File #: 21-5787    Version: 1 Name: Charlene Smith - 11/03/2021
Type: Workers' Compensation Claims Status: Approved
File created: 10/8/2021 In control: Finance Committee
On agenda: 11/3/2021 Final action: 11/4/2021
Title: Employee: Charlene Smith Job Title: Telecommunicator Department: Police Department Date of Incident: 08/09/2016; 12/19/2019 Incident/Activity: On August 9, 2016, Petitioner injured her right ankle while walking on an uneven surface. On December 19, 2019, Petitioner injured her bilateral knees, left hip, head, and left arm when she tripped on an uneven surface. Accidental Injuries: Right ankle, bilateral knees, left hip, head, left arm Petition and Order No: 16 WC 29110 Claim Amount: $26,747.93 Attorney: Stiberth, Scarlati & Boudreau, LLC Date of Subcommittee Approval: 07/27/2021 Prior/pending claims: n/a

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Employee: Charlene Smith

Job Title: Telecommunicator

Department: Police Department

Date of Incident: 08/09/2016; 12/19/2019

Incident/Activity: On August 9, 2016, Petitioner injured her right ankle while walking on an uneven surface.  On December 19, 2019, Petitioner injured her bilateral knees, left hip, head, and left arm when she tripped on an uneven surface. 

Accidental Injuries: Right ankle, bilateral knees, left hip, head, left arm 

Petition and Order No: 16 WC 29110

Claim Amount: $26,747.93

Attorney: Stiberth, Scarlati & Boudreau, LLC

Date of Subcommittee Approval: 07/27/2021

Prior/pending claims: n/a

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