Resolution No. 782141
1 RESOLUTION NO. 7821
2
3 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF
VERNON GRANTING THE DISABILITY RETIREMENT OF GARY
4 A. WISKUS, A LOCAL SAFETY MEMBER EMPLOYED BY THE
5 CITY OF VERNON (Government Code Sections 21154 and
21156)
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7 WHEREAS, the City of Vernon (hereinafter referred to as
8 "Agency") is a contracting agency of the Public Employees' Retirement
9 System; and
10 WHEREAS, the Public Employees' Retirement Law requires that a
11 contracting agency determine whether an employee of such agency in
12 employment in which he is classified as a local safety member is
13 physically or mentally incapacitated to perform his duties for purposes
14 of the Public Employees' Retirement Law; and
15 WHEREAS, on or about August 29, 2000, Gary A. Wiskus,
16 employed by the Agency in the position of Battalion Chief in the Vernon
17 Fire Department, filed an application for service pending industrial
18 disability retirement with the Public Employees' Retirement System
19 ("PERS") ; and
20 WHEREAS, on or about September 27, 2000, PERS requested the
21 Agency make a determination regarding whether Gary A. Wiskus was
22 incapacitated from the performance of his duties and therefore eligible
23 to retire for disability; and
24 WHEREAS, by letter dated August 15, 2001, Bruce V.
25 Malkenhorst, the City Administrator, notified Gary A. Wiskus that the
26 matter of his orthopedic disability retirement, based on the findings
27 contained in the medical reports, would be considered by the City
28 Council; and
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WHEREAS, the City Council of the City of Vernon has reviewed
medical evidence and other evidence relevant to whether Mr. Wiskus was
incapacitated; and
WHEREAS, the City Council of the City of Vernon has reviewed
evidence both as to whether any incapacity was industrial and as to
whether any third -party liability is possible with respect to any
incapacity.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE
CITY OF VERNON AS FOLLOWS:
SECTION 1: The City Council of the City of Vernon hereby
finds and determines that Gary A. Wiskus is disabled within the
meaning of the Public Employees' Retirement Law from the performance
of his duties in the position of Battalion Chief in the Vernon Fire
Department.
SECTION 2: The City Council of the City of Vernon hereby
finds and determines that such orthopedic disability is industrial, in
that it is the result of injury or disease arising out ofandin the
course of employment, that neither the City Council of the City of
Vernon nor Gary A. Wiskus has applied to the Workers' Compensation
Appeals Board for a determination pursuant to Section 21026 to determine
whether such alleged disability is industrial, and that there is no
possibility of third -party liability in this case.
SECTION 3: The City Council of the City of Vernon hereby
determines from the orthopedic evaluation report of Dr. David B. Landers
dated April 16, 2001, that Gary A. Wiskus is unable to perform the
essential job function of his position as a Battalion Chief in the
Vernon Fire Department, that no appropriate reasonable accommodation can
be made to do so and that the permanent and stationary date for
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retirement purposes is April 10, 2001. The City Council therefor
determines that Mr. Wiskus should be retired. The last day Gary A.
Wiskus was on the City's paXroll was December 3, 2000, and Mr. Wiskus
retired effective December 3, 2000.
SECTION 4: The City Clerk shall notify Gary A. Wiskus of the
City Council's determination granting his application for disability
retirement.
SECTION 5: The City Clerk of the City of Vernon shall
certify to the passage of this resolution, and thereupon and
thereafter the same shall be in full force and effect.
APPROVED AND ADOPTED this 22"d day of August, 2001.
ATTEST:
BRUCE V. MALKENHORST, City Clerk
LEONIS C. BURG, YMayor
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STATE OF CALIFORNIA )
) ss
COUNTY OF LOS ANGELES )
I, BRUCE V. MALKENHORST, City Clerk of the City of Vernon, do
hereby certify that the foregoing Resolution, being Resolution No.
7821, was duly adopted by the City Council of the City of Vernon at an
adjourned regular meeting of the City Council duly held on Wednesday,
August 22, 2001, and thereafter was duly signed by the Mayor of the
City of Vernon.
(SEAL)
D1%UVL' V . 1'1'11J1\J.:L1V11V1\J 1, trlt .y \w1Gl J1
- 4 -
SUPPORTING
DOCUMENTS
CITY COUNCIL
LEONIS C. MALBURG
Mayor
THOMAS A. YBARRA
Mayor Pro-Tem
WM. 'BILL" DAVIS
Councilman
H. "LARRY" GONZALES
Councilman
W. MICHAEL MCCORMICK
Councilman
BRUCE V. MALKENHORST
City Administrator / City Clerk
FAX (323) 581-7924
City Council
City of Vernon
Honorable Members:
CITY HALL
4305 SANTA FE AVENUE, VERNON, CALIFORNIA 90058
TELEPHONE (323) 583-8811
August 13, 2001
EDUARDO OLIVO
City Attorney
FAX: (562) 927-8722
KEVIN WILSON
Director of Community Services & Water
FAX: (323) 588-2761
KENNETH J. DeDARIO
Director of Municipal Utilities
FAX: (323) 583-1983
STEVEN E. PARKER
Fire Chief
FAX: (323) 581-1385
BRUCE W. OLSON
Police Chief
FAX: (323) 583-5236
Former Battalion Chief Gary Wiskus retired on a Service Retirement on
December 3, 2000, pending a disability determination. He applied for
Industrial Disability Retirement on August 29, 2000. In accordance
with Government Code Section 21154 and 21156 the City is required to
make a determination of his disability.
Mr. Wiskus was hired as a firefighter on February 1, 1968. In a report
dated April 16, 2001, submitted by Dr. David Landers he concluded that
Mr. Wiskus cannot perform the essential job functions of a firefighter,
and that it appears that appropriate reasonable accommodation cannot be
made to allow him to do so. He rated him as is Permanent & Stationary
as of April 10, 2001.
Further information provides that his disability is orthopedic, that a
third party liability does not exist and neither the City of Vernon or
Mr. Wiskus has applied to the Workers' Compensation Appeals Board for
any determination. Based on Dr. Landers's medical report it is hereby
recommended that application of Gary Wiskus for Industrial Disability
Retirement be approved effective December 3, 2000.
Very truly yours,����
Bruce V. Malkenhorst
City Administrator/City Clerk
CITY CO
LEONIS C. M B G
Mayor
THOMAS A.
Mayor P em
WM. 'BILL" DAVIS
Councilman
H. "LARRY" GONZALES
Councilman
W. MICHAEL MCCORMICK
Councilman
BRUCE V. MALKENHORST
City Administrator / City Clerk
FAX (323) 581-7924
Mr. Gary A. Wiskus
18573 Santa Isadora
Fountain Valley, CA
CITY HALL
4305 SANTA FE AVENUE, VERNON, CALIFORNIA 90058
TELEPHONE (323) 583-8811
92708
August 14, 2001
RE: Request for Industrial Disability Retirement
Dear Mr. Wiskus:
EDUARDO OLIVO
City Attorney
FAX: (562) 927-8722
KEVIN WILSON
Director of Community Services & Water
FAX: (323) 588-2761
KENNETH J. DeDARIO
Director of Municipal Utilities
FAX: (323) 583--1983
STEVEN E. PARKER
Fire Chief
FAX: (323) 581-1385
BRUCE W. OLSON
Police Chief
FAX: (323) 583-5236
The matter regarding your application for an Industrial Disability
Retirement will be heard by the City of Vernon City Council on
Wednesday, August 22, 2001, at approximately 5 o'clock p.m. I will be
recommending to the City Council that your application for such
disability be approved.
Very truly yours,
CITY OF VERNON
Bruce V. Malkenhorst
City Administrator/City Clerk
cc: City Attorney
Risk Manager
/gjo
yi
MEMORANDUM
RISK MANAGEMENT/PERSONNEL I jj 7
TO: Bruce V. Malkenhorst, City Administrator
FROM: Joan Francone, Risk Manager/Personnel Assistant
DATE: May 9, 2001
SUBJECT: INDUSTRIAL DISABILITY RETIREMENT
GARY A. WISKUS, BATTALION CHIEF RETIRED
Gary Wiskus, Vernon Fire Department Battalion Chief retired, applied for a Service Pending
Industrial Disability Retirement on August 29, 2000. In accordance with Government Code
Sections 21154 and 21156, PERS requested that the City make a determination as to his
industrial disability in a letter dated September 14, 2000 and received by the City on September
27, 2000.
Mr. Wiskus was hired as a firefighter on February 1, 1968. He advanced through the ranks
retiring as a Battalion Chief. During his tenure he suffered several work -related injuries
including low back injury on 1-29-77, left hip injury on 8-24-81, back strain 1-21-82, and
chemical exposure on 4-6-89, among others.
In a report dated April 16, 2001, David B. Landers, M.D. Medical Director at Technimed -
Vernon concludes that Mr. Wiskus can not perform the essential job functions of a firefighter
and that no appropriate reasonable accommodation can be made to allow him to do so. He is
Permanent and Stationary as of April 10, 2001.
Dr. Landers bases his opinion on the following:
1. S/P Multiple Low Back Injuries (starting in the 1970's) - requiring limitation of
physical activities.
2. Significant bilateral hearing impairment -(which will require a 'hearing aid' evaluation
in the future).
3. Chronic dermatitis of the neck, chest, and axillae.
Based on the above, it is recommended that Council approve the industrial disability retirement
of Gary Wiskus effective December 3, 2000, and that his primary disability condition is
orthopedic. No third party liability exists. Neither the City Council of the City of Vernon nor
Gary Wiskus has applied to the Workers' Compensation Appeals Board for a determination
whether such disability is industrial.
JF/fs
Enclosures
cc: City Attorney
Benefit Services f ion
► P.O. Box 2796
Sacramento, CA 95812-2796
(916) 326-3232; (800) 352-2238
CalPERS TDD (916) 326-3240; FAX (916) 658-1280
September 14, 2000
City of Vernon
4305 Santa Fe Ave.
Vernon, CA 90058
Dear Personnel Officer:
U
Reply To: Unit 432
ReferTQ C-1 V 7D246
'00 SEP 27 P 4 :56
CITY (f';
RISK F
Enclosed is a copy of the application which is being filed with your agency for a
determination of the member's disability, in accordance with Section 21154 and 21156,
Government Code. It is required that you make this determination within six months of
this request unless the local safety member waives the requirements of this provision
(Government Code Section 21157).
Under the California Public Employees' Retirement Law, disability means the incapacity
of a member for the performance of duty in public services for permanent or extended
and uncertain duration, as determined on the basis of competent medical opinion.
Disability is not necessarily an inability to perform every function of a given position.
Rather, the courts have concluded that the test in any case is whether the employee
can substantially perform the duties of the position he occupies. These criteria apply
whether the member is being retired or is being reinstated from disability retirement.
Disputed questions regarding the industrial relationship of the disabling injury to the
member's work will be resolved by the Workers' Compensation Appeals Board. In the
event there is no dispute, such a finding can be made by the employer. A Workers'
Compensation Award is not sufficient evidence that a local safety member is disabled
for retirement purposes. There must be a specific finding under Government Code
Section 21166, by the employer, with respect to the disability for which the member will
be retired.
If it is determined that the member is not disabled for the performance of his or her
duties, a Resolution to that effect must be filed with the System. Please refer to Sample
resolution No. 1, Benefits Procedures, Procedures Manual for Public Agency reporting
to the Public Employees' Retirement System. If the member is found to be disabled, the
following will apply:
The Retirement System will require at least the following documentation:
1. A finding that disability exists.
PERS-BAS-175-W (3/96)
California Public Employees' Retirement System
Lincoln Plaza - 400 P Street - Sacramento, CA 95814
-2-
2a. A finding by your agency as to whether or not the disability is industrial.
2b. In case of a dispute, a Findings and Award by the WCAB, resolving the
industrial relationship.
3. A certified statement (Resolution) by the local agency, last day member is on
payroll. In case of a dispute regarding the members effective date of retirement,
a request must be filed with the WCAB for Finding of Fact to determine on what
date the member's condition became permanent and stationary. That date then
becomes the effective date of retirement (Government Code Section 21164).
4. A statement identifying the type of disability retirement determined, i.e., non-
industrial disability retirement or industrial disability retirement. A member must
have minimum of five years of credited service to qualify for non -industrial
disability retirement. If a member does not meet the minimum service
requirements for disability retirement, he may still qualify by re -depositing
previously withdrawn contributions, or contributing an amount for service
rendered prior to membership with the System. Time during which the member
is absent from State service by reason of injury or illness, which is determined
within one year after the end of such absence to be job -related, shall be
considered as time spent in State service for the purpose of qualification for
retirement and death benefits.
5. A statement by the agency to the effect that there is, or is not, a possibility of
third -party liability present, if member's disability was caused by negligence or an
intentional act of a party other than employer.
6. A statement identifying the reason for the disability, i.e. orthopedic,
psychological, cardio-vascular, internal, neurological or other.
7. If advance disability pension payments will be paid to the member, include the
monthly amount. Also include where the reimbursement check should be mailed.
8. If the employee was hired after 1/1/80, include the following in accordance
with Government Code Section 21417:
a. Was the disability the result of an injury which was a direct
consequence of a violent act perpetrated upon his or her person?
b. Did the disability occur during the performance of those portions of his
or her duties which are particularly hazardous and dangerous?
(For the particularly hazardous and dangerous exception to apply the disability must
have occurred during the performance of job duties which had an especially high risk of
danger when compared to other duties which were performed. It is not sufficient that the
-3-
overall job duties were hazardous or dangerous to some degree; the exception pertains
to hazards or dangers which stand above or apart from the expected hazards of the job.
This exception does not apply simply because a member has an inherently hazardous
and dangerous job.)
All such documentation submitted by your agency must be signed by the governing
body or its lawful delegate (City Manager, Chief Administrative Officer, County
Executive, or other comparable individual). If the governing body chooses to delegate
the responsibility of making a determination, a certified copy of the delegation order of
this authority must accompany the finding by such delegate in each instance.
Under the law, if a person (other than the employer) caused an injury that results in
certain CalPERS benefits being paid, then CalPERS has the right to recover from the
responsible person up to one-half of the total retirement benefit costs payable due to
this injury. This right is known as a "right of subrogation". (Government Code section
20250 et seq.) Accordingly, the Retirement System request that you, as the local
agency, send us copies of all injury reports sent to the State Compensation Insurance
fund (or your Workers' Compensation carrier) concerning any and all injuries sustained
by this employee.
Please advise us if you are aware our member is pursuing a claim (other than a
Workers' Compensation claim) against any person or entity for the same injuries that
also entitle the member to a disability retirement from CalPERS.
We hope the above information is helpful to you. If you have any questions, please call.
Sincerely,
Emily Sandoval
Disability Determination Section
Enclosure: Copy of BAS-369D & BAS-183B
cc: Gary A. Wiskus
Benefit Services Division, P.O. Box 942711, Sacramento, CA 94229-2711
CalPERS Telecommunications Device for the Deaf - (916) 326-3240 - (800) 352-2238
,i
Disability Retirement Election Application
❑ DisabilityRetirement ❑ Industrial Disability Retirement
tY
❑ Service Pending Disability Retirement M Service Pending Industrial Disability Retirement - i
Important: Local Safety Members Should Not Complete Sections C and D.
Section A - Member Information
Vi i IS 561-66-72Y6
First Name i Middle Initial Last Name Social Security Number
ling Address `' -'Male D Female 0 Date o� firth 7'
(i ' - 9(3 4
Gi Home Phone23
State ZIP Country Work Phone
Section B - Retirement Information
Other Final Compensation Period to Be Used:
• From To
Other California Public Retirement Systems: U Yes X No If yes, complete the section below.
Name of System Date of Retirement
Section C Workers' Compensation Information
If you filed a Workers' Compensation claim, please provide the following information.
Workers' Compensation Carrier
Name of Adjuster Telephone Number
Mailing Address City State ZIP
Claim Number(s) Date of Injury(ies)
PERS-BSD-369-D (3/00) page 1 of 6 /
Benefit Services Ssion •
P.O. Box 2796
Sacramento, CA 95812-2796
0 (916) 326-3232; (800) 352-2238 Reply To: Unit 432
CalPERS TDD - (916) 326-3240; FAX (916) 658-1280 Refer To: 561-60-7246
September 14, 2000
Gary Wisk
18573 S nta Isadora
Foun in Valley, CA 92708
Dear Gary Wiskus:
This letter acknowledges receipt of an application for your disability retirement. A copy
of the application has been forwarded to your employer for a determination of your
disability. Your employer is required to make a determination within six months of this
notice unless you waive the requirements of this provision (Government Code Section
21157).
Following your employer's finding of substantial incapacity, your retirement cannot be
canceled. However, if you are eligible, and wish to change to a service retirement in lieu
of disability retirement, you must apply for the change prior to the effective date of your
disability retirement or within 30 days after notification of approval (Government Code
Section 21156).
Under the law, if a person (other than your employer) caused an injury that results in
certain CalPERS benefits being paid, then CalPERS has the right to recover from the
responsible person up to one-half of the total retirement benefit costs payable due to
this injury. This right is known as a "right of subrogation" (Government Code section
20251 et seq.).
If you pursue a claim against any person for the same injuries that also entitle you to
disability retirement from CalPERS (other than a Workers' Compensation Claim or an
uninsured motorist claim) YOU MUST INFORM CALPERS OF THE EXISTENCE OF
THIS CLAIM. This is true even if the claim has not yet resulted in a court action.
CaIPERS has the right to participate in any such claim either through filing its own
action against the responsible party, intervening in your claim, or filing a lien against any
judgment which you may recover. IF YOU SETTLE SUCH A CLAIM WITHOUT
NOTIFYING CALPERS, CALPERS MAY ALSO BE ENTITLED TO FILE A LAWSUIT
AGAINST YOU FOR RECOVERY OF CALPERS' SUBROGATION RIGHTS.
If you entered your safety membership category after January 1, 1980, your industrial
disability allowance may less than 50% of your final compensation. The allowance
cannot exceed the amount that would be payable for a service retirement at age 55 if
you had continued in employment until age 55. This limit does not apply to a member
whose disability resulted from an injury which was a direct consequence of a violent act
PERS-BAS-18313-W (3/96)
California Public Employees' Retirement System
Lincoln Plaza - 400 P Street - Sacramento, CA 96814
—L^^//
• A —
s • �
perpetrated upon his or her person or occurred during the performance of those
portions of his or her duties which are particularly hazardous and dangerous
(Government Code Section 21417).
For the particularly hazardous and dangerous exception to apply you must show that
your disability occurred during the performance of job duties which had an especially
high risk of danger when compared to other duties which you performed. It is not
sufficient that the overall job duties were hazardous or dangerous to some degree; the
exception pertains to hazards or dangers which stand above or apart from the expected
hazards of the job. This exception does not apply simply because a member has an
inherently hazardous and dangerous job.
If you are notified by CalPERS that your disability application has been approved, and
upon receipt of a separation document form your employer reflecting your last day on
the payroll, the System will calculate and send the optional settlement information. This
information will be sent to you on our form PERS-BAS-898, Election of Optional
Settlement and Beneficiary Designation. The form will require the notarized signature of
both you and your spouse.
If at any time prior to the mailing of your first warrant you wish to receive a refund of
your accumulated contributions in a lump sum in lieu of a retirement allowance, you
may do so by sending written notification to the return address shown above. You
should be advised that membership in the Retirement System terminates upon the
mailing of a warrant refunding contributions, making you ineligible for future benefits
unless you return to employment covered by CalPERS Government Code Section
20340).
If you have any questions, please contact us.
Sincerely,
Emily Sandoval
Disability Determination Section
Enclosure: BAS-175
cc: City of Vernon
Attn: Personnel Officer
TECHNIMED - VERNON
INDUSTRIAL MEDICAL CENTER, INC.
3364 E. SLAUSON AVENUE
VERNON, CA. 90058
FAX (323) 584-0059 - TEL (323) 584-7242
DAVID B. LANDERS, MD.
• MEDICAL DIRECTOR •
APRIL 16, 2001
CONFIDENTIAL MEDICAL REPORT
CITY OF VERNON
JOAN FRANCONE
RISK MANAGEMENT
4305 SANTA FE AVE.
VERNON, CA. 90058
IIE W13KUS GARY
EMPL, CITY OF VERNON - FIRE FIGHTER
( )
SUBJ SPECIAL EXAMINATION. - R)fSABMLITY BTATUS.........
Dear Ms. Francone:
MEDICAL HISTORY:
Mr. Gary Wiskus is a 55 year old male who has been a City of Vernon employee for
33 years (from 2-1-1968 - 12-3-2000) years. He has most recently served as a
Battalion Chief in the City of Vernon Fire Department.
I examined Mr. Wiskus in detail on 4-10-2001 for the purpose of determining his
present physical examination status and whether or not he could perform the
Essential Job Functions of a Firefighter for the City of Vernon. Based upon that
interview and examination, I have reached certain medical conclusions.
Mr. Wiskus was noted to have the following Medical Diagnoses:
- 1. S/P MULTIPLE LOW BACK INJURIES - (STARTING IN THE
1970'S) - REQUIRING LIMITATION OF PHYSICAL
ACTIVITIES
- 2. SIGNIFICANT BILATERAL HEARING IMPAIRMENT - (WHICH WILL
REQUIRE A 'HEARING AID' EVALUATION - IN THE FUTURE)
- 3. CHRONIC DERMATITIS OF THE NECK, CHEST, AND AXILLAE.
RED WI oWUS, GARY
EMPL CITY OF VERNON (FIRE FIGHTER
S.UBJ SPECIAL EXAMINATIQ.N - DISAB.�.LITY STATUS
WORK STATUS: It is my medical opinion the Mr. Gary Wiskus can not
perform the essential job functions of a Firefighter. It is my opinion that no
appropriate reasonable accommodation can be made to allow him to do so. He is P
& S (Permanent & Stationary) as of 4-10-2001.
FUTURE MEDICAL: He will need the provision of medical treatment in the
future consisting of ENT / Audiological Evaluations and probable Hearing Aids.
RECOMMENDATIONS: Therefore, I would recommend that Mr. Gary Wiskus be
retired from the City of Vernon Fire Department.
Sincerely,
David B. Landers, MD.
Medical Director
Fellow, ACOEM
American College of Occupational & Environmental Medicine
Diplomate, American Board of Family Practice
QME - Qualified Medical Evaluator 1993-94, State of California
• TECHNIMED - VERNON INDUSTRIAL MEDICAL CENTER, INC.
3364 E. SLAUSON AVENUE VERNON, CALIFORNIA 90058
CITY OF VERNON
JOAN FRANCONE
RISK MANAGEMENT
4305 SANTA FE AVE.
VERNON, CA. 90058
• TECHNIMED - VERNON INDUSTRIAL MEDICAL CENTER, INC.
3364 E. SLAUSON AVENUE VERNON, CALIFORNIA 90058
.► t
n
Oiron, Nelly
From: Lehr, Judy
Sent: Monday, May 14, 2001 2:06 PM
To: Giron, Nelly
Subject: Wiskus Disability
Nelly,
When you send out the letter giving notice to Mr. Wiskus of the Council considering the disability
retirement, please give me a copy.
Thanks.
Judy