HomeMy WebLinkAboutCC 7 BARTON RETIREMNT 7-21-80July 16, 1980
Inter-Corn
F~yor and City Council
Dan Biankenship, City Ad~ainistrator
Resolution ~80-79
Based on the review of the Retirement Review Board, the
recommendation is being made to retire Kenneth Barton on
the basis of a non-job~related disability. This action
is to be effective August 1, 1980.
Mr. Barton has the option of appealing the question of
the job-relatedness of his disability, and of requesting
a settlement based permanent disability. These matters
will be handled separately through the Worker's Compen-
sation Appeals Board. It is the City's impression that
M~. Barton will pursue both matters. If so, the City
will oppose both based on the information obtained to
date.
Attached are copies of the Resolution (#80-79), the Findings,
Conclusions and Recommendations of the Retirement Review
Board, and the exhibits presented before the Board which
formed the basis for their decision.
DB/RPG/kaf
RESOLUTION NO. 80-79
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF TUSTIN,
CALIFORNIA, PERTAINING TO THE DISABILITY RETIREMENT OF
KENNETH BARTON.
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5 WHEREAS, the City of Tustin (hereinafter referred to as Agency) is a
6 contracting agency of the Public Employee's Retirement System;
7 WHEREAS, the Public Employee's Retirement law requires that a contracting~
8 agency determine whether an employee of such agency in employment in which he
9 is classified as a local safety member is disabled for purposes of the Public
~0 Employee's Retirement law and whether such disability is "industrial" within
~1 the meaning of such law;
12 WHEREAS, an application for disability retirement of Kenneth Barton has
~3 been filed with the Public Employees Retirement System;
~4 WHEREAS, the City Council has delegated the fact-finding functions re-
~5 garding disability determinations to the Disability Retirement Review Board
16 pursuant to Tustin Personnel Rules and Regulations Section 10 (F);
17 WHEREAS, The Disability Retirement Review Board of the City of Tustin
18 conducted a hearing on June 16, 1980 and found that Kenneth Barton is disabled
~9 and that the disability is not industrially caused;
20 ~EREAS, the City Council of the City of Tustin has reviewed the medical
21 and other evidence relevant to such alleged disability and revigwed the Find-
22 ings and Conclusions of the Disability Retirement Review Board;
2~ NOW, THEREFORE, the City Council of the City of Tustin does hereby resolve
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25 1. That the City Council of the City of Tustin find and determine
26 and it does hereby find and determine that Kenneth Barton is incapacitated
27 within the meaning of the Public Employees' Retirement Law for performance
~8 of his duties in the position of Police Sergeant;
29 2. That a petition will be filed with the Worker's Compensation Appeals
30 Board for a determination pursuant to Section 21026, Government Code.
~1 3. That the member was or will be separated from his employment in the
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position of Police Sergeant, after expiration of his leave rights %Lnder
Section 21025.4, Government Code, effective August 1, 1980 and that no
dispute as to the expiration of such leave rights is pending.
4. That based upon the advice of the City Attorney, there is not a
possibility of third party liability for this disability.
PASSED AND ADOPTED this day of , 1980.
MAYOR
ATTEST:
CITY CLERK
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RE'I' [
FiNDINgS, CONCLUSIONS
~-.NI) EECOf.~.IENDAT.t ONS
The R~l iwom,.nh Rovlew Board c~nvencd on June 16,
.1980 at al:,l~:~o:-:~mately 10:00 a.m. to consider the matter of
!he disability ret]r,.mcnt of Kenneth Bnrton. In attendance
at :,;aid hca~yJng and ~'C<ing up the board were% Dan Blankenship,
:.zr%c Brokemark]e and }.id Bushong. Also in attendance were
roy Gonza]es of the Fer:;onnel Department to present the
,.. ..... .;.o.r, Robert T.avoJe of t:he City Attorney's office, and
k' I >ID I NG S
The Retirement P, ev~.ow Board of [he City of Tus[in
':*',.:~d$.. as followS:
1. The '~, a
Ro~ ~=cm.nt Rcview l?,oard co~..sidered the
following evidence:
(1) Letter from Dr. Vautrin to Captain Yaruss
dated 1/28/80
(2) l,etter ~from Santa Aha Tustin Indu-~trial Clinic
to Mike Taft dated 1/21/80
(3) Letter from Santa Aha Tustin Industrial Clinic
to M~ke Taft dahed 8/1/79
(4) Letter from Dr. Dauben to R. L. Kautz dated
5/7/79
(5) I,etter fro. m Dr. Daubon to Chief Thayer
dated 3/19/79
(6) Letter from Dr. Daubon to Dr. Vautrin dated
3/]6/79
(7) Letter from Dr. Dauben to Dr. Vautrin dated
3/8/79
(8) Excerpt from PERS Handbook regarding dis-
abil~ ty retirements
III
(9) ?e?ort from Dr. VJllalobos dated 5/27/80
].0) I,etter from Alan R. Burns to M. indy Peck
dated 2/13/80
]]) Ret.oft of ~','.d~cal ExaminatJon dated 10/29/71
]2) Testimony of Sgt. W~lliams of Tust.~n Police
Depar Lin,~nt
2. That the medical reports contained in Exhibits 1
~hrough 6 and Exhibit 8 indicate that Kenneth Barton is dis-
~b],Td as a result of hypertension. Dr: Villalobos i~]dicates
that ~4r. Barton should be c~pable of performing in a non-stress
related ?osition; however, the Tustin Police Depart~ent
~nd~cates that no such positio~]s are presently available.
3. That the finding of Dr. Melvin Reich in Exhibit 3
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~.:hich reads, "Since hypertension is considered a work-related
lily,ess for t~his patient, as ]]is occupation is that of a
]m~]]co.man, I feel the rcpo]'t of Dr. Galente's
is [~retty clear in this area", is based on a legal conclusion
r~][]~er than a medical evaluation. No medical evidence is
effected to support this "conclusion".
4. That the finding of Dr. Richard Dauben which
reads as follows, "as I understand, hypertension is considered
a work-related illness for this patient as his occupation is
that of a police[~an. If this is the case, I would also con-
sJder his spells of va.qospasm work-related as they are almost
cert~inly a result of his hypertension", like the opinion of
Dr. Reich, is based on a legal conclusion rather than on a
medical evaluation. Dr. Dauben presents no medical evidence
to .~upport his conclusion.
5. That the report of Dr. Frank Villalobos con-
eluded as follows:
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".qr. Barton can now be con.~;idered stable and
stationary £or rating purt~oses relative to
his hypert~nsion. He has a permanent prophy-
lactic restriction from prolonged, heavy
physical c>:ertion but should be able to carry
out all the duties of his occupation. He is
rear, ricked from severe and prolonged stress.
Because of the various nonindustrial factors
cited above, apportionment is indicated in
this case. It is my opinion that Mr. Earton
developed essential hypertension as a result
of heredity with aggravation by prolonged
cigarette smoking and predisposition to
development of arteriosclerosis. This con-
dition, however, was aggravated by the stresses
of his occupation as policeman for the City
of Tustin. I would apportion 70 percent of
his disability to nonAwork related factors
and 30 percent to the stresses of his occupa-
tion. I defer to the surgical consultants
for determination of his disability for his
peripheral vascular disease."
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6. That the conclusion of Dr. Villalobos concerning
the cause of Kenneth Barton's disability is based upon medical
ov~ d,pnce.
7. That },e,meth Barton stil~ulated that a prior
cbs/ruction to the blood flow of the lower aorta and which
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:.;aa cured by an aorta bi-femoral bypass graft was not And is not
related to his present condition of hypertension.
CONCLUSIONS
The Re[~.irement Review Board, based upon the evidence
and the findings here, concludes as follows:
1. That Kenneth Barton is disabled pursuant to
Public Employees Retirelnent Law.
2. That the disability is the result of hypertension
but not the result of heart trouble.
3. That the disability is not industrially related.
4. That .~hould hypertension be considered to be
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:.~.{~d]{n the deflni%ion of heart trouble so as to raise the
i'-~.~umpt_~on that the d i~;ability of Kenneth Barton is indus-
trJa]ly related, it ~:~ the conclusion of the Retirement Review
:-n,v~rd that the evJd~nce presented to t:.he board rebuts the pre-
s~.mpt ion.
REC O:.~4E~WDAT I ON
It is the recommendation o'f the Retirement Review
Board that the City Council of the City of Tustin find that
Kenneth Barton is disabled and that the disability is not
Jndushrially caused.
DAN Bi~i'iKENS HI P
City Administrator
RLL:lw:D:6/16/80
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January 28, 1980.
Tustin Police Department
300 So. Centennial Way
Tustin, CA 92680
Attention: Captain G. Yaruss.
Re. ~-'Kenneth Barton.
Dea~tain Ynruss:
RECEIVED
Mr. Barton was last seen on January 4th, 1980, at that time
his weight was 182 lbs., his B/P 1i2/'70 sitting, 103/66
~tanding. lte wag still comp!aining of some mild right tempal
headacl~e that was relieved ~,,~th aspirin. An attempt had been
made previ, ously to reduc0 the l~deral but tho patient di.,l get
an elevation in his blood pressure, go h0 i8 5~Lll taklng
approximately 40 rog. of Inderai. 4 times a day.
In November of 1979 he was seen in the Emergency Room of St.
Josephs Hospital because of painful left thumb with a diagnosis
of inflammatory arthritis of'the distal left thtnnb joint, otx
medication this has quieted down and the patient has had no
recurrence of symptomatology. There is some evidence of earl),
arthritic changes in the distal thumb joint, this should not
serve as any hinderance to his duties.
It appears that the patients hypertension problem and his
vascular type headaches have been control, led with the Inderal
It was our hope that we could reduce the dosage somewhat and
this may yet be possible. I think that it is feasible to
allow Mr. Barton to return go his work on February 15th, 191~
as I understand that he will prob;,.bly be at some other tyt
of duty.
All of the pertinent medical data has been sent to Dr. Ga
which I presume will be forwarded to blr. Barton's file.
he is Still Ia. king the Inderal it my be apparent from the
'maximal activzty such as stress and physical adeptness at
'prolonged or lifesaving type situations, that Mr. Barton
well not have the physical endurance that was present pr~
Tustin Police Department 2 - Kenneth Barton.
Patients who are on Inderal usually are not able to perform
as adequately as those who are not taking th£s preparation.
It has a slowing effect on the system and the heart, however,
it is the only drug available that we can use for his hyper-
tension and vascular headaches to avoid those. From a stand-
point of his aortoiliac surgery I think this has cl. eare'd
sufficiently enough so that he will have no major problem in
that area. I would however, caution that the patient will!
probably not be able to engage in life threatening actlv[tie~]
where maximal effort is needed,' where there is no peri. od of ~
rest during activities of this sort so as to avoid potential
trauma to him or those, he might be coveri, ng. This I think
}ins to be taken into consideration with' his assignment, into
the near future as long as he needs to remain on the Inderal.
We will make attempts with the passage of time and regular
follow-up to try to decrease the dosage and work in that
direction for his benefit.
Sincerely,
ahv; gh
Alvin [!. Vautrln, M.D.
15471 #B Red Hill Avenue
Tuslin, Calif. 92C80
(714) 731-70.58
DP,. M, FLVIN L. REICH
Hike Taft,
Personnel Director
Tile City of Tustin
T'astin, California 92680
Dear Mr. Taft:
Family Practlco
Indu3trl-I Medicine
21 January 1980
RECEIVED
PERSONNEL
Re:[.Lenneth Barton
',lease find enclosed a sun,nary of KenneLh Barton's medical
history in chronological order.
7-25-79
g-28-79
The patient entered St. Joseph's Hospital with a
provisional diagnosis of aortoiliac occlusive
disease, symptomatic, and arteriogram or an aortogram
(both terms are used interchangeably) was performed.
The history at that time was that the above named
patient was a 46 year old polic~nan who had noted
progressive intermittent claudication (the word
claudication means pain in the lower extremities
when walking). A angiogram was performed at this date
and this revealed the diffuse atheromatous involvc~ent
of the lower abdominal aorta With moderately severe
aortoiliac occlusive disease. This means that'the patient
had obstruction to the bloodflow of the lower aorta as it
branches into the two iliac arteries which are the main
supply to the lower extremities.
The patient underwent an aorto-bi-femoral byoass graft.
This surgery was performed by Doctor Hepps with the
assistance by Doctor West and Doctor Ryan. The operation
started at 8:35 A.M and ended at 1:35 P.H. According to the
surgeon's report, the patient tolerated the procedure well,
and he was taken to the Recovery Room in good condition.
The Discharge Sumnary of that hospitalization stated that the
patient was discharged on August 28, 1979. The postoperative
period was entirely benign and the patient was to be followed
by Doctor Hepps on an outpatient basis.
The patient was seen by his family physician, Doctor Alvin
Vautrin on Novonber 9, 1979. It was his impression at this
time that the patient had hypertension which was controlled"
on medication. Vascular headaches which were improved as a"'
result-of the medication was noted. The post operative course
Mike Taft -2-
Re: Kenneth Barton
21 January 1980
res~lting from the major surg,:ry of the bypass was without
probl~,~s.
12-7-79
A visit by Doctor Albert Vautrin.
To sun~arize this visit it seens that the patient is doing
well front the previous major surgery. The patient at that
time was started on a trial of anti-inflammatory medication
due to the fact that the patient ~.~as.experiencing some type
of arthritic problem. He was scheduled to see the cardiologist
within the next t~vo weeks..
It sec~,~s to me from reading this report, that t~e patient still is
disabl ed.
It is very difficult for me at best to evaluate a patient just b~!
reading heports fr(~,~ other physicians, however, it seems pretty %lear ~
that the patient underwent a major surgery involving a bypass operation.
He seems to have multiple other problems including hypertension, arthritis,~
headaches, etc. It further sca'ns that the patient will be unable to work
at this time.
If I may be of any further assistance in a description of this case,
please feel free to contact me at your convenience.
Sincerely,
Dr. I.leivin Reich
1.1R: j l:r
DR. MELVIN L. REICH
Red Hdl Avenue
Tustin. Calil. 92680
1714) 731.70fl$
pERgONNEL
August 1, 1979
Family Practice
Induslrlel Medicine
Hike Taft, Personnel Director ·
City of-Tustin
300 Centennial Way
Tustin, California 92680
Dear Mr. Taft:
RE:
Ken BARTOH /
City of Tustin Police Department
This letter is in response to your letter to me of June 27, 1979. I have
read all the reports from all of Kenneth Barton's physician. I have also
analyzed all the results of our complete physical examination performed
around May t5, 1979. The report of Louis Galente, cardiologist, is a good
sum.-~ary of the findings relating to this patient. It was Dr. Galente's
dia.~;-csis that ttie patient had_~ystoli'c and diastolic hypertension and
pheri~i~eral vascular discomfort in both legs. Dr. Galente's treatment
consisted of continued antihypertensive medication, peripheral as well as
cardiac angiography and discontinue smoking.
Since !:vDertensioP is considered a work related illness for this patient,.
as r~s occupation is that of a policeman, I fe'6'i the report of Or. Galente's
c'-"on$~.~.a~-n is prP_~t¥ clear in thi~' 'areal I would-also consider his s~s
of vaso-spasm and headache related to his systolic and diastolic hypertension,
If ~ can be Of any further assistance in the evaluation of this patient, please
feel free to call me at your convenience.
Sincerely,
Dr. Melvin Reich
MR/ap
o q
Hay 7,
R.L. ~utz Insurance
P.O. go× 19Gl0
lrvine, CA 92713
RE:
Police Department
~n t I croon:
Kenneth Barton was seen for followup neurological evaluation on 4/23/79.
The ~atient indicated a~ that time that he had no further spells on Propranolol
40 r.;.~s 4 times a day. Neurological examination was normal as on previous
examinations. His blood pressure.was 130/80.
It remains my impression that thc patient };ns t::,.~en suffering spells of vaso-
spa::n rej~resenting a migraine variant due to his hypertension. As I understand,
hypertension is considered a work rela~ed illness For this patle~t'as his
~d~g'tlbn'-i'~- that of-~"~oliccman. If this is the case, I ~o~ld also consider
his SF. Clls of vasbspasm work related as. they are ah~ost certb,in~y a result of
J~l'~'hv~crtcns on.' ~hes~ have been *~ell controlled on his Propranolo] mcdica-
tio:~ which I have reconl,,endcd that he continual. The patient is to have fol~owup
ca~e from Dr, Al Vau~rin. I will be happy to sec :he patient back at any
in t~u future if new neurological problems should develop.
I '..,'i!t be happy to provide any further inforr,'ation wr. ich you may require
regarding my care of tl~is patient, i
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RDD:dm
Harch 19, l.~.J
Chief of Police
Tusl:ln Police Departmr~nt
Centcnnlal at fh~In
Tustln, CA
p,,.= p
RE:. [J6RTO.H, Kenneth R.
Dear Sir:
~tr. Eenneth Barton was sec:n for evnluatlon of hr. adach(:s on ]/7/79. InlClnl
neurciogical examination was entirely normal and lC was my impression thnt
the pat lent ~.~.]s suffer lng from vascular c)r rnl,]ral~e h('ad,lches ~)Jth supt~rJmHos,~d
muscle contraction headach~ss. There ~v~)S nO evJd~]nce Of central nervous
tumor, hem~)rrhage, ~nfec~Jon~ ~r other etiology' for bls headaches. The vnscuJar
comoo-:ent of his headaches ~-~as thought to b,~ relat~:d to hls~w~er~enslon
of[~n precipitates this type of probJ~
Approxim.]teiy one ~eek later, the p.'~tl(~nt hagan having mnrc slgnlfic:mt problems
wl~h Lhese spetJs,-I~ls'bTbod'pres~tr6 ~a~'~m~ed to aa as'B[eh as 170/g5. The
patl,~nt '.-..os re,zvaJuated and h~d'o norm.~l neurological examJ~atJnn. 0Pg led CPA
~'as per-formed which showed normal fl~4 through boLh carotid .~rterles. CBC,
sedime; Lotion r,~te, and SHA-20 ~41th 2-hour postprandial fllucose t,.~re nil
pa~'J'~nt was h0vJng episodes of v~sospasm ~LJe ~O his hypertension c~uslng
spells of transien~ cerebral ischemJa. This represen[s a varJsnt 0f migraine.
For this reason, the patient was begHn on Prnj-)ronnJnl Ito rags It times a d;~y
are cs~enllaJl,/ no side eff~c:s and this m(:dlcatlon hopefully will be helpful
con:rolling th,t PatJont~s hyp,~rrffns]on ns ~vk-1J as his sp~lls of vaRospasnl. I
h~ve advised ~he pa:lent to see his general medical daccor. Dr. V,~utrln. for any
further measures ~.4~lch may b~: needed to help control his blond pressure. I plan
to see the patlenC back in on~ ~nth for follo~:up neurological evaiu~tlon.
the paLlent currenCly has a normal neurological cxamJn,~tJon and has baen
matlc °n ~edicatlon, I tJ~lnk he is able to return :o ~rk. Ho,~evor, h~ should
avoid cendi:lons of s:ress which may aggrava:e his blaod pressure. OtherWise, he)
I will be happy to provide any Eurther:hformatlon ~t~lch you may require r~gardlng
my care of kit. Barton.
DAVII) /',. J O: h~.,'sON, .kl. I3., I:.A.A.N.
Harch 16, 1979
Alvln Vautrln,
lO00 W~:sL
Orange, CA 92668
Dear Doctor
RE:
BARTON, Kenneth R.
Kenneth r!,3rton was seen far t'ollo,,.~¢ naurolugiaal evaluation on 3/16/79. The
pollen[ was previously seen on 3/7//3 for probabl,~ vascular hea,i4chc relr. tm~ to
hype~msion. Three days ago, the patient had three transient eplsodc~ of
arm ,~nd leg weakness and sensory ch;u~Ocs JastJn<j approxim.~tcly IO rninut,:s
'fhesc w~i'a not follc,..,'cd by hcod,~chu. F'ollowi.g those spells, an OP(; and
spel~s ~.as as high as J~O/lJO. The patient wn!; begun On PropranoJoJ ~0 mf,,s
4 tJ¢;,o~ a d,~y on the basis oF a presumptlv~ dldgno~is of vasospn~m. ~.Ince
betaiJcC ncurok~jJcal exa;;iJnatJon L'od,~.'¢ was ,:nLi~tJ'lriorl.~ai.
. ,,..=~ o day over thc ncx[ ~.,eek. I plan tn s,¢,t him back
in orle ~:~r, th for fcJig.-¢up 6vaJuatloq. J ha'v(: reco.':;;endcd that h,: set: you For
blood prussure i'cchcck and adjusts:ant of medication
'fhaak you for the opportunity
Yo.u C s ~lncerely,
/ /%, ':, ..
RICHARC D. DAOBLN, 14.D.
!o:-~in.,J Lhi:~ very l,[c,z man.
RDD:dm
LbAVID A, ,JO] !,~!50H, !,.~. i).,
~l~,rc!, fi, 19'/5
L~ear
wi t. Ji ri?con,*, r [gilt. sided head..~ch,:.
of th,: r'i,jht .[..~,.,~ ]m.~
InoJar, ',!ith Chis there
dllot¢~tlon o¢ LJ~c rJgh~ superficial temper,il ,~r'~ery le.Jlcar, lnq th.at this
;(llkeJy ........ Initially a vascular head6che.:
OARTCN, Kenneth R.
2 - ~arch 8, 1979
This :.,ould reprt:sent either a form of mlgralrm or perhaps a variant of cluster
headache.. There Is no evidence of central nervous system tumor, hemfjrrha9o,
infection, ut other etlo]ogy for the patient's headaches.
R¢car.'.,r;endatlons: I have explained to the patl,'.n~; the benign nature of his head-
aches. I do not think further neurological evaluation Is necessary nt this
time. I hav(: given [he patient a small number of Phrenllln to be used for his
milder more persistent headache. I will be happy to see [he pation~ back
any Lime In ~h~. future If he should have recurrent symptoms or any new neuro-
logical problems.
ThenK y~u very ~auch, Al f~r your referral of thi~ very nlc¢ man
Yours sincere I'/~ .....................
~/~ ' "' I' ~ I ~ i '"
RICttARD D. DAUBElt,
RDO/'zg
Disability
I:', accordance with Government Code Sectio[~ 21025. ~ local safety member shall be retired for
disability only upon }lis employer's determination that the me~nber is incapacitated physically or
mentally for the performance of the duties of the pos[[io:: and termination of the member's employ-
rnent for that reason.
The eml)loyer will determine if the disabiiit,/ is industrial except that in dispu£ed cases the agency
muy re[er the matte~ to tt~e Worker's Compensation Appeals Board for a determin:~tion.
The re, ember's effective date of retirement without tile m~;mbeFs consent cannot be earlier than tho
t~,'min~tion of the employee's leave of absence, without loss of salary; or, if earlier, when disability
is perm3nent and stationary as found by the Worker's Con~pensation Appeals Board. (See Section
21025.4, Government Code)
L¢,c~d ~j~ency Determ,;nation Procedures
Bcf(;~e the Retirement System can act on any local safety member's application for disability retire-
ment, the following questions m, ust be resolved by the agenc'/:
is the member substantially incapacitated for the p~rformance of work duties, and will the
incapacity exist for a permanent or extended and uncertain duration? It is the agency's responsi-
biliw to order a medical examination and obtain such evidence as is necessary to m:~ke a defer-
ruination. Such evidence may be obtained from tim S~a[e Compensation Insurance Fund. On ti~e
basis of its accumulated evidence, the agency mus~ d,~te~mine whether the member is disabled.
Z',lso, the agency must bear the responsibility for uny investigation of retired rnembers for possible
~ einstatement action.
If a determination is made that the member is disabh;d, is th',; disability "industrial"? Industrial
means disability as a resuh et injury or disease arisimj out of and ill tile course u[ emldoymunt
~:s a local safety member (Gnv"~rnm~r~[ (;&ib-,-.%~{~Oi~ 2~)Ci38). If eKher the rneml)er or agency
a~;plies to Worker's Compensation Appea!s Board for a determination, only that Board can decide
the "industlial" question (Government Code, Seclion 21026). A copy of this decision must be
filed with the Public Employees' Retirement System. tf no such application is filed with the
2,.ppeals Board, tile agency's determinatior~ must be fil,,xi with tile System.
What is the effective date of the retirement? The Retircm~;nt System will require that ll~e agency
determining the member's disability Certify an effective retirement date as established in accord-
[:nce with Section 21025.4. Section 21025.4 states that:
If a member is found to be disabled, tile member's effective date of retirement, withou~ tile
member's consent, cannot be earlier than the termination of the employee's leave of absence
without loss of salary under Sectio~ 4850 of the Labor Code or, if earlier, when disability
is permanent and stationary as found by [l~e Workeds Compensation Appeals Board.
ts there any third party liability related to the injury ¢.'ifich caused the disability? The Retirement
System requires that the agency file an accident report along with its decision as (o the possibility
(~f any third party liability. The reason for this information is that the System will retain its right
of sub~ogation in disability cases.
If the member is found to be disabled due to a mental disorder, is the member competent to act
on his own behalf in legally binding retirement matters? Tile agency must certify this information
tt~ tile Retirement System before any decision by tile mdmber will be accepted.
The following Resolutions (page 3-031) are suggested samples which may be used by your agency
transmitting the required information to the Retirement System.
2/79
3-030
May 27, 1980
City of Tustin
City Center
300 Centennial
Tustin, california
92680
Attention: Roy Gonzales
Acting Personnel Director
Re: Kenneth R. Barton
Gentlemen:
I had the pleasure to examine Kenneth Barton who is a 47-year-old
white male, who was seen in my office om May 6, 1980, for medical
evaluation. All available medical records were reviewed, and an
extensive personal history and complete physical examination were
performed.
Mr. Barton started work as a patrolman for the City of Tustin Police
Department in November, 1971. He worked his way up to sergeant in
1973. For two years he was Technical Services Supervisor. He then
returned to uniform duty patrol sergeant and watch commander, a
posit:ion he has held since 1976. lie worked 40-45 hours per week
on different shifts. He enjoyed his work and got along very well
with subordinates and fairly well with his superiors.
He states that he was under constant stress due to his supervising
duties. He was in charge of scheduling, personnel, integrating
citizen complaints, public re!atiens, reviewing police reports, and
evaluating performance standards of his officers. He had no direct
field duty but was always a back up for his officers.
He states that in February, 1979, he was cleaning the windshield of
his car and had a sudden shooting pain in the right side of his face.
He went to the dentist and had a tooth removed but the pain continued.
He went to a neurologist and he was tested for headaches. He was
City of ?ustin
Dace
:,lay 27, ]980
Re: Kennc, th R. Barton
found to have hypertension up to 190/'110. lle went to Dr. Vautrin.
'"~', He had no prior
tie was started on inderal which he has taken s~..~c.
knowledge of hypertension.
He states that in April, 1979, he was referred for a routine depart-
ment physical examination which included a Treadmill Stress Test.
He was found to have peripheral arterial occlusion and was referred
to Dr. Hepps who performed an aorto iliac graft on August 20, 1979.
He had an uneventful recovery and has had no problems since. He has
not returned to work since.
He states that he smoked one and one-half to {wo packages of cigarettes
per day for 30 years. He quit in August, 1979. He drinks alcohol only
occasionally. He drinks one to two cups of coffee per day. He states
that presently he has symptoms of mild dizziness associated with nausea.
He feels that things are going around in his head. The episodes last
apprcximately ten minutes and occur three to five times per day.
PAST N!STORY:
Childhood Diseases: Admits measles, mumps, chicken pox. Denies
whooping cough, rheumatic fever, scarlet fever, thyphoid
fever, or diphtheria.
Adult Illnesses: Admits hypertension diagnosed in February,
1979, hiatal hernia, aorto iliac/femoral bypass, August,
1979, (St. Joseph Hospital in Orange by Dr. Stanley Hepps).
Surgical Procedures: Appendectomy, 1968, benign tumor removed
from right side of neck, 1970, rhinoplasty, repair of
deviated septum, 1959 and 1955, T&A as a child, aorto
iliac femoral bypass, August, 1979.
Other Hospitalizations: None, except as above.
!nj~ries: Knocked unconscious in 1967, in fight. Fractured
nose, 1957, in fight.
PERSONAL itlSTORY:
}iarital Status: Married.
Spouse: Age 44, in good health.
Children: Five children, two sons and three daughters,
all in good health.
HABITS:
Medications: Inderal, 40 mg. qid; Dyazide.
Allergies: Penicillin and Demerol.
Sleeping Habits: Sleeps 8 hours nightly, good quality.
Tobacco: Smoked one and one-half to two packages of cigarettes
· per day fo~ 30 years. Stopped smoking in August, 1979.
Coffee or Tea: Drinks one to three cups of coffee per day
(heavy sugar (3-4) usage).
Alcoholic Beverages: Denies alcoholic beverages.
Page Three
May 27, 1980
Re: Kenneth R. Barton
Diet: We]qht watchers diet
Exercise: Walks one to two miles daily.
FAMILY HISTORY:
Father: Died at age 58 of cancer of the brain.
Mother: Died at age 70 of stroke.
Brothers: One brother living and well, has cancer of prostate.
Sisters: None.
REVIEW OF SYSTEMS:
Head:
Eyes:
Ears:
Denies recurrent or migraine headaches.
Admits blurring occasionally. Denies diplopia, eye
pain, or inflammation.
Admits hearing difficulty, possible in right ear.
Denies earaches, discharge, or tinnitus.
Nose: Denies nosebleeds, allergic rhinitis, sinusitis, polyps.
Throat and Mouth: Denies hoarseness, difficulty swallowing,
pharyngitis, tonsillitis, or glossitis.
~esp~ra~ory. Admits bronchitis once or twice yearly while
smoking, none at present. Denies cough, hemoptysis,
expectoration, URI, pleurisy, asthma, or tuberculosis.
Cardiovascular: Admits shortness of breath occasionally,
and palpitations occasionally, also feet cramps.
Denies chest pain, orthopnea, night sweats or fever,
edema, leg cramus, cyanosis, easy fatigability, or
varicosities.
Gastrointestinal: Admits food intolerance to tomato based
food or spicy food, abdominal pain occasionally,
nausea occasionally, constipation occasionally.
Denies loss of appetite, change in bowel habits,
diarrhea, hematemesis, abnormal or bloody stools,
or jaundice.
Genitourinary: Denies pain or burning, urinary frequency,
urgency, nocturia, or difficulty starting stream.
Metabolic: Usual-weight is 178 pounds with no recent change.
Denies diabetes, thyroid disorder.
City of Tustin
Page Four
!.[ay 27, 1980
fie: Kennehh R. P, arhon
Yusculoskeletal: Denies mu~scular weakness, back pain, joint
s~,'elling or pain, bone infection, or skeletal deformities.
Neuropsychiatric: Admits vertigo and dizziness, depression
occasionally. Denies epilepsy, paresthesia, paralysis,
stroke, syncope, anxiety, disturbance of gait or speech,
or nervous breakdown.
PHYSICAL EXA~INATION:
VITAL SIGNS: Height 70 3/4"; Weight 178 pounds; Temperature 98.9
Blood pressure - RA 120/78, LA 118/84 sitting.
RA 112/78, LA 110/80 standing.
Vision - OD 20/20, OS 20/20 uncorrected.
GENERAL: Middle aged, well nourished, white male, in no apparent
distress; alert and cooperative.
SKIN: Normal texture and turgor.
HEAD:
EYES:
EARS:
Normocephalic, with no scars or contusions noted on inspection.
Fundi - moderate focal sclerosis. Lids, selera, and conjunctiva
without ptosis, pallor, icterus, or petechiae. Cornea without
scars or ulcerations. Pupils equal and reactive. No e>:udates
or hemorrhages seen. Extraocular movements are normal. Visual
fields are normal by confrontation.
No tophi noted. External canals are clean. Tympanic membranes
are intact.
NOSE:
Grossly normal shape. Septum is midline without perforation.
Turbinates are normal.. No unusual congestion, discharge,
or polyps.
MOUTH AND THROAT: Moderate dental repair. Tonsils extracted.
Lips are symmetrical, without cyanosis or cheilitis. Pharynx
is injected without exudate. Mucous membranes and gingiva
have normal color without ulcerations or abnormal pigmentations.
Tongue has normal papillation without ulceration.
NECK:
LUNGS:
Carotids are 2+ bilaterally. No bruits. Two inch transverse
right anterior cervical surgical scar. Supple, with no venous
distention or abnormal pulsations. Thyroid is not palpable.
Trachea is midline. No palpable cervical, post auricular,
or supraclivicular nodes.
Thoracic cage of normal contour and symmetry and inspiratory
expansion. Fremitus normal. Breath sounds are normal. No
rales, rhonchi, wheezes, or rubs heard. Diaphragms move
normally with respiration.
City of Tust!n
Page Five
May 27, 1980
Re: Kenneth R. Barton
HEART:
Point of maximum impulse is not palpable. Heart rate is 62
beats per minute with regular rate and rhythm. A2 is greater
than P2. No murmurs, rubs, or gallops heard.
ABDO~EN: Ten inch zyphoid to pubis midline surgical scar. Bowel sounds
are normal. No inguinal, femoral, or umbilical hernia. No
inguinal nodes palpable.
GENITALIA: Normal circumcised male genitalia~ No hydrocele or varico-
cele. No testicular atrophy or palpable masses.
RECTAL: Deferred.
EXTREMITIES: Four inch bilateral inguinal surgical scar. Pedal
pulses are 1 to 2+ bilaterally. No gross deformities. No
pedal edema, clubbing, or cyanosis. Normal range of motion.
No joint tenderness, swelling, or inflammation. No superficial
varices.
NEUROLOGICAL: Cranial nerves grossly intact. Deep tendon reflexes
are 2+ bilaterally. No pathological relfexes elicited.
Sensation, vibration, and perception are normal.
REVIEW OF MEDICAL RECORDS:
Electroencephalogram of March 5, 1979, by Drs. Rappaport and Dauben
was normal.
On March 8, 1979, patient was evaluated by Dr. Richard Dauben, neurolo-
gist, on referral by Dr. Alvin Vautrin, with complaint of past history
of minor concussion and neck strain with no sustained symptoms. On
February 17, 1979, he experiepced shooting pain at the angle of the
righn jaw. He had a tooth extracted but still had a persistent
temporal headache. On examination his blood pressure was 150/90.
ENT examination was normal. A detailed neurological examination
was entirely normal. Dr. Dauben felt his headaches were most likely
related to a vascular headache. Phrenellin was prescribed.
Report from Dr. Dauben of March 16, 1979, indicates he again examined
Mr. Barton with complaint of three transient episodes of left arm
and leg weakness. An OPG and CPA were obtained which were normal.
He was begun on Propanolol. It was Dr. Dauben's impression that
the patient's problem was due to vasospasm as a result of hypertension.
Blood pressure was 160/110.
City of ?ustin
Page Fix
May 27, 1980
'Kenneth R. Earton
Re?or~ from Dr. Dcuben of March 19, ]979, indicates Mr. Barton could
return to work but should avoid conditions of sEress which could
aggrav~..t~~ ]]is hypertension; otherwise, thure wore no restrictions.
Medical examination report by Dr. Melvin Reich on May 1, 1979,
revealed:
i) Systolic/diastolic hypertension.
2) Peripheral vascular insufficiency.
3) Migraine cephalgia.
4) Class II back x-ray (disc space narrowing at L5-S1).
5) Two meta myelocyses and 9 Bands on WBC, rule out
blood dyscrasia.
EKG ~'evealed R BBB-C. Chest x-ray was normal. No physical stress was
indicated and he was referred to his regular physician for treatment.
Reporn from Dr. Dauben of May 7, 1979, indicates he did followup
neuro!ocical evaluation on April 23, 1979, which was normal. Blood
pressure was 130/80. Bis impression remained that of vasospasm repre-
senting a migraine variant due to his hypertension.
Treadmill on May 15, 1979, requested by Dr. Reich, was a normal
submaximal test with hypertensive response and peripheral vascular
disease.
Report from Dr. Louis Galente, cardiologist, of May 15, 1979, Jndicates
he first saw Mr. Barton three months prior. Blood pressure was 140/84.
He diacnosed hypertension, systolic and diastolic and peripheral
vascular discomfort of legs, right greater than left. He recommended
peripheral as well as cardiac angiography.
Report from Dr. Melvin Reich of January 21, 1980, indicates that Mr.
Barton was admitted to St. Joseph Hospital on July 25, 1979, and
arteriogram was performed which revealed diffuse atheromatous involve-
men~ of the lower abdominal aorta with moderately severe aortoiliac
occlusive disease. On August 28, 1979, he underwent aorto-bi-femoral
bypass graft performed by Dr. Hepps and his post-operative period
was benign. He was followed by Dr. Vautrin for his hypertension and
in December was tried on antiinflammatory medication due to some
arthritic problem. It was Dr. Reich's conclusion that, from the
indicated file, Mr. Barton was still disabled and was unable to
work at this time.
Report from Dr. Vautrin of January 28, 1980, indicates he last saw
Mr. Barton on January 4, 1980, with complaint of some mild headache.
Blood pressure was 112/~0. He was taking 40 mg. Inderal four times
a day. Be was apparently seen in the emergency room at St. Joseph
Hospital in November, 1979, with a diagnosis of inflammatory arthritis
of distal left thumb joint. Dr. Vautrin felt the patient was well
controlled for his hypertension and headaches and could return to
City of Tustin
Page Seven
May 27, 1980
Re: Kenneth R. 6arton
work on February 15, 1980; however, he should not engage in life
threatening activities.
X-RAY OR RADtOGP~J~PHIC PROCEDURES:
Chest, PA and Lateral - Performed on May 6, 1980.
Impression: Normal chest~
LABORATORY STUDIES:
Blood Chemistry - Creatinine Clearance: CPK 69; SGPT 38; Creatinine
1.1; Triglycerides 197.
Electrolytes: Sodium 137; Potassium 5.7; Chloride
95; CO2 31.
Alkaline Phosphatase 82; LDH 171; SGOT 25; Total
Protein 7.2; Albumin 4.7; Total Bilirubin 0.5;
Calcium 9.8; Phosphorus 3.6; Globulin 2.5; A/G
Ratio 1.9; BUN 17; Uric Acid 8.6; Cholesterol 213;
Glucose 119; Balance 11.0; Chol/Trig !.1.
Cholesterol Fractionization - HDL 31 mg/dl, LDL 143 mg/dl.
CBC - Neutrophils Segs. 68%; Lymphocytes 31%; Monocytes 1%.
Morphology - normal.
Platelets - adequate.
Wintrobe Sed Rate 11 mm/hr.
MCHC 31.7%; ?<,CH 29.2 pg;' MCV 093; PCV 51.5%; Hb 16.3 g/dl;
RBC 5.59; WBC 06.2; PLTS 250.
Urinalysis - Color yellow clear; Specific Gravity 1.021; PH is 6;
Protein, Glucose, Ketones, Occult Blood are negative.
Microscopic:
WBC are occasional/HPF; Casts are negative;
Crystals - few urates; Epithelial Cells are
occasional/HPF; Bacteria is light; Mucous, Sperm,
and Yeast are negative.
RPR Test is non-reactive.
T-4 by RIA is 10.1 mcg/df.
City of Tustin
Page Eight
May 27, 1980
Re: Kenneth R. Barton
CARDIOPUL~.~ONARY TESTS:
Electrocardiogram - Perfromed on May 6, 1980.
Impression: 1) Regular sinus rhythm.
2) Complete right bundle branch block with
associated ST and T wave changes.
Echocardiogram - performed on May 12, 1980.
Impression: 1)
2)
3)
4)
5)
6)
Normal aortic valve motion and aortic size.
Normal motion of anterior and posterior mitral
valve leaflets.
Normal septal motion.
Normal left ventricle and left atrium.
Normal thickness posterior left ventricle wall.
No evidence of pericardial effusion.
N OP~V,3t L EC HOCARD I OG PJ~'o
Treadmill Exercise Stress Test - performed on May 12, 1980, on a
motorized treadmill with a fixed 10 degree incline for 7 minutes,
reaching a treadmill speed of 4 miles per hour. He reached a
heart rate of 165 beats per minute or 93% of his maximum pre-
dicted heart rate. There were no significant ST or T wave
changes or arrhythmias noted before, during or after exercise.
The blood pressure response to exercise was normal. He
demonstrated good exercise tolerance.
Impression: Normal submaximal treadmill exercise stress test.
DIAGNOSIS:
1. Essential hypertension, controlled.
2. Status post aorto iliac bypass.
3. Vertigc of undetermined etiology.
DISCUSSION AND CONCLUSIONS:
Mr. Barton is a 47-year-old white male who worked as'a patrolman for
the City of Tustin Police Department from November of 1971 until the
present time. He started as a patrolman and worked his way up to
sergeant in 1973. For two years he was Technical Services Supervisor
and then returned to uniform duty patrol as sergeant and watch commander,
a position which he has held since 1976. He worked 40-45 hours per
week on different shifts and states that he enjoyed his work and got
51ong well with subordinates and fairly well with his superiors. He
City of Tustin
Page Nine
May 27, 1980
Re: Kenneth R. Barton
states that his present position placed him under constant stress due
to his supervising duties. He was in charge of scheduling personnel,
integrating citizen complaints, l~ublic relations, reviewing police
reports, and evaluating performance standards of his officers.
In February, 1979, while cleaning the windshield of his car, he had
sudden pain in the right side of his face. He went to a dentist
and had a tooth removed but the pain continued. He had several
evaluations by a neurologist, Dr. Dauben, but no evidence of neuro-
logical problems were found and it was felt that the symptoms were
due to his hypertension. He was treated for his hyptertension by
Dr. Vautrin who started him on Inderal which has controlled his
hypertension since. In April of 1979 on a routine departmental'
examination he had a Treadmill Exercise Stress Test. The stress test
was negative for ischemia but he was found to have peripheral arterial
occlusion and he was referred to Dr. Hepps who performed an aorto ilJac
graft on August 20, 1979, for severe peripheral vascular insufficiency.
He made an uneventful recovery but has not yet returned to work.
Comprehensive history and physical examination as .well as cardiovascular
evaluation reveals that Mr. Barton smoked one and one-half packages
to two packages of cigarettes daily for approximately 30 years. He
quit in August of 1979. Laboratory evaluation reveals high density
lipoprotein is up 31 mg. which places him in the high risk category
for development of arteriosclerotic diseases. A Treadmill Exercise
Stress Test was performed on May 12, 1980, on a motorized treadmill.
He was able to reach a heart rate of ]65 beats per minute and 90 per-
cent of his maximum predicted heart rate without significant ST or T
wave changes or arrhythmias, indicating no evidence of ischemic heart
disease. His blood pressure response to exercise was normal.
Mro Barton cann~ be considered stable and stationary for rating
purposes relative to his hypertension. He has a permanent prophylactic
restriction from prolonged, heavy physical physical exertion but should
be able to carry out all the duties of his occupation. He is restricted
from severe and prolonged stress. Because of the various nonindustrial
'factors cited above, apportionment is indicated in this case. It is
my opinion that Mr. Barton developed essential hypertension as a
result of heredity with aggravation by prolonged cigarette smoking
and predisposition to development of arteriosclerosis. This con-
dition, however, was aggravated by the stresses of his occupation
as policeman for the City of Tustin. I would apportion 70 percent
of his disability to non-work related factors and 30 percent to the
stresses of his occupation. I defer to the surgical consultants
for determination of his disability from his peripheral vascular
disease.
Cit? of Tustin
Page Ten
May 27, 1980
Re: Kenneth R. Barton
If I can provide further af;sistance or information r~garding this case,
please do not hesitate to contact me or my staff.
Sincerely,
F. R. ViLLALOBOS, M.D.
FRV:ls
cc: Dr. James A. Grimes
R ,, ,, ,. ,, & W,, ,,,I ,. ,, IT
]'Ml)ru n'v 13, 19 ~0
Bierly and Associates
(^
1400 5last Fourth S~t
~ta 3.aa, ~]ifo~a~ .......... .'~-z':''~9270I ...... .......... / ;'x[.'x
/' ' ) , ;' ,, . ,/ .
City of 'n]stin / % %j'/J ,'~,,
mar bLb~y: ..................... · ..... -. :. [. '
~ sp:~a&ing with Mike Taft regarding the options available for ~e
a~x%~-nzu~'~] individual, vis-a-vis v.~]rkers ~x'~l~nsati~]i and retir~-~nt pr~]i~Kjs,
it was related ~ ~';>{'hatt~our fi~ tcx~k the- fsit](~% ~%at the pres
~alb~g wig{ hea~ tre,~d aright ~ resist~]. As y(~u nu~y r~all, ti%is individtlal
~u~ez%.~-nt ~'.serious D!>e'~-ation for clotting in his ](~]s in v41i~h ~ of his
fe~ral arteri'~'%]~e re~vcd.' He r¢aw,]~s on n~dication and his dc~tor
cl~ hyf~rt~:nsicn. Our d~tor, without e>:;m~ng him, ac~%~ledcjes ~at he
pr~b]y is dis0J31~ fr(m pe~-fonning !x~]A~x~',x>rk du~ to the natu~ of tJ%e o~rati~.
.~ q~3stion to you is as fo]lcz,,~: if all ma{]ical cpinions are in
agre~ment as to disability_, is it w~rth fighting the pH2s,,r, pticn as to catusation
in iigkt cf }~znik rs. W.C.A.B. (1975) 51 C.A. 2~1 622, 124 Cal. P~tr. 407?
%~nat ca¢~ gem~rally gives an e~.~q~%nsive definition of "hc~%rt trcx~b].e" and gces on
to list the maladies ti%at h~ve beech h%]d to b~ included and excluded frcm the
definition. Particularly relevant to lhe ca:>~ at hand is the follo%~ing discussic~n
found in Y.,~u~.p2k:
Pm:t:~zz~'ore, "heart trox~le" kTs als()b..en fo'~d to
arise ~ot:gh interaction of t~e heart with o~er b~i].y
disorders. In State t%~¢~i~:ees' ~ti~c,~rcnt System v.
%'~rk;ren's ~up..~)p. ~., 267 C~n]..i.~)p. 2d 611 (73 ~!.~tr.
172), ~ statuto~ presumption of ~ection 3212 '~s applied
in ~e ca~ of a firefighter x,%]o had susb%ined d~m~ to
.~t~. Hi ndy ?eck
Febnm.~t' 13, 1980
Page 2.
\
r~ction ~s appli~l although rhe~ntic fev~
was not vie~.d as t~in~ either heart dil~ase,
nor as ne~ssarily rcsulting in cardiac i,!)ai~nt.
In City of IDs ~.J]gc]es v. '~rkn~>n's ~,?. App.
38 ~l. Cx3~p. C~n:~s 56]., thn claim~;~t wns a city
fir~?.n %,~o had eot'chary arl~'i~ d~ :w~.~sQ, })uh
"nil)st disabling prc:~]c~?' was a fo.su of intermittent
c]m~ification. C]andifi. cation was d,lfin~ as a
lam'~mess resulting frcn. artericwsle~xJtic di~ase
of ~le l~...~3r e:<tr~nities. The stal:nto~lf presunption
e~]ic~ in ~]ctJon 32]2 wns a~t)lied b2cauge ~e
~ne b~y cha~is~ %,~id] caused tile c],a~nnt's
~ronary artery disease had also c~uu~d the ~teri~
sclerosis rcsllonsJb]e for the %,a~:{'~l<n: insufficiency
of his legs.
is to ~ ]~3ral. ly o:~:',ssrx~:d and that statuto~ lano~age
is to b~ given its c~n~:only ~derstc,(] t~nnJng, the
phra~ "hea~ trotfl)le" asmm~-~s a rather e>:pnnsive
~a~ing. 'l~'~is result ~s further e','i,.]c~]c~ by the
legislature's decision not to uti!ix~3 a ne~.cal teNn
or to list or r~uire m'.v sN~cifJc nz~la~ for ~]e
pres~:q~tion of section 32].2 to t~g<~,~ ol~lrative, but
-~ra~er, to e~loy a lay te:nn %~i. ch is not nemssari, ly related
to ~]ysica]. fleterior~tinn or "disease" at all. ~ deflated
in 1'~ster's Dictiona:Q,, the teNn "~ [-o~9)le" %~en used as
a no~n covers a wide range of n',-~ani~ ~s, including dist:rer;:~,
affliction, amxiety, an:m~jan~, pain, ].at~r, or exe~ion.
~]e ~t~nt of the au!Acrs of the zm,-,.:;cNont adding t~
ii,rase "heart trouble" to sectJc~] 3212 wns no do~}t to
~nxe ~e ~aning of ~at t{]rasu enccm!~ss any affliction
to, or additi(z~al exertion of, the hc~%rt ca~ed directly by
~at organ or ~e syst~}m to %'h~ch it t-x~longs, or to it
~ou~ interaction ~th o~ler afflicted areas of ~e ~ly, /
~id ~%rough not envisioned in 1!)39, might ~ pr~ltuced by /
tho stIcss and strain of the pn~'tjcular jobs cove~d ~ /
~e section. (Sc~ Stef~cns v. %'y~r,:n,:~n's C(:]~p. A~als ~.[
supra, 20, C'~l.A~).3d 46], 465-467). /~
Fe/~ru~ury 13, 1980
Page 3.
I ¥.~u]d he intere, sta~3 in fi~dinv, out if you
has ~n in any wuy ~B~alified. If it ]~as not, it s{~ms an though the
affli~ion disca~s~d lq'~erein scorns closely ana]o?us to thc one in
f~ton C~se a~:c] th,_.rc~fore the pr~'~su~tion w~u]d apply. If all of the
for~join~ is t~e, and h]~x:~'tcnsion is also, invrqvo'l, ¥.~at >~uutd your
~o~hts ~ w.[~u l~9ard to l~e hanfll, in9 of the P,nrton
Ai~: ca \
cc:
~ !qike Taft
V,:ry truly y, ~.u:s,
CLINICAL EYALtJATIOi't
[' k,.PORT OF ~,~,[=DICAL. EX,',MIHATIO,.__j
29.
LABORATORY FIHDIHGS
_~,9. OTHER TESTS:
OTItER FIHDIHGS
FURTitFR EXAMt;4ATION$ INDICATED (Spe¢ily)
::RT b::EtBELBIS, M. D.
2420 f:~::WPORT AVE:.
idS'l::, .:/:~iF 92680
'J'i :. '.':
OCT 2 9 1~7i
]8, ]980
?]~ase f~nd ,3nc]or';cd a copy of t:]]e "F.i.n~.ings, Conclusions
;':!id i~,~:cc.::'.::-~d~:~tions'' prepar~;~d by this' of£ice. Please review the
,lc.,:m:,,->;-.t-t::d if it acc:ur~toly '~-cflects the determiuat]ou,'; m~tde by
the ]~,tf~-~-:-,~%nt Review Board, dar:2 and sisn the document and forward
it to ?':-.e Fersonnel Dirc. c[or.
The Personnel DJrecto[' ',.:ill for',..'nrd a colby to Kenneth
";~r[~:~n c:.:: ]aining to him [hat it ~..'ill be ~;t~viewcd by the City
~,'~um:~] .,:.d thc f. ime and l~]ace of its c(~n:~i,~crati~n. The original
'.,,'ill }..e ::,..t:ai~ed to be annt~:.:,,d to the resolution of the City
Cou:~cil :' 'tking its findings and conclusions.
you ha~e an~Z ,.fu~',~t.[ot~.$ or comments re~arding tho
Conclusions and Er~co;:'mr.,".,dat[ons", plcase advise.
cc:
~4[ke 5rokcmark].e
Roy Conzales
8/80