr.
Rent has met all requirements. The injury occurred at work and the disability is permanent.
He said Mr. Rent's attempts to perform other work for the City have not been successful.
He said Mr. Rent's condition is worsening as further degeneration of his knee occurs.
Assistant City Attorney Leslie Dougall-Sides said the Pension Plan requires job-
connected disability claims be denied for injured employees who are able to perform useful
and meaningful work for the City. The Human Resources Department has determined Mr.
Rent is qualified or can be trained to perform other positions. Mr. Rent has been rotated
out of an alternate position due to bad attitude and behavior problems unrelated to his
disability. Workerrs Compensation rated his disability at 12%. Medical evidence indicates
Mr. Rent cannot climb stairs repeatedly or walk for more than 4 hours. As he has passed
the Accounting Clerk test and is able to perform meaningful work, Ms. Dougall-Sides said
his request does not meet Pension Plan rules.
Mr. Rent reviewed his 25-year employment history with the City. Before his injury,
he had performed physical work, which required him to stand and walk for 8 hours. He
said laser surgery to his eyes in 1993 treated an aneurysm. He has limited peripheral
vision and wears special glasses to limit the strobeMlike affect caused by fluorescent light.
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06/17/99
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Mr. Rent said prior to his on-the-job injury, he was active and able to perform his
job. He was injured when walking up an incline at the water treatment plant. On
December 9, 1996, John Fraser, M.D. performed an arthroscopy on his right knee and
noted a torn medial meniscus. On June 10, 1997, Jeffrey L. Tedder M.D. performed an
arthroscopic procedure on his right knee to treat a residual medial meniscus tear. Mr. Rent
said he received physical therapy until May 3, 1999. He said he no longer can work at the
water treatment plant due to the large number of stairs there. He said the golf cart the
City provided does not help him climb stairs. He said he fell and injured himself recently
when climbing off the golf cart and when painting a tank.
Mr. Rent said he has attempted to fill otlwr jobs and had felt he was performing well
in a Finance position until sexual harassment and weapons charges were flied against him.
He said the lighting in the room had a negative affect on his job performance. His current
position as a painter requires him to move too much. In response to a question, he said his
disability request is based on the injury to his knee, not his eyes.
Ms Dougall-Sides introduced City Exhibits related to Mr. Rent's request for a Job~
Connected Disability Pension: 1) application for Disability Pension (Exhibit #1); 2)
interrogatories to applicant IExhibit #2); 3) first report of injury or illness - incident date -
October 21, 1996 IExhibit #3); 4) related history, prepared by Human Resources Manager
Cynthia Bender - May 1999 (Exhibit #4t; 5) medical & operative reports - December 1996 -
March 1999, Doctors Fraser, Tedder, Florida Spine Institute, et allExhibit #5); 6) Morton
Plant Mease Functional Capacity Evaluation - November 1, 1997 (Exhibit #6); 7)
HealthSouth Work Capacities Assessment Report - November 6, 1998 (Exhibit #7); 8)
Milton C Cason's December 22, 1997, memorandum to Mark Poteet regarding Mr. Rent's
light duty performance at Clearwater Gas System (Exhibit #8); 9) Scott Shuford's January
29, 1997, memorandum to Ken Gilmore regarding a 'commendation for Mr. Rent, Operator
Class C (Exhibit #9); 10) Jon Marcin's December 15, 1998, letter to Jeffrey Tedder, M.D.
(Exhibit #10); 11) job duties information for A Side and B Side WWTP (Wastewater
Treatment Plant) Operator positions (Exhibit #11); 12) lME (Independent Medical
Examination) Report, Orthopedic Associates - May 26, 1999 (Exhibit #12); 13) job
descriptions - Accounting Clerk; Custodial Worker; Service Dispatcher; Maintenance
Worker I; Marine Facility Operator; Library Assistant; Parking Attendant; Police
Communications Operator Trainee; Police Service Technician (Exhibit #13); and 14)
affidavit of Risk Management Specialist Jon Marcin (Exhibit #14).
In his October 16, 1997, Worker's Compensation IME report, Andrew C. Maser,
D.O. reported Mr. Rent seems more suitable to sedentary work that requires no stair
climbing. With proper technique, the doctor indicated Mr. Rent-:- could lift in the medium
capacity range. Dr. Maser recommended Mr. Rent not do work that requires him to get
down on the floor or pick up objects from the floor and place them on overhead shelves. In
his Apt';l 27, 1999, follow-up letter, Dr. Maser stated Mr. Rent would have to be retrained
for a more sedentary job or any other job that does not require significant stair climbing. In
his May 20, 1999, IME report, Harry Steinman, M.D. reported Mr. Rent should be restricted
to light duty where he lifts no more than 35 pounds, walks to no more than 4 hours a day,
does not climb on ladders and avoids stair climbing.
mpac0699
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Human Resources Manager Cindy Bender reviewed the responsibilities of the Cityts
Care Team, which evaluates employees, who can no longer perform their job duties due to
no fault of their own, and finds them other work. Mr. Rent completed a Work Capacities
Assessment at HealthSouth on November 6, 1998. The report indicated Mr. Rent was
functionally capable of returning to work as a plant operator with the exception of stair
climbing. The City then assigned Mr. Rent to an Accounting Technician position for the
Gas System. He began taking employment tests. When the Gas System position was
concluded, he was transferred to a light duty position in the Engineering Department's
office. Mr. Rent also was assigned as a Marine Facility Operator at the Pier 60 bait house
for non-traditional shift work. Although reluctant, Mr. Rent worked at the position for one
day and was reassigned after he complained about pain to his knee. Vocational testing at
SPJC (St. Petersburg Junior College) demonstrated Mr. Rent's aptitude and interest in
accounting and engineering work. In January 1998, Mr. Rent passed the Accounting
Technician test.
Mr. Ma~cin said staff had arranged for Mr. Rent to take worker's compensation paid
courses at SPJC, including computer and keyboarding skills and accounting. He was
placed in a temporary position in the Finance Department, to be trained and transferred to a
permanent job. When Mr. Rent had difficulty with an accounting class, an in-house mentor
worked with him to pass the course and helped him with his job duties. After 3 months in
the Finance Department position, Mr. Rent was reassigned to the Engineering Department
while Human Relations investigated a sexual harassment complaint brought against him by
a female employee. Mr. Rent did not appeal the resulting one.day suspension (decision~
making leave day), which is the final disciplinary step before termination.
Mr. Rent completed a Functional Capacity Test at Morton Plant Mease Hospital on
November 1, 1997, when he no longer used a cane to walk. The test concluded Mr. Rent
is able to work at jobs rated light to light medium. Staft continued to search for alternative
job assignments. Mr. Rent currently is assigned to light duty at the water treatment plant.
Ms. Bender reviewed positions staft feels Mr. Rent can perform successfully, Accounting
Clerk, Custodial Worker, Library Assistant, Maintenance Worker I, Marine Facility Operator,
Parking Attendant, Police Communication Trainee, Service Dispatcher, and PST (Police
Service Technician). The City has current vacanci~s for PST, Custodial Worker, and Marine
Facility Operator positions. Ms. Bender submitted a summary of staff efforts to assist Mr.
Rent. (City Exhibit #41
In response to a question from Mr. Lebo, Ms. Bender said while Mr. Rent had
performed physical labor for 22 years, he also had exhibited problem.solving skills at his
plant position. When Mr. Lebo suggested the behavior of physical laborers differs from
that of office workers, Ms. Bender replied that vulgar language is not appropriate in either
setting. Mr. Lebo said Mr. Rent had shown good faith in trying to meet the work
requirement but the City had not found him a position he could perform successfully.
Financial Services Administrator Margie Simmons reviewed Mr. Renes performance
in the Finance Department. His supervisor had indicated he was learning the job and felt he
could be successful. Ms. Simmons stated Mr. Rent had told her he could not believe the
City was putting him through this aggravation instead of approving his disability pension.
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In response to a question from Mr. lebo, Ms. Simmons said Mr. Rent was punctual but had
conflicts with other employees.
Mr. Rent said his Gas System position had nothing to do with financial statements.
He said he also had installed and removed signs around the City. He said his knee had
swollen after working one day at Pier 60, as he had no place to sit. He said employees
ridicule him when he paints, sitting in a chair. He said he had performed a physically active
position for 22 years before his injury, which causes his knee to throb at all times. He said
he cannot work when taking prescribed pain medication.
Mr. lebo said Mr. Rent had met his burden, proving he qualifies for a disability
pension. The injury to his knee is permanent. Mr. lebo said few of Mr. Rent's job skills as
a physical laborer are transferable. He said it would be unfair to deny the request after Mr.
Rent's 25 years of service. Ms. Dougall-Sides said the applicant has not met his burden of
proof. The IME indicates Mr. Rent's disability is limited to his inability to climb stairs or
walk distances. She noted Jeffrey L. Tedder, M.D. had reported Mr. Rent needs to be
trained for an alternative job or be allowed to retire. She said no medical evidence was
presented that indicates Mr. Rent qualifies for a job-connected disability pension. The cost
for the City to add lifts to the water treatment plant to accommodate Mr. Rent's injury was
estimated to be as high as $36,000 and found to be too expensive. Ms. Dougall-Sides said
Mr. Rent is capable of performing meaningful employment for the City.
In response to a question, Ms. Dougall-Sides said Mr. Rent qualifies for retirement
after 30 years of service. In response to a question, Mr. Rent said his right knee had not
been injured prior to the 1996 accident. In response to a question, Pension Advisory
Committee Attorney Scott Christiansen stated Mr. Rent cannot be required to have surgery
to improve his knee. It was noted Mr. Rentts salary had not been reduced since his injury.
It was felt all City positions require dealing with people. In response to a question, Mr.
Rent said knee braces were not helpful.
Trustee Hart moved to deny lester Rent's request for a job-connected disability
pension. The motion was duly seconded and carried unanimously.
b) Louis G. Nemeth - Hearing for Non.job-connected Disability Pension
Member Johnson moved that louis G. Nemeth be granted a Non-Jab-Connected
Disability Pension effective on a date to be determined based on Mr. Nemeth's disability
which is described as throat cancer; this problem making him permanently unable to
perform his job and documented by numerous medical statements of Robert F. Geisler,
M.D., Eric Haynes, M.D., and Joseph M. DeFelice, M.D., IME physiCian, with
accompanying dates of all the doctor visits and fitness for duty evaluations at lakeside
Occupational Medical on May 18, 1999, and Professional Psychological Services on May
27, 1999. The motion was duly seconded and carried unanimously.
c) Glenn Weaver
AND
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d) Georgette Sunimarell
AND
e) Camille Motley
AND
f) James Kleinsorge
Concern was expressed approving pension buybacks for less than the actuarial
amount outlined in the Code will harm the Pension Plan.
Trustee Greer moved to rescind the PAC (Pension Advisory Committee)
recommendation to the Pension Trustees to allow David Krieger fmd Leonard Marotta to
purchase buybacks for reduced rates in violation of Pension Plan rules. The motion was
duly seconded.
Andra Dreyfus, representative for David Krieger, Leonard Marotta, Glenn Weaver,
'Georgette Summarell, Camille Motley, Kenneth Donagan, and James Kleinsorge, objected
to the motion. 'It was stated approvals for buy backs at reduced rates violate the rules of
the Pension Plan. It was indicated the only special condition related to these requests is
financial. ' Ms. Dreyfus said it was inappropriate to consider the buy backs of Messrs.
Krieger and Marotta at this time as the Pension Trustees have agendaed the case for
discussion at tor:lay's meeting. In response to a comment, it was indicated the Pension
Trustees had never voted on a failed motion to return the issue to the PAC.
Upon the vote being taken, the motion carried unanimously.
Trustee Greer moved to recommend the Pension Trustees not consider any buy back
requests that do not meet the rules of the Pension Plan. The motion was duly seconded.
It was stated unless the plan is changed, the boards must meet their fiduciary
responsibility to the plan. In response to a question, Mr. Christiansen said the Plan's two-
year bUy,.back window could be extended without harming the plan. Ms. Dreyfus stated '
the PAC had not heard evidence related to claims by several employees. Mr. Christiansen
stated buy_backs were not permitted before 1996, when the subject employees' breaks in
service had occurred. The 2-year window, opened in 1996 to permit buy backs, has
expired. Ms. Dreyfus said a buy-back procedure has been in motion for several months. It
was felt these requests are based on the desire to lower the buy back rate.
Upon the vote being taken, the motion carried unanimously.
In respons~ to a comment, Ms. Dougall-Sides referred to the minutes of the April 8,
1999, PAC meeting, indicating she had reviewed the Plan's rules for buy-back rates.
mpac0699
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It was recommended inconsistencies related to Pension Plan death benefits be
reviewed.
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g) Eafly Retirement Issue - Continued to July 14, 1999.
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ITEM #6 . Director's Reoorts
The Board Reporter was informed later that the next meeting is scheduled for July
14, 1999, at 2:00 p.m.
, , ITEM #7 - Board Members to be Heard
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Trustee Greer said it would be unfair to judge Mr. Christiansen's attendance based
on theshheduling of a last minute meeting.
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, Mr. Christiansen requested a discussion of new 5,tate legislation be agendaed for
July. It was requested related language be distributed prior to the meeting.
, ITEM #8 - Adiournment
The meeting adjourned at 3:23 p.m.
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Pension Advisory Committee
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crrv CLEARWATER. n.OIUOA
EMPLOYEES PEHS40N PLAN
APPUCAnON FOR DISABIUTY PENSION
(Please type or print In black Ink an klfonnatlon. oxcept signature. Use attachments if needed.
Be lure to clearly Indlcate for each attachment the relovant quostlon to which the response Is
made.)
Name:
Lester Rent
Home Address: 1148 Granada street, Clearwater, FL 33755
Stroet
Telephone Number: Home:
Current Job ClassificaUon:
441-8396
City, State and Zip Code
Wof1c
/~WTP Operator C
OepartmentlOivlsfon:
Engineering/Water Pollution Control
:;
1. Type of Disability Ponslon Applied For:
l Job-connected x
No n.Job-connected
2. Mecflcal condfUon for wfdch dlsablflty pensIon Is being sought. Be apecfflc and
Include any dtagnolll made of condition, name of doctor making dlagnolts, and
when and where made.
The (enn medical condition Includes psychologJcaVpsycNalric eon<frtions. as weD as
physical condItions or impairments.
I J-.I ~(I,e Y TO ~ !<'Pc(;. )/0 me',v/5C(/'S i//s~ /..EFT I~ K~cC: CJft l/e7!Y
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De.. rcbfJt'-J? ~~/a~91. {Jtt_19~ASE,e 8-/9-(j7
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3. If request II for Job-<:onnected disability, complete the foDowfng (even If you have
attached a cop~ of an Injury report or a notice of Injury):
8. Date and time of acddenVinjury: .I0~~/-9C
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b. 'Nhere accfdentllnJury occurred (physfcar Iocatfon): It; /)1/1/?5'}/NJ 57; tv.:.vT P...
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c. How accldentlJnJury cecurred (be very speciflc): wAtt"1 ~ "f' liP IpClIl,.,;~ I~
PAt/ePUJ",<.7f", t!A/lfe' TO L.E"lA::r1.. t1f;"C'A f' 12, ktVt:G' tv6-pf rtJ r11t!" ~,
d:;:' f"E/..t TO THe '-Crr.
d, If there were any witnesses to the acddent/InJUIY, list thoir name., Indlcate If they we..
City employees, and descnbe your relationship to witness, if any. ~ )
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8. Was medical treatment sought and provided (list date, time, place, and name of
attending phystctan and hospitaVclinic)? Yes -K..- No
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,f. Has a WOf1(ers CompensaUon dalm been ffled? Yes ~ No
date and claim number.
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4. For either type of dlsablnty pensIon requost, answer the roDowfng:
.. 'Nhat limitations, if any, have been placed on )'0\.1' physical actlvftles 81 this lime?
Explain who placed the nmitaUons on you, what they are, when they were ~ on
you, and if they are considered to be pennanent In natLn. ~p p~"t (}~1!J1) I t.Wf4!.l:'tJ..;6-
.7111/f/])/A/(;, lie,,"")' ~h&;;-/""'~,J Cllpt6lP~ -sI/9/"es' d,t! ~~/)IJJi"lf!.~ ~J>JJV'q
'S"ooP/,(/~ ;!6S/;.It:- rI1ll./'~~ 1.4;64~~~ 6p ~C"f' t'SL.i"R"~Y 5U':I"';'tCt!iY} PIII""rJI--'t:.
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b. What 'Dde( job duties or tasks are you unable to perfonn In your job 8S . result of the
medica! condiUon which Is the basis for your disabffity claim?
CAJ./ ~C1' D(/6 IU~ ~,. P~t.'!5C~ -rod, S-rfllJ€ Ct:./f7119/J'-"t::."' ~IFlIIV~ "vy
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4' (I /G #1 &19/VltffJf! C i. /#1 A/IV~ r p~,y,l/~ r" ..e.-/-fj I'RCltJ,c/(; ~A l~ ~,v6 .f' srA.,vA'~t:.
~~f(/Ilt/t:"/~ t'J,\/ P"e7' (' :sLIP,Pe~Y siJ.Rr/1c~SII'Il/vrl/V~
c. Other than In the performance of specific job duties 0( tasks you Isted In ,.. abovG.
describe any other kinds of deficiencies that exist 'NUll respect to your servJce in your
job that are caused by your medical condition (example: reguiar attendance).
,)
d. 'Nhat medicaUons are currently being taken (be speeiflC)?
Name of
MedlcatiOJl
PEPf: I /J
puroose
Or. Prescribing
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e. As a result of the accidentJlnjury. was ;suraeiy recommended? Yes L No
If "yes,. indicate who recommended surgery and when they recommended it be done.
O~ F{!~sc<< (lJV I~"" 9-'1& f p~ retV~.R iJ,v a-/(J-97
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f. As. result of the acddentJ1njufY, what .urgeries, if any. were ,crush oerformed,.
Indicate v.tlo performed the surgery, when and where it was perfonnecl, and v.1lat the
results of each surgery performed were.
DIZ r!?//:;,5"jf ov /11. - 9- 9'~ 1!6'11"~ "r d/'ic,e rl9~ eJr" /ff,s:J.45l:4::.~ OI5,t'
Il( tAt~() P1CO/C/'lt J D;g (cj)P!"e d,t/ ~-/I). ?7. R&1()VAt. ()~ r~d~ tV="G(//$[;c;.s
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g. Have you ever had an ,accident, injury. or medical concfrtion of a stmDar nature to that
which you defined In Question Number 2 or Number 31 Yes .L No
If yes, descnbe, beblg specific 8S to when, where, and how.
h. Did you ever have Ihls same or a related med"fC8J cond"rtJon prior 10 ycu employment
with the City? Yes No)l. If -Yes, - descnbe what and when.
I. Have you ever suffered an Injury to the same part of the body for whk:h this dlsabUity
applicaUon Is submitted? Yes No)t' If -yes,- atatI date, place. and
cilcumstances of each such InJury that occurred and 1st any dalms which were made
for such Injury and their result. .
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1. Have you ever appUed for 0( received Wcx1ters Compensation benefits 'due to or as .
...,sult of any ledcfent. ~, or medical condiUon? '
Vel X No
k Have you ever eppned for or received Veteran I Admlntsltatlon NA) mddlcal benefits?
V.. . No ~'
I. Hav. you ever appned for, whether by suit or otherMse. any type of Insurance
proceeds or sottlement IS I result of an accident, InJUIY, Of medical condition?
V.. No X
m. If you answered -yel,- 10 1\.-". or T above, Dst each such instance: When It occurred:
what Indivfduals, agencies, orlnsutance companies were motved; and when and what
benefits or settfement went applied for and received. (Attac:h addltionaJ sheets If
necessary, dealfy Indicating the question forwhJch the altachment Is provided.)
uJ \ C.tl~ o~ C ho. y uJ~~V" ~ 0 +.c -tr..J d wee Ks
\
5~ If this .ppncaUon for dIsability pension benetlts Is based on . psychIatric or .
psychological condition, have you .ver been diagnosed .. having this lame
condlUon or any other psvchlatric or psychofoglcal cond1tlon prIot to or duling VOW
omp'oy~nt with the City?
V.I No 'K If-ytls,- state what condition was dagnostd. by whom. when.
and where.
"" "'"
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,.....
.' ~
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I. Provide any other InfonnlUon you want the Pension Advisory Committee to consIder
In making a decIsIon on your appUcaUon for disability pension benef1ts. Attlch
copIes 0' Iny documents you want the Pension Advisory Committee to consider.
!.--\
....._~."'I .
I HEREBY SWEAR AND AFFIRM that the lnfonnation contained In this Application Is true and
corred to the best of my knoY.1edge.
ilJitv I%d ~-cJ.r-97
Employee Signature Data
STATE OF FLORIDA
COUNTY OF PINELlAS
The foregoing instrument was acknowfedg9Ji before me tis
~"S eJ: ~J ' 1'191 by LesJ..e", Ke YJ {-- who
is personally known to me or who has provided
a j) ,...' () t'v <<i. · L / c ~ Y1!" e as identification and
v.tlo~n~~ _ NolalyPublc
'])e bd~JJgrF;rcl
(Name of Notary Printed)
My commJsslon expires:
O~rlr1~
I""""-I\L NDrARYSEAL
NOTAR"( ~~%..AH L FORD
COMM ;SSfO;[ ~ or- ry.Of:lDA
MY CO.\fMISSIO~ --P.' CMCSSs09s
, c-^. A Y IS.2ln)
>,,;J
....f.-M
I'ih~ ~"DWiIiIJ"'"
Far. HfOO.
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crrv OF CLEARWATER
EMPLOYEES' SEPARAnON PAY PREFERENCES
PREFERENCE "
Employees can receive a lump sum payment for vacation, floating holiday pay,
sick leave Incontive, bonus days (if applicable), and 1/2 of accrued sick leave
at the time of separation 'rom the City. There will be no deduction for
pension from this lump sum payment nor will this amount count as earnings in
the calculation of the pension. The last day of work will be the termination
date and pension benefits will begin the following month.
Employee can extend termination date by part or all of the time due for
vacation, floating holiday pay, sick leave incentive, bonus days (if applicable),
and 1/2 of accrued sick leave. Employee may choose to run out this time in
any manner. Balance will be paid in 8 lump sum on employee's final
paycheck. Termination date will be the final day of extended time. Pension
benefits will begin the following month.
Only 8vailabfe to employees hired prior to 10/1/90 or Fire bargaining
employees hired prior to 10/1/88.
Police bargaining omployees can split their accumulated sick time at one-
quarter pay and one-quarter Barly retirement time. That portion received as
one-quarter pay will have no deduction for pension nor will it count 8S
earnings in the calculation of the pension. The portion applied toward early
rGtiremen~ time will be subject to the pension deduction and will count as
earnings for pension calculations. Termination date will be the final day of
extended time; pension benefits wi11 begin the fonowing month.
Only available to ponce employees hired prior to 10/1/90 covered by the FOP
10 or the Sergeants and Lieutenants labor contracts.
PREFERENCE '2
PREFERENCE '3
.
I_ Lester Rent , sn employee of the City of Clearwater, hereby apply for
pension benefits under the City's Employees' Pension Pian.
I hereby certify that I fully understand the preferences offered to me. I choose to retire using separation
pay preferem:e , d and wish my benefits to be calculated under this preference. Please use my
leave in the following manner:
Run Out vacation
Lump Sum vacation
~y- (Jll
I understand that my preference cannot be ch ged once this form is signed and that my decision is
irrevocable.
sick
sick
floaters
floaters
bonus Hours
bonus Hours
EMPLOYEE'S SIGNATURE: ~~
SOCIAL SECURITY I: 353-40-6442
I
..../
ADDRESS:
1148 Granada Street
Clearwater, FL 33755
PHONE: 441-8396
DATE:
8/25/97
ftevlHd .7/1
Fonn 18110O-OOOI
fie Name: ~ Separation P.., Prl'f
.
CITY or CLEARWATER
STATEMENT or RESIGNATION
"j
..~
.. ... ..
Lester Rent
WW'l'P Operator C
~ emplo)"ed . or
...
Water Pollution Control _ Dlvbloe fit r
Engineering
" .
Departascat cIo bcrcb, re.I,1 Ito. dM: unlet 01 dat CllJ 01 Clurwaur. I nqHtt thll 6It
""patlol .. dllIJ acccpted ., ., Departmcat Reed ... elM AppoIadl' AulhodtJ It keo..
. ,.. Pension Advisory Conunittee.
.n"OdIvt >01 ,upon .ap~roY~l o.f IllY ~hsa,1=Wt':::-ty.. penSJ.on by ..th'1\~M. ..~. ",I!Orl for 1118
. "'IJIWIH Is as fonowa:.. i.~:. ':'.:~:: ~: :~..~)
~ ... ~ ....... . - ... -. ....- ~ ,.
. . . .... -".. .---. ...-.
,-
. "
Retirement on cifi'p~~si~i1-: .~... :.,~. -,'f- '
.. ~ l
. ....
.'
l!aap1oJM., SllDltare ~ ~ .
r DIll "pod -B125/97 .
-",
DRPARTMINT ACTlOII,
.' ~\ Approved., Dlvllloe Held
, -'
DlYleloe Head Com.~ (Opdoul)
_ .:.! .-. ~. ...~~~.n..~~.:.
LL
...DIIa
.......
AJ'P'Oved ., DepaltlNai HeM
De,.maeDC Head Commeall (OplJooaI)
Dete_
1
ACTION or APPOINTING AUmORITY
....
! aece,. d1b resJpltJOtI 10 become effecdva oe the date 8!IC1 at the ttBC sbowa sbow:
.' .
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AppoJD'Ja. Au'bodlJ
Appolarlal Autho~~'~ C~~meD~ ~ (OpUo~) . "~_:
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..... ,
1IIPIJRTAN",..-pn)JIk. i\e reIIOII iOf 61. frcll~ must Dc IlMrd III ale .pace ~~ ~
011..... fora. whet IIIDC4 ., ... employee ... Ibc dlvltloe. ad dcplltlDeDe ki(~ '.. 10 lie
attKW to the penoflDeI actio. Ihcet ad forwarded to HuDWI ItctcMIrccI. I'enoutI acdoe Ikd
.... ICIIecl the lIat... 01 Ill' CllJ lDoDJea d.. 10 or ., dab cmploJce .. acconfADOlJ willi .., Civil
~""Rlllel and coDecllft bar"IIDI". ...reemeDtI c.neDd, I. etrecc. ..........
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CITY OF CLEARWATER
NOTIFICATION It RELEASE FORM FOR MEDICAL INFORMATION
I, Lester Rent an applicant for dIsability pension
under provisIons of the Employeos' Pension Plan of the CIty of Clea~ater, hereby
authorize any physician or other medical care provider who examines or treats me
or who has examined or treated me or who in the future examines or treats me to
release any and alf medical and related records pertaining to me to the City of
Clearwater's Pension Advisory Committee, Pension Trustees, Human Re'sourc8s
Department, Payrofl Department, or authorized empfoyees or agents of the City of
Clearwater, Rorlda.
ddi:.~
Signature
tf- tf )"-9 )
Date
STATE OF FLORIDA
COUNTY OF
PINELLAS
The foregoing instrument was acknowledged before me
this ,;15 off?!' /9 'l7 by
i ~s f. fy- I e r-} f- who Is personally
known to me or who has produced
F"L j),." verS L,'c.ehse as identificatIon end
who ~Ol take en oath.~
~ ,~ Notary Public
(Signature)
Dehora-/, .L. f7)"..~ 'Name of Notary Printed'
'Commission No.
Rev. 6/96
rom 19900-0013
Notification , Rele... rOEa
OFACIALNOfARYSEAL
DEBORAH L RJRD
NOTARY PUBUC STATE OF fLORlDt\
COMMtsslON NO, CCS55098
MY COMMtsSfON EXP. MAY 15
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CITY OF CLEARWATER
INDEPENDENT MEDICAL EXAMINATION (lME)JOCCUPAnONAL
ASSESSMENT (OA) CONSENT fORM
'I, Lester Rent an applicant for disability pension
under provisions of the Employees' Pension Pian of the City of Clearwater, hereby
consent to an independent medical examination/occupational assessment.
STATE OF FLORIDA
COUNTY Of
PINElLAS
Mev II"
FOrM "'00-
-"'~.:"""""'~'.'" 1Il~ ~':'~~~."'~~:i't:k.i;''''~'T'
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Signature
f'!-~)-97
Date
The foregoing instrument was acknowledged before me
this d.S af' 11vr:" I I '19"7 by
L r J /-rr R rv" I- ' who is personally
.
known to me or ~ho has Droduced
pt ~,t,.ey Sf hc..&hSe 8S Identification and
who ~ a,R. ~ ~~,h. ~
~~~ Notary Public
~ (Sijlnature)
'r!/ebc>,.-a..h L. 4c/ 'Name of Notary Printed)
Commission No.
OI-"flCIAl. NOfAR.YS Al
DEBORAH L RJRO
l\'OfARY P~L1CsrATE OF Fl.:J}lIDA
COMMiSSION NO. c~!
MY COMMISSION EXP. MAY lS
1Mt/Q,\ Connnt tom
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BEFORE THE PENSION ADVISORY COMMmEE
APPLICATION OF LESTER RENT
, for Job.connected Dlsablllty Pension
I
INTERROGATORIES TO APPLICANT
i~. '.
Please answer the following questions under oath and return to the Office
of City Attorney, within ten days of your receipt of these interrogatories.
1. \tVhat is the name and address of the person answering these Interrogatories, and, if
applicable. the person's official position or relationship with the party to whom the
Interrogatories are directed? L..€S1l R R€"I-ff
/ J '19 &, ttl,vrfOI1 S7
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2. Other than physicians and facilities already known to the City, Ost the names and
business addresses of each physician who has treated or examined you, and each
medical facility where you have received any treatment or examination for the
condition{s) for which you seek disability' pension benefits, and state as to each the date
of treatment or examination and the illness or condition for which you were examined or
treated. 0 --F "
Dr", ~-r- FC'y '-. Tc~~c~
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5 r; P!7E/?S f>61!", f:(..
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3. Other than physicians and facilities already known to the City, list the names
, and business addreeses of all other physicians; medical facilities or other heahh care
providers by whom or at which you hava been examined or treated in the past ten years;
and, state as to each the dates of examination or treatment and the condition or Injury for
which you were examined or treated. D(l.. c..vAyl./~ rncco~tt'I reI. R~ t';"Aft- ()If!.
. :pft /C1I(ti"e ,,3() S'".)J vS 19 N SVITa 101 (1- 9 J rl/~v ~ )
')'1tfJ trprs,cPIlI$CjJrt PAtl" tlNl4~~1 F"~ 1rC3f
ClLv(l/~l, 19'.~o!"8
799'-30'-1 I
{u/ftS ptY (Jtz Ffl(Ntf I-51 TO IJ..f.;l)
..,;' 199,). tI tJ.'GA./r ~lfce
Hit D r? ~ 0 I t..Itf1 $f./{l(jl/I!Y AT ~1I-/lN e-)s '1-1dSPI r~(". ,) /Q~J I
,"0" eX-PM ITv6'!-Jt' PltJM"Jl5 ,0 ~C-eCJ{l. rtf'~c'f)",IIN
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4. List the names and addresses of alt persons, who are be'lieved or known by yout your
agents or attorneys to have any knowfedge concerning any of the issues in this
application and specify the subject matter about which the witness has knowledge.
'IF (l.A '- j) /3e1-',vC"ff ,(:?f D o!'IF;e 11 Tt1tf? ,q r PI! 1'9.v7:
".', ,
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, 5. Do you nOWt or have you ever, consumed alcohol? If so, list time periods and
number of drinks per day or week consumed. .,. till V{i' I/ur HA D t'lt'I'I
I1l..cOHt;l. 3,;vCG PIFr 1990
6. List all physical activities which you now participate in (both as to work and'
recreation, hobbles, etc.) and state the amount or duration of such activity which you re
able to do (example: walking two miles per day). (!/('/~(c (ZIIJ IP~ ~ !'lIltS P;!"~w~1
F,/517/t'I 6 J J fI f S P(;~ tv rt"~ '~/7T/~~ I~ A ('titfV'J 'w,4 L/<, /pt:- /f'" w or:. K t/ f&V
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7. Do you ,Intend to call any expert witnesses at the hearing on your application? If so,
. state as to each such witness: (a) the name and business address of the witness: (b)
the witness' qualifications as an expert; (e) the subject matter upon which the witness is
expected to testify; and (d) a summary of the grounds of for each oolnlon. H i..P cF
: walJt.D Lll<tf TO tI.fi.N f?R TG/)J)~"1l "B"""i covtj) tv"..,. ~6-r d ,
1-+ 1M py p/lIJP&; ,
o fl ';fGF/f'cfCY ~~ "TG1:>DEf2.
~ ''-If) It 711 'ST ~
51: PcrtC~S'8v,t61 P'4!.
. '317 at!
8. As to any other witnesses which you intend to call at the hearing on your application,
, pfease state as to each such witness; (a) the name and address of the witness; (b) a
summary of the witness' anticipat6d testimony. )/ lit '
~~
, Signature
STATE OF FLORIDA )
COUNTY OF PINELLAS)
, Sworn to and Subscribed this c!J~ day of November, 1991. by Lester Rent. who Is
personally known to be 0' has produced as Identification.
~ph~
M
f.y..H'~&I~
FIRST REPORT OF INJURY OR ILLNESS
~ rU>RIDA OUT. or lA~' P'1.0YUUfT neURin
, otVllllON 0' WOAKlR" COMPVfSATlON
rOf ...htanc.... tolOO."'I.".'
Of eonIact '"' Joe., u.o 0M0.
R~" d..u-....., z. ~. (11)1) 4"~04.
MCEtVtD I" CAMIIA lENT TO DMa.IOH OMttON "'0'0 DATI
Em' ro nrn:=!r ~~!
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EMPl.OYEE INFORMAnOH
353 40 6442
10/21/1996 ....-.
08 30 cJ",. ON
"M--'~ 1148 GRANADA STREET
o.r.CLEARWATER ,... FL 34615
, ~ ,.,.. c:.- ~
WALKING UP SLIGHT GRADE AND KNEE WENT OUT
M 0'
MAlI'ToU.Ht.. fHA, OCCUMCD
STRAIN
EMPLOYER INFoRMAnoN
596000289
HA' f# tcI01' Nfl!::_
KNEE
c;cuoNtfru.acC.ITY OF Cl,EA.B~ER.
10/21/1996
't Nt
O.aAI ._
~ PO BOX 47.48
LI::i.IU<.WA J.'~ K
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MUNICI PALl'!".!
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813 462 6754 74
l.....sl'I..fl:t~'~ATER LAir OATE EMPlOYEE WORKED
PO DOX 4748 -.----.--..- 12/08/1996
~El'-J1WATER -FL -.-3-4-6*- "
,1,"1;, ~ hr. 8p: _____ AET\.ANED TO ~ 0 YEs NO
\ ~M 0CA11CIN." TU..I..... F YEt, GIVE DATI
I'Um 0l11oCCUNt """" c:a,. s-, ....
YO OttO
WIU. YOU CONT1N\.lE TO rAY WAGU INtTEAO
01 WC)BI(UI' COWl Ii 'Va
LAlT DAY WAGlI WU lIE PNO IfITEAD 0#
YtClRURr cow .
M"W~3 0 HII
. . fa C 01\"
'bnhr., hcura pet d-r
~ofhowl pet noli
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NAMl!. ADOAEas All) ~
OF PHYsaAN OR 140SPtTAL
WIt
p.m
46.6&
S
DR FRASER
n 1'-f~It,
DA_ ~
813,398,0600
~D':~ 0 D..
CARRIER INFORMATION
c... 0InIed-0WC-1t~ NoDcu' D.,.,&aI Alttchecl Dc 2. Medic" 0rIr"'" ~ lott 'rIM c... fCcmp1ete" Wo" ~
. 10/22/1996 1t; '. . ,
3. LMt 111M e...- f.' dl\t of dbablltr ----'--.J_ ~B~"1fv of ccrnp?.w;~ u..y.~, ~ --'---1~
:l-'-Fhl'~ ""'hi '-'_ AYNI ~.....
o T.T. 0 T.T.-IK a f.l'. 0 U. 0 ft.T. 0 0....
REUAAKS:. ,TT 10/22/96, 10/23, 10/24. RTW 10 25 96. OFF AGAIN 12 9 96 AND
CONT. CONTINUING TO PAY FULL SALARY PAST FIRST SEVEN DAYS. .
CAA1UER HAUE. ADORE" . ntmfOHI!
.,
~~'qn ~n IIlSlC cvu CODC EMPl YEln . CITY OF CLEARWATER
PO BOX 4748, .
;'! -"..
7580 9199 CLEARWATER Fb 34618
cwrf't\ CCIlt . " 813 562 4652
574 Ie ~.....WMIt 0Xvn DttO
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~ '.. Prepared 5/99
...
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" ') Lester Rent History
, .'
October, 1996: Injured on the job, knee injury - ligament damage.
October, 1997: Took Functional Capacity Evaluation
October, 1997: Placed in the Gas Department for one month to fill a temporary Accounting
Technician assignment. Was unable to petfonnance any accounting duties
despite being trained by Accounting Technician. The CARE Team (made up
of representatives of the City Manager's Office, Risk Management, Human
Resources, Human Relations, and Organizational & Employee Development)
decided to move him out and send to Vo~Tech for testing.
November, 1997: Took Account Technician test, did not pass.
December, 1997: Applied for disabj]jty pension...working in Engineering on Light Duty.
Signed up for vocational testing at SPJC
January, 1998: Mark Poteet, Human Resources ManagerlEmployment and Testing,
accompanied Lester to SPJC for the feedback regarding his vocational testing.
Public Works says that they have a light duty position open for the rest of
97/98.
,:-) Took Accounting Clerk test, passed.
~
February, 1998: Op'.:ning for a Marine Facility Operator came open. Duties involved
managing the bait shop. Mr. Rent initially e"-pressed no interest in the
position, but did agree to think about the. opening and give answer by
February 19th to HR. CARE team advised to inform Mr. Rent that he may
not be eligible for pension if he refuses a position.
March, 1998: Worked as a Marine Facility Operator for one day. Complained of knee pain
and detennine unable to perform position. Decided to give keyboard and
computer training to prepare for an indoor office position. RM determined
that Worker's Compensation would pay for an Accounting Course at PTEC.
April, 1998: Began typing skills training using Mavis Beacon computer program. Took
three City computer course: Introduction to Word and Windows 95,
Introduction to Schedule and Exchange, and Introduction to Excel.
June, 1998:
Taking an entry-level accounting course at SPJC. Experienced great difficulty
learning the material, so first 8 student tutor was contacted. TItis was
unsuccessful due to schedule conflicts. Signed up for three computer courses
through the City of Clearwater. Practicing typing training in HR for 3/days
per week. 20-30 minutes per day.
::J
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July, 1998
Arranged for Bill Kleinsorge to tutor Mr. Rent on the accounting course
material. Arrangement successful as Mr. Rent passed the class. Mr.
KJeinsorge indicated that Mr. Rent was able to learn the material and should
be able to perform at an Accounting Clerk level. Typing training continues.
August, 1998: Received a oneHyear continuance on his pension request to look for additional
assignments. Assigned to become an Accounting Clerk in Finance Department
on a temporary basis, with the intention of moving him into a permanent
vacancy in the department once he became familiar with the procedures. Mr.
Rent is going to be supervised and trained by a Finance Manager (Steve
Moskun).
October, 1998: Plac~d on administrative leave form City of Clearwater due to making
offensive remarks (hostile work environment) and a violation of the City's
Discriminatory Conduct Policy.
November, 1998: Sent back for another Functional Capacity Evaluation as it was noted he was
· no longer using a walking cane. Evaluation indicated that he should be able to
perform fonner duties as a WWTP Operator with job accommodations and
physical therapy. RM began working with WPCJEngineering to arrange for
job accommodations to be made. Mr. Rent was returned to WPC to perform
light-duty assignment until job accommodations were in place.
Sent to Employee Assistance Program for a mandatory appointment.
December, 1998: Mr. Rent was released to full duty as a WWTP Operator by his worker's
compensation doctor. He is waiting a knee brace.
January, 1999: Mr. Rent continues to receive physical therapy. City is pursuing renting a golf
cart to assist his mobility at his worksite.
February, 1999: Mr. Rent reports still experiencing pain in his knee (via doctor). Doctor
indicates no physiological reason for the experience of pain. City is pursuing
adding stair rails to the worksite.
-March 1999:
Doctor reversed his opinion and now feels that Mr. Rent cannot perform his
former duties as WWTP Operator~ Mr. Rent continues to perform light duty
functions at WPC.
May 1999:
Sent for Independent Medical Examination. Results are pending.
,
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COLUMBIA LARGO MEDICAL CENTRR
OPRRATI:VB RIPORT
DATE OF OPERATION:
PREOPERATIVE DIAGNOSIS:
RIGHT KNEE MEDIAL MENISCAL TEAR.
POSTOPERATIVE DIAGNOSIS:
1.
2.
RIGHT KNEE MEDIAL MENISCAL TEAR.
MEDIAL FEMORAL CONDYLE ABRASION.
1"'
OPERATIVE PROCEDURE:
1.
OPERATIVE ARTHROSCOPY OF THE RIGHT
KNEE.
MEDIAL MENISCECTOMY.
MEDIAL FEMORAL CHONDROPLASTY.
2.
3.
SURGEON:
JOHN FRASER, M.D.
ANESTHESIA:
GENERAL.
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DESCRIPTION OF PROCEDURE: The patient was given general anesthesia and
, the right knee was checked for stability and excellent stability was
,I noted. Anteromedial and anterolateral portals used for visualization
and treatment. The patellofemoral joint was unremarkable. The lateral
meniscus waa intact. Very early signs of lateral tibial degeneration was
noted. The ACL was intact medially. Multiply torn medial meniscus was
seen with horizontal and vertical tears. There was a large posterior
fragment and degenerative joint. The medial femoral condyle had grade 2
changes where impingement had occurred.
Debridement of the condyle back to a stable margin was carried out.
Utilizing basket forceps and articular shaver. medial meniscectomy back
to a stable rim was carried out.
j,
Copious irrigation was flushed through the area. The scope was removed
and Marcaine instilled. Dressings were applied.
John Fraser, M.D.
TSI, 260
DO: 12/09/96
DT: 12/11/96
RPTU: 1211-0079
JOB#: 0512/6800
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COLtJHBIA LARGO KBDXCAL CBNTBR
201 Fourteenth Street S.W.
P.o. Box 2905
Largo, Florida 34649-2905
NAIIB I
IBYS I
A<mr
RENT, LESTER
Jalm Fraser,
44 SBXI H
M000201178
M.D.
LOCI M.OS
OPERATIVE REPORT
Page 1 of 2
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NAME I
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Tampa NW - Patient Care Inquiry *LIVB*
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RENT,LBSTBR
John Fraser,
44 SUI M
M000201178
M.D'.
LOCI M.OS
(PCI I OB Database COCLR)
Page 2 of 2
Run: 01/09/97-15:23 by Moore.Del M.
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John Fraser, M.D.
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October 24, 1996
Mr. Jon Marcin
City ofCtearwater
Risk Management Division
PO Box 4748
Clearwater, FL 34618-4748
, RE
RENT, LESTER
Dear Jon.
Lester came in for evaluation of his right knee which buckled one time a few days ago. He WM
, placed i~ a brace.
CUnicaJly~ there is no evidence of effusion. The range ormotion is fuJl. Ligaments are intact. x-
rays nonnal.
My impression is that of a knee sprain.
He may resume tight duty on 10/25/96. He should see us in two weeks for follow up.
ely yours,
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John Fraser. M.D.
December 17, 1996
Mr. Jon Marcin
City of Clearwater "
Risk Management Division
PO Box 4748
Clearwater, FL 34618-4748
RE." :.
, RENT,LESTER
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Lester's folJowup on his affected knee was unremarkable. The medial meniscus was badly torn
and>thcre was some med~al femoral condyle degeneration which ~as shaved also.
, I will see him back in two week~. We will take a new x-ray and see how he is doing then.
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Since,rely yours. '
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lolul ser, M.D.
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omCE VISIT
NOVEMBER 7, 1996
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CHIEF COMPLAINT:
SUBJECTIVE:
OBJECTIVE:
PLAN:
Follow up right knee.
Rjghl knee stilfbothcring him.
No effusion. Range of motion full. No crepitus. Ligaments intact.
Return to nonnal duty 11/12/96. Check back in two weeks. If no better, consider MRl. If
be returns before then for evaluati~ and MRI of the right1mcc should be ordered and
appropriate procedure scheduled.
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JOHN FRASER, M.D.
RENT, LESTER
t
OFFICE VISIT
DECEMBER 3, 1996
CHIEF COMPLAINT: Follow up right knee.
SUBJECTIVE: ' Right knee still bothering him.
OBJECTIVE: Tender over the posteromedial joint. MRI consistent with tom posterior horn.
PLAN: Scope. WilJ schedule.
JOHN FRASER, M.D.
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John Fraser, M.D,
January 2, 1997
Mr. Jon Marcin
Cily of Clearwater
Risk Management Division
, PO Box 4748, , '
Cleanvater, FL 34618-4748
RE'
'RENT, LESTER
Dear Jon~
, Lester rctumcd for follow up and reevaluatiol~ of his right knee. There is minimal effusion. ,
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, .I would like to do some thernpy on him. He can relllm to light duty on 1/20/97 and go to full
duly' on 2/20/07. He should see me in 'six weeks for reevaluation.
ours, ,
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February 25. 1997
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John Fraser. M. D.
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Mr. Jon, Marcin'
City of Clearwater
Risk Mmiagcmenl Division
PO Box 4748
Ch::~rwau~r, FL34618~4748
, RE"
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RENT. LESTER
. 'Dear Jolm.
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Lester relumcd for faHow up. He continues to complain of inabilily to lio stairs on his right knee.
Jolm
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,John Fraser. M. O.
Murch 20, 1997.
,Mr. Jon Marcin
City of Clearwater
Risk Management Division,
PO Box 4748 .
Clearwaler, FL 34G18~4748
, RE
RENT,LESTER
Dear Jon,
, Lester retumcd for follow up. He still has fusifonn swelling behind the right knee but (he knee
itself has no effusion. He continues to have some discomfort.
I \vould recommend seeing me in twelve days following his vacalion to see if we need to aspirate
or scope the area. > .
ours,
John Fraser, M.D.
, JF/lr:jfw
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. ~NT, LESTER
FEBRUARY 13, 1997
OFFICE VISIT
CHIEF COMPLAINT: Follow up right knee. >
f)UBJECTIVE: Right knee bothering him doing stairs
."~ OBJECTIVE' . "
PLAN" No effusl~n. Ful,' ~an~e of stable motion. No rctropatellar crepitus.
. Offtred hJ~ an lnjcctlOr1 behind the knee cap. He deferred at this time. Check back
and see us m 3 weeks, Return to full duty 2120/97.
JOHN FRASER, M.D.
RENT, LESTER
OFFICE VISIT
FEBRUARY 13~ 1997
CHIEF COMPLAINT: Follow up right knee.
SUBJECTIVE: ' Knee moving well.
OBJECTIVE: As above.
PLAN: Injected as before. Check back and see us as scheduled.
JOHN FRASER, M.D,'
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RENT, LESTER OFFICE VISIT MARCH 4, 1997
CHIEF COMPLAINT: Follow up.
SUBJECTIVE: About the same.
OBJECI1VE: No neurovascular loss. No effusion. Bak~ cyst not palpable.
,ASSESSMENT: Baker cyst on MRl. Doubt further meniscal pathology.
PLAN: > Ultrasound on Baker's cyst area. Check bac1:t in 2.5 weeks. Ifno better, consider
rescope.
JoHN FRASER, M.D.
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02/2S/1997 08:40
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813-589-13730
MEDITEK
PAGE 01
SUN COAST HOSPITAL
2025 Indian Rocks Road
Largo, Fl 34644-2025
(8J.3) 586-7155
MR / AAD NO:
PT CLASS: OA ACCOUNT NO:
HOSP SERVICE:
EXAM DATE:
NS/ROOM NO:
RENT, LESTER - 44Y - M '
PHONE NO: (813)441-8396
ORDER DR: 1I'RASEltl JOHN MD
ATN DR: UNASSiGNED, DR.
ADM DR: UNASSIGNED, DR.
HISTORY/REASON:
PRIORITY:
DIAGNOB:tS:
231536
97119283
* ORF *
02/27/1997
/
RIo TEAR IN RIGHT KNEE
ROUTINE
RIGHT KNEE PAIN
EXAMINATION; 02/27/1997 07: 27 MRI 9148 JOINT LOWER EXTREMITY MRl-NT
INV NO: 1 RMS NO; 90001.1
PROCEO"O'RB REASON: RIO TEAR IN RIGHT KNEE
FULL RESULT I
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IMPRESBJ:ON:
.' lC'tlLL RESULT I
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MRI knee was compared to previous study of November 1996.
Current study shows that the quadriceps and patella
tendons are intact. The anterior and posterior cruciate
ligaments are intact. The cruciate ligaments are intact
anterior and posterior. Lateral meniscus is well viewed
and is homogeneous throughout. No areas of degeneration
or tear. Medial meniscus, especially posterior horn is
visible though attenuated or decreased in size since
previous study. Residual meniacal struc'tures show a
linear oleft-like hyperintensity traversing the substance
of the residual medial menisous and communicating with
the joint apace suggesting tear. In the upper medial
popliteal space, an oval hyperintense mass 1.5 x 2.5 em
is seen of the sam~ density as the synovial fluid. Also.
there is a mild joint effusion, mostly suprapatellar
bursa. Posterior patellar surface is unremarkable. There
is a subtle hyperintensity involving the medial aspect of
the medial femoral condyle suggest-ing bone'contusicn.
Coronal view shows that the collateral ligaments are
intact.
1. SUBTLE BONE CONTUSION MEDIAL ASPECT MEDIAL FEMORAL
CONDYLE.
2. 1.5 X 2.5 CM BAKER'S CYST OR POPLITEAL CYST WITH MILD
JOINT EFFUS ION.
3. LATERAL MENISCUS AND eRUCIATE LIGAMENTS INTACT.
4. RESIDUAL MEDIAL MENISCAL TISSUE SHOWS EVIDENCE OF
RESIDUAL OR RECURRENT MENISCAL TEAR.
KNEE X-RAYs
"
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PA and lateral knee radiographs correlated with MRt.::~~.
studies. Oistal femur i~tact. Patella/~.t~bia and fib~'ll' ':',:,~<
intaQ~., No old or ':~q:~~n~ fX'actur.~ ""r~ ,.' :', ali~~r~,"" '~',:~ ,
n?ted.', '<J~int space Wi.~J;J,,~is preBerved. .~.:F ",~';i'11~\i(.,:'
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SUN COAST HOSPITAL
2025 Indian Rooks Road
Largo, Pl 34644-2025
(813) 586-7155
RENT, LESTER - 44Y - M .
PHONE NO: (81.3) 441..8396
ORDER DR: FRASER, JOHN MD
ATN DR: UNASSIGNED, DR.
ADM DR: UNASStGNBD, DR.
MR I RAn NO:
P'l' CLASS: OA ACCOUNT NO:
HOSP SERVICE:
EXAM DATE:
NS/ROOM NO:
231536
97119283
*.....QBL*
02/27/1997
/
IMPRESSION: NO RADIOGRAPHIC PATHOLOGY IS DEMONSTRATED ON PLAIN KNEE
X-RAYS.
READING DOCTOR: JAMES R. JOHNSON, D.O.
TRANSCRIBED BY:
JL
READING DATEt 02/27/1997
TRANSCRIBED DATEz 02/27/1997 07:56PM
THIS DoCUMENT HAS BEEN ELECTRONICALLY SIGNED BY;
JAMES R. JOHNSON, D.O.
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. RENT, LESTER
May 06,1997
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, SUBJECfIVE: Lester is doing better. The shot did help him. He did show me pictUres of aU
the steps he goes up and down at work; I want him to continue to wear the brace and do quad
strengthening and hamstring stretching. The 4/1 injection did help him.
" ,
. Jeffi"ey L. Tedder, M.D.
JLT/cp
{Printed - 05/13/97 : Fe}
!Jill! $JOJfl1'.g
I Jeffrey L Tedder, MD~. Board certified Orthopaedic Surgeon
2140. 16th Street North. SL Petersburg, Rorida33704. (813)821a6648. Fax (813) 822.5493
10333 Seminole Boulevard. 1St Largo, Rodda 34648 · (813)393.7509 · Fax (813)399-2308
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RENT. LESTER
May 27. 1997
.,-
Lester is still hav;ng problems going'up and down Stairs. Knee cap is hurting him tremendously.
He \"ants me to go in and do a diagnostic anhroscopy and look to see why his knee cap hUI1s~ c
He may have some severe chondromalacia on the under surface of his patelJa.
We will ask for authorization for diagnostic arthroscopy and debridemem.
,
Jeffiey L. Tedder, M.D.
Boad'Cer:tified Orthopaedic Surgeon
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:! 140 -.1 6th Street Noeth. SL Petersburg. Florida 33704 · (813)821-6648 · Fax (813)822-5~93
10333 SeminoJeBou1ev~d. #5. Largo. Florida 34648 · (8J3)393.i509 · Fax UU3)399.2308 ,
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. Jeffrey L. Tedder. M:D.
2140 16th St. N.,
St. Petersburg, FL 33704
RE: Lester Rent
CHIEF COMPLAINT: Continued pain and swelling in the right knee
mSOTR Y OF PRESENT ILLNESS: This is a 44 year. old male, who injuied his right knee at
work on 10/20/96. He subsequently got an MRI that was read as a compJete posterior horn
medial meniscus tear, he tmderwcnt surgery by Dr. John Fraser in 12/96. Unfortunately post
operatively he did not improve. A new MRI was performed on 2/97 that showed a suttle bone
contusion medial aspect of the medial fibrial condia!. A I.S x 2.5 1mm Bakers cyst or popliteal
cyst with mild joint affusion lateral meniscus cnlciate ligaments are intact. Medial meniscal
tissue shows evidence of residual recurrent menisca1 tear. He has also seen Dr. John Barrett who
has by infonnation provided to me suggested a meniscalaligraph of the medial meniscus. I was
kindly asked by the City of Clearwater to evaluate Mr. Rent.
PAST MEDICAL HISTORY: Positive for seizures
PAST SURGICAL InSTORY: 12/96 right knee arthroscopy Dr. Fraser
SOCIAL mSTOR Y: 1 pack a day of smoking, ETOH negative
MEDICA nONS: TegTatol 200mg bid
ALLERGIES: Penicillin and sulfa
FAJ.fiL Y mSTORY: Unremarkable
PHYSICAL EXAMINATION: Trace swelling, negative Lachman. negative anterior drawer.
good step off. no posterior drawer, positive medial joint line tendem~ positive medial
McMurray. tenderness in the medial femoral chondiaI. no lateral joint line tenderness., no lateral
McMurray, negative verisfaIgus instability, good step off, no posterior drawer, 2/4 palellar
mobility, tenderness in the medial facet of the patella.
IMPRESSION: 1) Contusion medial femoral chondia4 2) Residual medial meniscus tear
RECOMMENDA nONS: At this point I gave him a 4 in 1 shot, I want him to continue '
stengthening. hamstring stretching. and I feel that another look see maybe warranted to examine
the ffieqial femoral chondial as well as to see if there is any residual or recurrent meniscal tear. I
do not recommend meniscal aligraph. I told the patient that I would be glad to see him in follow
up and I have him scheduled in 2 weeks.
Jeffrey L. Tedder. M.D.
Board Certified Orthopedic Surgeon
JLT/tsc
. el. I
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GEORGE GTERN, M.D.
Al INC. '5/97
GG/JH EL...
MORTON PLANT MEASE HEA,LTH SERVICES
CRS. BENJAMIN, CLINE, DROOZ. FISHER. GOODMAN. R. S. HOWARD. T. HOWARD. KENDALL. KRAUS. KROP. LICHT.
~ ' MCDOWELL. STERN, WEISS AND WOLLOWICK
. ".... Sammoor ImagIng Conter 391-4758 DIagnostic ImagIng Center 462.75'4 East lake Outpatient Conter 781.3160
Countryald.lmaglng Conter 787~506 TrInity Out~Uont Canter 372-4162
IMAGING REPORT
.-
, '
. Mad. Rae, No.
97.031920
Date of Exam:
6/4/97
6/11/52
COUNTRYSIDE
'Name
Referred by Doctor
RENT. LESTER G.
TEDDER, JEFFREY
BID
Canter
l' .'
examination:
PREOPERATIVE CHEST/PA AND LATERAL:
Clinical Information: SMOKER.
Findings:
PA AND LATERAL VIEWS OF THE CHEST WITH COMPRESSION FILMS
'FROM 8/30/94.
THE HEART SIZE IS NORMAL. THE LUNGS ARE FREE OF
INFILTRATES, EFFUSIONS, AND EDEMA. THE BONES AND SOFT
TISSUES ARE UNREMARKABLE. THERE ARE DEGENERATELY, CHANGES OF
THE DORSAL SPINE.
/~"~\
,\J
IMPRESSION:
1. NEGATIVE PA AND LATERAL CHEST. NO
, SIGNIFICANT INTERVAL CHANGE.
.~-
THANK YOU VERY MUCH FOR THIS REFERRAL.
~L~~,.
GEORGE STERN, N.D.
AT INC. 6/5/97
GS/JH EL2
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IG,qm PRDH,BPSC ~~ PETE SURCERY erR
10.91:) :147 40'6
PACK
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BBAL~SOOTll
st. ~.tersburq surgery C.Dt.~
REN'l', IJESTER
DATE:
6/10/97
PATtENT:
PATIENT NO: 50104
OPKJll\'r:tVB RlJPOIrl'
PREOPERATIVE DIAGNOSIS: Residual medial meniscus tear, right knee.
POSTOP~IVE DIAGNOSIS: Deqenerat1va complex tear of the medial meniscus,
posterior horn with ra-t.ari~q, riqhe kne., with
marked grade tII-IV medial temoral condyle
osteochondral lesion, meniscal' frayinq of tbe
lateral meniscus, plica formation in the lateral
suprapat.llar pouch, and tiqht lateral
r6t1naculum.
PROCEOl1RB: Arthrosoopy, right knee, with partial medial
meniscectomy and latQral ~eniscectQmy, debridement
of the medial femoral condyle, plicectomy, and
arthroscopic lateral release.
SURGEON: Jet'frray L. Tedder, Z,I _ D.
ANESTHESIA: General.
ANESTHESIOLOGIST:
Edward Norman, M.D.
PROCEDURE IN DETAIL: ~ha patient was ~aken to the opera~in9 room and
placed on the operatinq room ~abl. in the usual
supine manner. ~ter adequate endotracheal anesthesia was obtained, the
patient's right knee was prepped. and draped in the usual aseptic manner. 1
9 Erythromycin was given perioperatively due to the fact that pati.nt wac
extremely allerqie to penicillin. TWo prior arthroscopic inoision sites
wer. seen, well-healed., on the right knee prior to 'the surgery. Th. same
surgery si1:es as for the previous surgery wero made. The tourniquet was
placed on the ri9ht thigh and set for 300 1I1I1HCJ pressure.
The seop. was placed in the interolateral portal and the medial compartmane
was d1scarned.
Using an lS-gau<18 needle, the appropriate portal placement was pe.rtormed.
The fUll-radius resactor and probe WQre placed in the inferomedial portal.
There was a large 2S.X3.0 em grade III-IV lesion in the medial femoral
candyl. with a fibrocartilage-type coating inside the defect. This ~as
lightly abraded, a li9ht chondroplasty was performed. There was a
deqenerative complex te~r that appeared in the me.dial cOltlpartment, where a
prior partial meniscectomy was PQr%on!1ed. There was some ra-tearinq in the
posterior horn. An adequate partial meniscectomy was pertormecl in the
posterior horn. , The anterior crueiate ligament was intaee. The posterior
cruciate ligament was- intact. The latera~ compartment snowed a
OOftXWBDl
.... '.
~UN-IB-97 IBI~0 PROH.9P9C PT PBTE SURCERY eTR
lD,8':J ::147 4675
PACE
31' :3
ry
, .. ,,' PATIENT:
QN.~80~
81:. l'etusb\Uq Burqary center
RENT, LESTER
OAT!: 6/10/97
PATIENT NO: 50104
pPERA'I':IVB RBPORl1'
PAGB Z:
~' ~
degenerative frayin9 of the midbody ot the lateral meniscus. A partial
meniscectomy was performed. No loose bodies were seen in the lateral or
medial gutters or in the suprapatellar pouch. A fibrous plica was seen in
,the superolateral pouch. An adequate p11cectomy was performed with th.
fUll-radius resector. It appeared that the patella was trackinq laterally
in the trochlear qroov.. An adequate arthroscopic lateral release was
pertormed'throuqh the thickened lateral retinaculum.
The tourniquet was l.~ down. The kn.. was copiously irri9ated and drained.
#3-0 Nylon was used to close the portal $i~es. 0.25% Mareaine 30 co and
Depo-Medrol 1 cc were placed 1ntra-articularly,and into the portal sites.
A' Xeroform bulky dressinq was applied.
The patient was taken to the PACU in sati3tactory condition, having
tolerated the procedure well.
--
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0: 6/10/97
'1': 6/11/97
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OFFICE VISIT
RENT~ LESTER
"
June 12. 1997
Lester is here today. His wound is clean and dry. We went over his arthroscopic pictures,
I will see him back in one week to take his sutures out. I may think about putting him in an
Unloader type brace.
I
Je1frey L. Tedder. M.D. ,
Board Certified Onhopaedic Surgeon
JLT/cf
{Printed...06/13/97 : Fe}
, 11(/1f .DJOJ?1.9
2140. 16th Street North. St. Petersbwg. Ftorida33704 · (813) 821-6648 · Fax (813) 822.5493
10333 Semiriole Boulevard. #5. Largo. Florida 34648 · (813) 393.j"SQ9 · Fax (813) 399-2308
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RENT, LESTER
July 25, 1997
Lester is here today for follow-up. He is doing well. He is still having problems after
long distances. His using his crutches.
I believe he is going to need to be retrained for a more sedentary type job.
I will see him back in four weeks.
, ,
) do not think he can go back to his old job.
Jeffrey L. Tedder, M.D. , ,
Board Certified Orthopaedic Surgeon
JL T/fec
{Printed - 07/28/97......FC}
J '
. O.ySpom OrthOp4edlC $peeilll/sU
Jeffrey L. Tedder, M.D. - Board Certified Orthopaedic SUrgeon
2140 - 16th Street North, St. Petcnburg, Florida 5370.& · (813)821-6&48. Fax (813)822-5493
10333 Seminole Bou1cvard, #5, Largo, Florida 34S48 · (813)593-7509 · FAX (815)399-2308
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John Fraser. M.D.
August 19t 1997
City of Clearwater
Pension Division
, 'P.D Box 4748
Clearwater, Fl. 34618-4748
RE: Lester Rent
Dear Sirs:
This year Lester has undergone two right knee surgeries. One procedure was for a medial
. meniscus tear with a femoral condyle defect. The second procedure was necessary for a
degenerative, complex re~tearing of the medial meniscus, a lateral meniscus teart arid
pateUar subluxation.
On ,examination the joint remains painful to motion, and the patient is mobilizing with a
cane. ' I l:Kilieve that the conditions necessitating Lester's surgery have caused a disability
that is likely to be permanent. I also believe that utilizing the job description he has . >
provided me,the disability of the knee renders Lester Rent unable to perform any useful,
meaningful, or necessary work for the City of Clearwater. I hope this letter helps the
patient with his procurement of fuU-time disability benefits.
Sincerely yours,
JF/pb
,]
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~ECSVEC I T Y 0 F C LEA R W ATE R
OCT 1 7 1997
POST Oma &:c 4748, CtW1VATD,' FLORIDA 33758-4748
RISK MANAGE~IPAL SEIMCFS BUIlDING, 100 SOUTH MYRTlE AVENUE, CU!ARWAmt, fLORIDA 33756
Tm:J>oom (813) 5624650 FAX (813) 562-4659
fINANCE DEPARntENT
~k~~~~
1U: 0 (V PWSE COMPLEIE AND ~O PAm; ~ t f
DlP/.OYm ~ ~ Dlk f of~-j '7
EMPLOYEE SaC[AL SECUIUlY NO.' ~
DESCRIP110N OF INJURY:
At1fHORIZED PER 440.13, FS BY:
...
mE FOllOWING OPINIONS ARE TO BE ESTABUSHED, BY THE EXAMINING PHYSICIAN, TO A REASONABLE DEGREE
OF MEDICAL CERTAINTY AND BY OB]ECJ1VE MEDICAL FINDINGS.
A. DIAGNOSIS:
~ It is my opinion that this was a result of a Workers' CompeOS2tion injury,.uIness.
,~-~'1 - It is my opinion that this was not a result of a Workers' Compensation injuIyMJnes,s.
''"',..... _ I annat determine whether this inj was the result a W~ers' Com~ inJury~.
B. TREATMENT: i1A?, ~.
&~M.'
C. DUlY ASSIGNMENT: Please indiate beJow the level d work the employee is capable c:l performing and the a:xrespooding date
when such activity may begin.
RJLL DUlY may begin on . FuU duty me20S Ihat the employee does not Jm.e any restrictions as a rcsuh oCtile injury.
RESnuCTED DUlY may begin on t "') \ t v \:l. . Restricted duty means that as 2 result of the Injury the empJoyee has one
at more restrictions as indicated below.
Off WORK. nle employee's injury and treument are of such a nature that the employee is unable to perform any task without risk
of aggntvatlng the injury. fSe2se indlcue the antidp2ted dUCltloo oflmp;2irment;
D.
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PHYSICAL RESTRICJ10NS
v/
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)( 15-35 Ibsj
35-50 Ibs.
MMI? Yes _No
If "Yt:S", Date:
~
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"EQl'tU. EMPLOYMENT AND AFFIRMATIVE AcnON EMpLOYEll"
PPI Rating:
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OFFICE VISIT
RENT. LESTER
- OCTOBER 16.1997
.. 'The patient returns to my office today. He is still having pain in his knee. He has not
been back to work. I do feel that he will never be able to go back to his previous job
pOsition before the t\w surgeries and the injury. '
PLAN: I think he needs to be reeducated toward a more sedentary-type job and this is my
recomme'ndation.
Jeffrey L Tedder, M.D.
'Board Certified Orthopaedic Surgeon
, JL Tlfec '
'"
{Printed - 10!24197......FC}
BaySpms Orthopaedic SptcillllsU ,
Jeffrey L Tedder. MD. - Board CertUled OtthopaedJc Surpn
2}.tO. 16th Street North. St. Peterabwg; Florida 33704 · (813) 821..6648. Fax (813) 822.S493
10333 Seminole Boulevard.. #5. Largo. F10rida 34648 · (813) 393--7509. Fax (813) 399>2308
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Althrili5 Rr:lJd
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Soft Tissue InJUI)'
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Tri~cr Point Inteet/ons
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TlJ(t Large'SI Sillglr ,\1,111(' em'!! Ct'llt(tr IIIIIJ(t'l '"lll'd .\'talt's
PATIENT:
NUMBBR :
AGB: 45
RBF'HRRED BY:
DATB:
RENT, LESTER
38511
008:
WORKER'S COMP/IMB
10/16/97
CHIBF COMPLAINT AND HISTORY OF PRESENT ILLNESS: This is
a 45 year old male who is Been at the request of Worker's
Compensation for an Independent Medical Evaluation
because of continued right knee pain.
Mr. Rent was invol ved in an on the job inj ury on
10/21/96. At that time he was working for the City of
Clearwater when he was walking up an incline and then
onto a plateau when he suddenly fell to his right. He
cannot recall why he fell. He doesn't remember whether
or not he fell into a hole. At the time he injured his
right knee. He was sent to a walk-in clinic that day,
told to rest 1 week. He went back to work a week later
and returned for 1 day, but was unable to tolerate this
and he was subsequently referred to Dr., Fraser. Dr.
Fraser kept him off work for 2 to 3 weeks at that time
and then allowed him to return to work. He was only able
to tolerate 2 to 3 days of work and then went back to see
Dr. Fraser. Dr. Fraser reevaluated him at that time and
apparently scheduled him for a right knee arthroscopy
shortly thereafter. The surgery was performed on
December 9, 1996. Apparently a torn medial meniscus was
noted according to the operative note. According to the
patient Dr. Fraser confided in him that he was unable to
retrieve all the meniscus and that he may have to go back
some day to remove the remainder of the torn meniscus.
He continued to follow-up with Dr. Fraser thereafter and
about a month later did go back to light duty. He was
back at light duty for 2 months and then tried to return
to work at full duty. He could only tolerate this for a
brief period of time. There was one time when he had to
work the weekend and he said that he ascended and
descended approximately 1500 stairs and this caused him
a great deal of discomfort. He went back to follow-up
with Dr. Fraser in April of 1997. Apparently he had some
communication problems with Dr. Fraser in that Dr. Fraser
never told him anything so he subsequently sought
consultation from Dr. Tedder.
2250 Drew Street, Qearwater, Florida 33765 · (813) 797.7463 · Fax (813) 726-1580
"
/)
PATIENT:
NUMBRR :
DATE :
PAGE :
RENT, LBSTRR
38511
10/16/97
2
o
Dr. Tedder evaluated him and instructed him to stay of.f the knee.
He treated him conservatively and subsequently on June 10, 1997
performed an arthroscopic procedure of the right knee. The results
of the arthroscopic procedure are noted in my chart. Apparently he
alao performed a lateral release because of a mal-tracking patella.
Following this arthroscopic procedure, approximately 1 month later,
he did return' to work in a light duty capacity. In August he
attempted to go back to regular duty, was unable to tolerate this
and has pretty much been off work since 08/19/97.
His workup had included x-rays which were taken initially. He also
had an MRI done in February of 1997 at Sun Coast Hospital. This
apparently demonstrated evidence of bone contusion in the medial
aspect of the medal femoral condyle "lith a Baker' a cyst and
residual medial meniscal tissue showing evidence of residual or
recurrent meniacal tear. This was done following the 1st surgery
but prior to the 2nd surgery.
At the present time Mr. Rent complains of pain that is centered
around the kneecap. It hurts him to go up and down stairs. Alao
squatting sometimes is difficult for him to do. He states he was
able to tolerate office type work but cannot tolerate going up and
down the stairs that is required af him in his normal job capacity.
He states that he occasionally has awelling in the knee but when
further questioned he states that his knee usually is the way it is
today. It hasn't been much worse than this since the swelling has
gone down from the surgery. He has a more frequent clicking
sensation in the right knee that is sometimes painful. He states
that ,he has clicking sensations in his left knee about once a week.
He notes no other pains at the present time related to his right
lower extremity other than that around the knee. ,
PAST MEDICAL HISTORY: He has a history of seizure disorder which
~egan 4 years ago.
PAST SURGICAL HISTORY: The two aforementioned procedures in his
right knee. He also has previously undergone tonsillectomy,
appendectomy and an arthroscopic procedure on his left knee by Dr.
Barrett in 1983. His left knee has done well since this procedure.
ALLERGIES: Penicillin, sulfa.
,...)
CURRENT MEDICATIONS: Pepcid, Tegretol.
SOCIAL HISTORY: The patient is off duty. He has been off since
08/19/97. He does smoke approximately 1 pack of cigarettes per
day. Denies drug or alcohol use.
1)
PATIBNT:
NUMBER:
DATE :
PAGE:
RENT, LESTER
38511
10/16/97
3
PHYSICAL EXAMINATION: The pat1ent was examined in a gown. He was
asked to remove his shoes and socks for the examination. He was
rather reluctant to remove his socks because he thought the floor
was dirty. I was, however, able to convince him that for a
thorough examinacion ~his was required.
(rCj
J~
He did have, initially when he got up from a seated position a
'slight antalgic gait. This, however, corrected itself as he walked
several times across the room. He was able to get up on his toes
and heels without difficulty. He was asked to perform a squat and
stand up and could do this but did this reluctantly and stated it
caused him some right knee discomfort.
Seated examination noted well healed portals from his previous
arthroscopic procedure. As I flexed and extended the knee from
full extension to flexion no crepitus was noted at this time and
,the patella appeared to be tracking well within the trochlear
groove as compared to the left knee.
Supine examination revealed a negative Lachman test. Anterior and
posterior drawers were negative. Varus and valgus stress testing
and full extension at 300 of flexion also demonstrate no ligamental
flaccidity. McMurray's test was positive in that the medial
compartment demonstrated pain. He also had some discomfort with
medial and lateral patellar thrust. He had some minimal amount of
medial and lateral parapatel1ar tenderness. The left knee
examination was entirely normal with no discomfort appreciated.
There was also no effusion noted in the right knee at this time and
good distal pulses were noted in the right lower extremity with no
atrophy of the thigh or calf musculature compared to the left side.
I did review x-rays of his knee. No sunrise view was available.
I did obtain a sunrise view which demonstrated normal tracking of
the patella within the trochlear groove. The remainder of his x-
rays were essentially negative for any significant, osseous
abnormalities and joint spaces appear to be well preserved medially
and laterally.
2.
Status post two arthroscopic procedures with medial and
lateral partial meniscectomies with evidence of a
chondromalacia of the medial femoral condyle.
IMPRESSION:
1. Anterior knee pain of the right knee consistent with
patellofemoral disease.
v
.' '. r. "., ., :' ~ < .
}
,,'
PATIENT:
NUMBER :
DATE :
PAGE:
RENT, LESTER
38511
10/16/97
4
PLAN: I have read the reports from the two Burgeons. Apparently
he did have some tracking problems with his patella. I do not have
a preoperative sunrise view and cannot make any comments regarding
this. Nonetheless his sunrise view today appears to show
, satisfactory tracking. His main complaint is that of anterior knee
> pain 'which occurs when he ascends or descends stairs. This
certainly could be present based on the arthroscopic findings and
procedures performed. He doesn' t have any significant swelling or
,other problems with the knee other than when going up and down
stairs.
~
- I~-':,\
1 .
"'-' '
It is my recommendation thac he not be involved in any type of work
that would reqUire this~ He seems to be more suited for sedentary
type of work which requires no stair climbing. He can do some
infrequent ,bending and twisting. He could more than likely do some
lifting in the medium capacity range as long as he uses proper
technique. I would recommend against doing any lifting that would
require him to get down on the floor and pick up from'the floor and
place it on an overhead shelf. He could be allowed to transfer
weight belt high without having to bend over. This he could do up
to 40 to 50 pounds in this capacity.
I do not anticipate any further surgery at the present time for Mr.
Rent. He may require some intermittent sessions of physical
therapy in the future. He also may require some intermittent
antiinflammatory medication if the degeneration progresses.
Andrew C. Maser, D.O.
Orthopaedic Surgeon
ACM/lad
d: 10/16/97
t: 10/21/97
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CITY OF CLEARWATER
POST Oma Box 4748, CLU.n'ATn. Ft.OlaOA 33758-4748
MUNICIPAL SERVtCES BL.'tlDING, 100 SOlJm M\1m.E A\I'ENl."!, CI.1'.An'ATER, PIDRIDA 33756
TELEI'HONE (813) 562-4650 FAX (813) 562-4659
FINANCE OEPAR1l>lENT
ro~'~~~ Pm\SECOMPLrnAND~~OP~j; 0 L ~ ~
EMPLOYEE: ~ - ~ D/A: --1..2J.;l. t l q b
EMPLOYEESOOALSECURIlYNO.: :353 -\fo -he.( f.( <-
DESCRlPl10N OFlNJURY:~
AUIHORIZED PER 440.13, FS BY: Jl,t~, ~.1.L(7 ~,.-- (813) 562-4650
Risk Management ~
mE FOllOWING OPINIONS ARE TO BE ESTABUSHED, BY TIlE EXAMINING PHYSICIAN, TO A REASONABLE DEGREE
OF MEDICAL CERTAINlY AND BY OBJECI1VE MEDICAl FINDINGS.
~\, 0~ ~~
-.; ~ t1
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/~~
. ~
(813) 562-4659 FAX
A. DIAGNOSIS:_
v(t is my opinion that this was 3 result d a Workers' Comperw.tion injuryftUness.
.,-----\_ It is my opinion that this was not a result d a Workers' Compensation injuryADness.
\ )
'"-.-' _ I cannot determine whether this injury was the result oC a Woricer.;' Compensation injury,illness.
B. TREATMENT:
C. DUlY ASSIGNMENTt Please indicate below the level of work the employee is capable of performing and the corresponding date
when :;uch activity may begin.
FUll DUTY may begin on . FuU duty means that the employee does not h2ve any restrictions:lS 3 result of the injury.
RESTRICTED DUlY may begin on r~ . Restriaed duty mems that asa result dtbe injury the employee has one
or more restrictions as IndiC2ted below.
Off WORK. The employee's injury and treatment are of such a I13rure tJut the emplo}'ee is umble to perl'onn my task without risk
of aggravating the injury. Please indiClte the anticipated duration ofirnpairrnent:
1. GedSl3ndingO~
2. No climbin bending or stooping.
3. estriction or use of rightAeft hand.
4. Weight lifting restriction: 0-15 Ills;
5. Other restrictions ~E.
PHYSICAL RESTRICTIONS
'--"'"
10..-"'
1S-35Ibs; _35-50 Ills. /
..-1.-C :;. ';"'J1 ..-&-Arf ~
D. FOllOW.UP CARE
l. Referred to:
Follow.Up VISit 0
Disdlarxed - No
MMl? Yes _No
lC"Ycs", [Rte :
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0.
PPI Rmlg:
PHYSICIAN SIGNA
"EQUAL EMpLOYME.'l:r ,\'-':0 ..\FF1R.\I.\TI\"E ArnON E.\lpLOYD."
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RENT I LESTER
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OPFICE VISIT
JUNE 10 I '1998
"Lester Rent is here today., Lester is doing much better. He
'does not use his cane. I told him that was fine.
> PLAN:
1.
2.
I will see him back in a year.
I put the same restrictions on him, so as not
to overuse his knee.
Jeffrey L. Tedder, M.D., A~B.O.S.
JLT/nms' ,
'D: 06/10/98
T: 06/12/98
.1
"
RECEIVED
JUN r !l1~98
RISK MANAGEMENT
. r... : . .' . _ ;:..' . ...' ~". ~"
DESCRlPTlON OF INJURY:
'". ...... ! '.... ="" '"J. ~ , .
t... ~."'''''''''~i~ .;tI .,,~~"'.I' '., ... ....... ~ . I. ..... ..
~~ ,".: ..~.. :,; r~ .... '.. '. ~,,~ (" .,~::.J4 ~..:. ~ "..:~..-.I:.':
(" CITY OF C~ ' . ....,',. ..,.'... ....\...~/..:/ .,....' ,~CJEIIENT. DM810.~~
',' ',~.;. ~uttJ~~.!'!~.~1D, FL D788-47~
',' ...' .;.,-. ~;',TIa.IPHOHII~SO FAX(727)HZ-4CIt
.~. .1-,..... _ (01 I......... .......r..W"+~ 1"... .
. ..i- "t ..:..t~I.."t;'<. ..:"..".~.......:~.,. 2\.::.'" . .. ,. I '.
'." ..>::.':..\~.r~.~.~~.~.!;l~~.''''':''..'; 0" .
.f lit'" ~:"'~.";"'..:-::"":.t--;;"/''''':~::':' .:,.
NOV 1 7 1998 ".: ' .::....;-. !..,~-,~>..;""':.':~"~::~'
. .' . ; "'":........::.. . '''',+' t.,. ...r::'.' It.~ ~
R1SK~RM~~ETli: ~D RETURN '!'9 !~~~ .:.:~~ '. .
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TO:--L---XL \ ~1 ~ . .~ ,..:. -." ,;'.' 1;)A.1):: -1..W \,-- -, a
EMPlOvee l.L s --\< R R e t\) T ' , ...::.:"t. ',' . .,:~' _:}~.~;,,~:.CO' (.:2. \ I ~ .6
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RECEIVED
..
"
AUTHORIZED PER +W.13, FS BY: "
. Risll MSllllgoment ' , . ' ' .
me FOllOWING OPINIONS ARE TO BE ESTABUSHED. BY 11-IE INJNG PHYSlClM, TO A REASONABl.E DEGREE OF UEOICAl
CERTAINlY AND BYOBJECT~ MEDICAl.f!lDINGS. i '_-";', '.:', ': ': .'.:...,.. ' . ,;-- :'~.
. . ~ . .... . -. ~..\ " . . . '.. . " .;.
~JAGNOSIS; '~>' .~.''': '. .' . , :. ':~. "~:' .
It Is rnu"'""'nion that this was a result do Workers' 1'^"""""....lfOO WI~~'" ::~. ":..' :'~:": ~:[...:>:...~-.;,'. ..
IUI '1JII \"U"~1oiXJ "IJ'--l''''~..~.... 'I _ ......
o It fa my ~nion that tfls was not a rasult d a Woricers' Corrl>ensalion~' '.:: >:.; '::,~; :.:.~ .:,~':< .:' , .
~ ==;~, ;.I~=UIa~ldrrA::7:~~. ':,~tf#, · .
, . .':.. ......
.' , . . . Please frdcale below the l6vef of ~ .' eirpiyoo Is ~ d ~ a-d' c:are!pOI'dng date
.' \ when such activity may begin. '. ."....,.," -' ~. :' .__. 't ". .
"~ ) IIl:'UDUTYmaybe(inon _pldJfy~~~~~-::~'~~~asaresUlofthe
R~crrED DU~nwbegjn90 !uiIIUJ '. ~~'~:~;~~td~~~;.y1he~haaonecr
mORHBsfrlctJons as Incicatod below., ,,",' j' .-:'; , ,": ',". ' .;" ~, : '
. . " . . ~.""""H, .":~:'..:'. .':.?'-:"'~}J..~~'; :,~ ";~;.. . ' '.
OFF WORK. The 9I1"floYee'slnJLJY and lrealmenl are d such 8 natLre'lhal ihe ~ is lRtie fa ped~ 8rrt task v.;!hcAJt risk d
aggravating the iriuy. Pfeaso fndcale the anticipated dJralion of IfTl)aIrrnen:' ',: ~, :.;: . .':. ..... '. .'., ': '
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PHYSICAL RESTRlcnON8 ... ;'.' ", '"
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4. Weight lifting rasfrictlon:
5. Other restrictions .
D. FOLLOW-UP CARE;
1. Referred to:
0-15 b;
15-35 100;
- 35-501ls. .
'. : ,:-- , ,'. ,,': " ......: ~.;~~.:~: < '
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PHYSICIAN SIGNATURE:
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2. FdJow.Up Visit on:
3. Dlscharged-No fLlthai T
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RisK ~lA.'I\.-\(jE."E.'." DI\'SIO~
",
leffiey Tedder, M.D.
SOlS 4 Sl N.
fit Petersburg. fJ 33703
Re: Employee: l.esta'Rent
D/A: 1001/96
SSf#: 3S3-40.6442
FUel: 514
Dear Dr. Tedder:
(
CITY OF CLEARWATER
POSl' Oma Box 4748, CI.EAl'r'ATIJI, FLOIUDA 337;8-4i-l8
~fL"1CJJ'.U. SERVICES Bt.1tDL\V, 100 SOt.iH M\'Kt1.E AVE\1."E, C1.EAn"AnR. fLOIUD.\ 33-i6
TEU:PHO~'E (7Z7) 562-4650 FAl(.(727) 562-1659
December 15,1991
Thank you for taking time out of your busy schedule to talk with me regarding [.es(er Rmrt.
As we discussed, the City or Clearwater is agreeable to mllklng ., reasonable taX)I11modation necessary
to enable Mr. Rent to perform his job duties as a waste water ~ plant ~....
In that regard you advised that you were going to order a Pt~ Jcncc Ince for Mr. Rent which win
enable him to clbnb the stain necessmy to perform his job duties. The City ofae.watcr will also provide
Mr. Rent with a vehicle to drive between buiJ~gs so that ho caalimit his wafkiD&.
Yau advised that with the u.se of a bmce and a vehicle to trnn!port him betwteD buildings that the ph)'3icaJ
requirements of his job will be within his physica1limitatJons 8Dd 1hat be should ba able to safely perform
his job duties.
Very truly,
,Ch.~
~Marcin
Risk Management Specialist
cc: Joe ReckenwaJd
Mark Poteet
Lester rent
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OxE CITY. OZ\'! rl.1Th'IE.
"E(lI',\!. E.\tPU)"~IE.'\T .-\.'1\0 AFFJR.\tAm'E.~ E\1PlO\U"
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FOLLOW-UP EXAMINATION
PATIENT:
DATB:
LESTER RENT
JANUARY 13~ 1999
Lester, discussed wi.th me that the brace is not
. .
helping. He states that he can not' negotiate the
,'steps. I There has to be some provisions to aid him
wi~h going up and down the stairs or he needs to
bere-assigned. I do not feel he will pain free, ,
in any activity that requires him. to go ,up and
down stairs. I 'will see him. back as needed.
JEFFREY L. T~DDER~ U.D.
JLT/mls
T. 2-8-99
I
'1
J:i~c~' '
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cD In
111. ' f( ":J
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. N-1G~Atl:Nr
. CITY OF CL~AT~ii '~('-~GEMEN.T DIVISION
PQST OFFICI BOX 47-' Cf 1Ul..RWATm, FL 33781-47_
.." ., ',TELEPHONE (n7)H2-4aSO FAX'(T27)S824St
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PLEASE COMPLETE AND RETURN TO PATIENT
TO: k T~e-
EMPlOYEE: lE:-s ,$2.. 6< €EN r , '.
EMPlOYEE SOCIAl SECURITY NO: "35=3 - ~ 0 .- b l.{ 4 '2.,... " '
DESCRJPTtON OF INJURY: ~ \ - L E b . ';":'
AUTHORIZED PER 440.13, FS BY: ~ fJw...L-b ~ ' '. m/5624650 7271562-4659 r~
Risk M.1nagemenl ~
THE FOLLOWING OPINIONS ARE TO BE ESTABUSHED, BY THE EXAJ.lINING PHYSICIAN, TO A REASONABlE DEGREE OF MEDiCAl
CERTAINTY AND BY OBJECTIVE MEDICAL FINDINGS. '
A. ~GNOSIS: . '
ri It Is my opinion that this was a result of a WOf1(erst ~tion irjtlyliIlw'
o II is my ~nion thallhis was not a result of a Wori:ersl ~Iion fnjllYffllness. . ' ,
o I cannot determine whether thIs injury was the result r/ a Workerst ~tfon fnJlIYiUrness. '
, 8. TREATME!-!.: 4:/ J';fd-.:"YJ , Cunl r::S1//t1/~.' 'IM~ .::;rQ4,#..
,., C. DUTY ASSIGNMENT: Pfeasa indc:atebalow thereval of\Kllt the9lJlioyoo is~e otpM'aming and the corresponcing elate
:' \ when sa::h activity may begin.
'....../ i1~LL OUr! may t:egin on ~. Full clJty ~ ~ the ~oyee ~ ~ ~ SlT'/ ~ as a resUl of the
RESTRICTED ~urr m!l)' begin on C lIAAI/ J . Restricted dity means that as a restit d Ihe frlLIY the f.VI'4)Ioyoo has toe or
mora restrfctioos as indicaled below. ,. . , '
. .'
OFF WORK The employee's injury and trealment am or such a nabn that the employae Is mabIa to perf~ BIrf task without risk of
aggravating the injur!. Plaasa intfc.alB the anticipated dration of frrpainnant ,
/ PHYSICAL RESTRICTIONS
1. No prolonged sumc:ng or walking. ~ s(a
./ ~. /15
2. No cfimblng, bendr.g cr sloooing. ~
.
.
~. Weight lifting restf.c~~n:
O.15/bs;
15-351bs;
35-~ ~
: ,RECEIVED
JAN , 5 1999
R\SK MANAG~MENT
3. Restriction of USG ct rigntlldtt hand.
5. Other restrictions
D. FOLLOW-U =' ':~m::. '
I.tMI? Dv.. ~ If 'Yea', Oafs
1. Referred to:
2. Follow-Up Visit C:1: m
3. Dlschargad-No fLJr:'~sr iraau-nant Anticlpaled.
..~-)
PHYSICIAN 51
PPJ Rating:
.,. .-..
DATe ;/Y /11-
, ..:. L ~'.,'': " - .~. .' \ .... .: ,....'. I . . . ..
:':~-i'~'\" ....::..:II.'::.~..'.. ..':," :...... .~.'. ':'
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: I. ,..:. " ';" ". ..". ~., "J '. Jof,.: :. '.'~ '.<;. ", . ...
0~
Jeffrey L Tedder, M.D.
Board CsrtJfled Orthopaedic SurgflOtJ
Fellowship Tmln6d In Anh1'O$COPY and Spcirl:s Medk:ine
.. '
FOLLOW-UP EXAMINATION
111 ,
{.. '1.
I feel that the patient is at maximum medical improvement. i feel
'that he cnn do his current job as I have said many times in the
past. [, wi II see him back in one month.
'0
. :.
, "
JEFFREY L. TEDDER. M.D.
DIPLOMATE AMERICAN BOARD OF ORTHOPAEDIC SURGEONS
JLT/mJs
T. 2-16-99
RECEIVED
FEB 1 ~ j~O~
RISK MANAGEMENT
o
,
,5015 4th 51. N. · St. Petersburg, FL 33703 · Telephone (727) 821..s648 · Fax (727) 520-0292
10333 Seminole Brvd. #5. Largo. FL 34648. Telephone (727) 393-7509. Fax (727),399-2308
:' (~
.........c
o
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'~~j~~~
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Jeffrey L Tedder, M.D.
BOIIrU CIIrlHftld OrthofJlJOdJc !Jurgefm
FoIltJWSh/p >>aJnod In Arthroacopy and Spom M<<IJcIna
POLLOW-UP RXANINATION
'PATIENT: LESTER RENT
DATE: MARCH 9, 1999
......~,~.:.:....':.. ...._~.:.:,. ," :'I':""~" ~ ,'.:_
,"::':..". . ',,:::' ..;,:":. ,;~:,,'~"::' ""~' :~.: '.,:-}
,"
I fee 1 that Lester" is 'Iat maximu. medical ill}lroveaent, the therapy
has minimally helped. I do riot feel that his railing will help hi.
set up and down the stairs.
I fee 1 that he needs to ei ther ret ire or be re-educated or re-
trained for a new job duty.
JBPFREY L. TEDDBR, M.D.
DIPLOMATE/AMERICAN BOARD OF ORTHOPAEDIC SURGEONS
JLT/m13
T. 3-12-99
RECEIVED
MAR 1 :3 I :'O~
RISK l\';,",I'~AGEM ENT
5015 4th 51. N. · si. Petersburg, FL 33703 · Telephone (727) 522-8838 · Fax (727) 520-0292
10333 SemInole Blvd. #5. Largo, FL 33778 · Telephone (727) 393-7509. Fax (727) 399-2308
. ;. .'. I .t.
,..,. "~iI" ............... -A," II..... ..~. I.'~ ...
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;.; .
Jeffrey L Tedder, M.D.
Board Certified Orlhopaedic Surgeon
Fellowship Trained In Arthroscopy and Spora MtK:Iiclne
FOLLOW-UP EXAMINATION
PATIENT:
DATE:
LESTER RENT
~CU 24, 1.999
I
Lester is basically the same on his physical examination. He
states that. his right knee popped and he fell backwards.
I.ant him to stay at the same job description and I will see hi.
on a monthly basis.
, <-)..
. ,
. . .......:..,
JBFFREY L. TEDDER, M.D.
DIPLOMATE AMERICAN BOARD OF ORTHOPAEDIC SURGEONS
JLT/mls
T. 3-26-99
o
RECEIVE:J
MAR 3 iJ f~P.9
RISK MANAGEMENT
,'.
5015 4th St. N. · SL Petersburg, FL 33703 · Telephone (727) 522-8838 · Fax (727) 520-0292
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Jeffrey L Tedder. M.D.
Board Certffi6d Orthopaedic S4ugeon
Fellowship Troined In Arthroscopy and Spom ModJcino
FOLLOW-UP EXAMINATION
PATIENT: LESTER RENT
DATE: APRIL 6,- 1999
Lester is feeling .much better and having less problems.
Exam reveals tenderness in the medial
PHYSICAL EXAMINATION:
lateral joint space.
We will continue with the present management. I will see bim back
on bis next scheduled visit.
JEFFREY L. TEDDER, M.D.
DIPLOMATE AMERICAN BOARD OF ORTHOPAEDIC SURGBOHS
JLT/mls
T. 4-8-99
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5015 4th St. No · Sl Petersburg, FL 33703 · Telephone (727) 522-8838 · Fax (727) 520..0292
10333 SemInole Blvd. #5 -largo. FL 33na. Telephone (727) 393-7509. Fax (727) 399-2308
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APR 2 6 1999
Jeffrey L. Tedder, M.D.
Board Certified Orthops9dlc Surgeon
Followshlp Trained In Arthroscopy and SporlJJ M&dJcIne
FOLLOW-UP EXAMINATION
PATIENT: LESTER RENT
-DATE: APRIL 20, 1999
Lester states that he is stiil feeling better and having less
problems.
PHYSICAL EXAMINATION: Exam reveals that he is less tender in the
medial lateral joint space.
He will continue his present management and I will see him back in
one month.
JEFFREY L. TEDDER, M.D.
DIPLOMATE AMERICAN BOARD OF ORTHOPAEDIC SURGEONS
JLT/mls
T. 4-22-99
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Stc\'en SUbcrfarb. 0,0.
Sleven R. 'Wood. 0,0.
Philip W, Chrbl. 0,0.
James R, lngmn, D.O.
Physical Medicine
A Rehabilitation
Roben O. Gruber, 0,0.
Constantine G. BouchIu. M.O,
Fr.mdsc:o M. Torrcs-Ibmos. M,O,
Kenneth r. 8ln,'In. M.D.
Warren Sbtt'n. M.D,
GcorrrrySkcne.O,O.
. Neurology
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, Lub G. Figum>>. M,O,
1ntc:nW Medlclnc
Vlctor Arbolcch. ~I.D.
NC'Ul'Oradlology
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Psychology
Roben S. Rosen. Ph.D.
Oe Care Sel'l'ices
imaging
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Spinal Reconstructions
La.ser D1s1cectomr
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SpiJuJ Disorders
lk2c1aches &: Sdzures
Rch:dJWtaUon Services
Ph)'Sica1 Thcrapr.
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PJo')'Ckjoglcal Servkes
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ManIpulation
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Florida Spine Institute
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HAY 0 6 1999
April 27, 1999
Ms Deborah Ford
Administrative Analyst
City of Clearwater Human Resources Dept.
P.O. Box 4748
Clearwater, Fl 33758-4748
Re: Lester Rent (3851~)
Dear Ms. Ford:
This letter is sent to you regarding correspondence that'
we r,eceived dated 4/21/99 regarding Mr. Lester Rent.
Apparently I saw Mr. Rent on 10/15/97 for an Independent
Medical Evaluation.
At that time my recommendations were based on the
patient's subjective complaints of knee problems that it
would be difficult for him to do a job that requires
frequent stair climbing. This apparently has been noted
consistently throughout his postoperative course with Dr.
Tedder and also as part of the functional capacity
evaluation.
It is therefore my medical opinion that based on the
patient's subjective complaints of pain, he will be
unable to do a job that requires any type of stair
climbing and more than likely will have to be retrained
for a more sedentary job or any other job that doesn't
require any significant stair climbing.
If you have any further questions regarding this, plea~e
don' t hesitate to contact me at the Florida Spine
Institute.
Andrew C. Maser, D.O.
Orthopedic Surgeon
ACM/jr
D: 04/27/98
T: 04/28/99
2250 Drew Street, Clearwater. Florida 33765 · (727) 797-7463 · Fax (727) 726-1580
\
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/
*
Morton Plant Mease
HEALTH CARE
Outpatient Rehabililali\'e Services
.jjO PineH:Js SIra1, al.~rw:m~r. ft }l61u ~13-\62.7031 Fa);: 813-i61-82;8
30ill U.S. 19 N.. Palm Harhor, Ft. 34684 813.786-i036 Fax: ~13.78i.Q;76
FUNCTIONAL CAPACITY EVALUATION
CLIENT NAME: Lester Rent
MR#: 031920
PHYSICIAN: Wayne McCormick, M.D.
DIAGNOSIS: sip right knee arthroscopy 12/96 and 6/97
DATE OF INJURY: 10/21/96
DATE OF TESTING: 10/28/97
INSURANCE CARRIER: City of Clearwater Pension Plan
CONTACT PERSON: Debbie Ford
DATE OF REPORT: 11/1/97
REASON FOR REFERRAL:
Mr. Rent was referred for a Functional Capacity Evaluation by the City of
Clearwater, to determine his physical abilities as they relate to work
- 'unction.
\..._/
RECOMMENDATIONS AND CONCLUSIONS:
The results indicate that Mr. Rent is able to work at the LIGHT to LIGHT-
MEDIUM category of work according to the U.s. Department of Labor. He is
able to occasionally lift from the floor or from 12 inches above the floor 2S
pounds, lift to shoulder height or overhead 15 pounds, is able to carry 20
pounds, is able to push or pull 280 pounds of materials (exerting 28 pounds
of force pushing and 36 pounds of force pulling) and is able to carry in
either hand 20 pounds. He is able to constantly sit and reach forward or
overhead. He is able to frequently perform repetitive leg/arm movements. He
is able to occasionally stand, climb, squat, walk and balance. He is unable
to kneel or crawl secondary to patellar pain. He reports driving is limited
to approximately 30 minutes secondary to the right lower extremity use
required. It is recommended that he interrupt weight bearing postures with
sitting or propping the RLE on a step. At this time he will have difficulty
performing his prior duties at the wastewater treatment plan that required a
considerable amount of walking and stair climbing. He was also required to
work double shifts frequently.
<.J RECev~O
NOV , 0 1997
RISf< MANAG .
t:Iv1ENT
:;./'r,t;'?;:E~~:.\'.
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Lester Rent
-2-
!{~vember 1, 1997
, ~,
. )BEHAVIORAL PROFILE:
Inappropriate illness behavior is an observable and measurable behavior which
is out of proportion to the impairment and is measured by non-organic signs,
inappropriate symptoms, high pain drawing scores and movement patterns which
improve by distraction. Symptom exaggeration is a subjective determination
by the evaluator of whether the patient's pain is out of proportion to the
observed movement patterns throughout the evaluation. Validity criteria are
based on the results of tests and cross correlation of the test data and
determine if the test results are valid and represent good effort, according
to published research. Mr. Rent exhibited Borne symptom exaggeration of his
pain, but did not have inappropria~e illness behavior. He passed 88t of his
validity criteria, indicating he put forth good effort. He did state -I
don't know why they want to keep me so bad, why don't they just retire me.-
HISTORY:
, I
Mr. Rent was injured on 10/21/96 as he was walking upa grade and came to a
level area. For no apparent reason he stated his right knee went out to the
side and fell to the left while at work. He underwent arthroscopic surgery
for removal of a meniscus in the right knee in 12/96. He underwent further
arthroscopic surgery for removal of more meniscus and shaving of the end of
the femur and tibia and under the patella on 6/10/97. He states he tried to
return to work for 3 afternoons and couldn't. He was placed on light duty at
/,...~ desk for approximately 30 days. He experienced trouble getting up and down
. <.._,10 do filing (this was done at the end of August). He is to try to return to
work again on 10/29 for data entry. He reports his job required him to climb
approximately 1500 stairs per day and walk 6 to 8 miles per day as well as
required bending over and lifting. He enjoys wood working, but reports he is
unable to stand long enough to do larger projects and will be trying some
smaller ones. He reports he is unable to fish because he cannot stand greater
than 10 to 15 minutes at a time secondary to pain. He stated ~I can walk
better on a fishing boat than on hard land surface.- He stated -The M.D.
feels my knee is as good as it will get. If he has to operate a TKR. Why
don't they just do it? I know someone who had it done at age 50 and it
lasted 16 years.-
MUSCULOSKELETAL EVALUATION - SIGNIFICANT FINDINGS:
Subiective Pain Symptoms: Mr. Rent complained of pain in the right anterior
and posterior knee. He rates his pain currently at 3/10 (0 = no pain, 10 =
most severe pain).
u
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'1'1.......1 lit
/)Lester Rent
-3-
November 1, 1997
:.J
~ester Rent
-4-
November 1, 1997
He stated he 'would normally genuflex the left knee keeping the right lower
extremity forward and protecting it.
.
Reoetitive Reachinq: He completed the ~esired 20 repetitions of reaching
overhead and at a normal speed and movement pattern with an end stretch. He
complained of right knee pain rated 3/10.
Reoetitive Bending: He completed 10 repetitions of forward bending, touching
his toes consistently. He performed it in a normal speed and normal movement
pattern. He reported stretching/tightness in the posterior knees/hamstrings
bilaterally. He sat down to rest after this.
HAND TEST~
.
Mr. Rent reported he was ambidextrous. His grip strength was tested with the
Jamar dynamometer with'3 trials at each of 5 spans alternating between the
right and the left. He consistently performed within 15% of the previous
trial.each span indicating a valid test for maximal effort in this testing.
His average grip strength at the second span on the right was 81 pounds and
on the left was 83 pounds. This is less than the average performance of other
4S year old males according to Mathiowetz. Graphic plotting of the average
grip strength reveals a bell shaped curve with the left being slightly higher
..........han the right except for the last span. He had a negati ve REG (Rapid,
',,-,.~change Grip Test) because. his results did stay under the maximum attained
at the second span. His grip declined greater than the normal average of 1St
with a decrease of 19% on the left and 30% on the right.
OCCASIONAL MATERIAL HANDLING:
Lea Lift: He lifted a maximum of 25 pounds from the floor. Limiting factor,
pain in the right knee rated 3/10. On the final lowering of the box, he did
not fully squat, but forward bent at the trunk instead. He sat down to rest.
Twelve Inch Leq Lift; The peak weight li~ted was again 25 pounds. He would
repeat the lift 2 times as if to recheck~it felt. It took 5 trials to attain
the 25 pound maximum. Limiting factor, pain in the right knee rated 3-4/10.
He sat to rest after completing this. Normally one would expect the amount
lifted in the 12 inch leg lift to be greater than the leg lift as it would
require less knee flexion. Questionable as to why his values were not
greater in the 12 inch leg lift than in the leg lift.
Carrv-Two Hand 30 Feet: His peak weight was 20 pounds. It took two trials to
attain this. He was observed to limp. Limiting factor "I feel dependent on my
cane. II
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.
11Lester Rent
-5-
November 1, 1997
Shoulder Lift: He lifted-a peak weight of 15 pounds to S3 inches above the
floor. It took 3 trials to attain this. He needed cues for proper body
mechanics. Limiting factor pain in the right knee rated 3-4/10.
Overhead Lift :. He lifted a peak weight of lS pounds to a level of 58 inches
above the floor, taking 3 trial to attain this. L1mi ting factor, pain in the
right knee rated 4/10. There was no squatting or twisting involved in either
the shoulder or overhead lift. Frequently the overhead lift value is less
than the shoulder lift value due to weaker shoulders in the overhead
position.
Push 30 Feet: He was able to push 280 pounds of materials in a wheeled cart
over a carpeted floor, exerting 38 pounds of force to push it.
.
Pull 30 Feet: Again he was able to pull 280 pounds of materials in a wheeled
cart over' a carpeted floor, exerting 36 pounds of force to pull. It took
four trials of pushing and pulling to attain the maximum weights. He sat
down to rest after this. Limiting factor for both pushing and pulling was
pain in the right knee rated 4/10 (pulling was more painful than pushing) .
.
Carry Riqht Hand 30 Feet: He carried a peak weight of 20 pounds, taking 2
trials to attain this. He sat momentarily after this. Limiting factor, pain
._i.n right knee rated 4/10.
""-'6arrv Left Hand 30 Feet: Again he carried a peak weight of 20 pounds, with 2
trials. Limiting factor pain in right knee 4/10. He limped during both
carrying activities. He sat down and rubbed his right knee after the left
hand carry also.
NON-MATERIAL HANDLING TASKS:
Balance: The client's balance was assessed by his ability to walk a beam 6
feet long and 4 in~hes wide. The total distance for each test is 24 feet (4
times the length of the board). It took him 20 seconds in the forward normal
gait pattern with no errors. In the forward heel to toe pattern it took 1
minute and 2 seconds with 2 errors. In the backward heel to toe pattern, it
took S5 seconds with S errors. In the sideways gait pattern, it took 32
seconds with no errors.
Walkinq: He walked indoors on flooring with no cane for a total time of 6
minutes and 23 seconds. Total distance 1200 feet. He was observed to limp.
Limiting factor, ~tired" greater than pain.
Crawlinq on Padded Mat: He proceeded forward one foot crawling I with a
duration of 5 second)complaining of pain in the patella on the right.
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~Lester Rent ._
-6-
November 1, 1997
. ,.
.
Kneeling on Padded Mat; He was unable to kneel for more than 3 seconds due to
patellar pain on the right.
Repetitive Reachinq: He performed re.petitive reaching to a height of 60
inches above the floor fastening and unfastening bo1 ts and screws for a
duration of 12 minutes. He stated ~I can do this for a long time.w
Stair Climbinq: He completed 1 minute and 13 seconds of the desired 4 minute
stair climbing test. He completed one flight of stairs. He used bilateral
upper extremity support. He ascended the steps in a reciprocal pattern on 2
attempts up and on the final attempt up he favored the right lower extremity.
He favored the right lower extremity descending at all times. Right knee
pain rated 6/10. RPE (Rating of Perceived Exertion) 13. Post test heart
rate 84 BPM. This corresponds with the RPE being less than a 50 unit
difference. .
Sustained Reach: He threaded a chain for a duration. of 12 minutes and 30
seconds. He propped his right foot up on a step at the 5 minute mark for
approximately 1.5 minutes. Limiting factor, "left shoulder gave out.W
Sittinq:, Accumulated sitting 1 hour 20 minutes, maximum sitting at one time
1 hour 15 minutes during the history taking and grip strength testing.
(~tandinQ: Accumulated standing 45.5 minutes. Maximum standing at one time
.........
17 minutes.
Walkinq; Accumulated walking 28.5 minutes. Maximum walking at one time 18
minutes. This encompassed the carrying, pushing/pulling, balancing and stair
climbing activities.
PHYSICAL DEMAND LEVEL OF WORK:
Based on his maximum effort lifting and endurance testing, this client's
physical demand characteristic of work level if LIGHT to LIGHT-MEDIUM.
Thank you for referring Mr. Rent to UB. Please call if we can be of further
help at 461-8874.
Sincerely,
~~' ~-cUt Pi ).'3~~
Carolyn Rickrode, P.T.
cc;. MPH Medical Records
Clinic File
CR;jlg/pfl
'~
. .
FUNCTIONAL CAPACITY EVALUAnON
TE8T1
~ MATEBI6L HANQUNG ACnvtnE8
~ ActMtIH h.umct NotrIVl BlHg
Unlo..lndbted
(0 - 1-3 hrI. F. 3-5 hrw, C · 5-8 hrw)
Floor to KnLICkSe - l.8g LJft.....n...u.................H
1 ~ to KnLJCkJo-.......... ,.......... ..... ...........,............"....
Knuclde 10 Shoulder.......... ............ ..... ,..........,
Shoulder to ~rf1.gad............III....n.................
Canying.".......... ....... ",'t. ,............. ..... ...... ...... ..... I"
Pu.hlng.....tS,P.:!. .\I.t..U~ n~{. ~.!~ ..p.!F.~hA.... .........
It ... 'I 4.
Pull1l1g... ... .......... .....11I.. IU II II' ...... ....... ..... .1.. ...... ."Il
Carry Left ~nd........ ...... ......"................ ...... ....1-.....
Caf'lY' Right Hand...._ ...,....... ...... ..... ............. .....
COMMENTS
~ON MATERIAl HANOUNG ACTIVITIeS
Stttlng. ....... ........... ........ ..... ..... .... It ..... ........'t. ,.....
Stsndlrag..........' .,.. ........... lit ..11-.......... ,.... ".... .........,
Bendlr1g (StOQlFllng)........... ..... ...... ...... .... .........
RIt.chlng - Forward............".........................
Aeac.hlng - Owmoad.....................................
CUlllb'lr1g............. ..... ..,... ...... ...... ,.... ... ..... I.' ...... ...
Squa:tt:ln g.."....".. ...... 4.... ...... ............ ........ .... .,... ....
Kn.HlI.r1g...................... .... ...... .... ....,... ...... ........ .... ,..
....... WaDc:Ir1g.... .."...... .......,.... ...... .............. ..... ... ..... ....
, \... no.
... J .'IW1Iflg...... ... lit ............. ........ ....... .... ..,.......... ..,t .......
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Bala.nclng........ ...... ..... ..t.. ....... ,.... ............ ...........
RO~or ~~=~ant.....................
l.8:ft............ ....... ....... ...
R IgtJt.......,.. ...&1- ..... ......
COMMENTS
... ... __ ....__. __.. . _... a_....... _ _. .."-..... . _... _......""'1
pccasfonaJ
1-a31' olD...
1 - S2 AeptiDay
~5 tJI.
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I 5 lb..
;} 0 "..
.oN Ibl. Mu-C t ~ (O~ tcJ
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) (I IJI.
+. (j Ibl.
Frequent
34-" of DIIV
33-200 Fhps.Oay
Ill.
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III.
II..
IJI.
IJI.
Ibl.
lb..
-!!!:
Never
~ ciCIlY
"" ..._-..--..- . .- ..... . ,.
Constant
fJ7-100% of D-v
>200~1'f
Ibl.
b..
IJI,
bl.
bl.
~..
.,..
bl.
b..
OccalJonaJ
, -33'Jli. or~
Frequent
S4 -tIS'Jf. of OIlY
ConItAnt
a7-t~ 01 OIlY
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x
X-
X
.X
)(
)(
x
HIg~ I Low
Aasan-oly
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Heavy
Grasp
No
ReSJtrictionl
)(
X'
DATE: IDJ~H I ,'J
wr 157 ff HT 5 't...
RENT ,LESTER G
10/28/97 27013281&7
UNASSIGNED DOCTOR
031920 0&/11/1952
COMMENTS ")'\A:rl.~ J..-u1"J !L .... .30 ~...,. ~. {-Ill': -WI!> ~fIlJ+lJ..l.. )U~ j~. "'~JlMI.AI. f11A
p-mhMt'Il- L (IJt 111 ~1P-4 At f. Oh nbf"
HAND FUNCnON Cannot Implllrvd FIne WNL FlrKt
Use Motor Coord. Motor Coord.
x
)(
PHYSICAL DEMAND CLASSJFlCAnON OF WORKER -
, _u Llgn~ Medium _
Sodantmv Ua.h!, --7 Medfum Medium HeavY
Oecalfonal- (1-33%) 101:.. 20 Iba SO Ib, 60 lb. 761b,
Frvquont'" (34-66%) NegBg1b1e 10 b. 16 lb. 20 IJ. 351b1
Constant · (67-100%) NegUglb1a Na " / 10 Ib, 16lba
· Tenna which ~ to tw hqUM'lCY oC "Uectlnsa' .. tcrc."lncludi'lg 1lftIng, canyIng. puahlng or Wrj other IICtNIty
PURRENTWORK STATUS EV.6LUATQfi
CANPAnENTWORKNOWl Ca__1M"..... &lvu.-I.Jl fT J3lf"/
'NO B --r-
) SIGNATURE
pAJl(f TIME Hl'IlDay
NAME: L t ~ hr' ~(.,\t'
AGE: ..,., "SEX: IV)
DOCTOR: fV1 ( l -: r"",,\J~
Heaw
100 Ib,
50 lb.
20 lb.
Varv Heavv
Over 100 lb.
OVer 50 Ibl
OVer 60 b.
----
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. . HEALTHSOU1H
Sports fv1edcine & RdtabitaOCin Cem'
,~
CLIENT: Lestet Rent
HEAL THSOUTH 1.0. NO.: 002498().(0949
REFERRED BY: Emplo el
PHYSICIAN: Jeffre Tedder, MD
DATE OF INJURY: 10/21196
DATE OF EVALUATION: 11/6198
008: 6/11/52
EMPLOYER: ClI of Clearwater
DATE OF REPORT: 1119J98
INSURANCE CARRIER: elt of Clearwater
INSURANCE REP,: Jon Moreln
INSURANCE 1.0. NO.:
SOCIAL SECURITY NO.: 353-40.6442
DIAGNOSIS: SIP Menlsectomy knee
AGE: 46
OCCUPA TlON: Plont Operlltor
PURPOSE OF ASSESSMENT
RECEIVED
NOV 1 31998
RISK MANAGEMENT
Me Rent was referred to HeallhSouth Rehabilitation Center of Clearwater for assessment of
his current physicaVfunctlonal capabilities with regard to his usual and customary job as a plant
operator for determination of his potential to safely return to that job situation.
RECOMMENDA TJONS
We would recommend the following:
Mr. Rent is functionally capable of returning to work as a plant operator With the exception of his
floor to knuckle lift and stair climbing in Which he is self-limited due to complaints of increased pain,
(Please refer to comment sections in the MATERIAL AND NON-MATERiAl HANDLING Seclion.)
SUMMARY OF RESUL T5
Mr, Rent IS a 46 year old male with the current diagnosis of status post right menisectomy. He
reported that his injury took place when his feg gave out atter climbing a slight incline, Deficits
found In the musculoskeletal evaluation included leg stance, gait, decreased patellar mobility,
decreased balance and decreased right lower extremity strength. Client unable to point to pain but
reports generalized anterior knee pain. The following self-limiting behaviors and inconsistencIes
were noted:
1. Lacks full right knee extension adive/y. but able to heel walk.
2. InconSistent effort on Manual Muscle Test of knee flexion and darsinexion,
3, Self-limiting pain behaviors with no significant change in heart rate or swelling.
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1499 Gulf to Bay Blvd., Suite 100 · Clearwater, FL 33755 · 813443-3800
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Dynamomeler lesting revealed consistent effort as demonstrated by coefficients of variance of less
than 15% on 5 of the 5 tests. Client was consistent on 7 of 8 measures on the Biodex lest
Functional testing revealed that Mr. Rent is presently lifting in the Medium category of work as
demonstrated by maximum occasional floor to knuckle lift of 25 pounds, knuckle to shoulder lift of .
35 pounds, shoulder. to overhead lift of 35 pounds, and carry of 35 pounds 100 feet wilh pivoting.
Ounng positional tolerance testing, the client demonstrated a tolerance of sitting, standing, walking,
stair climbing, trunk bendingj stooping on a frequent basis. Squatting and ladder climb on an
occasIonal basis and crouching on a rare basis
SUBJECTIVE,H'$JORY
Mr Rent is a 46 year old male with the current diagnosis of status post menisectomy of right knee
on 06110197 He was injured on 10/21/96 when after ascending a slight incline, his right knee gave
oul
He reported at the time of inJUry, he was workIng for the City of Clearwater as a plant operator. He
stated he has not worked regular job since 10121/96 and is presently working modified duty.
DIAGNOSTIC TESTS AND RESUL 15 FOR THIS INJURY INCLUDE:
,
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X.RA YS X
CT SCAN
MYELOGRAM
EMG
OTHER
MRI X
BONE SCAN
ARTHROGRAM
PSYCH
PAST MEDICAL HISTORY:
PrevIous treatment for his injUry (as stated by the client) includes:
PhYSical therapy November 1996 for 3 weeks.
OUTCOME, No improvement.
Ar1hroscopic surgery December 9,1996,
OUTCOME. Worsening of symptoms.
PhYSical therapy February 1997.
OUTCOME, No improvement.
Right menisectomy June 10, 1997.
OUTCOME: Slight improvement.
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. Page 3
CURRENT AND PREVIOUS MEDICATIONS:
,
Are you taking any medication not related to this Injury? Yes X No Wha~: Tegritof, Propepcld
Have you taken medication for this mjury? Yes No What:
Are you taking any medication now? Yes X No What: Darvocef
An toda ? No
Mr Rent states he is presenUy taking Darvocet and unknown paIn medicine, on an as~needed
basIs, to assist him in pain management.
Overall, he rates the outcome of all previous treatment as providing "fair improvement" from hIS
onglnal condition following his injury. His subjective pain complaInts presently are right knee
parn ~Irh occasronal swelltng,
Mr. Rent reported his pain at an intensity level of "2" on a pain scale of 0 to 10 (0 = no pain; 10
= severe pain). He reported that his pain ranges from a "2" at best, to a "8" at its worst. His
pai"n is located right knee and is described as constant in Inature. He stated that increased time
walking, bending and lifting aggravates his symptoms the most, and that ice and elevation and
medication provides the most relief, He reported his pain level at the end of the evaluation as
being a "5". A 24 hour post-WCA pain rating was not reported.
Client reported perceived activity level for:
51111 NG:
STANDING:
WALKING:
LIFTING
60 Minutes
15 Minutes
15.20 Minutes
25 Lbs.
Mr. Trent completed the following pain questionnaires today, His perception of pain/disability
was measured and objectively scored as follows:
1 . Beck Inventory
21
JOB DESCRleJJO-N
A formal lob analysis was requested and obtained prior to the evaluation. A job description
was oblmned from the client and employer,
OCCASIONAL: 0%. 33%
FREQUENT: 34%. 66%
CONSTANT: 670t'o. 100%
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VOCA llONAl PROFll.E
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Mr Rent IS a right hand domInant individual, who has complet~ the 12th grade. His work
history Includes
(By Client)
Mr Rent reported that, at the time of his injury, he was employed by City of Cleacwafer as a
plant operator. He described the physical demands of his job as requiring:
MA TERrAL HANDLING: (Note pounds, item. levels and frequency)
Maximum occasional 50# floor to shoulder
Carry SOH
Push/Pull pumps. motors
ACTIVITY I FREQUENCY
pATIENT
occasionaVrare
occasional
constant
1500 stairs
occasIonal
0Ct3SIonal
occasional
occasIOnal
occasional
frequent
occaSional
occasional
EMP~OYE~
frequent
frequent
frequent
up to 1214+
frequent
SITTING
ST ANDING
WALKING
STAIR CLIMBING
SUSTAINED BENDING
OVERHEAD REACHING
CRAWLING
saUA TTING
KNEELING
STOOPING
CROUCHING
lADDER CLIMBING
TRUNK TWISTING
FORWARD REACHING
PUSHING/PULLING
fINE MOTOR
TYPING WRITING
ANSWERING PHONE
WRIST FLEXION/EXTENSION
RADIAl/ULNAR OEVIA liON
SUPINATION/PRONATION
CERVICAL
OTHER
occaoonal
occaslOI1al
frequent
occasIonal
By Mr. Rent's description. his work falls into the Medium work classification category
based on the amount of the maximum occasional lift.
(By Employer)
Mark Poteet of City of Clearwater provided job information that described the work of a plant
operator as requiring: '
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MATERIAL HANDLING: (Note item, levels and frequency)
Maximum lift of 50#. 30# occasionally and 15# frequently
Position tolerances. due to amount of walking and stairclimbing,
employer is willing to accommodate with golf cart and will !3l1ow
breaks or the use of a brace to assist with stairclimbing.
By this description, his work falls into the Medium work classification category based on
the amount of the maximum occasional lift.
~ABDIOV ASCULAR ASSeSSMErn
HIS resting blood pressure was 140/86, and hiS resting heart rate was 80 beats per minute.
MUSCULOSKELETAL SCREEN
POSTURE: Right hip external rotation, right knee flexed, bilateral foot pronation with
decreased great toe extension in standing. In standing, left foot rearfoot valgus and
sweUing noted right posterior knee and lareral distal patella.
,
GAtT: Prolonged stance phase right lower extremity with hip in external rotation.
Weight bears fateral to medial foot with decreased toe off right.
ACTIVE RANGE OF MOTION: Left knee 0_1500, right knee lacks 30.1300 in supine,
Moderately decreased parellar mobility on the right.
NEUROLOGICAL: Intact to gross light touch. Able to heel walk. Difficulty toe walking
bilaterally. Stork stand: left 10 seconds, right 3 seconds.
STRENGTH: Rigbt Lm1
Hip Internal rotation 4+/5 5/5
HIp external rotation 4+/5 5/5
Knee flexion 4/5 5/5
Knee extension 4+/5 5/5
Dorsiflexion 4/5 5/5
When distracted and retested, knee nexion = 4+/5 on right and dorsiflexion 4+/5 on right.
InconSistent right dorsiflexion strength - vaned effort from 3+/5. 4/5 to 4+/5.
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Page 6
GIRTH:
J
With Pain
End of Stairs
Right
. ,- Initial
J.e!1 B.iWJ1
At End of Test '
~
MId Calf
(7" below
mid patellar)
Mid ParellaI'
Supenor
Patellar
Mid thigh
(6" above
. mid patellar)
355cm
36.1 em
35 Bern
36.~m
36,3cm
35,8cm
37.8c01
36.9cm
37 gcm
37.Oem
37.2cm
36.8cm
45.Ocm
45.0cm
45. Oem
45.8cm
All tests negative: Varus, valgus, anterior drawer, Lachmans, MczMurray's, Appley's
compression, Appley's distraction, PF Grind, Apprehension, .
FLEXIBILITY: Not tested,
PALPATION: Tender right distal quad and patellar tendon. Reports "tenderness" pen
patella and mediaVlateral joint line.
(j
INCONSISTENCIES: Lacks full right knee extension actively, but able to heel walk.
Inconsistent strength test.
FUNCTIONAL C~AC[f1~S ASSESSMENTIWORK TOLERANCe SCREEN
A thorough "functional" evaluation was completed. The safe maximum limits for material
handling activities and the functional limits for non~materiaJ handling activities are
summarized in the tables befow. Frequent material handling and non-material handling
(positional tolerances) were assessed in a continuous adivity circuit of jOb simulated tasks.
CONSISTENCY OF EFFORT TESTING:
Mr Rent underwent a formal screening procedure of 5 different isometric strength tests
designed to identify those individuals who put fonh less than maximum effort on the evaluation
tasks. Each task was repeated four times to test for consistency of response. A coefficient
of vanance statistic was calculated for each task. He was consistent in 5 of 5 isometric tests,
CHent also performed strength 'measures for flexion and extension on Biodex, He was
consistent on7 of 8 tests performed.
Biodex Test
Unlnvolvedtrnvolved
Uninvolved/Involved
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Page 7
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FUNCTIONAL CAPACITIES EVALUATION
WORK TOLERANCE SCREEN
ISOMETRIC .CONSISTENCY TESTS~
lEST lRlA.lS tPOUNDS OF FORCE) AVERAGE S.DJC. V.
STRAIN GAUGE SQUAT lifT 160. 160, 200, 200 180 20111 %
ISOMETRIC PUSH 55, 55t 60, 48 55 4,3/8%
ISOMETRIC PUll 40, 40, 42, 38 ~o 1.414%
GRIP STRENGTH, RIGHT HAND BO, B2, B5, 111 81 2.613%
GRIP STRENGTH, LEfT HAND 90, 8~ 82, 90 86.8 1414%
0%-15% considered consistent in effort
S.D. = Standard Deviation C.v. = Coefficient of Variation
(:)
COMMENT: Reports of increased right knee pain with squat lift.
Extension CV%
Flexion CV%
8.1%/10.6%
2.0%18.6%
11.6%116.2%
14.3%/13.8%
MATERIAL HANDLING (LIFTING):
LIFT
DEMONSTRATED
J08 REQUIREMENT
OCCASK)NAl fREQUENT OCCASKJNAl fREQUENT YES/NO
FLOOR TO KNUCKLE 25 Las. 2tI LBS. Up to SO Las. 1Slas. NoNn
90.93
KNUCKLE TO SHOULDER 3S LBS. 20 LBS. 30 LBS. 15LBS. Yel
92.96
SHOULDER TO OVERHEAD 35 LBS. 20 lBS. 30 Las. 15 LBS. Yes
geM 00
100 fOOT CARRY WITH PIVOT 35 Las. 20 LBS. 30 Las. 15 Las. NolYes
96.106
0 COMMENT: Client was self limited with airlifts due to bnateral knee pain, right
greater than left. Reports of generalized anterior knee pain. bilaterally. Unable to
specifically point to pain. (No significant change In ~aart rate.)
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BODY MECHANICS: Demonstrated good mechanics with cueing. .
HEART RATE: 89, 89, 96, 96
NON.MATERIAL HANDLING:
AOEOU
ACTIVITY DEMO NEVER OCCASION FREQUENT CONSTANT JOB fOR
RO\.IRINiT JOB?
YESlNO
SITTING 60mn X frequeri Yes
EO MlnlEPlS
STANOINI) 35 mn X frequeri Yes
30 MlI\lEplS
WALKING 112 X freqyenl .
Yo moletEOIS
CLIMBING", Stal~l 130 stalls X 1012. No
.. F.Qhlo;/EoII
TRUNK BENDING 1 MlntEplS X freque1t Yn
1 M.n/EplslXGIHf XSlHr
SOUATTlNG X occasIonal yes
Re-pellhve
SXJEPlS X6IHr SX/Epit
X3IHr
KNEELING Refused 10 Oed
1 MlntEPIS X6IHr II')' refused
REPETITIVE X freQUe1t Yes
BEND
SXJEPts X6IHr 5XlEpls
XSlHr
STATIC SQUAT 105etlEpl$ Rere octaSlonal No
1 Mln1E!:It X6IHr X 1/Hr
lADDER CLIMB X occasional No
3R~ 3 Rungs
))(Jfp.s SX/HI 1 X/Epls
1)(JH'
COMMENT: Client was self-limited by complaints of right knee pain (heart rate 92)
with stalrcllmblng. Able to perform on a frequent basis, but limited in regards to
job description due to reports or pain. (No signjfjcant change in heart rate or
swelling.) Client was instructed to take breaks as needed. Client utilized moderate
assistance from hand rails and on 4th and 5th round, required breaks every 3 to 4
steps. CHent refused to perform kneeling. Reports increased pain with squat.
"It should be noted that although client demonstrated ability to walk on a frequent
basis. the use of a golf cart may be beneficial in r.,duclng the cumulative effect on
the knee and assist with decreased pain complaints. It should be noted that
although employer Is willing to accommodate with use of knee br,ilCe, it Is not
recommended due to effect excessive stair climbing with brace may have on hip
and back.
A flare-up protocol was explained to the client. The client was instructed to call tomorrow
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and to report his status and to ask any questions he may have following the evaluation,
CUent was instructed to return today before 5:00 If he experienced Increased
.. swelling. It was also explained to client that the result of this evaluation will be sent to hiS
physic',an and insurance adjustor,
f
Thank you for referring Mr. Rent to HealthSouth Rehabilitation Center of Clearwater. If you
have any rurther questions regarding his evaluatlon or the recommendations made. please'
'. do not heSItate to contact us.
.,.
. Testing time Was 5 hours.
//
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Tr'acy ~ooney.. MPT . . , .
. PhystCal Therapist . . . ,
J. a LA~^", 6rr.u z'~/?7t.d
Deanna Krautne I MEd
.Industrial Rehabirilafion Coordinator
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CL€ARWA TER GAS SYSTEM
rnterofficlJ Corr~cJenclJ Shut
TO:
Mark Poteet_ Human Resources
D~C 23 1997
E 1'ir "rr14~
FROM:
Milton C. Cason, Program Coordinator, Safety & Training ~
COPIES: Sandy Barley, eGS
SUBJECT: ~estor Rent"s Ught Duty Perfonnance in CGS
DATE: December 22, 1997
The. purpose of this correspondence is to make you aware of the good job which
Lester Rent did for us during the period that he performed a light duty work
assignment in eGs. He assisted us in many of short notice tasklngs which we
received regarding vehicles, reports and the like. Special note should be made of the
excellent assistance which he provided to me in working on the City's United Way
Campaign.
.J
Please convey to him our appreciation for a job well done. He performed well for us
and always exhibited a positive attitude.
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CtmaI PcnnIum, DcpeJ1mcd
tmecomce~
TO:
FROM:
Ken Gilmore, Assistant Water Pollution Control Superintendent
Scott Shuford, Central Permitting Director 55
SUBJECT: Commendation. Lester Rent, Operator Class C
co: .
IUsk Management
r,{Juman Resources
DATE:
January 29, 1997
On January 20, 1997, Las Rent was assigned to the Central Permitting Department
in a light duty capacity. We wanted to relay to you bow pleased we are with the
work he has been able to perform for us. Lea bas been a tremendous help to all of
us. On a daily basis, his duties have included; relief tor our greeter dUring lunch
hour, breaks, etc., prepares microfilm for our building permit address files and
accomplishes a variety of deparbnental filinr. <keasionally, Lea is called upon to
work in other departments as well, i.e. Risk Management. ete.
Anything we ask Les to do, he does with expedience and a cheerful manner. We
are all enjoying working with him and appreciate all that he does ror U8.
I thought you might be interested in how Les has been working out for us.
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1/ftf , 611 j/ /0 DEt 1 6 1998
CITY'OF CLEARWATER
POST OFFICE Box 4748, C~\RWAT!R, FLORIDA 33758-4748
MC;";ICIP.U. SERVICES BL:ILOI~Q, 100 Sol-llt MYRTU ^VE.~L'E, CLE.lJrl","TER. FLORIO... 33756
TELEPHO:-;E (727) 562.4650 FAX,(727) 562...6;9
FISA.~CE OEPAJlr.;IE.\T
Rlsl\ M"'~,\(jE.\IE.\T 01\1510S
December IS, 1998
Jeffrey Tedder. M.D.
50154 8L N.
. '8t. Petersburg, FI 33703
Re: Employee: Lester Rent
D/A: 10121/96
88#: 353-40-6442
FilcH: 574
Dear Dr. Tedder:
Thank you: for taking time out of your busy schedule to tark with me regarding Lester Rent
As we discussed, the City of Clearwater is agreeable to making any reasonable aa:ommodation DecessIIY
to enable Mr. Rent to perfonn his job duties as a waste water treatment plant operator.
In that regard you advised that you were going to order a Protonic knee brace for Mr. Rent which will
enable him to climb the stairs n~ to perfonn his job duties. The City of Clearwater will also provide
Mr. Rent with a vehicle to drive between buildings so that be can limit his walking.
You advised !hat with the use of a brace and a vehicle to transport him between buildings that the physkaJ
requirements of his job will b.: within his physica11imitations and that he should be able to safely pcrfOlDl
his job duties.
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Risk Management Specialist
cc: Joe Re<:kenwald
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Lester rent
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NARRATIVE SUMMARY OF THE PHYSICAL REQUIREMENTS OF THE A SIDE
POSITION.
Through th~ a-hour work day. the incumbent has to navigate a total of 1012 stairs, This
total may increase if additional checks on equipment are required. The attached memo
eMjdnight Shift c A' Side"). outlines the number of steps at each building the incumbent
needs to climb, how many times per shift the incumbent climbs each set of steps, the total
, , number of step to be climbed at each building, and the distance between stair steps at each
building.
Under nooria! working conditions, the incumbent will walk one round consisting of the
entire set of stairs throughout the plant, have a break between stair climbing (normally 1-
, 1 ~.5 hours), and then walk the steps a second, third, and fourth time (with roughly.
equivalent time intervals between rounds). For the A shift, the total number of steps.
. during one .round would be roughly 212,
The A Side position entails considerably more walking (e.g., between buildings) than does
. the B side. We can accommodate this with a golf cart.
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From: Gerald Bennett
Copies: Ken Gilmore
~ . Subject: MIDNIGHT SHIFT -A- SIDE
Date: 11-04-98
STAIRS FOR THE A SIDE. PLANT TOUR EVERY TWO HOURS
rlu~nsct. ~~ 1c9.S'
, CONTROL BUILDING ONE WAY TIMES TOTAL RISER
~\lEt:~~6~ft~~Jj ftrL 5-\4Il"1 6 %" CONCRETE
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CONTROL BUILDING TO CIRCULARS
TO SUP TUBES TIME 4 TANKS 4 1 16 6~" CONCRETE
TO TOP OF CIRCULAR TIME 4 TANKS 6 2 48 6%" CONCRETE
, TO REAERATION 6 4 24 6%" CONCRETE
" PRIMARIES 5 4 20 6%" CONCRETE
,0
REACTOR 5 4 20 6%" CONCRETE
RECYCLE 13 4 52 7. FIBERGLASS
AERATORS 2 4 a 6%. CONCRETE
RETURN PUMPS 2 4 8 6%. CONCRETE
BLOWER ROOM 5 4 20 6%. CONCRETE
BREAK BUILDING UP 29 5 145 6%. CONCRETE
BREAK BUILDING DOWN 29 5 145 6%. CONCRETE
TOTAL ONE WAY
106
506
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THIS NUMBER IS A MINIMUM AND WOULD INCREASE IF ADDITIONAL CHECKS WERE
REQUIRED.
THIS TOUR WOULD BE A LARGE CIRCLE, LESS THE BREAK BUILDING AND WOULD
BEGIN AT THE CONTROL BUILDING. USING THE ELEVATOR TO GET TO AND FROM THE
CONTROL ROOM AND THE TANKS. THERE IS MORE WALKING TO MONITOR THE
EQUIPMENT AND MAKING PROCESS CHANGES.
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TOURING ON MIDNIGHT SHIFT
VISUALLY CHECK ALL EQUIPMENT EVERY TWO HOURS THAT PERTAINS TO THE
OPERATION AND ANY ADJUSTMENTS AS REQUIRED FOR PROCESS CONTROL.
REACTOR BUILDING AND ALL ASSOCIATED EQUIPMENT.
FEED PUMPS, DISCHARGE PUMPS. PO(YBLENDS, MIXERS, SCREENS, FLOWS,
CHARTS AND READINGS.
FERMENTATION TANKS
ALL MIXERS, MOTORS AND APPEARANCE.
FIRST ANOXIC
I ALL MIXERS, MOTORS AND APPEARANCE
RECYCLE
PUMPS. GATES. AND FLOW METER.
AERATION
ALL TANKS, DIFFUSERS, VALVES. DISSOLVED OXYGEN METERS, CHARTS AND
ADJUSTING VALVES.
RETURN SLUDGE PUMPS
PUMPS, MOTORS AND VALVES METER. CHARTS AND READINGS
BLOWER ROOM
BLOWERS, MOTORS, VALVES. GAUGES, PIPING AND ALL ASSOCIATED
EQUIPMENT.
ALUM FEED
MOTOR CONTROLS, PUMPS. TANKS. AND PIPING.
AUXILIARY GENERATORS
350 ONAN
CATERPILLAR FOR AUXILIARY BLOWER.
600 ONAN FOR AUXILIARY MOTOR FOR BLOWER.
CONTROL ROOM
ALL CHARTS, TOTALIZERS, VISUAL OVERHEAD OF All EQUIPMENT AND
COMPUTER ENTRY.
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DUTIES OF THE A SIDE
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CHECK ALL CHARTS AND RECORD DAILY READINGS. ENTER COMPUTER DATA.
CHECK ALL CIRCULAR SLIP TUBE RECORD SETTINGS AND ADJUST AS NEEDED.
CHECK SLUDGE LEVELS rN CIRCULAR TANKS TWICE PER SHIFT AND lOG READINGS.
PUMP DOWN CIRCULAR SCUM PITS AS NEEDED,
. RECORD DISSOlveD OXYGEN READING TO CIRCULARS.
CHECK REAERATION TANKS AND ADJUST AIR AS NEEDED.
CHECK 12 SECOND ANOXIC MIXERS.
RECORD SECOND ANOXIC DISSOLVED OXYGEN READING.
CHECK INFLUENT FLOW METER
TANK DRIVES
SLUDGE PUMPING SYSTEM
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RETURN SLUDGE FLOW METER
CHECK ALL 6 FERMENTATION MIXERS
CHECK SLUDGE nnCKENER AND MAINTAIN AS NEEDED.
CHECK INTERNAL RECYCLE PUMPS.
CHECK 9 FIRST ANOXIC MIXERS
CHECK, RECORD READINGS AND ADJUST ALL 13 AERATORS. CALmRATE DISSOLVED
OXYGEN METERS AS NEEDED.
CHECK RETURN SLUDGE PUMPS
CHECK AND ADJUST BLOWER AS NEEDED
CHECK ALUM PUMPS AND FEED.
o ENTER ALL COMPUTER DATA.
ASSIST IN CLEAN CONTROL BUll..DlNG FDtST AND SECOND FLOOR.
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NARRATIVE SUMMARY OF THE PHYSICAL REQUIREMENTS OF THE B,SIDE
POSITION.
. Through the 8-hour work day, the incumbent has to navigate a lotal of J2J4 stairs. This
total may increase if additional checks on equipment are required. The attached ,memo
("Midnight Shift. 'B' Side") outlines the number of steps at each building the incumbent
needs to climb, how many times per shift the incumbent climbs each set of steps,. the total
. number of step to be climbed at each building, and the distance between stair steps at each
. building, ' . ,
. Under normal working conditions. the incumbent will walk one round consisting of the
. . entire set of stairs throughout the plant, have a break between stair climbing (normally I-
. 1.5 hours). and then walk. the steps a second, third, and fourth time (with roughly
equivalent. time intervals between. rounds). For the B shift, the total number of steps
during one round would be roughly 318.
, .
The B side position contains more stair-climbing, but Ie.~ walking..
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~ To: Joe Reckenwald
From: Gerard Bennett
Copies: Ken Gilmore
Subject: MIDNIGHT SHIFT .B" SIDE
Date: 1 0-30-98
.. STAIRS FOR THE B SIDE. PLANT TOUR EVERY TWO HOURS
BREAK BUILDING ONE WAY TIMES TOTAL RISER
. BREAK ROOM 29 5 145 6%. CONCRETE
FILTER BUILDING
INSIDE GOING UP TO FILTERS 16 4 64 6%. CONCRETE
PIPE GAlleRY 3 4 12 6%" CONCREYE
TO TOP OF SCREWS 5 .4 20 9. CONCRETE
BOTTOM OF SCREWS TO GREASE POTS 8 4 32 7" FIBERGLASS
D.O. BOOST EFFLUENT 6 4 24 7" FIBERGLASS ,-
REUSE
(7) OLD PUMP STATION 5 4 20 r CONCRETE
. ~"" NEW PUMP STATION 6 4 24 6%. CONCRETE
SECONDARY D1GESTOR S 2 10 T' CONCRETE
PRIMARY PUMP ROOM 1 4 4 12" CONCRETE
INFLUENT BUILDING
PUMP ROOM TO INSIDE 2 4 8 r CONCRETE
MOTOR CONTROL ROOM 20 4 80 7" CONCRETE
PUMPS 20 4 80 .,. CONCRETE
BARSCREN ROOM
UP TO SCREENS 5 4 20 7" CONCRETE
LOWER LEVEL 16 1 16 7" CONCRETE
PRESS BUILDING
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TO BLENDING TANK LEVEL METER 12
TOTAL ONE WAY 159
UP AND DOWN 318
4 48
607
1214
6 %. CONCRETE
8" ALUMINUM
THIS NUMBER IS A MINIMUM AND WOULD INCREASE IF ADDITIONAL CHECKS WERE REQUIRED.
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TOURING ON MIDNIGHT SHIFT
VISUALLY CHECK ALL EQUIPMENT EVERY"fWO HOURS THAT PERTAINS TO THE
OPERATION.
CHECKING THE CHEMICAL BUILDING AND ALL ASSOCIATED EQUIPMENT.
TON CONTAINERS. CHLORINE AND SULFUR DIOXIDE MACHINES AND ANALYZERS
CL 17 ANAL VZER AND pH METER. CHARTS AND READINGS.
FILTER COMPLEX AND ALL ASSOCIATED eQUIPMENT.
SAMPLERS, SAMPLES, AND REFRIGERATORS. PUMPS AND VALVES FOR FILTER
, OPERATION. TURBIDITY METER. CHARTS AND READINGS
GENERATOR AS NEEDED
PRIMARY DIGESTOR
PUMPS AND READINGS
. I
PRIMARY PUMP ROOM
CONTROLLER. VALVES AND PUMPS.
SECONDARY DIGESTOR
SUMP PUMP AND READINGS
INFLUENT BUILDING
PUMP ROOM
GENERATOR AS NEEDED
MOTOR CONTROLS AND PUMPS.
READINGS
BARSCREEN ROOM
SCREENS AND DUMPSTER
ODOR CONTROL
TEA CUP AREA
TEA CUPS ,
INFLUENT SAMPLER ,SAMPLE AND PUMP.
ODOR CONTROL BUILDING
WATER CONDITIONERS ,
AIR COMPRESSOR AND CHEMICAL PUMP.
BELT PRESS
BLENDING TANK lEVEL READING.
GENERATOR AS NEEDED
,~ REUSE SYSTEM
TRANSFER AND DISCHARGE PUMPS AND READINGS.
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TASKS TO PERFORM DAilY.
CALIBRATION OF THE
TWO CHLORINE ANALYZERS
CL 17 ANALYZER.
pH METER
TURBIDITY METER
NOTE: IF WE ARE PUMPING REUSE WATER TO THE HOLDING TANK THE CHLORINE AND
TURBIDITY MUST BE MONITORED AND RECORDED HOURLY.
, IF ANY OF THE ABOVE MENTIONED ANALYZERS OR METERS MALFUNCTIONS,
, READING AND TEST Wll..L BE DONE HOURLY.
COLLECTION OF THE FECAL SAlvtPLE.
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COLLECTION OF TIlE DAn. Y COMPOSITE SAMPLES.
MAINT AINlNG TIPSTERS LEVELING, ODOR CONTROL AND DUMPING.
HOSING DOWN THE BARSCREBN ROOM.
ENTERING DATA IN COMPUTER
OTHER DUTIES:
. MAINTENANCE OF THE Cm.ORINE CONTACT CHAMBER TRAINS.
PUMP DOWN ONE TRAIN AND HOSE OUT ONCE A WEEK.
COMPARISON TEST THE TITRA TOR EVERY 2 WEEKS.
COLLECT TIlE SLUDGE SAMPLES THREE TIMES A WEEK ON MONDAY, WEDNESDAY AND
. FRIDAY. TInS Wll..L INCREASE THE ~ER OF STAIRS.
THE REACTOR 16 STEP~ AND PRIMARY SAMPLES 12 STEPS. TOTAL 28.
MAINTENANCE AND CLEANING OF THE CONTROL BUll..OING.
CONTROL ROOM
FLOORS AND EQUIP:MENT
BLOWER ROOM
FLOORSANDEQUWNrnNT
STORAGE ROOM
ALUM AND GENERATOR ROOM
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JnS(K.natA~n' H:Jmlf'l RfXOI.l'~1I 100 Mrr1IQ Cloatwllte' :13756
AqUSla" ORbie 'OM
Phone I Fer. 7:Z7.5ft2-~lIeo I 7~7.~2-4677
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CT sCAN
RCNE SCAN
ARTHROGRAM
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IllEQUESTfD rACIU''':
MORTON PlANT SUNCOAST
ACCfSS
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FIft(7U11ncy QD TIW 8fW
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WH SURGER'y
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RESTRICTIONS: S ' ~
N()~ino Of (::Jfl)1"D n\'''' L lbs (Righi LtfI
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No llse
(Sitting I ~tflnB"91 Walk.i'lg) ._._ "0VtS pel03y
(Bt1llJinwt "00png , t'ft'lr.oog l.qUlt!'nO , knullng , climbing)
Ovt"h.,aa acDwdlC$ (RlQhtl Len)
Drivl'lO of (:ll"t1rnllf1C I ~nctard)
(UUJ,lt!I ex'lfffMY 110wtt tl\tTvcmy, IR~ht I Left)
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(No I limited)
{No , L,rhlcd}
(No lumitod.
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NO repelb",. use
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Rev. 4/97
CIlY OF CLEARWATER
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0220
n
Class Title: ACCOUNTING CLERK
CLASS DEFINITION, IN TERMS OF:
1. Duties that are Characteristic as to Tvoe and Level:
Bookkeeping and clerical work of more than ordinary difficulty and responsibility in maintaining
automated financial and accounting records.
Work of employees in this classification requires the exercise of a considerable degree of initiative
and judgment In carrying out established City and departmental procedures. Employees work
under general supervision and may exercise supervision over other bookkeeping and clerical
employees.
2,
Tvpical Tasks or Assfanments:
(:) ,
Communicates with the public or other employees to provide data or to respond to requests or
complaints. Enters Information from verbal or written sources into the computer or onto proper
forms. Makes routine entries Into a log. ledger. or journal to record the receipt or status of
materials or Information. Composes correspondence or memoranda to communicate or request
Information. Makes arithmetic calculations to determine totals, costs, rates, discounts. etc.
Gathers information needed for purchase orders, billing statements, Invoices, etc., by telephone,
memos, letters, or personal visits to various agencies. May prepare purchase orders, record
vendors in automated vender file, prepare bid documentation and tabulate results. or calculate
cost of inventories. Checks andlor verifies lnfonnation on various forms, purchase orders, billing
statements, invoices, printouts, etc. Serves as a backup for other clerks or office personnel in
order to ensure smooth office functioning. Operates CRT to input data into computer. Perlorms
related tasks as assigned.
3.
Minimum Qualification Reaulrements:
a. As to knowledge, skills, abillties, and other attributes:
Knowledge of office procedures and appliances.
Knowledge of basic bookkeeping procedures and formats.
Ability to follow oral and written instructions.
Ability to record Infonnatlon accurately.
Ability to make arithmetic computations (percentages, discounts, etc.) with speed and
accuracy.
Ability to review, check, classify, and compare information with established
standards/terms. .
Ability to establish and maintain effective working relationships with other employees
and the public.
Ability to operate a CRT and use department operating systems.
As to sChoolfng, training, and experience:
b.
.l '.
V
High School graduation, High School Equivalency Diploma, or G.E.D. Certificate,
including or supplemented by courses in bookkeeping or accounting. Two (2) years of
experience in responsible clericaJ and bookkeeping work with automated system
preferred. Any equivalent combination of education, training, and experience.
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Rav. 3/92 CITY OF CLEARWATER
()
'/," Class Title: CUSTODIAL WORKER
CLASS DEFINITION, IN TERMS OF:
!
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6500
1.
Duties that are Characteristic as to Type and Level:
Routine cleaning and other custodial work in City buildings.
Work involves the custodial maintenance and care of a single building complex or a variety of
geographically separated buildings, with hours subject to variation depending upon department
and use of buildings. In situations where work Involves a variety of buildings, the position may
require 'a driver's license. Performed under general supervision.
2.
Typical Tasks or Assignments:
Sweeps, dusts, washes. waxes, and polishes floors, furniture, woodwork, walls, windows, and
the like. Shifts furniture and arranges rooms; picks up paper, litter and refuse; moves books and
magazines and straightens shelves. Opens and closes doors and windows; turns lights on and
off. Occasionally assists in a helper activity In such work as is incidental to the location and
. particular activity in connection with cleaning operations. Performs minor maintenance work.
Performs related tasks as assigned.
Minimum Qualification Reaulrements:
a. As to knowledge, skills, abilities, and other attributes:
Knowledge of cleaning methods and materials.
Ability to understand and comply with oral and written instructions.
Ability to perform the essential functions of the job.
. b. As to schooling, training, and experience:
Ability to read and write.
Any equivalent combination of education, training, and experience.
,--.--_. .- .-~'11~ '.... " ...... t.. . . . . ~
C":'Rev. 7/90
CITY OF CLEARWATER
0170
Class Title: SERVICE DISPATCHER
CLASS DEFINITION. IN TERMS OF:
1. Duties that are Characteris.tic as to Tvpe and Level:
Dispatching and clerical work of ordinary difficulty and responsibility in receiving and transmitting
radio and telephone messages.
2.
Employees In this classification are responsible for operation of the base unit of a radio
communications network. Work involves the receipt and transmission of a volume of service
orders and messages to expedite the work of the department.
Typical Tasks or Asslonments:
Operates the base unit of a two-way radio communications network. Operates a PBX telephone
switchboard. transferring routine calls to appropriate persons. Determines the nature of
complaint and other vital information; maintains radio contact with equipment dispatched.
Transmits service orders and messages and receives routine check-in calls from servicemen
and other personnel. Maintains a log of all calls and messages received and transmitted and/or
equipment dispatched; maintains and makes out various records, forms. and reports, and
perfonns routine clerical duties. Performs related tasks as assigned.
.")
"-~...'
. 3.
Minimum Qualification ReQuirements:
a. As to knowledge, skills, abilities. and other attributes:
Knowledge of the geography of the City, including the location of streets. buildIngs,
schools. subdivisIons, and other landmarks.
Ability to handle emergency situations calmly and promptly and to handle excited persons
in a calm, guiding manner In order to secure the essential information pertaining to an
emergency situation.
Ability to understand and eany out written and oral instructions.
Ability to keep records and maintain simple fifes.
Ability to quickly learn department practices. rules. and regulations.
If receiving and dispatching emergency calls for the Gas Division, ability to meet and
maintain complfance with drug testing standards as required by the City Gas Division
Drug Program.
b.
As to schooling, training, and experience:
\~
. "
High School graduation, High School Equivalency Diploma. or G.E.D. Certificate.
One (1 )year experience in teJephone or radio dispatching.
Any equivalent combination of education. training, and experience.
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· Rev. 10/94
CITY OF CLEARWATER
6530
"'-Ylass Title: MAINTENANCE WORKER r
CLASS DEFINITION, IN TERMS OF:
1. Duties that are Characteristic as to Tvge and Level:
Manual work of ordinary difficulty In performing Ught to heavy physical labor and assisting in the
performance of a variety of semi-skilled and skilled landscape and grounds maintenance,
building maintenance, andlor construction related tasks,
2.
Employees In this classification normally. work under supervision performing routine physical
labor. Speclflc work assignments are given and work is performed under direct supervision and
is continually checked for compliance with instructions.
Tvplcal Tasks or Assignments:
Loads and unloads materials, supplies, equipment, gravel. shell, trash, and other debris. Digs
ditches and other excavations; assists In laying pipe and sewer lines and making sewer taps.
Assists In the construction, maintenance and repair of sewers. water lines, hydrants, curbs.
sidewalks and gutters, and other instaUations. Mixes cement and mortar. Mows lawn and park
areas with push or ride power mowers; trims hedges; edges grass, removes weeds; piles up and
. disposes of rubbish, seaweed, and other litter. Cleans sewers, culverts, ditches, drains, and
creans catch basins. Assists in pJanting and propagating trees. shrubs and pJants; grades, turfs,
and seeds lawn areas. Performs miscellaneous building cleaning and maintenance and assists
In plant and equipment repairs. Moves office furniture and sets up meeting rooms. May dig
graves and assist at intennents and placing grave markers. Uses a variety of hand and power
tools and pumps. sewer rodders, power mowers and similar equipment and may occasionally
drive trucks in dally work. Performs related tasks as assigned.
,')
.",,-,
3.
Minimum Qualification Requirements:
a. As to knowledge, skills, abilities, and other attributes:
Ability to understand and carry out oral instructions.
Ability to read and write.
AbiJity to perfonn heavy physical rabor, occasionally under adverse weather conditions.
Ability to learn the proper use of assigned hand and power tools.
Ability to secure an appropriate State of Florida drivers license based upon area of
assignment.
b. As to schooling. training, and experience:
Some experience in performing heavy manual work in landscape and grounds
maintenance. building maintenance, and/or construction related activities.
u
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Rev. 2/98 CITY OF CLEARWATER
o .
. ., Class Title: MARINE FACILITY OPERATOR
3010
CLASS DEFINITION, IN TERMS OF:
1. Duties that are Characteristic as to TYRe and Level:
Service, sales, and maintenance work of ordinary difficulty In connection with the operation of
municipal marina docking or pler/bait house facilities.
An employee in this classification Is responsible for the safe and efficient operation of a marine
fueling facility, public docks, andlor a pierlbait house facility. Performed under gerieral
supervision.
2.
Tvpical Tasks or Assignments:
,/",\
,_J
Dispenses marine fuels and lubricants to a variety of watercraft. Insures that all appropriate
safety precautions are observed at the marina or pier/bait house. Receives and accounts for
cash, and processes checks and credit card sales. Prepares daily shift reports and records.
Receives, accounts for, and inventories fuel andlor bait house stock. Assigns slips to transient
vessels and assists vessels in mooring. Monitors docks, piers, and moored watercraft through
periodic inspections. Adjusts and re-positions mooring lines as needed. Answers telephone
calls and provides marine and fishing related information. Collects slip rentals and issues
parking permits and fishing passes. Reads and records electric meters. Performs minor
maintenance, custodial assignments, and other marine or pierlbait house tasks as directed.
3.
Minimum Qualification Reauirements:
a. As to knowledge, skills, abilities, and other attributes:
Knowledge of general marine practices related to fueling and mooring vessels.
Knowledge of focal and surrounding beach and geographic areas.
Knowledge of local fishing practices and related fishing regulations.
Ability to handle large sums of money.
Ability to make change quickly and accurately, to prepare simple reports, and to maintain
records.
Ability to work rotating shifts.
Ability to provide general information to boaters, pier customers, and tourists in a
courteous and friendly manner.
Good physical condition with no serious defects of vision. hearing, or limbs.
As to schooling, training, and experience:
b.e
~)
, High School graduation, High School Equivalency Diploma, or G.E.D. Certifteate.
One (1) year of experience in work rerated to boating and/or bait house operations.
Six months of experience handling money and making change.
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Rev. 8/96
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. . 'Class Title: LIBRARY ASSISTANT
CLASS DEFINITION, IN TEAMS OF:
CITY OF CLEARWATER
2110
1. Duties that are Characteristic as to Tvpe and Level:
Para-professional work of more than ordinary responsibility. Employees within this classification
perform para-professional work in one of the major library service dMsions. Includes responsibility
for making minor decisions on standard procedures. May serve alone or with minimal staff at public
service points during evenings and on weekends, andlor may coordinate activities of Library
Assistants and Pages in the absence of higher authority. Work Is performed under general
supervision.
2.
Typical Tasks or Assignments:
o
Uses library computer systems to check materials in aJ')d out, register new customers, collect fines
and fees, process overdue notices, register reserve requests, or enter interlibrary loan requests.
Explains policies; shelves materials; reads shelves; compiles basic statistical reports; answers
telephones; assists customers In locating items; and provides back-up help for special programming;
assists with ordering. processing, and cataloging materiars: processes audio-visual requests and
materials: and mends library materials. Has additional responsibility for processing daily cash
receipts, maintaining borrower records, managing the overdue materials function, maintaining
interlibrary loan. sign-making, or other special assignments.
Performs related tasks as assigned.
Minimum Qualification Requirements:
3.
8. As to knowledge. skills, abilities, and other attributes:
Ability to operate a personal computer and to accurately transpose information from written
materials Into a database.
Ability to understand and follow oral and written instructions.
Ability to record and document information accurately.
Ability to quickly learn library methods and procedures.
Ability to use tact. courtesy. patience, and judgment in working with library customers of
various ages, Interests, and capabilities.
Working knowledge of basic English spelling and grammar. filing, and basic mathematical
calculations. '
Ability to accurately process cash receipts transactions and operate a cash register.
Ability to lift and transport relatively heavy library materials.
Willingness to work shifts, including weekends and evenings.
As to schooling. traIning. and experience:
b.
o
High School graduation, High School Equivalency Diploma, or G.E.D. Certificate. One year of
experience In public contact work. Any equivalent combInation of education, traIning, and
experience.
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Rev. 12/87 CITY OF CLEARW~TER
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."..'Class Title: PARKING ATTENDANT
2066
CLA.SS DEFINITION, IN TERMS OF:
1.
Duties that are Characteristic as to Tvpe and Level:
2.
Caretaking and collection work in connection with the operation of the City parking facilities.
Principal responsibility of employees within this classification is for the safe and efficient
operation of City parking facilities. Performed under s,upervision.
Tvoical Tasks or Assignments:
Operates' a cash register to receive and give out cash. Perfonns simple repairs on parking
equipment (stuck gates, corrects jammed spitters, etc.). Instructs monthly customers on the
proper use of magnetic cards. Counts money and fills out money record sheets at the close of
shifts. Keeps parking facilities clean (sweeps lanes and booths, picks up the lawn ai"eaS,
empties trash, cleans windows and equipment). Performs related tasks as assigned.
Minimum Qualification Reauirements:
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Ability to safely handle large sums of money.
Ability to make change quickly and accurately and to prepare simple reports.
Ability to work shifts.
Ability to explain charges and give routine infoonation to the public in a courteous and
tactful manner.
Freedom from physical difficulties that Interfere with successful completions of the work.
As to schooling, training. and experience:
High Schoof graduation, High School equivalency Diploma, or G.E.D. Certificate.
a. As to knowledge, skills, abilities, and other attributes:
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Rev. 6/89 CITY OF CLEARWATER
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.: Class Title: POLICE COMMUNICATIONS OPERATOR TRAINEE
3568
CLASS DEFINITION, IN TERMS OF:
1. Duties that are Characteristic as to Type and Level:
Training work leading to progressively responsible tasks in answering and responding to phone
jnquiries~ receiving and answering requests for information; radio police dispatching.
Employees in this classification will be trained to operate several types of communications
equipment used in the Police Communications Center. The employee uses standard
procedures for receiving and channeling phone calls and emergency and routine radio calls from
officers and the public. Upon the successful completion of training, and after satisfactory job
performance, employees are promoted, subject to passing a civil service examination.
Employees not promoted are subject to dismissal from City employment. Work is performed
under close supervision in a stressful, fast-paced environment.
2.
Tvpical Tasks or Assignments:
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On assigned shifts, answers phone calls for police assistance, records necessary information,
and sends the requests to appropriate dispatchers via a Computer Aided Dispatch (CAD)
system. Communicates with surrounding community public safety agencies, ambulances,
wreckers, and other emergency apparatus. Operates computer terminals to supply police
officers with information such as person descriptions, vehicle registrations, license checks, etc.
Contacts state and national law enforcement agencies to provide or receive inlonnation. Refers
messages to proper persons or units; operates Teletype and monitors alarm panel. Answers all
incoming local and rang distance calls and. makes proper connections at the switchboard.
Answers routine, non-technical questions from citizens and refers other questions to proper
departmental authorities. Dispatches calls for service and responds to requests from field units
using the CAD system. Handles emergencies and deals with excited persons calmly while
obtaining essential information. Performs related tasks as assigned.
3.
Minimum Qualification Reauirements:
a.
As to knowledge, skills, abilities, and other attributes:
Ability to learn radio dispatching, incfuding the CAD system.
Ability to learn the location of local streets, subdivisions, and other landmarks.
Ability to speak and hear clearly.
Ability to read maps.
Ability to remember descriptive details, license numbers, etc.
Ability to understand and carty out written and oral instructions.
AbiJity to keep records and maintain files.
Ability to learn departmental practices, rules, and regulations quickly.
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)Rev. 7/95 CITY OF CLEARWATER
Class TiUe: - POLICE SERVICE TECHNICIAN
CLASS DEFINITION, IN TERMS OF:
3610
1. Duties that are Characteristic as to Tvoe and Lev~:
General nonswom police related duties involving the writing of official police reports, parking citations,
and the rendering of assistance to the public. Duties may also Involve the Investigation of certain types of
criminal incidents and motor vehicle accidents.
Employees perform dutIes In accordance with departmental rules and regulations and in accordance with
existing laws and ordinances. Work is performed under general supervision through the assignment of
duties, personal Inspection, and review of reports. Clvitian technicians must be able to exercise sound
judgment In the performance of police.related duties. Must attend a training programs sponsored by the
Pollee Department.
2.
Typical Tasks or AssiQnments:
Employee may be assigned to any of the following duties: Prepare reports on initial Investigation of
assigned calls for service which may include criminal matters; make the Initial Investigation of motor
vehicle accidents and make appropriate charge based on laws which are civil In nature; Issue appropriate
parking tickets and warnings; take Into custody found property and items of evidence as directed by
competent authority; use a computer to input and retrieve Information; work the front desk position giving
information and assistance to the public; transport Police Department vehicles to and from the City
garage for service; testify in court; work the court liaison position as needed; may serve in the
Communications Center or perfonn other pOIiCE:Helated functions as necessary; use telephone and radio
communications equipment; may a~lst in processing forfeiture cases and the collection of settlements
for deposit In the Special Law Enforcement Trust Fund; and operate Police Department vehicles for the
above purposes as necessary for the performance of those duties. Performs related tasks as assigned.
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3.
Minimum Qualification Reoulrements:
a.
As to knowledge, skills, abilities. and other attributos:
Knowledge of major street, highway, and hospital locations In Clearwater.
Ability to understand and carry out oral and written Instructions.
Ability to observe situations anaJytlqal1y and objectively and to record them clearly and completely.
Ability to learn the basic principles, practices, and procedures of police work to the extent they are
necessary for the performance of the above-descnbed duties.
Ability 10 use a computer to input and retrieve accurate information.
Ability to establish and maintain effective rerations with the publfc and enforce laws and
ordinances tactfully, firmly, and impartially.
Ability to learn applicable laws and ordinances and departmental rules of conduct and procedures
and work within their scope.
Ability to get Information verbally and write it down In an accurate, understandable, and
grammatlcaDy correct manner.
Ability to complete training needed to successfully perform assigned job duties.
Possession of a valid State of Aorida driver's license.
l~
b.
As to schooling, training, and experience:
High School Graduation or High School Equivalency Diploma or G.E.D. Certificate.
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AFFIDA vir
STATE OF FLORIDA
COUNTY OF PINELLAS
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Jon C. Marcin, being first duly sworn, deposes and says:
1 . That I am a Risk Management Specialist employed by the City of Clearwater
and as such my duties include review and analysis of workers' compensation
benefits documents filed by City of Clearwater employees.
2. That I am familiar with the First Report of Injury or Illness filed by Lester Rent
regarding an alleged incident on October 21, 1996, and the case file regarding said
Report.
3. That Mr. Rent received a 12% impairment rating In early 1999, that all
claims arising out of the Notice have been paid, and that the only future benefits
available to Mr. Rent under the workers' compensation program would be ongoing
medical expenses.
4. That the Risk Management Department has reviewed reasonable
accommodations in conjunction with Mr. Rent's continuing employment in his
position as a Waste Water Treatment Operator, that a golf cart has been provided to
Mr. Rent, and that installation of lifts on the stairs for all five buildinQs at the subject
complex is possible and would cost $30,000 to $36,000.
Jt~ur.
The foregoing instrume~t was acknowledged before me this 7tL day
l=urther Affiant sayeth not.
of June, 1999, by Jon C. Marcin, who is personally known to me and who did take
an oath.
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: ..Qif; Sharon O. Walton . i
) !:\ ~ NOlal)' Public. Slale or Florida : C
:?''t ~ QunmJuloll No. CC'9J69' .:
O'fL~ MyCommiulon Exp.IJtOJI2000 : C
: ...oo..J.llOrAlv. FI&. folctlf)' Scnict.. BocldUweo ::
'{(((("(((((((((((((((((((((((((((((((((I((((((I(~ ;
L~a,
~otary public
Print or type name: SHARON O. WALTON
My Commission Expires:
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