File #: 21-5038    Version: 1 Name: Tiffany Vanderbilt - 10/06/21
Type: Workers' Compensation Claims Status: Approved
File created: 9/7/2021 In control: Finance Committee
On agenda: 10/6/2021 Final action: 10/7/2021
Title: Employee: Tiffany Vanderbilt Job Title: Investigator I Department: Department of Revenue Date of Incident: 01/12/21 Incident/Activity: Petitioner injured her bilateral knees and back during a motor vehicle accident. Accidental Injuries: Bilateral knees, back Petition and Order No: 21 WC 07270 Claim Amount: $13,676.36 Attorney: Saks, Robinson & Rittenberg, Ltd. Date of Subcommittee Approval: n/a Prior/pending claims: n/a

title

Employee: Tiffany Vanderbilt

Job Title: Investigator I

Department: Department of Revenue

Date of Incident: 01/12/21

Incident/Activity: Petitioner injured her bilateral knees and back during a motor vehicle accident.

Accidental Injuries: Bilateral knees, back 

Petition and Order No: 21 WC 07270

Claim Amount: $13,676.36

Attorney: Saks, Robinson & Rittenberg, Ltd.

Date of Subcommittee Approval: n/a

Prior/pending claims: n/a 

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