CALPERS IDR - CHRISTIAN N. MOSCOSO - CITY ADMIN APPROVED 12/07/17 CONFIDENTIAL
INDUSTRIAL DISABILITY
RETIREMENT APPROVED BY THE
CITY ADMINISTRATOR ON
DECEMBER 7, 2017 - *SEE CLERK
DEPARTMENT FILES (INTERNAL) -
CALPERS DISABILITY RETIREMENT
RESOLUTIONS FOLDER IN
LASERFICHE FOR RESOLUTION
**RESOLUTION IS ON FILE IN THE
CITY CLERK'S OFFICE
**CONTACT H.R. BEFORE
RELEASING ANY INFORMATION
FOR PUBLIC RECORDS REQUESTS
A RESOLUTION OF THE CITY ADMINISTRATOR OF THE CITY
OF VERNON APPROVING THE INDUSTRIAL DISABILITY
RETIREMENT APPLICATION OF CHRISTIAN N. MOSCOSO, A
LOCAL SAFETY MEMBER FORMERLY EMPLOYED BY THE CITY
OF VERNON (GOVERNMENT CODE SECTIONS 21154 AND
21156)
(1) Pursuant to the authority delegated to me by action of
the City Council of the City of Vernon (hereinafter referred to
as Agency) via Resolution No. 2016-45, dated August 2, 2016, and
pursuant to the authority under Government Code section 21173,
after review of medical and other evidence relevant thereto, I
hereby determine that Christian N. Moscoso, a local safety
member of the California Public Employees' Retirement System
(CalPERS) who was employed by the Agency until October 12, 2017,
is incapacitated within the meaning of the California Public
Employees' Retirement Law for performance of his duties in the
position of Police Officer for an orthopedic (right
shoulder) condition. I hereby certify under penalty of perjury
that this determination was made on the basis of competent
medical opinion and was not used as a substitute for the
disciplinary process . If the disciplinary process occurred
before the member' s separation from employment, all relevant
personnel documents were forwarded to CalPERS for determination
of the member' s eligibility for disability retirement and
CalPERS' determination that the member is eligible to apply for
disability retirement was obtained prior to starting the process
of determination.
(2) Christian N. Moscoso had filed a Workers' Compensation
claim for his disabling condition. The Workers' Compensation
claim was accepted.
(3) Pursuant to such authority I also determine that such
incapacity is a result of injury or disease arising out of and
in the course of his employment as a local safety member. I
certify that neither the Agency nor the member has filed a
petition for determination under Government Code section 21166,
to be made by the Workers' Compensation Appeals Board.
(4 ) I hereby certify that the member was separated from his
employment in the position of Police Officer after expiration of
his leave rights under Government Code section 21164 , effective
October 12, 2017, and that no dispute as to the expiration of
such leave rights is pending. His last day on pay status was
October 12, 2017 .
(5) There is not a possibility of third party liability.
( 6) Advanced Disability Pension Payments will be made. The
payments will be made monthly in the amount of $5, 003 . 00
beginning November 1, 2017 .
(7) The primary disabling condition is orthopedic (right
shoulder) .
(8 ) The duration of the disabling condition is expected to
be permanent or last at least twelve consecutive months from the
date of the application for benefit or will result in death,
which is certified by competent medical opinion, as determined
on the basis of competent medical opinion.
APPROVED this 29th day of November, 2017 .
)011
L
NAME: Carlos R. F, dino, Jr.
TITLE: City Administrator
ST :
/
Maria E. Ayal. City Clerk
APPROVED AS TO FORM:
Zayna► Moussa,
Seni. Deputy City Attorney
TRANSMITTAL COMMUNICATION
CITY CLERK'S OFFICE
INTEROFFICE MEMORANDUM
DATE: December 7, 2017
TO: Michael Earl, Director of Human Resources
FROM: Deborah Juarez, Records Management Assistant
I
RE: Confidential—A Resolution of the City Administrator of the City of Vernon Approving the
Industrial Disability Retirement Application of Christian N. Moscoso, a Local Safety
Member Formerly Employed by the City of Vernon (Government Code Section 21154 and
21156)
Please find attached for your transmittal to the proper party, one certified copy of the above-referenced
resolution that was approved by the City Administrator on December 7, 2017.
Please ensure that a copy of the transmittal letter is sent to my attention for the file.
Thank you.
Attachment
c: CALPERS IDR File
CERTIFICATE
STATE OF CALIFORNIA )
ss
COUNTY OF LOS ANGELES)
I, Maria E. Ayala, City Clerk of the City of Vernon, County
of Los Angeles, State of California, hereby certify that the
attached is a full and complete copy of:
A Resolution of the City Administrator of the City of Vernon
Approving the Industrial Disability Retirement Application of
Christian N. Moscoso, a Local Safety Member Formerly Employed
by the City of Vernon (Government Code Sections 21154 and
21156)
IN WITNESS WHEREOF, I have hereunto set my hand and affixed
the official Seal of the City of Vernon, County of Los Angeles,
State of California, on this —111' day of December 2017 .
SEAL:
'4-------)Mari E. Ayala
City Clerk
STAFF REPORT
(61,
RfECEAVED
c � DEC 07 2017
CONFIDENTIAL -�L.�N°• co toms-mon
INTEROFFICE MEMORANDUM
HUMAN RESOURCES DEPARTMENT
DATE: November 29, 2017
TO: Carlos R. Fandino,Jr. City Administrator
FROM: Michael A. Earl, Director of Human Resources .
RE: A RESOLUTION OF THE CITY ADMINISTRATOR OF THE CITY OF
VERNON APPROVING THE INDUSTRIAL DISABILITY RETIREMENT
APPLICATION OF CHRISTIAN N. MOSCOSO, A LOCAL SAFETY
MEMBER FORMERLY EMPLOYED BY THE CITY OF VERNON
(GOVERNMENT CODE SECTION 21154 AND 21156)
Background
In accordance with Government Code Sections 21154 and 21156, the City is required to
determine a member's disability eligibility within six months of an IDR request. On its own a
Worker's 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 from the performance of his or her own duties, a
resolution to that effect must be submitted to Ca1PERS. On August 2, 2016, City Council passed
Resolution No. 2016-45, delegating the authority for making such determinations for local safety
members to the City Administrator.
Mr. Moscoso was hired on September 22, 1987. At the time of injury, Mr. Moscoso was a 48-
year-old Police Officer who sustained an injury to the right shoulder on December 9, 2014, while
lifting his equipment bag. On or about January 27, 2015, Mr. Moscoso suffered from pain
traveling from the right shoulder to the neck. It was determined that the cervical symptoms were
related to the right shoulder injury. Subsequently, on April 23, 2015, Mr. Moscoso filed an
application for adjudication of claim with the Worker's Compensation Appeals Board, by and
through his attorney of record, Andrew Dhadwal, for his injury to the right shoulder and neck.
The claim was accepted and notice was issued on December 14, 2015, for the right shoulder and
the cervical spine was also accepted as part of the claim. Mr. Moscoso underwent cervical spine
surgery on September 17, 2015. On January 11, 2016, his treating physician recommended that
Mr. Moscoso undergo a second surgery to the cervical spine. Mr. Moscoso elected to begin
treating for his right shoulder injury and when treatment for the right shoulder was completed, he
would then resume treatment for the second cervical spine surgery. On March 2, 2016, Mr.
Moscoso underwent surgery for his right shoulder and on August 27, 2016, he was released back
to work with restrictions and continued treatment with physical therapy. On January 20, 2017,
his treating physician for the right shoulder, Dr. Woodson, released Mr. Moscoso back to work
with no restrictions.
On March 1, 2017, Mr. Moscoso attended a Functional Capacity Evaluation ("FCE")
administered by Terry Lawson, PT. Based on the FCE, Mr. Lawson indicated that Mr. Moscoso
was not safe to perform his job and recommended a short-term work conditioning program. Mr.
Moscoso attended approximately twelve sessions of the work conditioning program and during
the visits it was determined that he was unable to tolerate work related activities in a pain free
manner and unable to lift over 501bs. On May 17, 2017, Mr. Moscoso returned for a follow up
appointment with his treating physician, Dr. Woodson, whereas Dr. Woodson reviewed the notes
from the work conditioning program and at that time discharged Mr. Moscoso as permanent and
stationary with permanent work restrictions of no lifting over 501bs, no pulling over 2781bs, and
no pushing over 1251bs. Additionally, Mr. Moscoso will continue to treat for the cervical spine.
On October 2, 2017, Mr. Moscoso participated in an interactive reasonable accommodations
meeting with representatives from the Human Resources Department and the Chief of Police,
where we explored any options that may exist to support return to work possibilities based on his
permanent work restrictions. During the meeting it was determined that Mr. Moscoso was not
able to perform the essential functions of his job classification as a Police Officer and the
placement into an alternative position was not available, therefore, he elected to retire effective
October 12, 2017.
In conclusion, in accordance with government code 21156, a local safety member shall be retired
for disability only upon the employer's determination that the member is substantially
incapacitated physically or mentally for the performance of the usual job duties with the current
employer. The disability decision is based upon competent medical opinion and all medical and
vocational information provided by the member, employer, and workers' compensation carrier.
The determination is based on actual/present disability, not prospective inability to perform the
job duties. Based on the competent medical opinion of Dr. Woodson, where he found Mr.
Moscoso substantially incapacitated with permanent work restrictions due to his orthopedic
(right shoulder) condition, I am therefore recommending the approval of an industrial disability
retirement effective October 13, 2017.
Fiscal Impact
None.
Attachment(s)
1. Resolution
cc: Hema P. Patel, City Attorney
MAE/kr
SUPPORTING INFORMATION
CERTIFICATE
STATE OF CALIFORNIA )
ss
COUNTY OF LOS ANGELES)
I, Maria E. Ayala, City Clerk of the City of Vernon, County
of Los Angeles, State of California, hereby certify that the
attached is a full and complete copy of:
RESOLUTION NO. 2016-45 - A Resolution of the City Council of
the City of Vernon Delegating Authority to the City
Administrator to Make Determinations Regarding Industrial
Disability Retirements
IN WITNESS WHEREOF, I have hereunto set my hand and affixed
the official Seal of the City of Vernon, County of Los Angeles,
State of California, on this ', '" day of November 2017 .
SEAL:
4i .
Mar a E. ala
Cit Clerk
RESOLUTION M . 2016-45
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF
VERNON DELEGATING AUTHORITY TO THE CITY
ADMINISTRATOR TO MAKE DETERMINATIONS REGARDING
INDUSTRIAL DISABILITY RETIREMENTS
WHEREAS, the City of Vernon (hereinafter referred to as
"Agency") is a contracting agency of the California Public Employees'
Retirement System ("CalPERS") ; and
WHEREAS, the Public Employees' Retirement Law requires that
a contracting agency determine whether an employee of such agency in
employment in which he/she is classified as a local safety member is
disabled for purposes of the Public Employees' Retirement Law and
whether such disability is "industrial" within such meaning of such
Law; and
WHEREAS, the City Council of the City of Vernon has
determined upon staff and legal advice that it may delegate authority
under Government Code Section 21173 to make such determinations to the
incumbent of the office/position of City Administrator.
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 the above recitals are true and correct.
SECTION 2 : The City Council of the City of Vernon finds
that this action is exempt from California Environmental Quality Act
("CEQA") review, because it is an administrative activity that will
not result in direct or indirect physical changes in the environment,
and therefore does not constitute a "project" as defined by CEQA
Guidelines section 15378 .
SECTION 3: The City Council of the City of Vernon hereby
delegates to the incumbent of the office/position of City
Administrator the authority to make determinations of disability on
behalf of the Agency under Government Code Section 21156 and whether
such disability is industrial and to certify such determinations and
all other necessary information to Ca1PERS.
SECTION 4 : The City Council of the City of Vernon also
delegates to the incumbent of the office/position of City
Administrator the authority to make applications on behalf of the
Agency pursuant to Government Code Section 21152 (c) for disability
retirement of all employees and to initiate requests for reinstatement
of such employees who are retired for disability.
SECTION 5 : The City Clerk, or Deputy City Clerk, of the
City of Vernon shall certify to the passage, approval and adoption of
this resolution, and the City Clerk, or Deputy City Clerk, of the City
of Vernon shall cause this resolution and the City Clerk' s, or Deputy
City Clerk' s, certification to be entered in the File of Resolutions
of the Council of this City.
APPROVED AND ADOPTED this 2nd day of August, 2016 .
Name: William J. Davis
Title: Mayor / -
T - :
Mari - E . Aye'la
City Cl- i k / - -
APPROVED AS TO FORM:
Zayn h oussa, Senior Deputy City Attorney
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STATE OF CALIFORNIA
ss
COUNTY OF LOS ANGELES
1, Maria E • 'Ayala, City Clerk / -Bep y City CI-ere-of the City
of Vernon, do hereby certify that the foregoing Resolution, being
Resolution No. 2016-45, was duly passed, approved and adopted by the
City Council of the City of Vernon at a regular meeting of the City
Council duly held on Tuesday, August 2, 2016, and thereafter was duly
signed by the Mayor or Mayor Pro-Tem of the City of Vernon.
Executed this 4'41° day of August, 2016, at Vernon, California.
M ria E . la
City C erk /
(SEAL)
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