Exhibit_G2_-_Loss_Run_Report.xlsx
XLSX spreadsheet 1006 KB Posted
- Solicitation number
- BPM006716
- Issued by
- Maricopa County, Arizona
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| Exhibit_G1_-_Custom_Report-_2018_-_2023.xlsx | XLSX spreadsheet | |
| 4870_Addendum_1_FINAL.pdf |
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Summary
| Exhibit G2 - Loss run report |
| Custom: 01/01/2003 - 06/30/2024; |
| Summary | |||||||
| Open | Reopened | Closed | Total | ||||
| # of Claims | 107 | 14 | 3,210 | 3,331 | |||
| Finance Detail Level 1 | Paid-to-Date | Reserve | Incurred | ||||
| ALE | $4,928,574.08 | $755,526.21 | $5,684,100.29 | ||||
| CMP | $7,926,207.58 | $8,736,661.49 | $16,662,869.07 | ||||
| MED | $18,854,403.98 | $2,335,753.21 | $21,190,157.19 | ||||
| Gross | $31,709,185.64 | $11,827,940.91 | $43,537,126.55 | ||||
| Total Recoveries | $811,649.37 | $811,649.37 | |||||
| Recoveries Not Impacting Incurred | $92,756.90 | $92,756.90 | |||||
| Recoveries Impacting Incurred | $718,892.47 | $718,892.47 | |||||
| Net | $30,990,293.17 | $42,818,234.08 |
Data
| HIPAA WARNING - This report contains protected patient information | ||||||||||||||||||||||||||||||||||||||||||||||||
| Claim Number | CNR | Class Code | Accident Description | Status | Jurisdiction | Claimant Age | Claimant Sex | Status Date | Injury Date | Injury Time | Hired Date | Employer Notification Date | Date Administrator Notified | Date Incident Reported | Location Of Loss | Subrogation | Nature of Injury | Part of Body | Source of Injury | Occupation | Job Class | Litigation | Injury State | Payroll State | Policy Number | Excess Policy Number | Excess Carrier | Excess Reportable | Excess Claim | Policy Effective Date | Policy Termination Date | Gross Paid | Total Reserve | Gross Incurred | Total Recoveries | Recoveries Not Impacting Incurred | Recoveries Impacting Incurred | Net Paid | Net Incurred | ALE Paid | ALE Reserve | ALE Gross Incurred | CMP Paid | CMP Reserve | CMP Gross Incurred | MED Paid | MED Reserve | MED Gross Incurred |
| CN-03-0500001 | CN-03-0500001 | MO | Suspects fleeing from the officer in stolen truck drove into the officers vehicle causing a secondry collision between the two as well as colliding w/ street light & fence | Closed | Arizona | 53 | M | 04/04/2003 | 01/02/2003 | 03:11:00 AM | 01/02/2003 | 01/02/2003 | No | Contusion | Wrist | Vehicle Upset Overturned or Jackknifed | Police Officers & Drivers | (7720) POLICE OFFICERS & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $2,244.62 | $0.00 | $2,244.62 | $0.00 | $0.00 | $0.00 | $2,244.62 | $2,244.62 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $2,244.62 | $0.00 | $2,244.62 | ||||||
| CN-03-0500002 | CN-03-0500002 | RO | At accident scene stepped on piece of plastic from vehicle & twisted ankle | Closed | Arizona | 63 | F | 07/01/2012 | 01/02/2003 | 04:15:00 AM | 01/02/2003 | 01/02/2003 | No | Strain | Ankle | NOC-Strain or Injury By | Police Officers & Drivers | (7720) POLICE OFFICERS & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | ||||||
| CN-03-0500003 | CN-03-0500003 | IND | Performing keyboard, switchboard, writing & file activities at a desk that was way too high for her | Closed | Arizona | 65 | F | 07/26/2003 | 01/03/2003 | 12:00:00 AM | 01/01/2003 | 06/16/2003 | 06/16/2003 | No | Strain | Wrist | Repetitive Motion Callous, Blister, etc. | Municipal, Township, Cnty or St Empl NOC | (8810) CLERICAL OFFICE EMPLOYEES NOC | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $78,602.20 | $0.00 | $78,602.20 | $0.00 | $0.00 | $0.00 | $78,602.20 | $78,602.20 | $12,855.00 | $0.00 | $12,855.00 | $11,609.10 | $0.00 | $11,609.10 | $54,138.10 | $0.00 | $54,138.10 | |||||
| CN-03-0500004 | CN-03-0500004 | MO | Fell to ground full body weight on knee struck asphalt street | Closed | Arizona | 58 | M | 05/20/2013 | 01/04/2003 | 11:15:00 AM | 01/04/2003 | 01/04/2003 | No | Contusion | Knee | Absorption, Vaccine, Ingestion or Inhala | *Captured Data | (0000) UNKNOWN | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $1,217.46 | $0.00 | $1,217.46 | $0.00 | $0.00 | $0.00 | $1,217.46 | $1,217.46 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $1,217.46 | $0.00 | $1,217.46 | ||||||
| CN-03-0500005 | CN-03-0500005 | MO | Kicked door extending knee | Closed | Arizona | 56 | M | 04/21/2003 | 01/06/2003 | 01:07:00 AM | 01/06/2003 | 01/06/2003 | No | Strain | Knee | NOC-Strain or Injury By | Firefighters & Drivers | (7704) FIRE PATROL OR PROTECTIVE CORPS & DRIVERS. FIREFIGHTERS & DRIVERS. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $240.94 | $0.00 | $240.94 | $0.00 | $0.00 | $0.00 | $240.94 | $240.94 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $240.94 | $0.00 | $240.94 | ||||||
| CN-03-0500006 | CN-03-0500006 | MO | Foot was sore after running on rocky trails | Closed | Arizona | 46 | M | 02/18/2003 | 01/06/2003 | 08:40:00 AM | 01/09/2003 | 01/09/2003 | No | Strain | Foot | NOC-Strain or Injury By | Police Officers & Drivers | (7720) POLICE OFFICERS & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $149.30 | $0.00 | $149.30 | $0.00 | $0.00 | $0.00 | $149.30 | $149.30 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $149.30 | $0.00 | $149.30 | ||||||
| CN-03-0500007 | CN-03-0500007 | MO | Leaned over & blew some debris that was on the engine w/ his mouth, the debris blew back into face & eye | Closed | Arizona | 67 | M | 10/21/2003 | 01/08/2003 | 02:00:00 AM | 01/09/2003 | 01/09/2003 | No | Foreign Body | Eyes | Foreign Matter (Body) in Eye(s) | Building-Operation by Owner or Lessee | (9102) PARK NOC—ALL EMPLOYEES & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $61.99 | $0.00 | $61.99 | $0.00 | $0.00 | $0.00 | $61.99 | $61.99 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $61.99 | $0.00 | $61.99 | ||||||
| CN-03-0500008 | CN-03-0500008 | MO | Picking up debris that had fallen beside truck, bumped metal stakes protruding from the bed of the truck | Closed | Arizona | 75 | M | 02/18/2003 | 01/08/2003 | 06:50:00 AM | 01/08/2003 | 01/08/2003 | No | Laceration | Nose | Stationary Object | Municipal, Township, Cnty or St Empl NOC | (7580) SEWAGE DISPOSAL PLANT OPERATION & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $620.87 | $0.00 | $620.87 | $0.00 | $0.00 | $0.00 | $620.87 | $620.87 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $620.87 | $0.00 | $620.87 | ||||||
| CN-03-0500009 | CN-03-0500009 | MO | Fell off curb | Closed | Arizona | 79 | F | 02/04/2011 | 01/21/2003 | 03:30:00 AM | 01/21/2003 | 01/21/2003 | No | Fracture | Lower Arm | From Liquid or Grease Spills | *Captured Data | (0000) UNKNOWN | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $709.98 | $0.00 | $709.98 | $0.00 | $0.00 | $0.00 | $709.98 | $709.98 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $709.98 | $0.00 | $709.98 | ||||||
| CN-03-0500010 | CN-03-0500010 | MO | Apprehending a suspect & suspect resisted arrest, & fell down the stairs. | Closed | Arizona | 52 | M | 04/03/2003 | 01/23/2003 | 08:00:00 PM | 01/23/2003 | 01/23/2003 | No | Strain | Knee | From Different Level (Elevation) Off Wal | Police Officers & Drivers | (7720) POLICE OFFICERS & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $1,013.83 | $0.00 | $1,013.83 | $0.00 | $0.00 | $0.00 | $1,013.83 | $1,013.83 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $1,013.83 | $0.00 | $1,013.83 | ||||||
| CN-03-0500011 | CN-03-0500011 | MO | Wiped face on towel & eye began to swell. | Closed | Arizona | 55 | M | 04/07/2003 | 02/08/2003 | 12:55:00 PM | 02/08/2003 | 02/08/2003 | No | Inflammation | Eyes | Other-NOC | Firefighters & Drivers | (7704) FIRE PATROL OR PROTECTIVE CORPS & DRIVERS. FIREFIGHTERS & DRIVERS. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $171.01 | $0.00 | $171.01 | $0.00 | $0.00 | $0.00 | $171.01 | $171.01 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $171.01 | $0.00 | $171.01 | ||||||
| CN-03-0500012 | CN-03-0500012 | MO | Pulling on rebar cutter, bar slipped out of cutter & he fell on his back, catching himself w/ hand | Closed | Arizona | 63 | M | 04/22/2003 | 02/10/2003 | 07:00:00 AM | 02/13/2003 | 02/13/2003 | No | Strain | Wrist | Absorption, Vaccine, Ingestion or Inhala | Municipal, Township, Cnty or St Empl NOC | (5506) STREET OR ROAD CONSTRUCTION: PAVING OR REPAVING & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $678.15 | $0.00 | $678.15 | $0.00 | $0.00 | $0.00 | $678.15 | $678.15 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $678.15 | $0.00 | $678.15 | ||||||
| CN-03-0500013 | CN-03-0500013 | IND | Another employees full body weight impacted him from behind causing him to collapse to ground on knee | Open | Arizona | 65 | M | 02/17/2003 | 02/12/2003 | 01:30:00 AM | 10/02/2003 | 02/12/2003 | 02/12/2003 | No | Fracture | Upper Leg | Fellow Worker; Patient; Not in Act of a | Parks NOC - All Employees & Drivers | (9402) STREET CLEANING & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | TRUE | TRUE | 01/01/2003 | 06/30/2008 | $618,712.48 | $166,500.24 | $785,212.72 | $94,824.95 | $92,641.90 | $2,183.05 | $616,529.43 | $783,029.67 | $53,722.63 | $13,761.78 | $67,484.41 | $15,664.51 | $0.00 | $15,664.51 | $549,325.34 | $152,738.46 | $702,063.80 | |||
| CN-03-0500014 | CN-03-0500014 | MO | Attempting to effect mock arrest during training a 2nd ee fell against his knee causing immediate pain. | Closed | Arizona | 56 | M | 04/16/2003 | 02/12/2003 | 01:00:00 PM | 02/13/2003 | 02/13/2003 | No | Sprain | Knee | Falling or Flying Object | Police Officers & Drivers | (7704) FIRE PATROL OR PROTECTIVE CORPS & DRIVERS. FIREFIGHTERS & DRIVERS. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $861.24 | $0.00 | $861.24 | $0.00 | $0.00 | $0.00 | $861.24 | $861.24 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $861.24 | $0.00 | $861.24 | ||||||
| CN-03-0500015 | CN-03-0500015 | MO | Lifting roll of butcher paper & felt pain. | Closed | Arizona | 44 | F | 04/03/2003 | 02/12/2003 | 07:15:00 PM | 02/16/2003 | 02/16/2003 | No | Strain | Lower Back Area | NOC-Strain or Injury By | Municipal, Township, Cnty or St Empl NOC | (9063) YMCA, YWCA, YMHA, OR YWHA, INSTITUTION—ALL EMPLOYEES & CLERICAL | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $105.46 | $0.00 | $105.46 | $0.00 | $0.00 | $0.00 | $105.46 | $105.46 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $105.46 | $0.00 | $105.46 | ||||||
| CN-03-0500016 | CN-03-0500016 | MO | Applyiing water to vehicle fire, vehicle exploded w/ debris striking face | Closed | Arizona | 49 | M | 03/11/2003 | 02/21/2003 | 01:18:00 PM | 02/21/2003 | 02/21/2003 | No | Contusion | Soft Tissue-Head | NOC-Struck or Injured By (Includes Kicke | Firefighters & Drivers | (7704) FIRE PATROL OR PROTECTIVE CORPS & DRIVERS. FIREFIGHTERS & DRIVERS. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $925.70 | $0.00 | $925.70 | $0.00 | $0.00 | $0.00 | $925.70 | $925.70 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $925.70 | $0.00 | $925.70 | ||||||
| CN-03-0500017 | CN-03-0500017 | MO | Co-worker face piece /scuba mask struck by expooding object, he grabbed object w/ ungloved hand, he was in process of gloving when event occurred | Closed | Arizona | 54 | M | 03/22/2003 | 02/21/2003 | 01:18:00 PM | 02/21/2003 | 02/21/2003 | No | Burn | Hand | Hot Objects or Substances | Firefighters & Drivers | (7704) FIRE PATROL OR PROTECTIVE CORPS & DRIVERS. FIREFIGHTERS & DRIVERS. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $563.54 | $0.00 | $563.54 | $0.00 | $0.00 | $0.00 | $563.54 | $563.54 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $563.54 | $0.00 | $563.54 | ||||||
| CN-03-0500018 | CN-03-0500018 | MO | Chasing suspect on foot in dark alley in rain, slipped & fell, got up & kept pursuing suspect, a few minutes later became ill | Closed | Arizona | 48 | M | 04/10/2003 | 03/01/2003 | 08:00:00 PM | 03/01/2003 | 03/01/2003 | No | *Captured Data | Part of Body: | Absorption, Vaccine, Ingestion or Inhala | Police Officers & Drivers | (7720) POLICE OFFICERS & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $534.38 | $0.00 | $534.38 | $0.00 | $0.00 | $0.00 | $534.38 | $534.38 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $534.38 | $0.00 | $534.38 | ||||||
| CN-03-0500019 | CN-03-0500019 | MO | Reached to clear pruning debri from gas powered hedge trimmer as the debri was removed the blade started moving cut through glove & cut finger | Closed | Arizona | 73 | M | 04/03/2003 | 03/11/2003 | 09:15:00 AM | 03/11/2003 | 03/11/2003 | No | Laceration | Finger(s) | NOC-Caught In, Under, or Between | Building-Operation by Owner or Lessee | (9102) PARK NOC—ALL EMPLOYEES & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $223.58 | $0.00 | $223.58 | $0.00 | $0.00 | $0.00 | $223.58 | $223.58 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $223.58 | $0.00 | $223.58 | ||||||
| CN-03-0500020 | CN-03-0500020 | MO | While examining next tree to prune entered a wood chipping operation discharge area & was struck on forehead w/ piece of flying wood debri | Closed | Arizona | 67 | M | 03/28/2003 | 03/11/2003 | 01:30:00 PM | 03/11/2003 | 03/11/2003 | No | Laceration | Soft Tissue-Head | Falling or Flying Object | Building-Operation by Owner or Lessee | (9102) PARK NOC—ALL EMPLOYEES & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $325.50 | $0.00 | $325.50 | $0.00 | $0.00 | $0.00 | $325.50 | $325.50 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $325.50 | $0.00 | $325.50 | ||||||
| CN-03-0500021 | CN-03-0500021 | MO | While lifting a box of books ee turned w/ box & felt strain. | Closed | Arizona | 47 | M | 01/14/2013 | 03/14/2003 | 09:15:00 AM | 03/14/2003 | 03/14/2003 | No | Strain | Lower Back Area | NOC-Strain or Injury By | Firefighters & Drivers | (7590) GARBAGE WORKS. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | ||||||
| CN-03-0500022 | CN-03-0500022 | MO | Holding pod from tree in hand felt something in eye touched finger to eye & eye began to burn & tear | Closed | Arizona | 58 | F | 04/01/2003 | 03/19/2003 | 10:30:00 AM | 03/19/2003 | 03/19/2003 | No | Foreign Body | Eyes | Foreign Matter (Body) in Eye(s) | Waterworks Operation & Drivers | (6217) EXCAVATION & DRIVERS NOC | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $202.97 | $0.00 | $202.97 | $0.00 | $0.00 | $0.00 | $202.97 | $202.97 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $202.97 | $0.00 | $202.97 | ||||||
| CN-03-0500023 | CN-03-0500023 | IND | In pursuit of suspect, subject pulled handgun & fired at him & he returned fire on subject | Closed | Arizona | 47 | M | 02/03/2004 | 03/20/2003 | 03:43:00 PM | 03/20/2003 | 03/20/2003 | No | Laceration | Skull | Person in Act of a Crime; Robbery or Cri | *Captured Data | (0000) UNKNOWN | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $7,614.66 | $0.00 | $7,614.66 | $0.00 | $0.00 | $0.00 | $7,614.66 | $7,614.66 | $4,911.85 | $0.00 | $4,911.85 | $157.80 | $0.00 | $157.80 | $2,545.01 | $0.00 | $2,545.01 | ||||||
| CN-03-0500024 | CN-03-0500024 | MO | Slipped on wet gravel & fell striking side of dumpster | Closed | Arizona | 49 | M | 04/04/2003 | 03/21/2003 | 03:30:00 PM | 03/21/2003 | 03/21/2003 | No | Contusion | Knee | From Liquid or Grease Spills | Street/Rd Construct: Pave/Repave & Drvr | (5506) STREET OR ROAD CONSTRUCTION: PAVING OR REPAVING & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $123.13 | $0.00 | $123.13 | $0.00 | $0.00 | $0.00 | $123.13 | $123.13 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $123.13 | $0.00 | $123.13 | ||||||
| CN-03-0500025 | CN-03-0500025 | MO | Placed his hand on suspects shoulder to take her down, suspect pulled & twisted thumb as they both tumbled to the floor | Closed | Arizona | 53 | M | 07/09/2005 | 03/24/2003 | 09:10:00 PM | 03/24/2003 | 03/24/2003 | Yes | Fracture | Thumb | Person in Act of a Crime; Robbery or Cri | Police Officers & Drivers | (7720) POLICE OFFICERS & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $1,741.73 | $0.00 | $1,741.73 | $1,741.73 | $0.00 | $1,741.73 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $1,741.73 | $0.00 | $1,741.73 | ||||||
| CN-03-0500026 | CN-03-0500026 | MO | Taking burn sheet off truck & pressure from leaning on step | Closed | Arizona | 58 | M | 04/25/2003 | 03/27/2003 | 06:30:00 PM | 03/27/2003 | 03/27/2003 | No | Strain | Knee | NOC-Strain or Injury By | Firefighters & Drivers | (7704) FIRE PATROL OR PROTECTIVE CORPS & DRIVERS. FIREFIGHTERS & DRIVERS. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $665.49 | $0.00 | $665.49 | $0.00 | $0.00 | $0.00 | $665.49 | $665.49 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $665.49 | $0.00 | $665.49 | ||||||
| CN-03-0500027 | CN-03-0500027 | MO | Jumped over 6 foot wall to assist another officer & landed flatfooted w/ heel striking concrete | Closed | Arizona | 48 | M | 04/24/2003 | 03/28/2003 | 02:36:00 AM | 03/28/2003 | 03/28/2003 | No | Contusion | Foot | NOC-Strain or Injury By | Police Officers & Drivers | (7720) POLICE OFFICERS & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $191.14 | $0.00 | $191.14 | $0.00 | $0.00 | $0.00 | $191.14 | $191.14 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $191.14 | $0.00 | $191.14 | ||||||
| CN-03-0500028 | CN-03-0500028 | IND | Has been doing data entry work for city for 16 yrs, recently shes experienced problems w/ hands going to sleep, weakened grip strength & pain in both wrists | Closed | Arizona | 80 | F | 09/05/2003 | 04/01/2003 | 12:00:00 AM | 07/28/2003 | 07/28/2003 | No | Strain | Hand | Repetitive Motion Callous, Blister, etc. | Municipal, Township, Cnty or St Empl NOC | (8810) CLERICAL OFFICE EMPLOYEES NOC | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $15,645.49 | $0.00 | $15,645.49 | $0.00 | $0.00 | $0.00 | $15,645.49 | $15,645.49 | $0.00 | $0.00 | $0.00 | $1,282.08 | $0.00 | $1,282.08 | $14,363.41 | $0.00 | $14,363.41 | ||||||
| CN-03-0500029 | CN-03-0500029 | MO | Lost balance on ladder & forearm struck top of ladder when ee stepped down. | Closed | Arizona | 53 | M | 04/23/2003 | 04/02/2003 | 08:45:00 AM | 04/02/2003 | 04/02/2003 | No | Contusion | Lower Arm | NOC-Struck or Injured By (Includes Kicke | Municipal, Township, Cnty or St Empl NOC | (8380) AUTOMOBILE SERVICE OR REPAIR CENTER & DRIVERS. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $169.29 | $0.00 | $169.29 | $0.00 | $0.00 | $0.00 | $169.29 | $169.29 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $169.29 | $0.00 | $169.29 | ||||||
| CN-03-0500030 | CN-03-0500030 | IND | Attempting to shift gears usting automatic shift. base of rt thumb struck the shift handle. | Closed | Arizona | 77 | M | 09/22/2003 | 04/11/2003 | 10:00:00 AM | 04/29/2003 | 04/29/2003 | No | Strain | Thumb | NOC-Struck or Injured By (Includes Kicke | Street/Rd Construct: Pave/Repave & Drvr | (9402) STREET CLEANING & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $6,500.40 | $0.00 | $6,500.40 | $0.00 | $0.00 | $0.00 | $6,500.40 | $6,500.40 | $0.00 | $0.00 | $0.00 | $213.68 | $0.00 | $213.68 | $6,286.72 | $0.00 | $6,286.72 | ||||||
| CN-03-0500031 | CN-03-0500031 | MO | Cut thumb w/ utility knife while cutting rope | Closed | Arizona | 56 | M | 05/13/2003 | 04/14/2003 | 10:15:00 AM | 04/14/2003 | 04/14/2003 | No | Laceration | Thumb | NOC-Cut, Puncture, Scrape— Injured By | Waterworks Operation & Drivers | (7580) SEWAGE DISPOSAL PLANT OPERATION & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $136.07 | $0.00 | $136.07 | $0.00 | $0.00 | $0.00 | $136.07 | $136.07 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $136.07 | $0.00 | $136.07 | ||||||
| CN-03-0500032 | CN-03-0500032 | MO | Lifting up large pt & felt pain | Closed | Arizona | 51 | M | 05/05/2003 | 04/14/2003 | 08:00:00 PM | 04/14/2003 | 04/14/2003 | No | Strain | Lower Back Area | NOC-Strain or Injury By | Firefighters & Drivers | (7704) FIRE PATROL OR PROTECTIVE CORPS & DRIVERS. FIREFIGHTERS & DRIVERS. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $56.53 | $0.00 | $56.53 | $0.00 | $0.00 | $0.00 | $56.53 | $56.53 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $56.53 | $0.00 | $56.53 | ||||||
| CN-03-0500033 | CN-03-0500033 | MO | Vehicle he was driving was rammed head-on by unknown suspect driving a stolen vehicle | Closed | Arizona | 55 | M | 07/11/2003 | 04/15/2003 | 10:30:00 PM | 04/15/2003 | 04/15/2003 | No | Laceration | Skull | Vehicle Upset Overturned or Jackknifed | Police Officers & Drivers | (7720) POLICE OFFICERS & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $1,139.83 | $0.00 | $1,139.83 | $0.00 | $0.00 | $0.00 | $1,139.83 | $1,139.83 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $1,139.83 | $0.00 | $1,139.83 | ||||||
| CN-03-0500034 | CN-03-0500034 | RO | Was resting during testing & experienced onset fluttering sensation in his chest. | Closed | Arizona | 64 | M | 07/01/2012 | 04/17/2003 | 03:00:00 PM | 04/17/2003 | 04/17/2003 | No | No Physical Injury | Soft Tissue-Head | Collision or Sideswipe With Another Vehi | Firefighters & Drivers | (7704) FIRE PATROL OR PROTECTIVE CORPS & DRIVERS. FIREFIGHTERS & DRIVERS. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | ||||||
| CN-03-0500035 | CN-03-0500035 | MO | Veh swerved to avoid collision & struck blocked fence & air bag deployed, he self extricated. | Closed | Arizona | 55 | M | 07/15/2003 | 04/19/2003 | 08:52:00 PM | 04/19/2003 | 04/19/2003 | No | Strain | Lower Back Area | Stationary Object | Police Officers & Drivers | (7720) POLICE OFFICERS & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $930.88 | $0.00 | $930.88 | $0.00 | $0.00 | $0.00 | $930.88 | $930.88 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $930.88 | $0.00 | $930.88 | ||||||
| CN-03-0500036 | CN-03-0500036 | RO | Veh swerved to avoid collision, veh struck small blocked fence, air bag deployed she self extricated. | Closed | Arizona | 51 | F | 07/01/2012 | 04/19/2003 | 08:52:00 PM | 04/19/2003 | 04/19/2003 | No | Inflammation | Shoulder(s) | NOC-Struck or Injured By (Includes Kicke | Police Officers & Drivers | (7720) POLICE OFFICERS & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | ||||||
| CN-03-0500037 | CN-03-0500037 | MO | Lifted up to cut next section of steel, arm brushed against steel that was cut | Closed | Arizona | 80 | M | 05/29/2003 | 04/21/2003 | 08:30:00 AM | 04/21/2003 | 04/21/2003 | No | Laceration | Lower Arm | NOC-Cut, Puncture, Scrape— Injured By | Municipal, Township, Cnty or St Empl NOC | (7520) WATERWORKS OPERATION & DRIVERS. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $398.30 | $0.00 | $398.30 | $0.00 | $0.00 | $0.00 | $398.30 | $398.30 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $398.30 | $0.00 | $398.30 | ||||||
| CN-03-0500038 | CN-03-0500038 | MO | Deployed smoke grenade made unintentional contact w/ the ees head | Closed | Arizona | 47 | M | 06/30/2003 | 04/23/2003 | 12:15:00 PM | 04/23/2003 | 04/23/2003 | No | Laceration | Soft Tissue-Head | NOC-Struck or Injured By (Includes Kicke | Municipal, Township, Cnty or St Empl NOC | (8810) CLERICAL OFFICE EMPLOYEES NOC | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $1,225.29 | $0.00 | $1,225.29 | $0.00 | $0.00 | $0.00 | $1,225.29 | $1,225.29 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $1,225.29 | $0.00 | $1,225.29 | ||||||
| CN-03-0500039 | CN-03-0500039 | MO | Bumped up against a cactus growing on the edge of the trail | Closed | Arizona | 50 | M | 05/23/2003 | 04/24/2003 | 12:15:00 PM | 04/24/2003 | 04/24/2003 | No | Puncture | Hand | NOC-Striking Against or Stepping On | Police Officers & Drivers | (7720) POLICE OFFICERS & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $100.43 | $0.00 | $100.43 | $0.00 | $0.00 | $0.00 | $100.43 | $100.43 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $100.43 | $0.00 | $100.43 | ||||||
| CN-03-0500040 | CN-03-0500040 | IND | Loading & unloading 70 lb training mannequin & 4 large boxes including a very heavy compressor used for training purposes-this occurs 5 times per month | Closed | Arizona | 68 | F | 03/11/2004 | 04/25/2003 | 12:00:00 PM | 09/25/2000 | 05/20/2003 | 05/20/2003 | No | Strain | Upper Arm | NOC-Strain or Injury By | Municipal, Township, Cnty or St Empl NOC | (9410) MUNICIPAL, TOWNSHIP, COUNTY OR STATE EMPLOYEE NOC. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $57,370.30 | $0.00 | $57,370.30 | $0.00 | $0.00 | $0.00 | $57,370.30 | $57,370.30 | $0.00 | $0.00 | $0.00 | $2,190.22 | $0.00 | $2,190.22 | $55,180.08 | $0.00 | $55,180.08 | |||||
| CN-03-0500041 | CN-03-0500041 | MO | During work ee experienced pain in chest. | Closed | Arizona | 56 | M | 05/29/2003 | 04/29/2003 | 06:00:00 AM | 04/29/2003 | 04/29/2003 | No | No Physical Injury | Soft Tissue-Head | Other Than Physical Cause of Injury | *Captured Data | (0000) UNKNOWN | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | ||||||
| CN-03-0500042 | CN-03-0500042 | MO | May 1st his job duties changed & he began spending several hrs/day searching & typing at the computer keyboard & using the mouse | Closed | Arizona | 63 | M | 09/23/2003 | 05/01/2003 | 12:00:00 AM | 07/09/2003 | 07/09/2003 | No | Strain | Lower Arm | Repetitive Motion Callous, Blister, etc. | Firefighters & Drivers | (7704) FIRE PATROL OR PROTECTIVE CORPS & DRIVERS. FIREFIGHTERS & DRIVERS. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $512.81 | $0.00 | $512.81 | $0.00 | $0.00 | $0.00 | $512.81 | $512.81 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $512.81 | $0.00 | $512.81 | ||||||
| CN-03-0500043 | CN-03-0500043 | MO | Gloved finger caught between metal demo trailer & flat bed trailer ramp | Closed | Arizona | 54 | M | 06/16/2003 | 05/03/2003 | 10:45:00 AM | 05/03/2003 | 05/03/2003 | No | Laceration | Finger(s) | NOC-Caught In, Under, or Between | Firefighters & Drivers | (7704) FIRE PATROL OR PROTECTIVE CORPS & DRIVERS. FIREFIGHTERS & DRIVERS. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $1,277.33 | $0.00 | $1,277.33 | $0.00 | $0.00 | $0.00 | $1,277.33 | $1,277.33 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $1,277.33 | $0.00 | $1,277.33 | ||||||
| CN-03-0500044 | CN-03-0500044 | MO | Responding to domestic disorder situation when suspect intentionally kneed him in the groin | Closed | Arizona | 56 | M | 11/19/2003 | 05/08/2003 | 12:33:00 AM | 05/08/2003 | 05/08/2003 | Yes | Strain | Abdomen | Person in Act of a Crime; Robbery or Cri | Police Officers & Drivers | (7720) POLICE OFFICERS & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $798.56 | $0.00 | $798.56 | $782.77 | $0.00 | $782.77 | $15.79 | $15.79 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $798.56 | $0.00 | $798.56 | ||||||
| CN-03-0500045 | CN-03-0500045 | IND | While changing shooting stance, foot slipped on loose gravel. Sustaining an injury to his right nee. | Open | Arizona | 69 | M | 05/22/2003 | 05/08/2003 | 12:00:00 PM | 11/26/1984 | 05/12/2003 | 05/12/2003 | No | Strain | Knee | NOC-Fall, Slip, or Trip Injury | Police Officers & Drivers | (7720) POLICE OFFICERS & DRIVERS | No | Arizona | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | TRUE | FALSE | 01/01/2003 | 06/30/2008 | $240,242.96 | $13,465.70 | $253,708.66 | $0.00 | $0.00 | $0.00 | $240,242.96 | $253,708.66 | $25,830.91 | $4,245.24 | $30,076.15 | $32,628.20 | $0.00 | $32,628.20 | $181,783.85 | $9,220.46 | $191,004.31 | ||
| CN-03-0500046 | CN-03-0500046 | IND | Missed step striking toe on step & twisting ankle | Closed | Arizona | 72 | M | 04/14/2004 | 05/12/2003 | 07:45:00 PM | 05/12/2003 | 05/12/2003 | No | Fracture | Toes | Stationary Object | Municipal, Township, Cnty or St Empl NOC | (9410) MUNICIPAL, TOWNSHIP, COUNTY OR STATE EMPLOYEE NOC. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $5,855.11 | $0.00 | $5,855.11 | $0.00 | $0.00 | $0.00 | $5,855.11 | $5,855.11 | $0.00 | $0.00 | $0.00 | $3,360.00 | $0.00 | $3,360.00 | $2,495.11 | $0.00 | $2,495.11 | ||||||
| CN-03-0500047 | CN-03-0500047 | MO | Stepped down off 2 foot step,,ankle twisted in as his foot landed | Closed | Arizona | 54 | M | 07/04/2003 | 05/18/2003 | 10:00:00 AM | 05/18/2003 | 05/18/2003 | No | Sprain | Ankle | NOC-Strain or Injury By | Building-Operation by Owner or Lessee | (9102) PARK NOC—ALL EMPLOYEES & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $1,158.76 | $0.00 | $1,158.76 | $0.00 | $0.00 | $0.00 | $1,158.76 | $1,158.76 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $1,158.76 | $0.00 | $1,158.76 | ||||||
| CN-03-0500048 | CN-03-0500048 | MO | Investingating a suspicious person & stepped into a non-visable hole & sprained ankle. | Closed | Arizona | 50 | M | 06/12/2003 | 05/18/2003 | 11:00:00 AM | 05/18/2003 | 05/18/2003 | No | Sprain | Ankle | NOC-Strain or Injury By | Police Officers & Drivers | (7720) POLICE OFFICERS & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $969.52 | $0.00 | $969.52 | $0.00 | $0.00 | $0.00 | $969.52 | $969.52 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $969.52 | $0.00 | $969.52 | ||||||
| CN-03-0500049 | CN-03-0500049 | MO | Bumped by another officer while attempting to arrest a role player, causing her to fall down | Closed | Arizona | 54 | F | 12/09/2003 | 05/20/2003 | 10:00:00 AM | 05/20/2003 | 05/20/2003 | No | Contusion | Knee | Absorption, Vaccine, Ingestion or Inhala | Police Officers & Drivers | (7720) POLICE OFFICERS & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $4,057.70 | $0.00 | $4,057.70 | $0.00 | $0.00 | $0.00 | $4,057.70 | $4,057.70 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $4,057.70 | $0.00 | $4,057.70 | ||||||
| CN-03-0500050 | CN-03-0500050 | MO | Not feeling well on job, exited vehicle feeling the need to vomit then lost consciousness while seated on the side walk | Closed | Arizona | 58 | M | 07/17/2003 | 05/21/2003 | 11:30:00 PM | 05/21/2003 | 05/21/2003 | No | *Captured Data | Part of Body: | Collision or Sideswipe With Another Vehi | *Captured Data | (0000) UNKNOWN | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | ||||||
| CN-03-0500051 | CN-03-0500051 | IND | As he completed obstacle portion of the annual P.T. test he felt pain in knee, thought would resolve, pain continues & now seeks medical eval. | Closed | Arizona | 65 | M | 11/11/2004 | 05/21/2003 | 10:30:00 AM | 06/13/2003 | 06/13/2003 | No | Strain | Knee | NOC-Strain or Injury By | Police Officers & Drivers | (7720) POLICE OFFICERS & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $3,953.69 | $0.00 | $3,953.69 | $0.00 | $0.00 | $0.00 | $3,953.69 | $3,953.69 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $3,953.69 | $0.00 | $3,953.69 | ||||||
| CN-03-0500052 | CN-03-0500052 | IND | In foot pursuit of subject, climbed over a fence & jumped down to other side, when landed twisted knee | Closed | Arizona | 52 | M | 04/14/2004 | 05/23/2003 | 08:42:00 AM | 05/23/2003 | 05/23/2003 | No | Strain | Knee | NOC-Strain or Injury By | Police Officers & Drivers | (7720) POLICE OFFICERS & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $46,284.33 | $0.00 | $46,284.33 | $0.00 | $0.00 | $0.00 | $46,284.33 | $46,284.33 | $0.00 | $0.00 | $0.00 | $12,747.88 | $0.00 | $12,747.88 | $33,536.45 | $0.00 | $33,536.45 | ||||||
| CN-03-0500053 | CN-03-0500053 | MO | Stood up & ceiling fan blades struck forehead 2-3 times causing cuts & bruising to r. side of forehead | Closed | Arizona | 62 | M | 06/24/2003 | 05/26/2003 | 09:10:00 PM | 05/26/2003 | 05/26/2003 | No | Laceration | Skull | NOC-Struck or Injured By (Includes Kicke | Police Officers & Drivers | (7720) POLICE OFFICERS & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $689.03 | $0.00 | $689.03 | $0.00 | $0.00 | $0.00 | $689.03 | $689.03 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $689.03 | $0.00 | $689.03 | ||||||
| CN-03-0500054 | CN-03-0500054 | MO | Noticed odor in air & worked for 15 minutes & detected odor of natural gas & they evacuated the building | Closed | Arizona | 82 | F | 01/14/2013 | 05/27/2003 | 07:45:00 AM | 05/27/2003 | 05/27/2003 | No | Respiratory Disorders | Soft Tissue-Head | Absorption, Vaccine, Ingestion or Inhala | *Captured Data | (0000) UNKNOWN | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $1,935.58 | $0.00 | $1,935.58 | $0.00 | $0.00 | $0.00 | $1,935.58 | $1,935.58 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $1,935.58 | $0.00 | $1,935.58 | ||||||
| CN-03-0500055 | CN-03-0500055 | MO | Walking down the hall & turned the corner & slipped & fell due to floor being wet. | Closed | Arizona | 50 | F | 06/25/2003 | 05/28/2003 | 04:00:00 PM | 05/28/2003 | 05/28/2003 | No | Contusion | Knee | From Liquid or Grease Spills | Municipal, Township, Cnty or St Empl NOC | (9410) MUNICIPAL, TOWNSHIP, COUNTY OR STATE EMPLOYEE NOC. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $105.03 | $0.00 | $105.03 | $0.00 | $0.00 | $0.00 | $105.03 | $105.03 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $105.03 | $0.00 | $105.03 | ||||||
| CN-03-0500056 | CN-03-0500056 | MO | Was in squatting position & was unable to get up. | Closed | Arizona | 70 | M | 06/25/2003 | 05/28/2003 | 09:45:00 AM | 06/10/2003 | 06/10/2003 | No | Strain | Knee | NOC-Strain or Injury By | Sewage Disposal Plant Ops & Drivers | (6217) EXCAVATION & DRIVERS NOC | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $359.93 | $0.00 | $359.93 | $0.00 | $0.00 | $0.00 | $359.93 | $359.93 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $359.93 | $0.00 | $359.93 | ||||||
| CN-03-0500057 | CN-03-0500057 | MO | Large tree branch fell & bounced & struck leg. | Closed | Arizona | 47 | M | 07/14/2003 | 05/30/2003 | 09:00:00 AM | 05/30/2003 | 05/30/2003 | No | Contusion | Lower Leg | NOC-Struck or Injured By (Includes Kicke | Municipal, Township, Cnty or St Empl NOC | (9402) STREET CLEANING & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $222.34 | $0.00 | $222.34 | $0.00 | $0.00 | $0.00 | $222.34 | $222.34 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $222.34 | $0.00 | $222.34 | ||||||
| CN-03-0500058 | CN-03-0500058 | IND | EE is rt hand dominant & does repetitive keyboard etc. caused pain in rt elbow & forearm. | Closed | Arizona | 67 | F | 07/26/2003 | 05/30/2003 | 12:00:00 AM | 05/30/2003 | 05/30/2003 | No | Carpal Tunnel Syndrome | Elbow | Repetitive Motion Callous, Blister, etc. | Clerical Office Employees NOC | (8810) CLERICAL OFFICE EMPLOYEES NOC | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $4,998.81 | $0.00 | $4,998.81 | $0.00 | $0.00 | $0.00 | $4,998.81 | $4,998.81 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $4,998.81 | $0.00 | $4,998.81 | ||||||
| CN-03-0500059 | CN-03-0500059 | MO | Felt pop & experienced acute pain in the r rib cage. | Closed | Arizona | 64 | M | 08/28/2003 | 06/03/2003 | 12:30:00 PM | 06/03/2003 | 06/03/2003 | No | Strain | Soft Tissue-Head | NOC-Strain or Injury By | Firefighters & Drivers | (7704) FIRE PATROL OR PROTECTIVE CORPS & DRIVERS. FIREFIGHTERS & DRIVERS. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $405.48 | $0.00 | $405.48 | $0.00 | $0.00 | $0.00 | $405.48 | $405.48 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $405.48 | $0.00 | $405.48 | ||||||
| CN-03-0500060 | CN-03-0500060 | MO | Assisted in pulling 3 supply line hose then pulled 5 supply line hose at a call for smoke from a structure | Closed | Arizona | 68 | M | 09/10/2003 | 06/03/2003 | 03:40:00 AM | 06/09/2003 | 06/09/2003 | No | Strain | Lower Back Area | NOC-Strain or Injury By | Firefighters & Drivers | (7704) FIRE PATROL OR PROTECTIVE CORPS & DRIVERS. FIREFIGHTERS & DRIVERS. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $1,039.33 | $0.00 | $1,039.33 | $0.00 | $0.00 | $0.00 | $1,039.33 | $1,039.33 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $1,039.33 | $0.00 | $1,039.33 | ||||||
| CN-03-0500061 | CN-03-0500061 | IND | Reaching & stretching above shoulder for paper printouts from printer. | Closed | Arizona | 81 | F | 10/16/2003 | 06/04/2003 | 02:00:00 PM | 06/04/2003 | 06/04/2003 | No | Strain | Shoulder(s) | NOC-Strain or Injury By | Municipal, Township, Cnty or St Empl NOC | (8810) CLERICAL OFFICE EMPLOYEES NOC | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $28,918.61 | $0.00 | $28,918.61 | $0.00 | $0.00 | $0.00 | $28,918.61 | $28,918.61 | $50.00 | $0.00 | $50.00 | $2,510.74 | $0.00 | $2,510.74 | $26,357.87 | $0.00 | $26,357.87 | ||||||
| CN-03-0500062 | CN-03-0500062 | MO | During training exercise, ee jammed rt thumb into handle of car door. | Closed | Arizona | 51 | F | 01/14/2013 | 06/04/2003 | 02:00:00 PM | 06/04/2003 | 06/04/2003 | No | Crushing | Thumb | NOC-Struck or Injured By (Includes Kicke | Police Officers & Drivers | (7720) POLICE OFFICERS & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $1,956.03 | $0.00 | $1,956.03 | $0.00 | $0.00 | $0.00 | $1,956.03 | $1,956.03 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $1,956.03 | $0.00 | $1,956.03 | ||||||
| CN-03-0500063 | CN-03-0500063 | MO | Jumped in shallow end of pool to assist camper, landed hard on heel | Closed | Arizona | 54 | F | 07/02/2003 | 06/10/2003 | 01:15:00 PM | 06/10/2003 | 06/10/2003 | No | Contusion | Foot | NOC-Strain or Injury By | Municipal, Township, Cnty or St Empl NOC | (9063) YMCA, YWCA, YMHA, OR YWHA, INSTITUTION—ALL EMPLOYEES & CLERICAL | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $240.31 | $0.00 | $240.31 | $0.00 | $0.00 | $0.00 | $240.31 | $240.31 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $240.31 | $0.00 | $240.31 | ||||||
| CN-03-0500064 | CN-03-0500064 | MO | Walking on sidewalk when dog leased to tree jumped at him tearing his shirt & as he turned dog bit leg | Closed | Arizona | 79 | M | 07/26/2003 | 06/13/2003 | 09:00:00 AM | 06/13/2003 | 06/13/2003 | No | Puncture | Upper Leg | Animal or Insect | Waterworks Operation & Drivers | (7520) WATERWORKS OPERATION & DRIVERS. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $137.05 | $0.00 | $137.05 | $0.00 | $0.00 | $0.00 | $137.05 | $137.05 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $137.05 | $0.00 | $137.05 | ||||||
| CN-03-0500065 | CN-03-0500065 | MO | Leaving scene of MVA and was struck on r. side of vehicle | Closed | Arizona | 65 | M | 04/14/2004 | 06/17/2003 | 05:35:00 PM | 06/17/2003 | 06/17/2003 | Yes | Strain | Shoulder(s) | Vehicle Upset Overturned or Jackknifed | Firefighters & Drivers | (7704) FIRE PATROL OR PROTECTIVE CORPS & DRIVERS. FIREFIGHTERS & DRIVERS. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $851.98 | $0.00 | $851.98 | $851.98 | $0.00 | $851.98 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $851.98 | $0.00 | $851.98 | ||||||
| CN-03-0500066 | CN-03-0500066 | MO | Leaving scene of MVA, and struck by another vehicle on r. side | Closed | Arizona | 68 | M | 02/20/2004 | 06/17/2003 | 05:35:00 PM | 06/17/2003 | 06/17/2003 | Yes | Strain | Knee | Vehicle Upset Overturned or Jackknifed | Firefighters & Drivers | (7704) FIRE PATROL OR PROTECTIVE CORPS & DRIVERS. FIREFIGHTERS & DRIVERS. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $305.94 | $0.00 | $305.94 | $305.94 | $0.00 | $305.94 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $305.94 | $0.00 | $305.94 | ||||||
| CN-03-0500067 | CN-03-0500067 | MO | Leaving scene of MVA and was struck by another vehicle | Closed | Arizona | 56 | M | 04/14/2004 | 06/17/2003 | 05:35:00 PM | 06/17/2003 | 06/17/2003 | Yes | Strain | Lower Back Area | Vehicle Upset Overturned or Jackknifed | Firefighters & Drivers | (7704) FIRE PATROL OR PROTECTIVE CORPS & DRIVERS. FIREFIGHTERS & DRIVERS. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $2,190.10 | $0.00 | $2,190.10 | $2,143.91 | $0.00 | $2,143.91 | $46.19 | $46.19 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $2,190.10 | $0.00 | $2,190.10 | ||||||
| CN-03-0500068 | CN-03-0500068 | MO | Guarding kids swimming pool from sit/stand platform & fainted falling back into slide pool water | Closed | Arizona | 38 | F | 07/31/2003 | 06/17/2003 | 10:45:00 AM | 06/17/2003 | 06/17/2003 | No | *Captured Data | Part of Body: | NOC-Burn or Scald—Heat or Cold Exposures | Municipal, Township, Cnty or St Empl NOC | (9063) YMCA, YWCA, YMHA, OR YWHA, INSTITUTION—ALL EMPLOYEES & CLERICAL | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $56.53 | $0.00 | $56.53 | $0.00 | $0.00 | $0.00 | $56.53 | $56.53 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $56.53 | $0.00 | $56.53 | ||||||
| CN-03-0500069 | CN-03-0500069 | MO | Vehicle was struck by on coming vehicle while making l. hand turn | Closed | Arizona | 80 | M | 02/18/2004 | 06/18/2003 | 11:50:00 AM | 06/18/2003 | 06/18/2003 | Yes | Strain | Lower Back Area | Vehicle Upset Overturned or Jackknifed | Building-Operation by Owner or Lessee | (9410) MUNICIPAL, TOWNSHIP, COUNTY OR STATE EMPLOYEE NOC. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $844.56 | $0.00 | $844.56 | $844.56 | $0.00 | $844.56 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $844.56 | $0.00 | $844.56 | ||||||
| CN-03-0500070 | CN-03-0500070 | MO | EEs foot slipped when exiting fire truck causing him to fall backwards | Closed | Arizona | 54 | M | 07/10/2003 | 06/18/2003 | 10:00:00 AM | 06/18/2003 | 06/18/2003 | No | Contusion | Hand | NOC-Fall, Slip, or Trip Injury | Firefighters & Drivers | (7704) FIRE PATROL OR PROTECTIVE CORPS & DRIVERS. FIREFIGHTERS & DRIVERS. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $267.44 | $0.00 | $267.44 | $0.00 | $0.00 | $0.00 | $267.44 | $267.44 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $267.44 | $0.00 | $267.44 | ||||||
| CN-03-0500071 | CN-03-0500071 | MO | Was in SCBA & full turn out gear tearing down ceiling in a structure fire when he began to experience shortness of breath that was later ruled an asthma attack by treating physician at the ER | Closed | Arizona | 59 | M | 01/13/2004 | 06/19/2003 | 07:11:00 PM | 06/19/2003 | 06/19/2003 | No | *Captured Data | Part of Body: | Absorption, Vaccine, Ingestion or Inhala | Firefighters & Drivers | (7704) FIRE PATROL OR PROTECTIVE CORPS & DRIVERS. FIREFIGHTERS & DRIVERS. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $622.65 | $0.00 | $622.65 | $0.00 | $0.00 | $0.00 | $622.65 | $622.65 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $622.65 | $0.00 | $622.65 | ||||||
| CN-03-0500072 | CN-03-0500072 | MO | Picked up kitten to take to animal hospital, enroute to hospital cat bit finger | Closed | Arizona | 48 | F | 07/11/2003 | 06/22/2003 | 07:20:00 PM | 06/22/2003 | 06/22/2003 | No | Puncture | Finger(s) | Animal or Insect | Police Officers & Drivers | (7720) POLICE OFFICERS & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $545.24 | $0.00 | $545.24 | $0.00 | $0.00 | $0.00 | $545.24 | $545.24 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $545.24 | $0.00 | $545.24 | ||||||
| CN-03-0500073 | CN-03-0500073 | IND | Slipped on glass beads left behind by paint stripping machine in driveway | Closed | Arizona | 49 | M | 04/14/2004 | 06/30/2003 | 09:30:00 AM | 06/30/2003 | 06/30/2003 | No | Contusion | Knee | Absorption, Vaccine, Ingestion or Inhala | Street/Rd Construct: Pave/Repave & Drvr | (9402) STREET CLEANING & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $43,882.60 | $0.00 | $43,882.60 | $0.00 | $0.00 | $0.00 | $43,882.60 | $43,882.60 | $8.00 | $0.00 | $8.00 | $15,722.44 | $0.00 | $15,722.44 | $28,152.16 | $0.00 | $28,152.16 | ||||||
| CN-04-0500001 | CN-04-0500001 | MO | Using shovel to remove debris in basement of house fire, when beam fell striking helmet & bouncing onto his shoulder | Closed | Arizona | 44 | M | 07/23/2003 | 07/03/2003 | 10:00:00 AM | 07/03/2003 | 07/03/2003 | No | Contusion | Shoulder(s) | Falling or Flying Object | Municipal, Township, Cnty or St Empl NOC | (9410) MUNICIPAL, TOWNSHIP, COUNTY OR STATE EMPLOYEE NOC. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $61.01 | $0.00 | $61.01 | $0.00 | $0.00 | $0.00 | $61.01 | $61.01 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $61.01 | $0.00 | $61.01 | ||||||
| CN-04-0500002 | CN-04-0500002 | MO | Got blood on hands,wrists & arms while taking subject into custody, officer had scabs on both hands/wrists from an unrelated 7-4-03 event, he touched his own face/eyes before washing | Closed | Arizona | 54 | M | 09/16/2003 | 07/07/2003 | 03:45:00 AM | 07/16/2003 | 07/16/2003 | No | *Captured Data | Part of Body: | *Captured Data | *Captured Data | (0000) UNKNOWN | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $86.11 | $0.00 | $86.11 | $0.00 | $0.00 | $0.00 | $86.11 | $86.11 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $86.11 | $0.00 | $86.11 | ||||||
| CN-04-0500003 | CN-04-0500003 | MO | Investigating scene of burglary felt something in eye & when woke up next morning her eyelid was swollen shut | Closed | Arizona | 63 | F | 07/23/2003 | 07/07/2003 | 08:10:00 AM | 07/07/2003 | 07/07/2003 | No | Foreign Body | Eyes | Foreign Matter (Body) in Eye(s) | Municipal, Township, Cnty or St Empl NOC | (9410) MUNICIPAL, TOWNSHIP, COUNTY OR STATE EMPLOYEE NOC. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $115.37 | $0.00 | $115.37 | $0.00 | $0.00 | $0.00 | $115.37 | $115.37 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $115.37 | $0.00 | $115.37 | ||||||
| CN-04-0500004 | CN-04-0500004 | MO | While in SCBA & full turn out gear reaching to shut off valve in tight quarters caused face seal on mask to break allowing inhalation exposure of MEK vapors | Closed | Arizona | 53 | M | 10/10/2003 | 07/08/2003 | 10:00:00 AM | 07/08/2003 | 07/08/2003 | No | *Captured Data | Part of Body: | NOC-Burn or Scald—Heat or Cold Exposures | Firefighters & Drivers | (7704) FIRE PATROL OR PROTECTIVE CORPS & DRIVERS. FIREFIGHTERS & DRIVERS. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $1,433.87 | $0.00 | $1,433.87 | $0.00 | $0.00 | $0.00 | $1,433.87 | $1,433.87 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $1,433.87 | $0.00 | $1,433.87 | ||||||
| CN-04-0500005 | CN-04-0500005 | MO | Lost footing while climbing ovr fence arm punctured on barbed wire | Closed | Arizona | 51 | M | 07/23/2003 | 07/15/2003 | 08:18:00 PM | 07/15/2003 | 07/15/2003 | No | Puncture | Upper Arm | Stationary Object | Police Officers & Drivers | (7720) POLICE OFFICERS & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $477.16 | $0.00 | $477.16 | $0.00 | $0.00 | $0.00 | $477.16 | $477.16 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $477.16 | $0.00 | $477.16 | ||||||
| CN-04-0500006 | CN-04-0500006 | MO | Walking across parking lot felt something snap in low leg followed by pain | Closed | Arizona | 74 | F | 09/05/2003 | 07/16/2003 | 11:15:00 AM | 07/16/2003 | 07/16/2003 | No | Strain | Lower Leg | NOC-Strain or Injury By | Municipal, Township, Cnty or St Empl NOC | (9410) MUNICIPAL, TOWNSHIP, COUNTY OR STATE EMPLOYEE NOC. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $61.01 | $0.00 | $61.01 | $0.00 | $0.00 | $0.00 | $61.01 | $61.01 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $61.01 | $0.00 | $61.01 | ||||||
| CN-04-0500007 | CN-04-0500007 | IND | Rolling & lifting lane line holder from pool area & moving it to storage | Closed | Arizona | 39 | F | 08/07/2003 | 07/16/2003 | 08:50:00 AM | 07/16/2003 | 07/16/2003 | No | Strain | Lower Back Area | NOC-Strain or Injury By | Municipal, Township, Cnty or St Empl NOC | (9063) YMCA, YWCA, YMHA, OR YWHA, INSTITUTION—ALL EMPLOYEES & CLERICAL | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $178.19 | $0.00 | $178.19 | $0.00 | $0.00 | $0.00 | $178.19 | $178.19 | $0.00 | $0.00 | $0.00 | $33.12 | $0.00 | $33.12 | $145.07 | $0.00 | $145.07 | ||||||
| CN-04-0500008 | CN-04-0500008 | MO | As part of mandatory on-shift PT was playing racquet ball in the court at LA Fitness & wre in the 5th game when experienced sudden pain in leg | Closed | Arizona | 63 | M | 09/05/2003 | 07/23/2003 | 03:20:00 PM | 07/23/2003 | 07/23/2003 | No | Strain | Lower Leg | NOC-Strain or Injury By | Firefighters & Drivers | (7704) FIRE PATROL OR PROTECTIVE CORPS & DRIVERS. FIREFIGHTERS & DRIVERS. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $335.95 | $0.00 | $335.95 | $0.00 | $0.00 | $0.00 | $335.95 | $335.95 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $335.95 | $0.00 | $335.95 | ||||||
| CN-04-0500009 | CN-04-0500009 | MO | Large records storage box fell off shelf & metal stip scraped skin off back side of leg | Closed | Arizona | 65 | F | 08/22/2003 | 07/25/2003 | 06:15:00 AM | 07/25/2003 | 07/25/2003 | No | Laceration | Lower Leg | Falling or Flying Object | Municipal, Township, Cnty or St Empl NOC | (8810) CLERICAL OFFICE EMPLOYEES NOC | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $628.50 | $0.00 | $628.50 | $0.00 | $0.00 | $0.00 | $628.50 | $628.50 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $628.50 | $0.00 | $628.50 | ||||||
| CN-04-0500010 | CN-04-0500010 | MO | Running after suspected criminal EE ran & climbed over & through gates & fences, he wrestled & fought w/ suspect & eventually collided w/ brick wall | Closed | Arizona | 46 | M | 04/14/2004 | 07/26/2003 | 04:14:00 AM | 01/01/2003 | 07/26/2003 | 07/26/2003 | Yes | Contusion | Lower Leg | Stationary Object | Police Officers & Drivers | (7720) POLICE OFFICERS & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $1,315.79 | $0.00 | $1,315.79 | $197.55 | $0.00 | $197.55 | $1,118.24 | $1,118.24 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $1,315.79 | $0.00 | $1,315.79 | |||||
| CN-04-0500011 | CN-04-0500011 | MO | Stake driver slipped striking forehead | Closed | Arizona | 69 | M | 09/05/2003 | 07/29/2003 | 07:30:00 AM | 07/29/2003 | 07/29/2003 | No | Contusion | Skull | Hand Tool or Machine in Use | Municipal, Township, Cnty or St Empl NOC | (9015) BUILDINGS—OPERATION BY OWNER OR LESSEE OR REAL ESTATE MANAGEMENT FIRM: ALL OTHER EMPLOYEES. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $235.50 | $0.00 | $235.50 | $0.00 | $0.00 | $0.00 | $235.50 | $235.50 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $235.50 | $0.00 | $235.50 | ||||||
| CN-04-0500012 | CN-04-0500012 | MO | Attempted to flip offender off, the offender pushed down as her back was twisted | Closed | Arizona | 49 | F | 01/14/2013 | 07/30/2003 | 12:00:00 PM | 08/04/2003 | 08/04/2003 | No | Strain | Lower Back Area | NOC-Strain or Injury By | Municipal, Township, Cnty or St Empl NOC | (8810) CLERICAL OFFICE EMPLOYEES NOC | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | ||||||
| CN-04-0500013 | CN-04-0500013 | MO | Hit in eye w/ chip of water pipe that was being cut w/ a saw by another person | Closed | Arizona | 74 | M | 09/16/2003 | 07/31/2003 | 10:00:00 AM | 08/01/2003 | 08/01/2003 | No | Foreign Body | Eyes | Falling or Flying Object | Municipal, Township, Cnty or St Empl NOC | (7520) WATERWORKS OPERATION & DRIVERS. | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $505.52 | $0.00 | $505.52 | $0.00 | $0.00 | $0.00 | $505.52 | $505.52 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $505.52 | $0.00 | $505.52 | ||||||
| CN-04-0500014 | CN-04-0500014 | MO | Vehicle traveling approx. 30-35 mph struck him on r. side of chest. Doing traffic control, Standing in street manually directing traffic | Closed | Arizona | 58 | M | 09/05/2003 | 08/01/2003 | 10:49:00 AM | 08/01/2003 | 08/01/2003 | No | Contusion | Shoulder(s) | NOC-Struck or Injured By (Includes Kicke | Police Officers & Drivers | (7720) POLICE OFFICERS & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $917.51 | $0.00 | $917.51 | $0.00 | $0.00 | $0.00 | $917.51 | $917.51 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $917.51 | $0.00 | $917.51 | ||||||
| CN-04-0500015 | CN-04-0500015 | MO | Loading equipment into patrol car & struck forehead on corner of the car door | Closed | Arizona | 49 | M | 09/05/2003 | 08/01/2003 | 10:00:00 AM | 08/01/2003 | 08/01/2003 | No | Contusion | Skull | NOC-Struck or Injured By (Includes Kicke | Police Officers & Drivers | (7720) POLICE OFFICERS & DRIVERS | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $756.46 | $0.00 | $756.46 | $0.00 | $0.00 | $0.00 | $756.46 | $756.46 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $756.46 | $0.00 | $756.46 | ||||||
| CN-04-0500016 | CN-04-0500016 | MO | Has been employed over 2 yrs w/ COC shes r. handed & uses the mouse & ten-key w/right hand/arm | Closed | Arizona | 56 | F | 10/15/2003 | 08/01/2003 | 12:00:00 AM | 09/11/2003 | 09/11/2003 | No | Strain | Shoulder(s) | Repetitive Motion Callous, Blister, etc. | Municipal, Township, Cnty or St Empl NOC | (8810) CLERICAL OFFICE EMPLOYEES NOC | No | Arizona | 86-6000238 | 3793SOAZ | Midwest Employers Casualty Company | 01/01/2003 | 06/30/2008 | $1,739.77 | $0.00 | $1,739.77 | $0.00 | $0.00 | $0.00 | $1,739.77 | $1,739.77 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $1,739.77 | $0.00 | $1,739.77 |
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