LAWOFFICES
`
`
`
`SUITE1309
`
`;LLP
`
`KEENEY&CORDERY
`
`IMAI,TADLOCK,
`
`SANFRANCISCO,CA$4104
`
`
`
`(415)675-7000
`
`
`
`100BUSHSTREET
`
`BWW
`SoCO“EPKNWM
`
`10
`
`11
`
`12
`
`13
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`14
`
`15
`
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`17
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`18
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`22.
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`al
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`28
`
`Theodore T. Cordery, Esq. (Bar No. 114730)
`Eunice Chang, Esq. (Bar No. 193800)
`IMAI, TADLOCK, KEENEY & CORDERY, LLP
`100 BUSH STREET, SUITE 1300
`SAN FRANCISCO, CA 94104
`Telephone:
`(415) 675-7000
`Facsimile:
`(415) 675-7008
`Attomeys for Defendant
`GEORGIA-PACIFIC CONSUMER PRODUCTS LP
`
`ELECTRONICALLY
`FILED
`Superior Court of California,
`County of San Francisco
`JAN 21 2010
`GORDONPARK-LI, Clerk
`een eeeok
`eputy Clerk
`
`IN THE SUPERIOR COURT OF THE STATE OF CALIFORNIA
`
`IN AND FOR THE CITY AND COUNTY OF SAN FRANCISCO
`
`UNLIMITED JURISDICTION
`
`WARREN TURLEY,
`
`CASE NO.: CGC-07-274395
`
`Plaintiff,
`
`v.
`
`ASBESTOS DEFENDANTS,et al.,
`
`Defendant.
`
`
`(ASBESTOS)
`
`REQUEST FOR JUDICIAL NOTICE
`
`Date: March 25, 2010
`Time: 9:30 a.m.
`Dept: 220
`Judge: Honorable Harold E. Kahn
`
`Defendant GEORGIA-PACIFIC CONSUMER PRODUCTSLPrequests this Court take
`
`Judicial Notice pursuant to Evidence Code § 452 of all documents contained in Warren Turley’s
`
`State of California Workers Compensation Appeals Board Case No. 2000 LBO 0312046, which
`
`is attached hereto as Exhibit A:
`
`Dated: January 21, 2010
`
`IMAL TADLOCK, KEENEY & CORDERY, LLP
`
`By:
`
`/S/ Eunice Chang
`Eunice Chang
`Attorneys for Defendant
`GEORGIA-PACIFIC CONSUMER
`PRODUCTSLP
`
`
`ado
`REQUEST FOR JUDICIAL NOTICE
`
`

`

`EXHIBIT A
`
`

`

`RECORDTRAK
`
`CASE NAME:
`
`100 Webster Street, Suite 201
`Oakland, CA %4607
`Phone #:
`(510) 465-3200
`Fax #:
`(510) 465-3652
`www. recordtrak.com
`TURLEY WARREN vw. ASBESTOS DEFENDANTS
`
`RECORDS PERTAIN TO: WARREN AUSTIN TURLEY
`
`BRAYTON & PURCELL
`PL. COUNSEL:
`SFSC 274395
`DOCKET NO.:
`SOCIAL SECURITY NO.:
`,
`
`bop:
`09/28/1848
`DOB:
`BERRY & BERRY FILE NO.:
`
`552-68-6349
`/
`of
`M2219.RCD
`
`RECORDS FROM: WCAB - LONG BEACH
`300 OCEANGATE
`SUITE #200
`LONG BEACH, CA 90802
`(562) 590-5004
`RECORD IDENTIFICATION:
`EMPLOYMENT RECORDS
`
`RECORDTRAK FILE NO.: 183639
`RECORDTRAK TAG NO.: 15
`
`000000
`
`

`

`
`
`THE TRACK RECORD OF SUCCESS
`
`@pecorvTrak aetot
`
`Phone:
`Fax,
`
`(80%) 355-5774
`(540) 465-3652
`
`March 19, 2008
`
`WCAB - LONGBEACH
`RECORD CUSTODIAN
`360 OCRANGATE
`SUITE #206
`LONG BEACH, CA 90802
`
`Re: WARREN AUSTIN TURLEY .
`
`,
`
`§52-63-6349
`SSH.
`09/28/1948
`DOR:
`183639
`RF Firs:
`Roa#: M2219,.RCD
`
`pop.
`Tack
`
`//
`15
`
`Tiear Record Custodian:
`ATTACHED PLEASE FIND AN AUTHORIZATION FORTHR RELEASE OF THEFOLLOWINGRECORDS
`FOR THE ABOVE REFERENCED PLAINTIFF.
`ALL EMPLOYMENT RECORDS, COMPENSATION CLAIMS, MEDICAL RECORDS AND BILLS
`INCLUDINGALL PFT DATAAND FLOWVOLUME LOOPS AND ALL DEPOSITION TRANSCRIPTS.
`«**WCAB CALIM NUMBER: LBO 0342046"**
`PLEASE CONTACT OUR OFFICE AT YOUREABLIFST CONVENIENCE TO ARRANGE FORTHE
`RECORDS TO BE COPIED OR FOR PRICING APPROVAL FOR YOUR OFFICE TO SUPPLY A COPY OF
`THE RECORDS.
`
`Very Froly Yours,
`RecordTrak Representative
`Phonc: (860) 355-5771
`
`
`
`PLEASE SIGNATTACHED AFFIDAVIT
`
`PLEASE NOTE GUR NEW ADDRESS:
`100 Webster Street
`Suite 201
`Oakland CA 94607
`
`|
`
`900001
`
`

`

`Foal
`*,
`RE: TURLEY WARREN vs. ASBESTOS DEFENDANTS
`DEPONENT: WCAB - LONG BEACH (TAG 15)
`DEPOSTTION NOTARY: RECORDTRAK
`-
`WARRE
`RECORDS PERTAIN TO: W.
`N AUSTIN
`
`TURLEY
`
`RECORDTRAK. FILE #: 133639
`DATE OF DEPOSITION; 04/14/2008
`DATE OF BIRTH: 09/28/1948
`SOCIAL SECURITY #: 552-683-6349
`
`RECORD [DENTITY:
`
`ALL EMPLOYMENT RECORDS, COMPENSATION CLAIMS, MEDICAL RECORDS AND BILLS
`INCLUDING ALL PET DATAAND FLOW VOLUME LOOPS AND ALL DEPOSITION TRANSCRIPTS.
`*eRWOAB CALIM NUMBER: LBO 03120460**
`
`SECTION I
`
`Signature
`Phone Nuniber
`
`AFFIDAVIT OF CUSTODIAN OF RECORDS
`(Pursuant to California Evidence Code Section 1561)
`1, the undersigned, being the duly authorized custodian ofrecords or other qualified witness, and having the suthority to certifythe attached
`records declare the following: The attached recordswere prepared by the personnel ofthis business inthe ordinary course of business at or near
`the time ofthe act, condition or event, and that:
`A,
`___. Pursuant to Evidence Code Section 1560(e) the original recordsdescribedweremada available to the atiomey’srepresentative for
`copying at ou place ofbusiness,
`B. __ Ame, lepible and durable copy ofeach ofthe described records was delivered to the attorney or the atlormey's representative,
`and that the entries in. the attached recurds are entries made by company personnel with actual knowledge or with knowledge from a report
`repuletly made byo person under a business duty to ao report.
`mo
`BILLING: __ records are produced herewith we have no billing records as requestext
`[DECLARE UNDER PENALTY OF PERIURY UNDER THE LAWS OF THE STATE OF CALIFORNIA THAT THE FOREGOINGIS
`TRUE AND CORRECT.
`
`Executed on (date)
`at (city,state}
`
`Print Name
`_ Department
`AFFIDAVIT OF PROFESSIONAL PHOTOCOPIER
`(Pursuant to California Business and Professional Code Section 22462)
`i declare that I am the Attorney's representative in the above referenced matter and that I made true copies of all the original
`records made available to me by the above named Custodian of Records ofthe within named business, and these records will be
`delivered to the authorized persons or entiti
`directed in the subpoena.
`
`
`Executed on (dats)
`at (city,state)
`
`Signatnre
`
`Phone Number
`
`Print Name
`
`Department
`
`SECTION I
`
`CERTIFICATION OF NO RECORDS
`A thorough search of our files, carried ont undermy direction revealed no documents, recorda or other materials called for in the subpoena or
`authorization, for the following reason;
`,
`__.. All recordsfor the time period in question heve been destroyed in accordance with our document retention policy.
`
`_.. Recotds do exist, but none within the tine limitation set forth in the request.
`
`__. A thorough search has been perfoomed and no such records were found,
`
`—. (other)RTran
`
`[DRCLARE UNDER PENALTY OF PERIURY UNDER THE LAWS OF THE STATE OF CALIFORNIA THAT THE FOREGOINGIS
`TRUE AND CORRECT,
`
`
`Executed on (date)
`
`
`at (city,state}
`
`
`
`
`Q00002
`
`Signature
`
`Phone Number
`
`Print Name
`Department
`
`

`

`iED Development
`Qe
`ve
`Department
`i
`‘State of California
`&
`1glrime
`
`.
`
`‘Notice of Record Transfer
`{
`
`WCAB Long Beach
`Arco Center, 300 oceangate, STE 200
`Long Beach, CA 90802-4339
`
`cena
`
`.
`
`WCAB Case No.: 1800322046
`
`Name: Warren Turley
`
`SSA No.: 552-68-6349
`
`Date: 03/28/06
`
` eon Employment
`
`Records concerning State Disability Insurance benefits for the above-captioned lien claimant have
`been transferred to the following office:
`
`State of California
`Employment Development Department
`P.O, Box 469
`Long Beach, CA 90801-0469
`
`.
`|
`
`Phone: 562-984-1612
`Please sendall further correspondence and notices regarding this jien claim to the aboveoffice.
`! They are now the official record-holding office and possess full settlement authority in this case.
`2 petmeaw / os
`|
`/C Norman/jk
`Disability Insurance Program Representative
`
`Copies of this notice are being sent to the following interested parties at the addresses shown:
`
`' Rose Klein & Marias
`g01 S. Grand Avenue, 11° Floor
`Los Angeles, CA 90017-0050
`
`DE 2560WCA Rev. 2 (5-05) (INTRANET)
`
`Page t of f
`
`cu
`
`000003
`
`

`

`wee Employment
`: ED Development
`
`Department
`State of Cafifernia
`
`i
`
`ad
`
`a
`
`vost
`
`Notice of Service / Request for Medical Records
`
`WCAB Long Beach
`
`|
`
`|
`
`TARO cee ccs neteecreeetce tne eens March 28, 2006
`
`SSN oooccc eceeertetceenee nr iaecenes 552-968-6349
`APpliGant........-.e eee Warren Turley
`WCAB Case No... LBO0312046
`EMployer oo... cc ceere eee Unknown
`Date of Injury... eens
`insurance Claim No.................0.. Unknown
`Insurance Carrier: Unknown
`
`Enclosed are copies of medical reports to support the EDD fien pursuant to Labor Code section 4903. 1(¢}.
`[] Demandis hereby made on the defendant(s)for all medical and rehabilitation reports in thelr possessionfor the
`above-referenced Workers’ Compensation Appeals Board (WCAB)case.
`
`| C] Medicat reports have NOT been served to any parties. This information is protected by Code of Federal
`Regulations, Title 42, Part 2 and California State jaw, which prohibit making further disclosure ofit without the
`specific written consent of the applicant. A general authorization for the release of medical or other information is
`NOTsufficientfor this purpose. Medical reports will be served on the WCAB upon demand orreceipt of notice of
`a Mandatory Settlement ConferenceorTrial.
`Cj Medical reports have been served on the WCABbutnot other parties of record. This information is protected by
`Code of Federal Regulations, Title 42, Part 2 and California State iaw, which prohibit making further disclosure of
`it without the specific written consentof the applicant. A general authorization for the release of medical or other
`information is NOT sufficient for this purpose.
`| declare | have served a copy of this document and any enclosures on 03/28/06to the persons listed abave and
`below. Parties served by personaldelivery are identified by an asterisk(*).
`C Potted /
`;
`G Norman/jk
`Disability Insurance Program Representative
`
`i
`
`Rose Klein & Marias
`
`if other persons should be served with this document, please notify the Employment Development
`Departmentat the addressindicated on the Notice and Request for AHowance of Lien.
`
`DE 2578M Rev. 2 (11-99) (NTRANET)
`
`Page i of 1
`
`cu
`
`000004
`
`

`

`ssv1 552-68-6349 naleow’ W..KREN A Turi? JUN 2205
`
`CLAIM EFFECTIVE
`
`.
`
`DATE ISSUER: 06/03/05
`
`E: 06/07/64
`
`013154
`
`SUPPLEMENTAL CERTIFICATION
`iF YOU ARE STILL DISABLED, COMPLETE THE CLAIMANT'S CERTIFICATION AND CONTACT YOUR DOCTOR IMMEDIATELY FOR
`COMPLETION OF THE PHYSICIAN'S SUPPLEMENTARY CERTIFICATE. THIS PHYSICIAN'S CERTIFICATE MUST BE SUBMITTED
`WITHIN TWENTY (20) DAYS GE THE DATE ISSUED SHOWN ABOVE OR YOU MAY LOSE ADDITIONAL BENEFITS.
`
`I certify that | continue te be disabled and incapable of doing my regular work, and that ! have reported all wages, Workers’
`Compensation benefits and other monies received during the claim period to the Employment Development Department.
`
`CLAIMANE'S CERTIFICATION
`
`ren
`~
`_
`Date
`.
`Sign
`
`
`Your Namefamke”ORSigned
`
`
`PHYSICIAN'S SUPPLEMENTARY CERTIFICATE
`
`1. Are you stil treating the patient?_TES Date of last reatmant. 6/06/05
`2. What present concition continues 10 make the pationt disabled?
`Sis
`Si
`
`G DISSICATION
`Diagnosis (REQUIRED):
`Date of next appointmentAZL5/05
`ICD Codafs} (REQUIRED): Primary22am SECONdEFY — 739.3
`3. Describe how the patient's presenl condition ar impairment prevents him or her from returning to regular and customary work.
` PA N i Q
`
`
`
`IN LOW BACK COMPLAINTS.eeeeaIAEOeeppntnrninaraerarerrieeiiisissuunasrrarrerreremrrirspsainntnattbbtehittdiiaLLLtrmarererreenrerrtthlAek
`
`4 What factors or complications are disabling the patient longer than previously estimated for this type of illness or injury?
`PATIENT LS DECONDITIONED, PATIENT'S AGE, NATURE OF CONDITION.
`
`
`
`§. Present estimated date patient (aven If stil under treatment) will be able to performhis/her regular or customary work:
`12/1/05
`
`&. Would disclosure of this informatios to your patient be medically or psychologically detrimentalto the patient? Yes
`
`
`—
`No*
`
`
`
`i HEREBY CERTIFY THAT THE ABOVE STATEMENTS IN MY OPINION TRULY DESCRIBE THE PATIENT'S CONDITION AND
`ESTIMATED DURATION,
`an
`LD. FRIGARD D.C
`Cf
`Doctor's Nameee «6?
`Dearchor's Signet
`
`nos,
`os,
`aeee
`{print or type)
`
`
`
`Date Signed
`
`
`
`Specialty,if any CHIROPRACTOR ne a“State Licenseoe0364
`
`
`
`‘> Phone Number ——
`
`DE 2525XXA Rev. 1 (7/26)
`
`CLPAT9
`
`RETURN THIS FORM TO
`
`DbabeasDuabeldscflancad eabeasT ivdideliteesfals ba boesd steel
`EMPLOYMENT DEVELOPMENT DEPARTMENT
`PO BOX 1857
`GAKLAND
`CA
`
`94604-1857
`
`6vE9-89-29S
`
`#"
`
`o00005
`
`

`

`su: 552-68~6349 wale’ WARREN A TURLEY
`SUPPLEMENTAL CERTIFICATION
`
`CLAIM EFFECTIVE
`
`BATE ISSUED: 01/05/05
`E: 06/67/04
`
`i
`
`013268
`
`fF YOU ARE STILL DISABLED, COMPLETE THE CLAIMANT'S CERTIFICATION AND CONTACT YOUR DOCTOR IMMEDIATELY FOR
`COMPLETION OF THE PHYSICIAN'S SUPPLEMENTARY CERTIFICATE, THIS PHYSICIAN'S CERTEFICATE MUST BE SUBMITTED
`WITHIN TWENTY (23) DAYS OF THE DATE ISSUED SHOWN ABOVE OR YOU MAY LOSE ADDITIONAL BENEFITS.
`
`1 certify that | continue to be disabled and incapable of doing my regular work, and that | have reported all wages, Workers!
`Conipensation benefits and other monies received during the claim period to Lhe Emplayment Development Department.
`
`CLAIMANT'S CERTIFICATION
`
`Sign
`
`Date
`
`
`
`
`
`
`
`Your NamepldeteeLO~AS”Signe
`
`
`
`PHYSICIAN'S SUPPLEMENTARY CERTIFICATE
`
`
`Date of last treatment: OL 10/0
`1. Ave you still treating the patient? LES
`2, What present condition coniinues to meke the patiant disabled?
`91/17/05
`Diagnosis (REQUIRED): DISC DESSTCATION
`Date of next appointment__
`
`Secondary
`39.3
`721.3
`ICD Code(s) (REQUIRED): Primary
`@. Describe how the patient's srasant condigon of inipamont provants him or her tran retuming 40 regular and customary work,
`PATIENT UNABLE TO SIT, :aeeaENaSlacheAaeeaecertainBEND, KNEEL OR CARRY WITHOUT MODERATE INCREASE
`
`
`TniAOREA=SSratanar
`IN LOW BACK COMPLAINTS.
`
`.
`
`4. What factors or complications ara disabling the patlanl ionger than previously estimated fer this type of iiness oFinjury?
`
`
`PATIENT'S ACE,PATIENT 1S BECONDITIONED, NATURE OF CONDITION,
`
`
`5. Prasent estimated datc patient (eveni still under treatment} will be able to perform his/her regular or customary warle
`
`GLOLLOS
`No. x
`6. Would disclosure of this information 1c your patient be medically or psychologically detrimental tc the patient? Yas
`
`| HEREBY CERTIFY THAT THE ABOVE STATEMENTS IN MY OPINION TRULY DESCRIBE THE PATIENT'S CONDITION AND
`ESTIMATED DURATION.
`:
`
`
`Doctor's Name__ 2 Ds FRIGARD D.c.
`2RBS FEE ou BY diPmt Gr type)
`
`State
`Specialty, if any
`
`Date Signed___01/21/05 Phone Number
`
`925-754-1441
`
`DE 2525XXA Few. 1 (7/06)
`
`CU-PAI29
`
`RETURN THIS FORM TO
`
`: WabieaDesLlDeeITsccobustuseD HD ealactabubacalalsfolessdalall
`EMPLOYMENT DEVELOPMENT DEPARTMENT
`PO BOX 1857
`CAKLAND
`CA
`
`94604-1857
`
`G6¢r&9-89+-25S
`
`000006
`
`

`

`
`
`G0 A
`_ gsNz 552-68*6349 nity WARREN & TURLEY
`K~
`.
`CLAIM EPPECTIVE
`.
`‘
`4
`:
`SUPPLEMENTAL CERTIFICATION
`\
`Loc
`IF YOU ARE STILL DISABLED, COMPLETE THE CLAIMANT'S CERTIFICATION AND CONTACT YOUR DOCTOR IMMEDIATELY FOR), “ey
`COMPLETION OF THE PHYSICIAN'S SUPPLEMENTARY CERTIFICATE. THIS PHYSICIAN'S CERTIFICATE MUST BE SUBMITTED, ro
`
`
`WITHIN TWENTY (20) DAYS OF THE DATE ISSUED SHOWN ABOVE OR YOU MAY LOSE ADDITIONAL BENEFITS.
`ie
`
`
`nate resueps ogva0ren
`E+ G6/07/04
`
`0137194,
`
`I certify that | continue to be disabled and incapable of doing my regular work, and that | have reported all wages, Workers’
`Compensation benefits and other monies received during the claim period to the Employment Development Department.
`
`CLAIMANT'S CERTIFICATION
`
`YourNameLedastindebug SignedLO-fnOf
`
`Sign
`
`Date
`
`
`
`PHYSICIARHS SUPPLEMENTARY CERTIFHCATE
`
`
`
`1. Ate you still treating the patient? YES... Date of last treatment:
`2. What present condition continues to make the patient disabled?
`Date of next appointmentTD£06LOAennneHANA hott
`Diagnosis (REQUIRED
`a REQUIREDH Primary2B Sectayma
`a. Describe how the pafient’s preseni condition o: impairment prevents him or her from returning to regutar and customary work.
`PATIENT UNABLE TO SIT POR ANY LENGTH OF TIME,BEND,KNEEL,LIFT, CARRY OR CRAWL.
`
`
`4, What factors or complications are disabling the patient longer than previously estimated for this type ofillness or injury?
`-
`.
`ft
`¥
`‘i
`
`
`
`5. Present estimated date patient (even if sill under treatment} will be able to perfor his/her regular or customary work:
`aLt
`
`
`6. Would disclosure of this information to your patient be medirally or psychologically detrimental! to the patient? Yes
`
`No_X
`
`DE 2525XXA Rev. 1 (7/96)
`
`CPA 126
`
`i HEREBY CERTIFY THAT THE ABOVE STATEMENTS IN MY OPINION TRULY DESCRIBE THE PATIENT'S CONDITION ANB
`ESTIMATED DURATION.
`
`
`
`Fon NeweRIGABR..— —-au:, <a. Doctor's Siznataygy
`LET.
`Dretag's Name,
`- a
`vint oF type}
`.
`KmBreet. State License Number
`LER me e
`
`Leo,
`
`BieSigneSfOE-oO (BP faimbat GeLOEOESGEIL.
`
`
`
`
`!
`sa
`
`
`
`RETURN THIS FORM TG.
`
`Eb tavbedlbesHavcodolsallblaldsbaldiabaldiell
`EMPLOYMENT DEVELOPMENT DEPARTMENT
`PO BOX 1857
`GAKLAND
`CA
`
`94604-1857
`
`cH
`an
`Na
`i
`oD
`om
`\
`
`oH
`ad
`>wo
`
`000007
`
`

`

`
`
`
`
`If “Yes,” the disabilly COMMENCED ONesc sseerseemsarcneeseseeescsetseretereneanseeteen napaeaaeateens sia cceatuennnenaneny sec esnlnangenamareg snes secs
`
`
`
`34. Objective Findings/Detailed Statement of Symptoms (REQUIRED IF-NO DIAGNOSIS HAS BEEN DETERMINED):
`RESTRICTED LOW BACK RANGE OF MOTION AND POSITIVE ORTHOPEDIC TESTS.
`
`re
`. iver,
`.
`‘eo
`wee
`og .
`Claim for Disability Insurance Benefits - Doctor's Certificate
`: Certification may be made by a licensed madical or osteopathic physician and surgeon, chiropractor, dentist, podiatrist, optometrist, designated
`: psychologist, or an authorized medicalofficer of a United States Government factlity. Certification may aise be made by a licensed aurse-midwife, nurse
`practitioner, or feensed midwifefor disabtlities retated to normal pregnancy or childbirth. Ali tems on this sheet must be completed legibly.
`
`
`74. Palient File No.
`24. Patient Name
`25. Doctor's State License Number
`
`
`Mette) 4. Fire
`DC10364
`
`
`
`
`26. This patient has been under my
`care and teatment for this
`VARIES
`_
`at intervals of
`medical problem from:
`06 14 04 © |PRESENT
`
`
`
`
`(daily, weekly, manthy. etc.)
`Year
`Dai
`Month
`D
`Year
`Month
`
`
`
`
`27, Atany time during your attendance forthis medical problem, has the patient been incapable of performing his/her pegular or
`customary work as stated in Questions 14 and 167 no.cssscesetcereeeesenertecessnanesenssecuueuressuenseueaeecenbiensaseueiveceesnesetreceuaenennennineves18] ves
`{Iso
`
`
`
`
`# “Ho.”
`you may
`skip the remainderof the numbered questions. Please compleie the Doctor's Ceriificalion and Signature section on pa
`
`28. Are the functional fimifations described bythe patient in Question 16 consistent with yourevaluation? .......ssscscssseesarscsaneenenasearsecees RRyes
`
`H“No,” please explain in Question 31 (Objective Findings),
`
`
`
`29, (CD Codes and Diagnosis:
`
`739.3
`ICD 9 Disease Code, Secondary:
`721.3
`ICD 9 Disease Code, Primary (REQUIRED):
`
`
`DEGENERATIVE DISC DISEASE, MECHANICAL LOW BACK DYSFUNCTION
`Diagnosis (REQUIRED):
`
`
`
`paTTENT PRESENTS WITH LOW BACK PAIN OF INSUDIOUS ONSET. DENIES a SPECIFIC
`36, History?
`“WOKE UP IN PAIR".
`LNJURY.
`
`
`
`
`33. Has patient been referred to another doctor? ........0-.
`32. Type of teatment and/or medication rendered to patient:
`
`if "Yes," to whom?
`SPINAL MANEPULATIVE THERAPY TRACTION,
`
`ELECTRIC MUSCLE STIMULATLON AND HEAT.
`
`
`34. Surgery or Procedure:
`
`NONE
`Type of surgery or procedute:
`}CD9 Procedure Code:
`
`
`
`
`
`
`36.If patient is‘was pregnant, isiwas pregnancy nonal?.... [} ves
`35, Hihis patient is new pregnantor has been pregnant since thefirst date
`
`If"No,” stafe the abnormal and involuntary complication
`erfered in question 26 above, please provide date pregnancy terminated or
`
`causing matemal disability.
`
`
`fulure EDC:
`
`
`
`
`
`37, On whatdate did you releaseor will you release the patient to return to his/her regular or custamary work?
`Answers such as “indefinite”or “don’t know" are not sufficientto allow paymentof benefits.}
`
`Date performed or to bo porlormad wearectsrecrenersenenetsessieeeessetareeee
`
`N/a
`
`DE 2501 Rev. 69 (12-99)
`
`pi
`
`000008
`
`

`

`
`
`Nes
`
`well
`
`
`
`STATE OF CALIFORNIA
`WORKERS' COMPENSATION APPEALS BOARD
`CASE NUMBER(S) CHO LBC S/2-O¢4
`
`MINUTES OF HEARING/ORGER/ORDER AND
`DECISION ON REQUEST FOR CONTINUANCE/
`ORDER TAKING OFF CALENDAR!
`NOTICE OF HEARING
`.
`CO BEFORE CAT
`Ofmial38mse
`PLCONF
`CI EXP HEARING
`0 LIEN
`DATE OF: HEARING {22 OF pcquest
`DEFENDANTS
`APPLICANT
`(©) PRESENT nor PRESENT
`f
`JRCHEARING REP.
`(] ATTORNEY
`&
`pw SS
`Mare
`C) HEARING REP.
`G ATTORNEY
`
`DEFENDANT REPRESENTED BY
`() HEARING REP,
`O ATTORNEY
`
`
`
`CERTIFICATION NO.
`
`does [- (00
`
`APPEARANCES
`:
`APPLICANT REPRESENTED BY
`
`.
`
`OTHERS APPEARING
`INTERPRETER
`
`_
`PARTY MAKING REQUEST
`REQUEST FOR: CONTINUANCE
`
`POSITION OF OPPOSING PARTY
`
`OC) JOINT
`
`# oToc
`sercrer
`
`CQ) APPLICANT
`
`REQUEST BY: O LETTER
`
`Peorreionn
`
`C) TELEPHONE
`
`O OTHER
`
`
`
`() OPPOSE
`
`OC] UNREACHABLE
`
`f] UNKNOWN
`
`Wailea A. Turley
`eRERTET
`oooocoonmacoo
`nnNIH
`
`C)
`
`BOARD REASON
`O TO FINIS-
`O TO START
`INSUFFICIENT TIME
`CO] REFUSED CT NOTAVAILABLE
`Cl REASSIGNMENT:
`OO) REPORTER OC INTERPRETER
`CP NOT AVAILABLE
`(CF WJ NOT AVAILABLE
`(F RECUSAL
`Cl uerissues CISeERvicg DEFECTIVE © BANKRUPTCY
`PENDING
`
`REASON FOR REQUEST
`
`FURTHER DISCOVERY: C] APP MED
`
`CALENDAR CONFUCT) 1 APPLICANT
`SETTLEMENT PENDING
`
`DEF MEG CAME [} DEPO
`O) DEFENSE O LC.
`
`IMPROPER/INSUFFICIENT NOTICE BY PARTY
`IMPROPER DECLARATION OF READINESS/VALIC GBJECTION
`NON APPEARANCE €] APP O OFF £1 WIEN CLAIMANT C1 WITNESS
`APPLICANT (1) OEF COUNSEL
`G VACATION ( ILLNESS
`UNAVAILABILITY OF WITNESSES .
`C) APP ©] DEFENSE
`OTHER/COMMENTS
`DISPUTE RESOLVED BY AGREEMENT CI NO ISSUES PENDING
`
`deerepatnaENERREELAA
`JOINDER CICONSOUDATION (VENUE EC NEWAPPLICATION
`AUTO REASSIGN Ci DISQUALIFY
`CI APP
`€] DEFENDANT
`Cl APPLICANT NOWREPRESENTED [J REQUESTS
`ititt
`REPRESENTATION
`eRtt
`C1 CHANGE OF CIRCUMSTANCES
`
`Cl DEFECTIVE WCAB NOTICE
`CO ARBITRATION
`
`GOOD CAUSE APPEARING, {TIS ORDERED THAT THE REQUEST FOR OcoNT GoTo? is O GRANTED O DENIED
`OM oTroc O RESET.
`DAYS FOR
`Q car stirs,
`OTHERWISE:
`
`Ci CaR/STIFS SUBMITTED FOR APPROVAL
`O oFroc
`oF N.O.1. TO ALLOW/DISALLOW ISSUED
`(0 LIEN STIPS AND ORDER APPROVED
`CL THR (2HRS G4HRSO_._
`TIME
`C1 SETFOR G Msc C1 CONF C1 TRIAL C1) WEN TRIAL O GONTD TESTIMONY
`BEFORE JUDGE
`—————
`
`
`{3
`
`caRr/sTiPS APPROVED
`
`LOCATION
`AT
`SET ON
`C) SUPPLEMENTAL PAGES ATTACHED
`DATE
`
`PAGES
`
`lt
`.
`PRESIDING
`WoreeHohseneRotheMINISTRATIVE LAW JUDGI
`Pursuant to Rule 10500 you are designated to serve thisithese
`geeneeecient
`NOTICE TG
`document(s} on all parties as shown on the Official Address Record. Served on designated server with a copy ofthe Official Address Record
`
`Date
`Cl
`
`By
`___..
`Served on parties and tien claimants present
`
`000009
`
`

`

`WORKERS*COMPENSATION APPEALS
`
`BOARD
`
`
`
`STATE OF CALIFORNIA
`
`WARREN A. TURLEY,
`
`Case No.
`
`2000 LBO 0312046
`
`PARTIAL
`
`Applicant
`
`vs.
`
`Order Approving
`Compromise and Release
`
`AMERICAN MFG. administered by
`BROADSPIRE/DOES 1-100
`Defendants
`
`Based upon a review of the medical file and the disability facters contained
`herein,
`the Compromise and Release is deemed adequate and is approved.
`The release of the rights to death benefits of the applicant's dependents has
`heen considered in determining the adequacy of the settlement. This
`settlement will include a release of those rights.
`There is a bona fide igsue as to intury AOE/COBR and it is the intention of
`the parties to settle all issues including rehabilitation.
`Pursuant
`to the
`holding in Thomas v. Sports Chalet,
`the parties request that the Workers '
`Compensation Judge make a finding that injury is legitimately at
`issue and
`that rehabilitation is settled.
`The
`parties
`to the above-entiticd action having filed a Compromise and Release herein, on
`(B,2007
`settling this case for $1,000.00
`in addition to all sums which may have been paid previously, and requesting ‘that it be approved,
`and this Board having considered the entire record, including said Compromise and Release, now
`finds that it should be approved.
`{T IS ORDEREDthat said Compromise and Release be approved.
`Award is made in favor of WARREN A. TURLEY in accordance with the amounts
`indicated in Exhibit
`“A" attached hereto.
`
`Attorney's fees in the sum of 4220.00 to be deducted from the settlement.
`Medical-legal costs are to be paid in accordance with the amounts indicated
`in Exhibit
`"A" attached hereto.
`
`THE LIEN OF THE EDD IS DENIED DUE TO BENEFITS BEING PROVIDED FOR A NON
`ASBESTOS INJURY.
`
`,
`
`The Board shall retain jurisdiction of unpaid medical-legal, self-procured
`medical, other liens and penalty and interes® claims.
`
`Dated_DEC 2 0 2087
` REERS COMPENSATION APPEALS BOARD
`Service by mail on parties as shown on
`Official Address Record effected on above date.
`
`
`
`BY: K,CALsLapenecn. DEPARTMENT OF INDUSTRIAL RELATIONS
`
`DIA WCAB PORM 55 {REV. 5 73}
`
`BIVISION OF INDUSTRIAL ACCIDENTS
`
`000010
`
`

`

`
`
`RE: Warren A. Turley va. Boas 1-100
`WCAB CASE NO.:
`2000 LBO 0312046
`
`EXHTBIT "Ar
`
`CONTRIBUTION SHEET
`
`CARRIER
`
`CONTRIBUTION
`
`**1, American Mfq-.
`administered by Broadspire
`
`.
`
`$32,000.00
`
`TOTAL
`
`$ 1,000.00
`
`**>DLBASH AWARD REASONABLE ATTORNEY'S FER IN THE SUM OF $220.00.
`
`MEDICAL-LEGAL COSTS ARE TO BE PATD BY CARRIER AS FOLLOWS:
`
`Robert M. Gromis, M.D.:
`Rose, Klein & Marias:
`
`$284.17
`$ 15.76
`
`PLEASE DENY THE LIEN OF THE EDD IN THE SUM OF $37,856.00.
`BENEFITS PROVIDED WERE FOR A BACK INJURY AND THEREFORE HAVE NO
`RELATION TO THIS ASBESTOS EXPOSURE CLAIM.
`
`000011
`
`

`

`VICTOR C. ROSE (1907-4972)
`ALFRED M. KLEIN (1913-2600)
`EUGENE MARIAS (1919-1982)
`*ROSERT 8. STEINGERG
`*HOWARD N. LEHMAN
`“JASON A. GOTTLIEB
`TIASONA. GOTTLIESon
`MARVIN NM. SHAPIRG
`7 BARRY |, GOLDMAN
`*G, RONALD FEENBERG
`DENNIS 0. WELCH
`GREGORY STAMOS
`DENNIS J. SHERWIN
`"STEVEN M, HOFF EERG
`*RORERT |. VINES
`"MANUEL 1, NEES
`OAVID A. ROSEN
`RICHARD G, BARONE
`WILLIAM M. GREWE
`CHRISTOPHER FP, RIROUT
`HARR
`a
`TONIRAYKOVIEH een
`* DENOTES PRAFESSIONAL GORPORATION
`TAPMITTES GHLY IM EWEGEN
`
`‘eae’
`
`‘al?
`
`LAW OFFICES OF
`ROSE, KLEIN & MARIAS LLP
`801 SOLITH GRAND AVENUE
`PITH FLOOR
`LOS ANGELES, CALIFORNIA 90017-4645
`FAX (273) 623-7755
`{213} 626-057 1
`
`.
`
`'
`
`December 17, 2007
`
`2 -(e
`|
`WENDY HAYWARD-MARSHALL
`ANOSREW JJ, SHORENSTEIN
`BABETTEFSEMEL
`DAVID S. GALPERSON
`FRONANY MARTINSSON
`Ri
`JANETM MBorr
`JULIE A, CRABTREE
`LAUREN BELGER
`CHAISTEL A. EGHOENFELOER
`MARGUS S. LOO
`MIA R, ELEAS
`KEVIN MAHONEY
`LISA F, JOU
`JSULEAN A. MOORE
`ALEXIS 8, DIVRE
`JOSEPH YALON
`
`WORKERS' COMPENSATION APPEALS BOARD
`300 Oceangate, Suite 202
`Long Beach, CA 90802
`
`RE: Warren A, Turley vs. Does 1 - 100
`WCABCase No.: 2000 LBO 0312046
`
`Gentlepersons:
`
`PARTIAL
`
`In accordance with the Rules of Practice and Procedure of the Workers' Compensation Appeals
`Board, we enclose herewith for filing:
`
`COMPROMISE AND RELEASE AGREEMENTand
`PROPOSED ORDER APPROVING COMPROMISE AND RELEASE.
`
`A copy of this documenttogether with a copyofthis letter are being forwarded this date to the
`parties listed below.
`‘
`
`Very traly yours,
`
`fants
`
` .
`
`Howard N, Lehman, Esq.
`:
`of Rose, Klein & Marias
`
`HNL-:auv
`Enclosures
`.
`PT
`ee: See attached "Service Sheet
`
`tt
`
`\
`
`me
`| yo
`
`01 ©OCEAN BOULEVARD, SUITE 4D0
`LORG BEACH, CALIFORNIA SOBOZ40E5
`$82) 496-4695 > FAK ER) ABE ST
`3234 SOUTH ANITA DRIVE SUITE FOO
`ORANGE, CALIFORNIA 92468-3720
`CFL G37-9208 « FAKCLA) 9379208
`
`343 &. INLAND EMPRE BLYD., BRITE aco
`ONTARIO. CALIFORNIA 817642922
`WOH DASE TIE + FAX (SGB} S401 722
`S730 RALSTOM STREPT. SUITE Sor
`VENTURA, CALIFGANIA 83003-6009
`{O81 BAF 109 « FAM OS) C42-0627
`
`TSS OVENTUMA BOULEYARTS, [ATH FLOCK
`ENCING. CALIFORNIA 91835-2819
`#2181 FES -FARO + FAX (2931 622-7785
`895 WEST GEECH STREET, SUITE 205
`BAN DIEGH,CALIFORMA ttt 2oa8
`(G99 294-3621 - FAX (E15) a340b4p
`
`1256 CENIER COURT ORIVE
`TOVELA, CALIFORNEA 61724
`(826) $37-14608 « FAM (900) F447722
`AORN. BAAND OLYD,, SUITE 250
`GLEXDALE, CAUPORNIADI R07
`MBE FEL ARO + FAK (2S G23-7755
`
`bcery
`. ee soe
`
`000012
`
`

`

`
`
`WORKERS*COMPENSATION APPEAYS BOARD
`
`STATE OF CALIFORNIA
`
`
`
`WARREN A. TURLEY,
`
`Applicant
`
`vs.
`
`AMERICAN MFG. administered by
`BROADSPIRE/POES 1-106
`
`Case No.
`
`2000 LBO 0312046
`
`PARTIAL
`Order Approving
`Compromise and Release
`
`Defendants
`
`etnaeRACLETEAIA
`
`Based upon a review of the medical file and the disability factors contained
`herein,
`the Compromise and Release is deemed adequate and is approved.
`The release of the rights to death benefits of the applicant's dependents has
`been considered in determining the adequacy of the settlement. This
`settlement will include a release of those rights.
`There igs a bona fide issue as to injury AOE/COE and it is the intention of
`the parties to settle all issues including rehabilitation. Pursuant to the
`holding in Thomas v. Sports Chalet,
`the parties request that the Workers!
`Compensation Judge make a Finding that injury is legitimately at issue and
`that rehabilitation is settled.
`The parties to the above-entitled action having filed a Compromise and Release herein, on
`settling this case for $1,000.00
`in addition to all sums which may have been paid previously, and requesting that it be approved;
`and this Board having considered the entire record,
`including said Compromise and Release, now
`finds that it should be approved.
`IT IS ORDEREDthat said Compromise and Release be approved.
`Award is made in favor of: WARREN A. TURLEY in accordance with the amounts
`indicated in Exhibit
`"A" attached hereto.
`Attorney's feee in the sum of $220.00 to be deducted from the seattiement.
`Medical-legal costs are to be paid in accordance with the amounts indicated
`in Exhibit
`"A" attached hereto.
`THE LIEN OF THE EDD IS DENIED DUE TO BENEFITS BEING PROVIDED FOR A NON
`ASBESTOS INJURY.
`
`The Board shall retain jurisdiction of unpaid medical-legal, gelf-procured
`medical, other liens and penalty and interest claims.
`
`
`
`Dated
`Service by mail on parties as shown on
`Official Address Record effected on above date.
`
`Judge, WORKERS' COMPENSATION APPEALS BOARD
`
`BYee DEPARTMENT OF INDUSTRIAL RELATIONS
`DIVISION OF INDUSTRIAL ACCIDENTS
`DLA WOAB FORM 65 (ARV.5-75}
`
`000013
`
`

`

`VICTOR ¢, ROSE (F 907-1972}
`ALFRED M. KLEIN (19 14:2600}
`EUGENE MARIAS (1919-1962) ©
`*ROBERT B, STEINBERG
`"HOWARDS N. LEHMAN
`TIASON A. GOTTLIED
`*HERSERT |, GALPERSON
`MARVIN N, SHAPIRG
`*RBARRY I. GOLDMAN
`"G, RONALD FEENBERG
`DENNIS D. WELCH
`GREGORY STAMGS
`| BENNIE +. SHERWIN
`"STEVEN M. HOFFBERSG
`“ROBERT i. VINES
`"MANUEL iL, NUNES
`DAVID A. BOGEN
`AICHARD G. BARONE
`WILLEAM MH, GREWE
`CHRISTOPHER P, RIDQUT
`HARRY H. SAMARGHAGCHIAN
`TONTRAYKGVICH
`+ DENOTES PROFESSIONAL CORPORATION
`f AGMITTED GHLY IN SWEDEN
`
`ed
`
`ed
`
`LAW OFFICES OF
`ROSE, KLEIN & MARIAS LLP
`801 SOUTH GRAND AVENUE
`14TH FLOOR
`Los ANGELES, CALIFORNIA 90017-4645
`FAM (213) 622-7755
`(213) 626-0571
`
`December 17, 2007
`
`WERDY HAYWARD-MARSH ALL
`ANDREW J, SHORENSTEIN
`BABETTE F. BEMEL
`LEJA BALLESTEROS
`BAYVID 5S. GALPERSON
`{RONNY MARTINSSON
`JANET UW. KROPP
`ALAN F. RIFFEL.
`SULIE A, CRABTREE
`LAUREN BELGER
`CHEISTEL A. FCHOSNFELDER
`MARCUS S. LOG
`MIA A, RELIS
`KEVIN MAHONEY
`LISA F. JOU
`JULIAN A, MOORE
`ALEXIS 8. DIIVRE
`JOSEPH YALON
`
`WORKERS' COMPENSATION APPEALS BOARD
`300 Oceangate, Suite 202
`Long Beach, CA 90802
`
`RE: Warren A. Turley vs. Does 1 - 100
`WCAB Case No.: 2000 LBO 03 12046
`
`PARTIAL
`
`Gentlepersons:
`In accordance with the Rules ofPractice and Procedure of the Workers' Compensation Appeals
`Board, we enclose herewith for filing:
`
`- COMPROMISE AND RELEASE AGREEMENTand
`PROPOSED ORDER APPROVING COMPROMISE AND RELEASE.
`er with a copy ofthisletter are being forwarded this date to the
`1
`
`A copy of this document togeth
`parties listed below.
`
`.
`Verytruly"Le.
`Gna ofJatoat~
`Howard N. Lehman, Esq.
`of Rose, Klein & Marias
`
`HNLsauv
`Enclosures
`
`ec: See attached “Service Sheet"
`
`AQ1 ©. DORAN BOULEVMEFD, SLATE 200
`LOKG BEACH, CALIFORNIA 802-4055
`(852) 4368600 - FAX (S62) 1366157
`SO SOUTH ARTTA DRIVE, SUITE FOR
`ORANGE,CALIFORNIA S2883-85260
`tial GaFe20S = FAX CF1 P37-R2IB
`
`3633 6 INLAND EM PHBLVD. SUITE 400
`ONTARIO, CALIFORNIA 2 | 744-0922.
`(OOS) Paat F14 |} PAROS) BaeTEE
`S740 RALSTON STREET, SUITE SD?
`VENTURA, CALIFORAIA BROOG6043
`GHGS) aa-FEO) © FA (GED) GAL95TT
`
`ven
`
`$5910 VENTURA BOULEVARD, TSTH FLOCK
`BRCING, CALAFORNIA 014967810
`1818) PACAA20 + FAX AI GRETISS
`S55 WEST BEECH STREET, SUPE 205
`BAK DIEGO. CALIPORIA S21 Ot-2its
`6197 24E-E2 |
`+ FAK OT OAD
`
`1299 CEHTER COURT DAIVEE
`SOWINA, CALIFORNIA S7S4
`{G26} SG71 208 + FAX OU) Odd 702
`BOON, BAND BLO. SUITEZSO
`GLENDAL. CALIFORNLA 21208
`{6 tOlT8 P14tO © FAX 1213) 623-7755
`
`000014
`
`

`

`-
`
`w
`STATE OF CALIFORNIA
`\w
`DIVISION OF WORKERS’ COMPENSATION
`WORKERS’ COMPENSATION APPEALS BOARD
`
`COMPROMISE AND RELEASE=PARTIAL
`
`[WARREN A. TURLEY
`Applicant (Employee}
`
`Case Nois). 2000 LBO 0312946
`
`Social Security No. §52-68-6349
`
`1568 Yosemite Dr.
`Antioch, CA
`Address
`
`95852-0810
`
`JOINDER
`DER
`, SHE
`Correct Name(s) of Employer(s}
`
`,
`
`Address(es)
`
`,
`
`:
`
`|| |
`
`SRE EXHIBIT "A"
`
`Address(es)
`Various
`
`{city}
`
`7
`by the employer(s),
`
`| CorrectName(s)ofInsurance Carrier{s) ClaimsAdministrator(s}
`. Tha employee, born September 38. 1948 claims that he/she was employedat
`Califormia
`_as a(n}
`Boilermaker
`foccupation)
`.
`{siate}
`and claimsto have sustalned injuryfies) arising out of and in the course of employment:
`(State with specificity the date(s) of injury(les) and what part(s} of bedy, conditions or systems are baling settled.)
`
`fo his pulmonary and internal system as a result of exposure to asbestos
`
`on 1965 - 1999
`
`i 1
`
`
`
`OF
`
`Body parts, conditions and systems may not be incorporated by reference to medical reports.
`2. Upan approval of this compromise agreement by the Workers’ Compensation Appeals Board or a workers’ compensation
`administrative faw judge and paymentin accordance with the provisions hereof, the employee releases and forever discharges
`the above-named employer(s