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PROPOSED PREVIOUSLY APPROVED ITEM AMENDMENT
Department: Civil Actions Bureau (State’s Attorney)
Request: Amendment to a previously approved item
Item Number: 16-0434
Fiscal Impact: $4,000.00
Account(s): N/A
Original Text of Item:
16-0434
Employee: Steven Bialczak
Job Title: Deputy Sheriff
Department: Sheriff’s Police Department
Date of Incident: 05/06/2014
Incident/Activity: The accident occurred when the Petitioner was involved in motor vehicle accident, which injured his head, neck and low back.
Accidental Injuries: Head, neck and lower back
Petition and Order No: 14 WC 30041
Claim Amount: $14, 041.51 $18, 041.51
Attorney: Meghan N. O’Brien of Ridge & Downes
Date of Subcommittee Approval: N/A
Prior/pending claims: 06/12/2010 ($22,500.00)
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