City_of_Green_Cove_Springs_WC_Loss_Report_01.01.2021_-_06.30.2026.xlsx
XLSX spreadsheet 25 KB Posted
- Solicitation number
- 2026-05
- Issued by
- Clay County, Harold CDP, Florida
About this file
This is a Workers Compensation Loss Report from the City of Green Cove Springs, Florida, documenting all workers' compensation claims filed between January 1, 2021, and June 30, 2026. The report tracks 57 total claims across various city departments including Police Officers, Street, Garbage/Ashes, Waterworks, Park, Electric Light, Sewage Disposal Plant Operation, Municipal/Township/County, and Clerical Office Employee classifications. Claims range from minor injuries such as eye injuries from insects or foreign objects to more serious incidents including police officer injuries during suspect apprehension, COVID-19 exposures, and occupational exposures to hazardous materials. The data includes claim numbers, employee names, NCCI class codes, dates of injury, injury descriptions, dates received, and comprehensive financial tracking through June 2026.
The report presents detailed loss data with total incurred losses of $2,099,397.61 as of the report date. The financial breakdown includes compensation payments totaling $525,883.45, medical expenses of $1,202,023.91, other costs of $177,902.78, recoveries of $16,365.39, and outstanding reserves of $209,952.86. Claims with the highest incurred amounts include Derek Asdot's COVID-19-related hospitalization ($601,725.67), Jeffrey Burr's knee sprain ($61,318.06), and Cora Milliken's motor vehicle accident ($4,758.41). The majority of claims are marked as closed (C), with a smaller number remaining open (O) as of the data run date. This loss history is directly relevant to the City's request for Workers Compensation Insurance Services quotes for the fiscal year October 1, 2026, through September 30, 2027, with potential for four additional one-year renewal terms.
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Data
| Run Date: 07/15/2026 | ||||||||||||||||||
| File Number | Name | NCCI Class Code | Location Code | Date of Injury | Close | NAT | PART | CAUSE | Event Description | Date Received | COMP | MEDICAL | OTHER | Recoveries | Outstanding Reserves | Incurred | ||
| WC2021150846 | Bradford Camp | POLICE OFFICERS | NULL | 3/7/21 | C | 28 | 56 | 89 | IW was attacked by a suspect Broke foot | 3/8/21 | $1,879.26 | $3,667.16 | $3,598.12 | $28.00 | $0.00 | $9,116.54 | 0218 | 2020 |
| WC2021151709 | Michael Williams | GARBAGE, Ashes | 5/27/21 | C | 59 | 55 | 25 | FA ONLY IW fell off truck Ankle became injured after falling truck | 5/27/21 | $0.00 | $5,167.97 | $13,512.37 | $14.00 | $0.00 | $18,666.34 | 0218 | 2020 | |
| WC2021151871 | Terence Vick | GARBAGE, Ashes | NULL | 6/15/21 | C | 40 | 38 | 98 | IW was loading trash into truck when his right shoulder got cut on a nail | 6/16/21 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2020 |
| WC2021152091 | Anthony Tice | STREET | NULL | 7/8/21 | C | 59 | 35 | 13 | IW was on the side of truck when driver backed into a fence | 7/8/21 | $0.00 | $54.00 | $0.00 | $0.00 | $0.00 | $54.00 | 0218 | 2020 |
| WC2021152238 | Tracy L Bishop | POLICE OFFICERS | NULL | 7/20/21 | C | 59 | 18 | 31 | IW fell off a chair while trying to sit down | 7/21/21 | $0.00 | $0.00 | $184.00 | $0.00 | $0.00 | $184.00 | 0218 | 2020 |
| WC2021152322 | Daniel A Santos | WATERW | NULL | 7/26/21 | C | 59 | 42 | 79 | While digging a hole in the ground IW had lower back pain | 7/27/21 | $0.00 | $948.00 | $575.00 | $0.00 | $0.00 | $1,523.00 | 0218 | 2020 |
| WC2021152558 | Timothy J Moulton | STREET | NULL | 8/11/21 | C | 25 | 14 | 87 | IW got up to go into the building and a bug flew into his right eye IW was able to pull part of the bug out but his eye is turning red | 8/11/21 | $0.00 | $353.70 | $0.00 | $0.00 | $0.00 | $353.70 | 0218 | 2020 |
| WC2021153106 | Janet C Willems | STREET | NULL | 9/15/21 | C | 40 | 54 | 19 | IW was looking for supplies on the shelf She turned around and something was sticking out of the floor She walked into it and cut her right ankle shin | 9/20/21 | $0.00 | $18.59 | $0.00 | $0.00 | $0.00 | $18.59 | 0218 | 2020 |
| WC2021153118 | Derek Asdot | POLICE OFFICERS | 8/16/21 | C | 83 | 91 | 83 | IW tested positive for COVID 19 on 8 16 He went to the hospital on 8 24 with pneumonia | 9/20/21 | $159,774.75 | $441,275.42 | $675.50 | $0.00 | $0.00 | $601,725.67 | 0218 | 2020 | |
| WC2021153174 | Erin Vineyard | POLICE OFFICERS | NULL | 9/15/21 | C | 83 | 91 | 83 | IW tested positive for Covid 19 | 9/27/21 | $0.00 | $391.24 | $16.50 | $0.00 | $0.00 | $407.74 | 0218 | 2020 |
| WC2021153179 | Barbara Luedtke | POLICE OFFICERS | NULL | 9/16/21 | C | 83 | 91 | 83 | IW tested positive for COVID | 9/27/21 | $0.00 | $31.15 | $13.75 | $0.00 | $0.00 | $44.90 | 0218 | 2020 |
| WC2021153446 | Corey J Hardin | SEWAGE DISPOSAL PLANT OPERATION | NULL | 9/28/21 | C | 59 | 44 | 98 | Not a work related injury but a personal medical event that happened while on the job IW felt chest tightness then fell to the ground While on the ground he started to black out | 10/20/21 | $0.00 | $30.00 | $2.75 | $0.00 | $0.00 | $32.75 | 0218 | 2020 |
| WC2021153570 | Chris Hess | POLICE OFFICERS | NULL | 6/30/21 | C | 83 | 91 | 83 | IW tested positive for COVID 19 from 7 2 2021 7 18 2021 | 11/3/21 | $0.00 | $1,028.96 | $24.75 | $0.00 | $0.00 | $1,053.71 | 0218 | 2020 |
| WC2021153308 | Garry Johnson | STREET | NULL | 10/5/21 | C | 10 | 55 | 98 | IW was assisting in unloading storm pipe and stepped on an uneven piece of ground | 10/7/21 | $0.00 | $208.49 | $0.00 | $0.00 | $0.00 | $208.49 | 0218 | 2021 |
| WC2021153926 | Van Robinson | PARK NOC - ALL EMPLOYEES | 10/26/21 | C | 40 | 14 | 19 | IW was taking paper out of printer When he grabbed the paper the corner poked his eye Cut his eye and it got infected | 12/15/21 | $0.00 | $1,323.00 | $3,649.10 | $0.00 | $0.00 | $4,972.10 | 0218 | 2021 | |
| WC2022155343 | Daniel Santos | WATERW | NULL | 2/2/22 | C | 01 | 66 | 45 | FA ONLY IW was backing out of parking spot at the same time as another vehicle The other vehicle struck IW s vehicles | 3/9/22 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2021 |
| WC2022155783 | Josh Jones | PARK NOC - ALL EMPLOYEES | NULL | 4/6/22 | C | 01 | 66 | 46 | FA ONLY IW was attempting to make a three point turn He misjudged the location of the gate He struck the left front of truck 700 with the gate | 4/14/22 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2021 |
| WC2022155857 | Garry Johnson | STREET | NULL | 4/19/22 | C | 01 | 66 | NULL | FA ONLY IW was removing signs from recently removed channel poles He lost his footing with the channel in his hands He was standing in front of truck 211 His forward momentum caused the channel to impale the AC condenser | 4/21/22 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2021 |
| WC2022156588 | Douglas Nick | Electric Light | NULL | 6/14/22 | C | 40 | 10 | 60 | IW was closing the bin door on the passenger side of the truck Bin door broke free from hinges and struck IW on the forehead causing bruising swelling and a laceration | 6/15/22 | $0.00 | $117.15 | $0.00 | $0.00 | $0.00 | $117.15 | 0218 | 2021 |
| WC2022156684 | Tammy Perry | POLICE OFFICERS | 6/21/22 | C | 59 | 53 | 99 | A call involved dealing with a juvenile who wanted to commit suicide She resisted and had to be escorted to the ground and handcuffed IW landed on her left knee | 6/22/22 | $0.00 | $5,816.45 | $1,382.85 | $0.00 | $0.00 | $7,199.30 | 0218 | 2021 | |
| WC2022157056 | Gerald Matthews | GARBAGE, Ashes | NULL | 7/18/22 | C | 52 | 25 | 56 | While riding on the back of the truck IW bent down to pick up a box and strained his neck | 7/19/22 | $435.20 | $929.80 | $539.75 | $0.00 | $0.00 | $1,904.75 | 0218 | 2021 |
| WC2022157207 | Joseph Shiller | POLICE OFFICERS | NULL | 7/26/22 | C | 59 | 53 | 29 | FA ONLY IW was conducting active shooter scenario training While running IW slipped and fell on his right knee causing redness and swelling | 7/28/22 | $0.00 | $249.45 | $650.00 | $0.00 | $0.00 | $899.45 | 0218 | 2021 |
| WC2022157364 | Nicholas Rulon | POLICE OFFICERS | NULL | 8/8/22 | C | 01 | 66 | 45 | FA ONLY conducting a traffic stop the vehicle collided backwards into IW s patrol vehicle | 8/9/22 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2021 |
| WC2022157499 | Timothy J Moulton | STREET | NULL | 8/17/22 | C | 37 | 35 | 82 | IW was pulling weeds when a wasp stung his right hand | 8/18/22 | $0.00 | $250.65 | $0.00 | $0.00 | $0.00 | $250.65 | 0218 | 2021 |
| WC2022157714 | Adam Stines | Electric Light | NULL | 9/6/22 | C | 40 | 35 | 59 | IW was cutting a zip tie from a piece of equipment when the knife slipped and cut IW s left palm | 9/7/22 | $0.00 | $247.20 | $0.00 | $0.00 | $0.00 | $247.20 | 0218 | 2021 |
| WC2022158003 | Erin Vineyard | POLICE OFFICERS | NULL | 9/29/22 | C | 52 | 54 | 56 | FA ONLY IW responded to a drowning victim during Hurricane Ian at the end of Pier 2 A heavy male 200 300lbs was non responsive in the water IW and another officer held onto the man so he would not sink The dive team went into the water to help keep the man above water Using a float and rope they were able to pull the victim out While pulling IW felt discomfort in left calf muscle causing a sharp pain | 10/3/22 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2021 |
| WC2022160573 | Brandi Acres | MUNICIPAL, TOWNSHIP, COUNTY | 7/1/22 | C | 59 | 90 | NULL | IW is experiencing gradual numbness to her right hand for about a year IW states she has carpel tunnel on her right hand wrist and lower arm to elbow | 7/26/23 | $0.00 | $1,109.39 | $600.00 | $0.00 | $0.00 | $1,709.39 | 0218 | 2021 | |
| WC2022158163 | Anthony Tice | MUNICIPAL, TOWNSHIP, COUNTY | 10/19/22 | C | 52 | 63 | 56 | IW was placing sandbags on a pallet with he felt a sharp pain in his back IW had trouble bending and walking IW asked to see a doctor | 10/19/22 | $0.00 | $523.64 | $500.00 | $0.00 | $0.00 | $1,023.64 | 0218 | 2022 | |
| WC2022158229 | Linda Keeler | MUNICIPAL, TOWNSHIP, COUNTY | NULL | 10/24/22 | C | 40 | 33 | 78 | IW was in the women s lobby restroom Bathroom stall door latch swung open scrapping IW on her left arm | 10/31/22 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2022 |
| WC2022158306 | Evan Hernandez | POLICE OFFICERS | NULL | 10/29/22 | C | 52 | 34 | 58 | FA ONLY IW was attempting to control a suspect in a motor vehicle At one point IW was concerned suspect was going to attempt to hit another officer IW reached into the vehicle to put the car in park injuring his left wrist | 11/3/22 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2022 |
| WC2022158347 | Jamari Jackson | NULL | NULL | 11/8/22 | C | 59 | 14 | 87 | IW was installing Christmas lights on a fiberglass sled when some fiberglass went into his eyes | 11/8/22 | $0.00 | $117.15 | $0.00 | $0.00 | $0.00 | $117.15 | 0218 | 2022 |
| WC2022158453 | William Kendrick | NULL | NULL | 11/22/22 | C | 40 | 10 | 99 | IW hit his head on Vac Con tube causing a laceration IW was bleeding and looked like it required stitches IW went for treatment but stitches were not required | 11/22/22 | $0.00 | $98.00 | $0.00 | $0.00 | $0.00 | $98.00 | 0218 | 2022 |
| WC2022158559 | Erin Vineyard | POLICE OFFICERS | NULL | 11/30/22 | C | 25 | 90 | 98 | FA ONLY IW was effecting arrest of a suspect when the suspect spit on IW s face | 12/7/22 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2022 |
| WC2022158666 | Tammy Perry | POLICE OFFICERS | NULL | 12/14/22 | C | 01 | 12 | 90 | IW was on duty in dispatch She reported to work with a minor migraine headache while in dispatch IW began to feel unwell and complained about worse headache and pressure behind eyes | 12/15/22 | $0.00 | $0.00 | $2.75 | $0.00 | $0.00 | $2.75 | 0218 | 2022 |
| WC2023158863 | Michael N Kelley | Electric Light | NULL | 1/5/23 | C | 19 | 91 | 84 | IW was shocked on his hands multiple times while changing a light in City Hall IW did not want treatment but went to his previously scheduled Cardiologist appointment on 1 6 23 IW s doctor excused him from work for one calendar week due to fatigue in his upper body | 1/10/23 | $4,074.54 | $1,796.61 | $3,753.35 | $0.00 | $0.00 | $9,624.50 | 0218 | 2022 |
| WC2023158867 | Cora Milliken | POLICE OFFICERS | 1/9/23 | C | 01 | 91 | 99 | After conducting a follow up investigation IW got a rash on her face neck and upper chest IW became light headed with high blood pressure 158 115 It is unknown if it was caused from fentanyl exposure or other medical reasons | 1/10/23 | $0.00 | $3,147.36 | $600.00 | $0.00 | $0.00 | $3,747.36 | 0218 | 2022 | |
| WC2023159064 | Kevon Lee | PARK NOC - ALL EMPLOYEES | NULL | 2/6/23 | C | 10 | 35 | 78 | IW was assigned to work with solid waste IW went to pick up a dress with another employee when the dresser drawer slammed on this IW s hand causing pain | 2/6/23 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2022 |
| WC2023159663 | Christopher Howard | PARK NOC - ALL EMPLOYEES | 4/13/23 | C | 49 | 56 | 79 | While assisting with repairing a beam at the park the beam broke free and landed on the IW s right foot | 4/14/23 | $0.00 | $117.15 | $0.00 | $0.00 | $0.00 | $117.15 | 0218 | 2022 | |
| WC2023159813 | Kaleb Cochran | STREET | NULL | 4/27/23 | C | 59 | 63 | NULL | IW was exposed to an insect or poisonous plant while trimming back planets from the right of way As a result the IW now has a rash blotches welts and blisters on his back | 5/2/23 | $0.00 | $5.22 | $0.00 | $5.22 | $0.00 | $0.00 | 0218 | 2022 |
| WC2023159906 | Jonathan Brugh | MUNICIPAL, TOWNSHIP, COUNTY | NULL | 5/11/23 | C | 40 | 37 | 76 | FA ONLY While attempting to cut a piece of weed eater string the IW cut the tip of his right thumb with a machete | 5/12/23 | $0.00 | $161.00 | $0.00 | $0.00 | $0.00 | $161.00 | 0218 | 2022 |
| WC2023160117 | Petto Bustamante | STREET | 6/6/23 | C | 52 | 35 | 57 | While pulling a string on a weedeater the IW injured his hand | 6/6/23 | $0.00 | $424.15 | $0.00 | $0.00 | $0.00 | $424.15 | 0218 | 2022 | |
| WC2023160164 | Erin Vineyard | POLICE OFFICERS | 6/9/23 | C | 49 | 55 | 60 | While responding to a call the IW stepped off a curb and twisted her left foot ankle | 6/12/23 | $563.72 | $8,123.65 | $11.00 | $0.00 | $0.00 | $8,698.37 | 0218 | 2022 | |
| WC2023160245 | Darrol Watson | STREET | NULL | 6/20/23 | C | 59 | 65 | 45 | FA ONLY IW was involved in a MVA | 6/21/23 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2022 |
| WC2023160302 | Gabriel Skelton | STREET | 6/20/23 | C | 68 | 33 | NULL | IW was cutting back some trees when he came in contact with the tree and moss which resulted in a rash on his left arm | 6/27/23 | $0.00 | $135.00 | $0.00 | $0.00 | $0.00 | $135.00 | 0218 | 2022 | |
| WC2023160323 | Tammy Perry | POLICE OFFICERS | 5/31/23 | C | 59 | 54 | 85 | IW was bitten by a dog on her left anterior lowe leg | 6/28/23 | $0.00 | $3,018.48 | $0.00 | $0.00 | $0.00 | $3,018.48 | 0218 | 2022 | |
| WC2023160476 | Kimberly Thomas | CLERICAL OFFICE EMPLOYEES NOC | 7/13/23 | C | 49 | 38 | 58 | While reaching to get something from the floor the IW s chair rolled out from under her causing her to injure her right shoulder | 7/17/23 | $0.00 | $769.25 | $600.00 | $0.00 | $0.00 | $1,369.25 | 0218 | 2022 | |
| WC2023160535 | Timothy Nazworth | WATERW | 7/19/23 | C | 49 | 34 | 56 | While lifting a gate valve to place on the truck the IW felt a pop in his left wrist | 7/20/23 | $4,289.16 | $2,076.81 | $16.50 | $0.00 | $0.00 | $6,382.47 | 0218 | 2022 | |
| WC2023160755 | Sean Thacker | GARBAGE, Ashes | NULL | 8/14/23 | C | 01 | 65 | 98 | FA ONLY IW was driving his truck when another driver s vehicle tire got stuck on the step ladder of the garbage truck popping the other car s tire | 8/16/23 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2022 |
| WC2023161685 | David E Carpenter | POLICE OFFICERS | NULL | 11/30/23 | C | 58 | 14 | 90 | IW was driving when he lost partial vision Additional details are unknown | 12/6/23 | $0.00 | $51.00 | $2.75 | $0.00 | $0.00 | $53.75 | 0218 | 2023 |
| WC2023161788 | Nathan A Nettles | STREET | 12/19/23 | C | 52 | 42 | 60 | IW was assisting with a broken water line and felt discomfort and pain in his back while shoveling dirt Initially did not want to seek treatment but awakened with pain and discomfort on 12 20 2023 | 12/20/23 | $0.00 | $218.02 | $0.00 | $0.00 | $0.00 | $218.02 | 0218 | 2023 | |
| WC2024162189 | Chris Hess | POLICE OFFICERS | 2/11/24 | C | 73 | 66 | 99 | IW was exposed to human remains | 2/14/24 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2023 | |
| WC2024162212 | William Kendrick | SEWAGE DISPOSAL PLANT OPERATION | 1/3/24 | C | 59 | 44 | 56 | The IW and his crew were cutting limbs from a ditch for cleanup and then hauling them to the road A few days after he started feeling soreness in his sternum | 2/15/24 | $0.00 | $215.32 | $0.00 | $0.00 | $0.00 | $215.32 | 0218 | 2023 | |
| WC2024162476 | Jason Laurenza | WATERW | 3/13/24 | C | 59 | 91 | 82 | FA ONLY While working in the field with a utility locator in tall grass the IW noticed an embedded tick IW is experiencing redness and joint pain | 3/20/24 | $0.00 | $303.84 | $0.00 | $0.00 | $0.00 | $303.84 | 0218 | 2023 | |
| WC2024276819 | Ronnie Gann | POLICE OFFICERS | 4/9/24 | C | 52 | 54 | 60 | IW was running the mandatory state approved physical abilities test and afterwards noticed his right calf was in discomfort and swollen | 4/9/24 | $0.00 | $3,715.67 | $0.00 | $0.00 | $0.00 | $3,715.67 | 0218 | 2023 | |
| WC2024277337 | Stacey Brown | CLERICAL OFFICE EMPLOYEES NOC | 4/30/24 | C | 10 | 11 | 78 | When trying to reach for bathroom tissue the bathroom tissue dispenser fell open and hit the IW on the left side of the head | 5/3/24 | $0.00 | $195.11 | $0.00 | $0.00 | $0.00 | $195.11 | 0218 | 2023 | |
| WC2024277396 | Nicholas Rulon | POLICE OFFICERS | 5/6/24 | C | 59 | 35 | 85 | FA ONLY IW was assisting with loose dogs and while taking possession of one dog picking dog up and the dog nipped at his hand | 5/7/24 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2023 | |
| WC2024277934 | Robert Mayben | Electric Light | 6/2/24 | C | 43 | 14 | 60 | IW took off his glasses to wipe sweat from his forehead and then he turned around and was poked by a wire in his right eye | 6/3/24 | $0.00 | $120.17 | $0.00 | $0.00 | $0.00 | $120.17 | 0218 | 2023 | |
| WC2024278121 | Hassell Skeens | WATERW | 6/11/24 | C | 40 | 37 | 60 | While loading a piece of ADS pipe IW suffered a laceration on his left thumb | 6/11/24 | $0.00 | $145.05 | $0.00 | $0.00 | $0.00 | $145.05 | 0218 | 2023 | |
| WC2024278481 | Wade Hoilman | Electric Light | 6/25/24 | C | 43 | 36 | 60 | IW was struck on his right index finger by a sharp plant | 6/26/24 | $0.00 | $112.09 | $0.00 | $0.00 | $0.00 | $112.09 | 0218 | 2023 | |
| WC2024279292 | Gerald Matthews | GARBAGE, Ashes | 8/1/24 | C | 52 | 32 | 60 | IW was working and felt a pain in his elbow | 8/2/24 | $0.00 | $341.62 | $0.00 | $0.00 | $0.00 | $341.62 | 0218 | 2023 | |
| WC2024279409 | Madison Lombardi | POLICE OFFICERS | 8/2/24 | C | 59 | 33 | 60 | FA ONLY IW was scratched on her left arm while assisting an intoxicated female to her feet | 8/6/24 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2023 | |
| WC2024280512 | Michael Williams | MUNICIPAL, TOWNSHIP, COUNTY | 9/19/24 | C | 49 | 55 | 60 | While on a garbage truck IW injured his right ankle | 9/20/24 | $0.00 | $198.00 | $0.00 | $0.00 | $0.00 | $198.00 | 0218 | 2023 | |
| WC2024281887 | Mike Babcock | POLICE OFFICERS | 10/17/24 | C | 43 | 52 | 60 | FA ONLY IW sustained a bite from his K 9 while performing a demonstration | 10/22/24 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2024 | |
| WC2024283039 | Madison Lombardi | POLICE OFFICERS | 11/13/24 | C | 40 | 33 | 74 | IW was arresting a resisting suspect when she cut her arm on the concrete | 11/20/24 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2024 | |
| WC2024283816 | Madison Lombardi | POLICE OFFICERS | 12/17/24 | C | 59 | 38 | 60 | While attempting to detain a resisting suspect the IW right shoulder popped out of socket | 12/19/24 | $0.00 | $1,242.60 | $0.00 | $0.00 | $0.00 | $1,242.60 | 0218 | 2024 | |
| WC2025284574 | Robert Thornton | MUNICIPAL, TOWNSHIP, COUNTY | 1/29/25 | C | 59 | 14 | 60 | IW was assisting the ROW department on Melrose Avenue and a branch poked him in his left eye | 1/30/25 | $0.00 | $484.01 | $0.00 | $0.00 | $0.00 | $484.01 | 0218 | 2024 | |
| WC2025285717 | Matthew Moody | WATERW | 3/20/25 | C | 01 | 66 | 45 | FA Only IW backed front end loader 202 into city owned truck 809 causing damage to the truck s grill and head light area No physical injury to IW | 3/25/25 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2024 | |
| WC2025287425 | Sean Thacker | GARBAGE, Ashes | 5/30/25 | C | 59 | 54 | 60 | IW was on the back of the sanitation truck When the truck stopped IW got off the truck to dump a can into the truck Shortly after IW s right leg started hurting and throbbing every time he walked on it | 6/10/25 | $0.00 | $4,559.31 | $11.00 | $0.00 | $0.00 | $4,570.31 | 0218 | 2024 | |
| WC2025287438 | Jamie Nguyen | POLICE OFFICERS | 6/10/25 | C | 16 | 38 | 75 | During Defensive Tactics in the Law Enforcement Academy IW dislocated her left shoulder IW stated this occurred during a take down move when another cadet landed on the IW | 6/10/25 | $0.00 | $1,103.51 | $0.00 | $0.00 | $0.00 | $1,103.51 | 0218 | 2024 | |
| WC2025287686 | Eric Luedtke | PARK NOC - ALL EMPLOYEES | 6/23/25 | C | 13 | 37 | 76 | IW was using a drill to fix a bracket on a picnic table The drill turned sideways cutting IW s left thumb | 6/23/25 | $0.00 | $541.35 | $0.00 | $0.00 | $0.00 | $541.35 | 0218 | 2024 | |
| WC2025287968 | Christopher Hess | POLICE OFFICERS | 6/19/25 | C | 43 | 37 | 60 | IW was testing cocaine at the station The vial broke and a piece of the glass stuck through the pouch and into the IW s finger IW was transported via ambulance | 7/7/25 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2024 | |
| WC2025289453 | Cora Milliken | POLICE OFFICERS | 9/10/25 | C | 10 | 41 | 45 | IW was stopped at the intersection on Ferris St and S Orange Ave in the outside turn lane when a vehicle behind rear ended the IW IW sustained injuries to the neck and head | 9/12/25 | $0.00 | $4,758.41 | $0.00 | $0.00 | $0.00 | $4,758.41 | 0218 | 2024 | |
| WC2025289545 | Joseph Boysen | GARBAGE, Ashes | 9/12/25 | C | 59 | 44 | 82 | IW was throwing out trash and was bitten by a horse fly on the left side of his chest causing a rash | 9/17/25 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2024 | |
| WC2025289664 | Eric Luedtke | STREET | 9/22/25 | C | 01 | 66 | NULL | FA Only IW was driving a Gator and turned too sharp on a corner causing the Gator to slide on grass clippings and go into the pond No injury reported | 9/23/25 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2024 | |
| WC2025289841 | Robert Mayben | Electric Light | 9/29/25 | C | 59 | 53 | 77 | IW hit his right knee on deck of truck | 10/1/25 | $5,180.00 | $6,844.91 | $24.75 | $0.00 | $0.00 | $12,049.66 | 0218 | 2024 | |
| WC2025291132 | Eric Luedtke | Street | 11/18/25 | C | 59 | 31 | 90 | IW noticed a small red bump on his left armpit area | 12/3/25 | $0.00 | $0.00 | $2.75 | $0.00 | $0.00 | $2.75 | 0218 | 2025 | |
| WC2026294135 | Jeffrey Burr | Sewage Disposal Plant Operation and Drivers | 4/13/26 | O | 52 | 53 | 25 | IW stepped down from the back of the garbage truck and sprained his right knee | 4/16/26 | $2,703.35 | $2,107.67 | $1,278.78 | $0.00 | $55,228.26 | $61,318.06 | 0218 | 2025 | |
| WC2026294391 | Darren Hayes | Street | 4/27/26 | O | 25 | 14 | 87 | While blowing leaves the wind changed direction and blew debris into IW s eye | 4/27/26 | $0.00 | $277.78 | $0.00 | $0.00 | $3,222.22 | $3,500.00 | 0218 | 2025 | |
| WC2026294495 | Corey J Hardin | Waterw | 4/29/26 | O | 59 | 34 | 82 | IW turned on a hose and was stung on the right wrist by a wasp | 4/30/26 | $0.00 | $91.89 | $0.00 | $0.00 | $1,408.11 | $1,500.00 | 0218 | 2025 | |
| WC2026294983 | Matthew Waller | Detective | 5/21/26 | O | 73 | 91 | 99 | IW was exposed to HIV while handcuffing a suspect that had dried blood on his hands | 5/26/26 | $0.00 | $4,302.92 | $0.00 | $0.00 | $3,197.08 | $7,500.00 | 0218 | 2025 | |
| WC2026295511 | Sean Thacker | Sewage Disposal Plant Operation and Drivers | 6/16/26 | C | 59 | 66 | 45 | FA Only While IW was backing up the garbage truck he backed into a parked car | 6/17/26 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2025 | |
| $525,883.45 | $1,202,023.91 | $177,902.78 | $16,365.39 | $209,952.86 | $2,099,397.61 |
Info
| Client Name: | FLC |
| Report Name: | FMIT Member Loss Report - WC |
| Description: | FMIT Member Loss Report - WC |
| Filter: | (LOB contains "Workers Compensation" and FMIT Number is less than 9,000.00) and Member Number (Member) is equal to "0218" |
| Group By: | Member Number then Policy Year |
| Sort By: | Claim Number |
| Options: | As Of Date is 06/30/2026 |
| Run Date: | 7/15/2026 |
Sheet3
File details come from the government source that posted it. Updated .