Date Number ant Name Date of Loss 9/1/2016 1425001080716 De La Rosa, Catalina 8/31/2017 Closed EE was walking from the lounge to her classroom when her left foot/ankle twisted causing her to lo $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1420001081467 Osorio, Ana M 8/30/2017 Closed When EE and another employee attempted to grab a student using CPI techniques in order to deter th $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1422001079984 Jimenez, Juan Carlos 8/28/2017 Closed EE went to pick up a can of tomato sauce and as he was walking he felt something stuck to his shoe $109.86 $0.00 $0.00 $109.86 1 9/1/2016 1422001079471 Valadez, Camelia 8/23/2017 Closed EE got up from her chair heading towards the conference room when she fell to the floor landing on $5,830.36 $0.00 $0.00 $5,830.36 1 9/1/2016 1423001080129 Moreno, Daniel Ramon 8/23/2017 Closed Student started yelling and kicking a desk in the classroom and when EE tried to control that is w $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1424001080121 Flores, Chelsea Rebekah 8/23/2017 Closed EE picked up a box of binders and felt a pull on her lower back and feeling a tingling sensation d $3,681.47 $0.00 $0.00 $3,681.47 1 9/1/2016 1424001079473 Flores, Laura M 8/22/2017 Closed EE was going down stairs and as she stepped on the stairs, her right foot twisted. $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1425001080032 Macias, Diana 8/22/2017 Closed A student was misbehaving and started grabbing a backpack and employee got up and started triyng t $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1426001080150 Gonzalez, Melissa 8/22/2017 Closed EE was walking holding on to two students, walking with them and another student crossed in front $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1428001080125 Chaney, Robert N 8/22/2017 Closed EE was walking and as he stepped off the curb with his left leg he heard and felt a pop on left k $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1428001080719 Trevino, Daniel A 8/22/2017 Closed As EE opened the door, the door opened all the way because it does not have a door stop and EE tri $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1427001079026 Lopez, Margarita 8/21/2017 Closed EE laid down a trash bag which had a blade of aluminum sticking out the bag and she cut herself on $256.07 $0.00 $0.00 $256.07 1 9/1/2016 1423001078995 Ybarra, Brenda Guadalup 8/17/2017 Closed EE was removing a box from the top shelve from the closet then the box fell off the shelve and EE $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1428001080134 Salas, Heriberto 8/16/2017 Closed while cleaning the women's restroom EE cut his left index finger with a piece of broken glass that $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1426001079034 Rodriguez, Tomas 8/10/2017 Closed EE was participating in training and during the scenario EE was portraying a victim in the hallway $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1425001079042 Sepulveda, Maria Lourde 8/4/2017 Closed Employee opened the door to her custodian closet where she keeps her supplies when the door closed $819.80 $0.00 $0.00 $819.80 1 9/1/2016 1420001076535 Mascareno, Maria Guadal 8/3/2017 Closed EE upon entering building, miss stepped and began falling injuring her left shoulder, right upper $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1428001075697 Contreras, Blanca 7/31/2017 Closed The employee placed a ladder by a window to clean blinds and did not notice that the legs of the l $357.30 $0.00 $0.00 $357.30 1 9/1/2016 1428001075688 Saldana, Margarita L 7/28/2017 Closed Washing the rotating mixer causing the item to fall onto the left arm and shoulder of EE. $310.79 $0.00 $0.00 $310.79 1 9/1/2016 1428001075706 Vasquez, Hermila 7/25/2017 Closed EE tripped on the pallet jack while carrying a pallet. EE landed on both hands, arms, shoulders, a $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1427001073527 Ibarra, Araceli P 7/13/2017 Closed EE was waxing the classroom floor and she was exiting the room when she turned her body and hit he $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1428001073321 Pruneda, Denise I 7/13/2017 Closed Ee was pushing a desk when she slid and fell on her left side injuring her left arm, left leg and $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1423001073316 Mendoza, Luis 7/12/2017 Closed Employee was moving a large book shelf and it slid to the left side, scrathing his left upper arm $646.87 $0.00 $0.00 $646.87 1 9/1/2016 1426001072455 Pompa, Joel 7/8/2017 Closed The employee was trying to stop an argument and advised the people to leave the area when a man pu $2,109.90 $0.00 $0.00 $2,109.90 1 9/1/2016 1424001072498 Macias, Celia 7/6/2017 Closed The employee was pushing a wax machine when she slipped on liquid and fell. $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1424001071940 Ramirez, Roberta 6/29/2017 Closed EE stepped on a crack/hole on the sidewalk and her ankle twisted causing her to fall and injuring $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1421001072459 Gaitan, Melissa 6/28/2017 Closed EE felt pain on hands, fingers, arms and wrists after cashiering using the automatic adding machin $0.00 $0.00 $0.00 $0.00 1 G:\#clients\Laredo ISD\2018\s PC\Misc\Loss Runs\WC 7.3.18 req\laredo ISD WC 15-17 valued 7.10.18 Page 1 of 20
Date Number ant Name Date of Loss 9/1/2016 1425001070852 De Hoyos, Enrique 6/28/2017 Closed As another employee was stripping area, EE was waiting out of the stripping area and he movied to $319.84 $0.00 $0.00 $319.84 1 9/1/2016 1426001071771 Trevino, Rodolfo 6/28/2017 Closed EE was helping lift a table to set it on top of another about 4 ft high when his left elbow popped $31,525.94 $0.00 $0.00 $31,525.94 1 9/1/2016 1425001070834 Cavazos, Norma 6/27/2017 Closed As EE was walking in hallway she slipped and fell on wet area hitting on the back hip and right ha $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1421001070956 Gonzalez, San Juana 6/26/2017 Closed EE was helping move some furniture to the classroom and slipped with the dolly and fell on the rig $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1426001070754 Ramos, Alicia 6/23/2017 Closed Ms. Ramos was waiting to exit from the working parking and to exit to the right when a vehicle hit $602.78 $0.00 ($595.82) $6.96 1 9/1/2016 1428001071926 Hernandez, Ricardo 6/21/2017 Closed EE fell on his back while washing the floor peroxy for waxing. $1,471.87 $0.00 $0.00 $1,471.87 1 9/1/2016 1428001070009 Reynoso, Armando 6/20/2017 Closed IW crushed was unloading pallets and crushed his finger on left hand. $439.59 $0.00 $0.00 $439.59 1 9/1/2016 1420001070946 Ortiz, Grace 6/19/2017 Closed EE picked up a student from the floor who didn't want to enter in the classroom. As she picked him $4,473.57 $0.00 $0.00 $4,473.57 1 9/1/2016 1420001069524 Gonzalez, Jose L 6/15/2017 Closed As he was moving a table on to a dolly, the table slipped and fell landing on his right foot. $215.71 $0.00 $0.00 $215.71 1 9/1/2016 1423001070940 Cruz, Blanca S 6/15/2017 Closed EE was opening the heavy door to the safe her left shoulder started to hurt and lower arm. $3,738.11 $0.00 $0.00 $3,738.11 1 9/1/2016 1425001070861 Pedraza, Francisco J 6/13/2017 Closed EE was driving in a company vehicle when another driver drove through a stop sign striking EE's ve $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1425001068404 Tijerina, Gerardo R 6/9/2017 Closed EE was moving his resources from one classroom to another. As he picked up some books with his han $1,072.60 $0.00 $0.00 $1,072.60 1 9/1/2016 1421001070839 Lozano, Anna Rosa 6/8/2017 Open she was called to open gate for trash pick up, the gate drags a little on the ground so it has to $7,499.39 $11,311.77 $0.00 $18,811.16 1 9/1/2016 1422001068131 Saenz, Rosalinda 6/8/2017 Closed As employee was running an errand to the main office, she fell down on uneven sidewalk hitting rig $7,389.20 $0.00 $0.00 $7,389.20 1 9/1/2016 1424001067458 Aranda, Raul 6/6/2017 Closed EE was picking up servers and batteries when he felt pain on his right upper elbow. $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1421001067455 Garza, Hugo Rene 6/1/2017 Closed EE arrived at classroom to unlock door and he used his left shoulder as leverage and tried to open $360.38 $0.00 $0.00 $360.38 1 9/1/2016 1426001067460 Gonzalez, Mary Louise 5/30/2017 Closed EE opened the door for a colleague and turned around to return to her room and her left foot slid $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1428001066841 Dovalina, Judy Lee 5/30/2017 Open EE was walking to her office and tripped with the mat and while trying to regain her balance she f $9,013.56 $1,762.39 $0.00 $10,775.95 1 9/1/2016 1421001066078 Miranda, Priscilla Ann 5/26/2017 Closed As EE was walking out of the award ceremony she fell on a puddle of water by the restroom area. Sh $981.47 $0.00 $0.00 $981.47 1 9/1/2016 1420001066149 Cassiano, Edna Graciela 5/24/2017 Closed EE carried 3 cases of grapefruit from the dolly to the table individually. She felt a pull around $657.73 $0.00 $0.00 $657.73 1 9/1/2016 1421001066150 Gonzalez, Mary Lou 5/23/2017 Closed EE was trying to get a student off the bus and student was already agitated. EE tried to walk him $242.88 $0.00 $0.00 $242.88 1 9/1/2016 1422001066151 Caloca, Sandra C 5/23/2017 Closed EE was in the hallway and fell when she tripped with a student's shoe lace while the student rain $1,466.32 $0.00 $0.00 $1,466.32 1 9/1/2016 1424001065604 Duncan, Veronica 5/23/2017 Closed EE had gone to her vehicle to get her umbrella and on her way back she fell down on sidewalk on he $4,756.21 $0.00 $0.00 $4,756.21 1 9/1/2016 1424001066153 Torres, Juan Anselmo 5/23/2017 Closed EE and another custodian were bringing the bull statue from the gym. EE was pulling from the front $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1427001066156 Blanco, Virginia E 5/23/2017 Closed The employee was walking up the stairs and had a misstep and slipped and fell injuring her left ha $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1421001065133 Medina, Perfecto 5/22/2017 Closed As EE was moving wood he stepped on a nail with his right foot. $308.60 $0.00 $0.00 $308.60 1 EE was moving a chair out from a student desk. The seat of the chair slid off falling on 9/1/2016 1421001066159 Delgado, Sandra Clara 5/22/2017 Closed her right $0.00 $0.00 $0.00 $0.00 1 G:\#clients\Laredo ISD\2018\s PC\Misc\Loss Runs\WC 7.3.18 req\laredo ISD WC 15-17 valued 7.10.18 Page 2 of 20
Date Number ant Name Date of Loss 9/1/2016 1423001065126 Hernandez, Jose Fidel 5/19/2017 Closed As EE was walking towards the front entrance of the school he didn't see the step and stubbed his $390.37 $0.00 $0.00 $390.37 1 9/1/2016 1427001065130 Gomez, Blanca Estela 5/19/2017 Closed ant was on a field trip at a park with students when she kicked ball she injured her right to $1,425.12 $0.00 $0.00 $1,425.12 1 9/1/2016 1422001066160 Castro, Sylvia 5/17/2017 Closed EE got on the bus and did not see the seat belt buckle sticking up the seat and she sat down feel $144.39 $0.00 $0.00 $144.39 1 9/1/2016 1425001064804 Morado, Rosa 5/17/2017 Closed EE was entering the ladies restroom in which at the entrance there is an uneven surface and when s $474.69 $0.00 $0.00 $474.69 1 9/1/2016 1427001064500 Molina, Irma 5/16/2017 Closed EE was seating on her teacher chair and she had her right hand on the hand rest. As she turned the $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1427001064257 Villarreal, Jacqueline 5/15/2017 Closed While throwing out the trash a spider bit her on her left hand. $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1427001064626 Chavez, Patricia 5/15/2017 Closed Employee got to nearest table to avoid falling on top of a student and that is when she felt a pul $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1423001064343 Zuniga, Javier 5/10/2017 Closed EE was trying to get some empty boxes out of the recyclable dumpster and could not reach the boxes $493.94 $0.00 $0.00 $493.94 1 9/1/2016 1421001063207 Rivera, Maria De Jesus 5/8/2017 Closed EE was opening a drawer in the kitchen area which was broken and the drawer fell on her right big $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1426001065147 Canales, Sylvia C 5/8/2017 Closed While EE was unlocking her office door, her MacBook slipped from her arms and landed on her left t $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1425001064408 De La Garza, Anna Sue 5/5/2017 Closed EE was carrying laptop and equipment while walking to the entrance of the bldg. Due to uneven surf $241.27 $0.00 $0.00 $241.27 1 9/1/2016 1420001063656 Polendo, Maria De La Lu 5/4/2017 Closed EE was walking at the Houston Airport from a national migrant conference. And she felt the sole of $14,325.74 $0.00 $0.00 $14,325.74 1 9/1/2016 1428001063025 Ehrhardt, Berta F 5/4/2017 Closed EE spilled water from her cleaning bucket on the floor. As she was walking in the hallway she trip $4,142.48 $0.00 $0.00 $4,142.48 1 9/1/2016 1420001063197 Santos, Ana Laura 5/3/2017 Closed While EE was unlocking and entering the library she felt a blow on the right side of her head in w $983.53 $0.00 $0.00 $983.53 1 9/1/2016 1421001064395 Salinas, Maria Elena 5/3/2017 Closed While Ms. Salinas was directing traffic she was closing the gate and when she pulled it to close i $17,886.42 $0.00 $0.00 $17,886.42 1 9/1/2016 1422001063118 Valdez, Maria Elena 5/3/2017 Closed EE was helping a mother with child bringing him inside campus so as EE turned quickly to hold him $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1423001063011 Mejia, Dora A 5/3/2017 Closed EE fell as she was sweeping the floor on the cafeteria. The fall was caused by the fruit syrup on $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1420001062990 De Leon, Jose 5/2/2017 Closed EE hurt his right index finger as he was opening vehicle door during drop off duty. $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1427001066174 Perez, Elsa Leticia 5/2/2017 Closed EE was walking in the hallway and slipped on some ice and strain lower back $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1425001062986 Garza, Jessica 5/1/2017 Closed EE was walking and bumped her left hand knuckle with the corner of a desk. $564.37 $0.00 $0.00 $564.37 1 9/1/2016 1425001064489 Rodriguez, Maria Josefi 5/1/2017 Closed EE was walking towards her desk and she tripped and almost fell. She twisted her left ankle and s $509.09 $0.00 $0.00 $509.09 1 9/1/2016 1427001064392 Tovar, Claudia 5/1/2017 Closed Two female students were engaged in a fight and employee intervened along with securities to separ $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1425001062959 Gamez, Christina G 4/28/2017 Closed EE fell on uneven sidewalk injuring both hands and both hands. $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1428001063088 Perez, Juan Eduardo 4/28/2017 Closed A student threw a chair to the floor then EE got student and student moved his head fast to the ba $190.43 $0.00 $0.00 $190.43 1 9/1/2016 1424001062967 Leza, Maria Luisa 4/27/2017 Open While supervising students at the cafeteria, EE tripped with a student behind her falling and inju $13,273.77 $3,754.96 $0.00 $17,028.73 1 9/1/2016 1423001063101 Campos, Martha 4/26/2017 Closed EE was attempting to move book shelf and her elbow slipped causing her to hit her left side of rib $250.67 $0.00 $0.00 $250.67 1 9/1/2016 1422001063109 Resendez, Jose 4/24/2017 Closed EE was restraining student and student was pushing back and as he was pushing EE felt his right kn $0.00 $0.00 $0.00 $0.00 1 G:\#clients\Laredo ISD\2018\s PC\Misc\Loss Runs\WC 7.3.18 req\laredo ISD WC 15-17 valued 7.10.18 Page 3 of 20
Date Number ant Name Date of Loss 9/1/2016 1425001061249 Guerrero, Maria Teresa 4/24/2017 Closed EE fell on her knees as she was carrying some laptops that were going to be used for registration. $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1425001061258 Saldana, Gloria 4/24/2017 Closed EE was kicked by student on left upper arm $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1428001061243 Sanchez, Alma Veronica 4/24/2017 Closed As EE was attending a student, two boys started fighting at the nurses office and she tried to get $1,974.59 $0.00 $0.00 $1,974.59 1 9/1/2016 1421001062964 Blanco, Sylvia 4/21/2017 Closed The morning was very windy and EE had trouble controlling the STOP sign used to cross students. Th $1,903.62 $0.00 $0.00 $1,903.62 1 9/1/2016 1425001060673 Gonzalez, Manuel De Jes 4/20/2017 Closed EE was pulling in a pallet jack through the kitchen entry door. As he pulled the jack in the door, $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1426001060647 Cabello, Claudia 4/20/2017 Closed The employee walked into the counseling center and her left ankle gave out, twisting it. $4,717.01 $0.00 $0.00 $4,717.01 1 9/1/2016 1426001060854 Diaz, Albina 4/20/2017 Closed During a fire drill a female student bumped into employee's right hand/wrist with her body. $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1423001060563 Serna, Celestina 4/17/2017 Open EE was picking up merchandise for the school downtown when she had a car/pedestrian accident $1,332.95 $3,567.05 $0.00 $4,900.00 1 9/1/2016 1425001060871 Carmichael, Daniella M 4/11/2017 Closed Walking with the students at the cafeteria when there was a spilled chocolate milk and slipped and $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1426001062870 Vichareli, Baltazar G 4/10/2017 Closed He was walking down the steps outside of the school and he missed a step and slipped. He grabbed $333.93 $0.00 $0.00 $333.93 1 9/1/2016 1428001060235 Vasquez, Luis Francisco 4/10/2017 Closed EE grabbed the neutral chemical to pour to a spraying container and the chemical splattered into h $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1428001060568 Hinojosa, Javier 4/10/2017 Closed Employee burned his right lower arm when he slipped & touched a hot copper pipe when he was weldin $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1427001059901 Macias, Jose 4/7/2017 Closed As EE entered the boys restroom he slipped and fell on a soapy floor injuring his back $299.87 $0.00 $0.00 $299.87 1 9/1/2016 1427001060207 Gamez, Roberto 4/7/2017 Closed Walking down the hallway when he slipped with the stripper soap hitting himself with the machine a $1,668.76 $0.00 $0.00 $1,668.76 1 9/1/2016 1420001060002 Alvarez, Maria M 4/6/2017 Closed EE was walking back to school from her lunch break down the stairs when her right foot twisted cau $779.63 $0.00 $0.00 $779.63 1 9/1/2016 1423001060014 Miranda, Priscilla Ann 4/5/2017 Closed EE was helping a student sign on to an I pad and when she came around the banana table to sit on h $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1424001059979 Montes, Norma 4/5/2017 Closed Employee fell hurting her right ankle as she walked throught the hallway. $1,664.59 $0.00 $0.00 $1,664.59 1 9/1/2016 1420001059588 Alvarado, Manuelita 4/3/2017 Closed Ms. Alvarado tripped and fell while she was monitoring the students in the classroom. $2,060.73 $0.00 $0.00 $2,060.73 1 9/1/2016 1424001059601 Castillo, Maria Guadalu 4/3/2017 Closed Ms. Castillo was walking outside, close to A/C units and did not see the mud close to the door. Sh $1,761.79 $0.00 $0.00 $1,761.79 1 9/1/2016 1425001060259 Gallagher, Phyllis 4/3/2017 Closed One of the students came from behind and struck EE several times on her back and neck $887.43 $0.00 $0.00 $887.43 1 9/1/2016 1426001058118 Guzman, Maria Elena 4/3/2017 Closed After coming back from a fire drill, she tripped and fell on a rug injuring her left thigh, left $948.86 $0.00 $0.00 $948.86 1 9/1/2016 1420001059579 Vasquez, Maria Del Pila 3/31/2017 Closed After dismissal EE walked out to parking lot and fell back and hit her head, spine after missing a $1,058.27 $0.00 $0.00 $1,058.27 1 9/1/2016 1422001058033 Garcia, Alma 3/30/2017 Closed Ms. Garcia tripped with a dust mop and fell face first on to floor. $5,445.83 $0.00 $0.00 $5,445.83 1 9/1/2016 1424001058125 Polendo, Pamela 3/30/2017 Closed The employee was standing at the entrance of bathrooms when one of the students began to run in he $435.01 $0.00 $0.00 $435.01 1 9/1/2016 1426001058199 Garcia, Maria Imelda 3/28/2017 Closed EE proceeded to close the school gate and as she walked through a high grass area in order to get $6,341.88 $0.00 $0.00 $6,341.88 1 9/1/2016 1420001059903 De La Cruz, Josefina 3/24/2017 Closed EE was transporting cafeteria tables up a ramp when she felt a pain on her right shoulder $8,334.61 $0.00 $0.00 $8,334.61 1 9/1/2016 1425001058189 Ibarra, Elaine 3/24/2017 Closed As ee stood by a folding table containing a box of juice with ice, coffee and a box of chocolates $0.00 $0.00 $0.00 $0.00 1 G:\#clients\Laredo ISD\2018\s PC\Misc\Loss Runs\WC 7.3.18 req\laredo ISD WC 15-17 valued 7.10.18 Page 4 of 20
Date Number ant Name Date of Loss 9/1/2016 1425001058180 Martinez, Mario 3/23/2017 Closed EE was using the hoe to cut some weed and the hoe's handle came off causing EE to fall having his $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1421001058203 Saldana, Margarita 3/22/2017 Closed EE injured right hand/wrist and fingers while moving frozen bread items by hitting her hand agains $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1423001057845 Hernandez, Anita 3/22/2017 Closed EE went into the restroom and she slipped and fell due to some water on the floor. She fell forwar $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1423001057836 Chaires, Aurora 3/10/2017 Closed EE was bending down for trash and hit her right eye with broom handle $343.60 $0.00 $0.00 $343.60 1 9/1/2016 1428001057814 Flores, Sofia 3/9/2017 Closed EE was presenting lesson and the student came from behind and hugged her tight then he slammed his $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1422001055081 Navarro, Sebastian 3/8/2017 Closed The employee was moving a desk for a teacher, when he lifted it up to put it on top of dolly, he f $10,454.77 $0.00 $0.00 $10,454.77 1 9/1/2016 1424001057765 Cadena, Amparo 3/8/2017 Closed EE was coming back from lunch where she slipped and fell. She landed on her left knee and left han $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1421001057429 Jimenez, Jesus 3/6/2017 Closed EE rushed to break a fight between two girls. He was pushed to the ground hitting his right elbow $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1425001057442 Juarez, Rebecca 3/6/2017 Closed Two girls started fighting and she attempted to break up the fight and EE was pushed and hit back $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1421001057762 Vela, Antonio 3/1/2017 Closed Mr. Vela was moving desks back to place after testing he hit his right knee on the corner causing $2,997.78 $0.00 $0.00 $2,997.78 1 9/1/2016 1422001053695 Medina, Dolores 3/1/2017 Closed EE tripped and fell while getting gloves from cabinet on stool to serve the students lunch. Fell o $296.37 $0.00 $0.00 $296.37 1 9/1/2016 1424001054003 Lopez, Eliseo A 3/1/2017 Closed EE was walking up the ramp when he attempted to adjust his duty belt and felt a sharp pain to his $4,140.34 $0.00 $0.00 $4,140.34 1 9/1/2016 1427001053664 Riojas, Alma 2/27/2017 Closed EE was mopping classroom and chair moved and fell on her left toe. $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1428001053143 Solorio, Marissa 2/27/2017 Closed EE was directing traffic when her whistle fell down and EE bend to grab it and felt a pull on her $862.88 $0.00 $0.00 $862.88 1 9/1/2016 1424001053679 Rodriguez, Mauro Alfred 2/25/2017 Closed As EE was preparing to load the floor unto the bus he was getting in the bus to lift the floor. Th $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1424001057414 Huante, Martin 2/24/2017 Closed While EE opened the van's door, the compressor fell on his left knee. $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1420001052793 Garza, Laura 2/22/2017 Closed EE was walking into principal's office and lost her balance and tripped and fell on both her knees $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1423001053111 Martinez, Anna Laura 2/21/2017 Open EE was walking down hallway when school bell rang and as students were entering their classrooms, $29,338.57 $34,740.75 $0.00 $64,079.32 1 9/1/2016 1427001054186 Medina, David 2/21/2017 Open Mr. Medina was found by two boarder patrol officers at a law enforcement gun range off of Highway $16.52 $25.00 $0.00 $41.52 1 9/1/2016 1424001052590 Cabrera, Maria Cruz 2/20/2017 Closed EE was coming back to main area but chose to not use designated walkway and stepped down to cut on $1,146.31 $0.00 $0.00 $1,146.31 1 9/1/2016 1425001053104 Ruiz, Patricia 2/17/2017 Closed EE was taking out pressure washing machine in reverse when she hit her right hand with handle. Han $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1427001053115 Soto, Lisa P 2/16/2017 Closed After walking the parade with her dance team, EE tripped on a broken sidewalk and fell forward. He $893.04 $0.00 $0.00 $893.04 1 9/1/2016 1421001052353 Castro, Pamela Kristine 2/14/2017 Closed EE was standing on bleachers when she twisted her right ankle. *Report Only* $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1423001052364 Tijerina, Melissa Johns 2/14/2017 Closed EE was untangling wires/cables and tripped on them falling down on floor hurting her neck and back $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1425001054517 Jasso, Adan 2/10/2017 Closed While walking K9 dog to relief himself before a search he quickly turned and pulled in the opposit $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1420001051038 Perales, Jose 2/9/2017 Closed When teaching PK students how to run to 1st base in baseball, the employee felt a pop on his right $170.33 $0.00 $0.00 $170.33 1 9/1/2016 1422001050905 Garcia, Jocelyn 2/9/2017 Closed After walking in from crossing guard duty EE began to get pain in her right ankle. $329.78 $0.00 $0.00 $329.78 1 G:\#clients\Laredo ISD\2018\s PC\Misc\Loss Runs\WC 7.3.18 req\laredo ISD WC 15-17 valued 7.10.18 Page 5 of 20
Date Number ant Name Date of Loss 9/1/2016 1424001051042 Leija, Lorena 2/9/2017 Closed EE was washing mop in sink when her hand slipped to the drain and her right middle finger was cut $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1423001050258 Blanquez, Jose Crus 2/1/2017 Closed Students playing with a tennis ball, one of them threw or kicked the ball towards the wall but mis $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1428001050092 Martinez, Melissa 2/1/2017 Closed EE was stepping down from the curb and stepped on uneven ground and her left ankle went inward $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1423001050195 Ramirez, Cecilia 1/31/2017 Closed EE was walking fast to sign in and fell on pavement in parking lot hurting her left ankle and righ $257.99 $0.00 $0.00 $257.99 1 9/1/2016 1427001049929 Garcia, Consuelo 1/31/2017 Closed EE was walking coiming from restroom and fell on wet surface floor injuring her hips, right wrist, $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1427001049938 Hinojosa, Susana 1/31/2017 Closed EE was walking towards the gym area when all of a sudden a student ran into EE and bumped into her $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1427001050244 Rodriguez, Maria Guadal 1/31/2017 Closed EE pulled out the dolly from the pantry to open as a flat bed to put the yogurt when it fell down $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1422001049843 Garcia, Adriana 1/30/2017 Closed EE was putting chairs in and used her right knee to push chair in and right knee got hurt with the $194.58 $0.00 $0.00 $194.58 1 9/1/2016 1425001050098 Santos, Ana Laura 1/30/2017 Closed EE was moving a portable bookcase full of books when books and shelves fell off and landed on EE's $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1428001050317 Macias, Diana 1/27/2017 Closed EE pulled a fork from a student with her right hand and her right hand/wrist hurts. $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1420001049274 Valdez, Silvia A 1/26/2017 Closed As Ms. Valdez changed a student's diaper, the student had a seizure. Ms. Valdez injured her low ba $15,401.06 $0.00 $0.00 $15,401.06 1 9/1/2016 1421001049311 Arredondo, Sylvia 1/26/2017 Closed Student was having an outburst episode and scratching his legs and as EE tried to intervene and re $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1422001051049 Herrera, Griselda 1/26/2017 Closed EE was walking from front office towards her office when she slipped and fell on her knees $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1428001049300 Moreno, Daniel Ramon 1/26/2017 Closed EE was supervising and assisting student with daily work. Student has tendency to spit and did it $172.73 $0.00 $0.00 $172.73 1 9/1/2016 1424001051051 Morales, Olga 1/25/2017 Closed EE tried to pick up something she had dropped and slipped from the chair and fell on her left wris $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1427001051054 Flores, Edna Angelica 1/24/2017 Closed EE was trying to convince student to get back to class and student became aggressive an pushed EE $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1427001051063 Garza, Gustavo Axel 1/24/2017 Closed EE was removing track equipment from the rafters and went up on a ladder losing his balance and bu $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1420001051065 Guerra, Michael 1/23/2017 Closed EE was trying to separate two students from fighting and as he did that he hit himself on his righ $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1425001050296 Montalvo, Lamar 1/23/2017 Closed The classroom phone rang and as she approached the phone and slipped on a piece of breakfast spoon $1,660.51 $0.00 $0.00 $1,660.51 1 9/1/2016 1420001049895 Serna, Maria D 1/20/2017 Closed IW was walking in the building the floor was wet, slipped and fell on left knee. $1,073.12 $0.00 $0.00 $1,073.12 1 9/1/2016 1420001050192 Medina, Martha 1/19/2017 Closed EE was getting out watermelons from a cart and injured her right shoulder $1,693.98 $0.00 $0.00 $1,693.98 1 9/1/2016 1424001051078 Benavides, Alberto 1/19/2017 Closed EE was assisting in excorting student to cafeteria after refusing to comply with classroom rules. $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1420001051083 Garcia, Karla M 1/16/2017 Closed EE was walking out to dismiss students and slipped and fell injuring both right elbow, both hands, $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1420001047762 Garcia, Jose 1/9/2017 Closed IW was mopping and sweeping and developed a bruise on his right arm. $1,152.68 $0.00 $0.00 $1,152.68 1 9/1/2016 1420001051146 Hernandez, Sandra 1/6/2017 Closed EE finished lunch and was standing. She moved the chair in a sliding motion (no lifting was done), $333.87 $0.00 $0.00 $333.87 1 9/1/2016 1427001051090 Vital, Jeanetti Yesenia 1/5/2017 Closed Student tried to push EE forward and down and EE exerted all her strength to push back the student $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1427001046023 Reyes, Gabiriel 1/4/2017 Closed EE was assisting to remove autistic student from computer area. At the time, he kicked desk and to $569.34 $0.00 $0.00 $569.34 1 G:\#clients\Laredo ISD\2018\s PC\Misc\Loss Runs\WC 7.3.18 req\laredo ISD WC 15-17 valued 7.10.18 Page 6 of 20
Date Number ant Name Date of Loss 9/1/2016 1420001046682 Anguiano, Christy 1/3/2017 Closed Employee was participating in a team event of knocker ball and collided with another co worker. $11,335.44 $0.00 $0.00 $11,335.44 1 9/1/2016 1426001046652 Madrigal, Alicia 1/3/2017 Closed Ms. Madrigal was participating in a staff development event, principal came up with the idea of a $5,636.82 $0.00 $0.00 $5,636.82 1 9/1/2016 1420001046034 Munoz, Alejandra 12/13/2016 Closed Walking down the hall and tripped and fell injuring her right ankle. $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1422001046081 Ramos, Maria Del Carmen 12/9/2016 Closed EE was walking to her desk and her right foot slipped and fell on her left side $211.93 $0.00 $0.00 $211.93 1 9/1/2016 1423001046046 Rodriguez, Tomas 12/9/2016 Closed Walkng to2wards entrance of school and tripped with curve and felt pain to left big toe $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1426001046085 Salazar, Maria Elsa 12/9/2016 Closed EE was walking behind a student and the student fell and EE tripped with student's foot injuring h $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1421001043758 Sepulveda, Melisa Angel 12/7/2016 Closed The employee went to knock at door very hard and teacher inside closed door and as she was closing $1,002.44 $0.00 $0.00 $1,002.44 1 9/1/2016 1421001042714 ESCALERA, CLAUDIA 12/5/2016 Closed Tripped and fell over a mail basket which was in the middle of a walk way and didn't see it fallin $583.28 $0.00 $0.00 $583.28 1 9/1/2016 1423001046118 Gonzalez, San Juana 12/5/2016 Closed EE was vacuuming the floor when the extension cord got caught on the legs of the chair and flip o $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1422001046072 Barberena, Alma Anais 12/2/2016 Closed Student attacked and bit her on the right forearm. $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1423001046109 Torres, Thelma 12/2/2016 Closed EE walked out to the loop area to look for a student. As she was walking she tripped with a board $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1428001042730 FALCON, LAURA 12/2/2016 Closed EE WAS PUTTING STUDENT DOWN FOR A NAP AND LOST BALANCE FALLING TO LEFT SIDE LANDING ON LEFT ELBOW, $783.19 $0.00 $0.00 $783.19 1 9/1/2016 1427001042711 TREVINO, CESAR G 11/30/2016 Closed STUDENT ATTACKED OTHER STUDENT AND WHEN EE HAD TO PULL STUDENT OFF THE OTHER STUDENT, ONE OF THE S $1,583.20 $0.00 $0.00 $1,583.20 1 9/1/2016 1420001046061 Ramirez, Melina 11/29/2016 Closed Walking upstairs and missed a step and fell hitting her right knee. $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1423001046064 Teniente, Ana Maria 11/28/2016 Closed EE was holding ice maker lid with one hand and the other pour ice into a glass and she let go the $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1424001042024 DE LA O, ABRAHAM 11/28/2016 Closed The employee was using the weed eater, going backwards cutting grass, slipped and fell in a hole a $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1427001042018 LOZANO, HECTOR 11/28/2016 Closed AS EE WAS PICKING UP THE "DO NOT ENTER" SIGN THAT WAS LYING ON THE DRIVEWAY AND THE TOP PART SLIPP $76.12 $0.00 $0.00 $76.12 1 9/1/2016 1426001041594 SANCHEZ, RODOLFO 11/16/2016 Closed EE WAS TAKING THE CASHIER BOXES AND CHANGE BOX OUT OF THE VAULT WHEN HE LIFTED THE CHANGE BOX IT S $208.64 $0.00 $0.00 $208.64 1 9/1/2016 1426001046067 Perez, Carlos D 11/16/2016 Closed As Carlos was assigting two other employees with a student, the student began kicking and hitting $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1422001040537 VILLARREAL, DORA L 11/14/2016 Closed THERE WAS A BEE ON A STUDENT AND EE TRIED TO GET IT AWAY FROM THE STUDENT AND THE BEE STUNG EE ON $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1423001040781 CANTU, MARTHA 11/14/2016 Closed The employee was organizing the MDF to remove loose cable, the cable caught on ups and moved it fo $9,884.18 $0.00 $0.00 $9,884.18 1 9/1/2016 1427001040452 GARCIA, CELIA 11/14/2016 Closed AS WALKING ON THE FIELD SHE MISSED A STEP AND FELL ON A 3INCH STEP INJURING HER BOTH KNEES, BOTH H $732.22 $0.00 $0.00 $732.22 1 9/1/2016 1425001042853 HERNANDEZ, MARIA 11/13/2016 Closed PAIN TO BACK AND RIGHT FOOT. "INJURY THAT OCCURRED ON 11/13/16, WHICH WAS WORK RELATED." PER MEDNA $98.85 $0.00 $0.00 $98.85 1 9/1/2016 1423001040448 Cazares, Margarita 11/11/2016 Closed The employee removed a tray of bread from the oven when the tray fell on her chest, right arm, rig $580.36 $0.00 $0.00 $580.36 1 9/1/2016 1421001040464 RIVERA, FABIOLA 11/10/2016 Closed THERE WAS SALT OR SUGAR ON THE FLOOR AND SHE SLIPPED AND FELL HURTING HER RIGHT KNEE. $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1426001040100 MERLA, JUAN C 11/9/2016 Closed EE WAS LANDING PALLET ON TO THE PLATFORM AND THE PALLET MOVED CAUSING HIM TO FALL LANDING ON HIS K $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1421001040230 GONZALEZ, JOSE LUIS 11/8/2016 Closed TRIP AND FALL WHILE RAKING IN THE PARKING LOT. $0.00 $0.00 $0.00 $0.00 1 G:\#clients\Laredo ISD\2018\s PC\Misc\Loss Runs\WC 7.3.18 req\laredo ISD WC 15-17 valued 7.10.18 Page 7 of 20
Date Number ant Name Date of Loss 9/1/2016 1423001040223 DYER, REBECCA 11/4/2016 Closed AS EE WAS TAKING OUT THE ICE CHEST AFTER BREAKFAST SHE TURNED AROUND TO GET THE TRASH CAN AND TWIS $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1422001039763 FLORES, SOFIA 11/3/2016 Closed AFTER DISMISSAL SHE ENTERED FRONT OF THE SCHOOL DOOR AND SLAMMED ON HER LEFT TOE AND PUNCTURED IT. $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1422001040213 URBINA, CLAUDIA 11/3/2016 Closed EE WAS GOING DOWN STAIRS AND SHE SLIPPED AND SPRAINED HER RIGHT ANKLE. $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1428001039760 AYALA, JESSICA 11/3/2016 Closed TWO GIRLS WERE FIGHTING AND WERE ON THE FLOOR SO EE PULLED ONE GIRL AWAY TO STOP THE FIGHT WHEN EE $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1426001039587 YDROGO, ASHLEY 11/2/2016 Closed The employee was guiding a student who was vomiting to the nearest trash can during lunch duty whe $2,362.76 $0.00 $0.00 $2,362.76 1 9/1/2016 1428001039751 Islas, Alma 11/2/2016 Closed EE WAS LEAVING FOR THE DAY AND AS SHE WAS WALKING ON THE SIDEWALK SHE TRIPPED OVER THE UNEVEN SIDE $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1424001040206 YORK, PILAR 11/1/2016 Closed EE WAS ROCKING A STUDENT ON A ROCKING CHAIR TO COMFORT HIM AND THE CHAIR BROKE AND SHE FELL DOWN H $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1426001040208 LOPEZ, PATRICIA 11/1/2016 Closed Fell from a high chair and injured her left knee. $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1426001038075 LUNA, MARIA ELENA 10/31/2016 Closed EE WAS WORKING IN HER AREA WHEN ANOTHER EMPLOYEE BUMPED INTO EE FALLING BACKWARDS INJURING HER LEF $299.00 $0.00 $0.00 $299.00 1 9/1/2016 1426001039254 VALENZUELA, RICARDO 10/31/2016 Closed A STUDENT HAD EPISODE AND RAN INTO HALLWAY, GOT A WET FLOOR SIGN AND THREW IT AT THE EMPLOYEE. STU $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1427001038157 GUERRA, SEAN MICHAEL 10/31/2016 Closed THE EMPLOYEE WAS LEANING TO SHIFT SOME ITEMS WHEN HE FELL HITTING HIS RIGHT SIDE SHOULDER, HEAD, A $2,672.42 $0.00 $0.00 $2,672.42 1 9/1/2016 1424001038082 FALCON, LAURA 10/28/2016 Open Ms. Falcon was transferring a student to a different wheelchair, and the student lost their balanc $26,252.37 $9,957.21 $0.00 $36,209.58 1 9/1/2016 1428001038149 GONZALEZ, ARMINDA 10/28/2016 Closed EE WAS DOING A HOME VISIT AND GOT DOWN FROM HER CAR AND WAS AT THE SIDEWALK AND A SMALL DOG BIT HE $770.26 $0.00 $0.00 $770.26 1 9/1/2016 1420001038069 Rodriguez, Guadalupe 10/27/2016 Closed Employee was sitting down between a table metal pole. When she got up from the table she forgot ab $5,924.64 $0.00 $0.00 $5,924.64 1 9/1/2016 1422001038080 TOBIAS, JOSE S 10/27/2016 Closed The employee was fixing a doorframe, and a shelf fell on the top of his head as he did so. $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1425001039163 PREVOST, MARY A 10/27/2016 Closed On 10/27, Ms. Prevost was walking down a handicap ramp at work when she tripped and fell onto both $1,982.18 $0.00 $0.00 $1,982.18 1 9/1/2016 1426001037895 BARRIENTOS, NORMA 10/27/2016 Closed AS EE WAS DISMISSING STUDENTS, A STUDENT CAME AROUND HER AND AS SHE STEPPED BACK SHE TRIPPED OVER $2,441.45 $0.00 $0.00 $2,441.45 1 9/1/2016 1424001038091 LOZANO, MARTHA A 10/26/2016 Closed EE WAS BITTEN ON LEFT LATERAL FOREARM BY SOME INSECT AS SHE TRIED TO SWAP IT AWAY. $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1427001042720 MADRIGAL, NANCY A 10/26/2016 Closed EE WAS COMING OUT OF THE TACHER'S LOUNGE WHEN CUSTODIAN WITH DRY MOP PASSED AND HIT EE AND FELL ON $13,978.28 $0.00 $0.00 $13,978.28 1 9/1/2016 1420001038105 AYALA, HUMBERTO MARTIN 10/25/2016 Closed WHILE DRIVING TO WORK SITE, EE WAS STOPPED AT A RED LIGHT ON SAN BERNARDO AND WASHINGTON ST WHEN H $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1420001038123 URBINA, ARTURO 10/25/2016 Closed WHILE GOING TO WORK SITE, EE WAS A PASSENGER IN THE VEHICLE AND WERE AT A RED LIGHT ON SAN BERNAR $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1428001037897 CANTU, ROGELIO 10/25/2016 Closed EE WAS WORKING ON A FREEZER MOTOR AND WAS CUTTING STRAP HITTING HIM ON HIS RIGHT EYE. $324.90 $0.00 $0.00 $324.90 1 9/1/2016 1420001037250 SANCHEZ, LUCIO 10/24/2016 Closed EE WAS CUTTING GRASS ON THE EDGE OF THE SIDEWALK AND STEPPED BACK AND BUMPED WITH A CAR CEMENT BUM $1,721.29 $0.00 $0.00 $1,721.29 1 9/1/2016 1421001037242 ORTIZ, PATRICIA P 10/24/2016 Closed The employee was lifting a student from the Rifton wheelchair to the changing table, and she felt $2,443.97 $0.00 $0.00 $2,443.97 1 9/1/2016 1427001037248 TORRES, FAUSTO 10/24/2016 Closed The employee was getting down from the truck and put his left hand on the truck, his coworker clos $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1428001037357 Martinez, Lydia 10/24/2016 Closed The employee was stopping a fight when a student pushed her, causing her to fall down and land on $810.21 $0.00 $0.00 $810.21 1 9/1/2016 1428001038095 ROLAN, ERICA L 10/21/2016 Closed EE STOPPED STUDENT FROM RUNNING FROM THE CLASSROOM AND FELL DOWN AND LANDED ON HER RIGHT KNEE $439.47 $0.00 $0.00 $439.47 1 G:\#clients\Laredo ISD\2018\s PC\Misc\Loss Runs\WC 7.3.18 req\laredo ISD WC 15-17 valued 7.10.18 Page 8 of 20
Date Number ant Name Date of Loss Expenses CC 9/1/2016 1422001037234 PANTOJA, GABRIEL 10/20/2016 Closed EE WAS PICKING UP STUDENT DESK AND SWIVELED HITTING HIM ON HIS LEFT EYE. $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1423001037127 MENDIVE, JUANA EDITH 10/20/2016 Closed Stepped on a rock and fell down. She injured her knees, right elbow and twisted her left foot. $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1427001039264 JUAREZ, VIRGINIA 10/20/2016 Closed The employee was getting ready for dismissal and she walked between chair and table and fell down $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1423001037154 Garza, Maria A 10/19/2016 Closed Ms. Maria Garza picked trash bag and threw in tall garbage bin and felt a strain on neck and right $632.61 $0.00 $0.00 $632.61 1 9/1/2016 1427001037131 PAYNE, MICHELLE RENEE 10/18/2016 Closed WALKING UP THE STAIRWAY AND MISSED A STEP AND LANDED ON HER HANDS TO PREVENT FALL. INJURED BOTH HA $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1428001036151 IBARRA, ANTONIO JESUS 10/17/2016 Closed WHILE EMPLOYEE WAS REMOVING THE LEGS FROM THE STAGE TABLE IT FELL ON TOP OF EMPLOYEE HITTING HIM O $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1421001036081 MORALES, REBECCA 10/13/2016 Closed AS EE WALKED INTO CLASSROOM SHE SLIPPED AND FELL ON HER RIGHT KNEE AND RIGHT ANKLE. HER LEFT LEG W $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1421001036144 VARGAS, JAMIE C 10/13/2016 Closed EE WAS WALKING AND SLIPPED AND FELL WHEN HER RIGHT FOOT GAVE OUT LANDING ON HER KNEES. $1,544.45 $0.00 $0.00 $1,544.45 1 9/1/2016 1427001035691 MADRIGAL, NANCY A 10/12/2016 Closed The floor was slippery and the employee fell onto her knees and was holding herself with her hands $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1420001037214 RANGEL, DOLORES ELIZABE 10/11/2016 Closed EE WAS USING THE BUFFER WHEN IT GOT TANGLED WITH THE REFRIGERATOR CORD AND WHEN SHE PULLED IT SHE $0.00 $0.00 $0.00 $0.00 1 WALKING TO BUILDING AND WHILE ON STAIRS SHE STEPPED ON AN UNEVEN STEP 9/1/2016 1422001037225 AGUILAR, MARIA VICTORIA 10/11/2016 Closed AND FELL LANDING ON HER KNEE $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1423001036218 Gonzalez, Diana 10/11/2016 Closed Employee was kicked in the right knee by a misbehaving child. $12,560.17 $0.00 $0.00 $12,560.17 1 9/1/2016 1423001036407 SOLDEVILLA, NOHEMI 10/11/2016 Closed EE WAS CUTTING PEACHES AND WITH THE KNIFE SHE CUT HER LEFT INDEX FINGER. $1,171.57 $0.00 $0.00 $1,171.57 1 9/1/2016 1425001037228 ARREDONDO, MARIA DE JES 10/11/2016 Closed DIRECTING TRAFFIC ON MALINCHE ST WHEN SHE STARTED WALKING BACKWARDS AND BUMPED INTO A CONE AND FEL $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1425001038092 ALMANZA, ELIZABETH 10/11/2016 Closed Employee was doing things real fast, when she hit herself with the drawer on her right hand. $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1426001036158 GUTIERREZ, VERA DOROTHE 10/11/2016 Closed SLIPPED OFF THE CHAIR AND FELL DOWN HURTING HER LEFT ARM. $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1427001037221 MENDOZA, ANA 10/11/2016 Closed The employee was in a food prep area when a coworker bumped her, causing her to slip and injure he $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1423001035957 RUBIO, YOLANDA M 10/10/2016 Closed LEFT SHOULDER, HIP,KNEE CONTUSION. LT HIP, LT KNEE. CLAIM CREATED FROM DWC73. $346.48 $0.00 $0.00 $346.48 1 9/1/2016 1420001057752 Zarate, Gloria 10/7/2016 Closed As EE was grabbing a student throwing water in the sink, he kicked and tripped her causing her rig $250.08 $0.00 $0.00 $250.08 1 9/1/2016 1422001037171 SOLIS, DIANA 10/7/2016 Closed Was cleaning table and student stood and she tripped with child's foot injuring her left leg and a $206.57 $0.00 $0.00 $206.57 1 9/1/2016 1426001037166 CORTEZ, LILIA E 10/7/2016 Closed The employee fell in the hallway hurting her left knee and left elbow. $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1427001036816 HOLGUIN, DELIA 10/5/2016 Closed The garage door had to be lifted but it was not able to go all the way up. She went underneath the $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1421001034920 VILLANUAVA, OSCAR 9/30/2016 Closed Employee was emptying trash bin and was struck by a needle that was sticking out, index finger pun $703.53 $0.00 $0.00 $703.53 1 9/1/2016 1420001033992 Lozano, Erika Del Carme 9/29/2016 Closed AS EE WAS WALKING FROM HER CLASSROOM SHE TWISTED HER RIGHT ANKLE AND FELL $1,713.94 $0.00 $0.00 $1,713.94 1 9/1/2016 1420001034010 ARMENTA, JOEL 9/27/2016 Closed Employee punctured his left thumb on an jagged edge on the stove. *Reporting purposes only* $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1422001033697 RIOS, EULALIO 9/27/2016 Closed EE WAS CARRYING A 12' LADDER AND WALKING DOWN HILL TOWARDS SIDEWALK WHEN HE SLIPPED AND LOST CONT $1,997.11 $0.00 $0.00 $1,997.11 1 9/1/2016 1425001034033 ESPINOZA, DIANA M 9/27/2016 Closed The employee was sitting on bottom bleacher when a student pushed another student who was sitting $0.00 $0.00 $0.00 $0.00 1 G:\#clients\Laredo ISD\2018\s PC\Misc\Loss Runs\WC 7.3.18 req\laredo ISD WC 15-17 valued 7.10.18 Page 9 of 20
Date Number ant Name Date of Loss 9/1/2016 1424001034014 Benavides, Sara A 9/22/2016 Closed Ms. Sara Benavides was trying to confiscate a calculator that student got from teacher's desk and $715.91 $0.00 $0.00 $715.91 1 9/1/2016 1425001034024 RODRIGUEZ, YVETTE 9/22/2016 Closed SLIPPED ON THE STAIRS AND FELL ON BOTH KNEES. $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1426001032441 SALDANA, JUAN JOSE 9/20/2016 Closed Employee was in the classroom with students when they began pushing desks & he was struck on his l $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1426001032450 URESTI, ESMERALDA 9/19/2016 Closed Employee was blocking the entrance classroom door for the student not to leave and all of a sudden $990.14 $0.00 $0.00 $990.14 1 9/1/2016 1428001036097 ARELLANO, ALMA D 9/16/2016 Closed THE EMPLOYEE SLIPPED (SPLIT TYPE) AT THE CAFETERIA DUE TO CORN ON THE FLOOR AND STARTED BLEEDING F $2.85 $0.00 $0.00 $2.85 1 9/1/2016 1420001032084 BRISENO, MARISELA 9/15/2016 Closed Employee was performing job duties during lunch time and a student fell back and hit her right, lo $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1420001035135 RODRIGUEZ, DANIELA 9/15/2016 Closed During a lesson a student dropped a ball he was holding, employee tried to catch it and hold it. S $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1424001031989 PERUSQUIA, LARISSA 9/15/2016 Closed EE WAS WALKING DOWN THE STAIRS AND SKIPPED SECOND TO LAST STEP FALLING HEAD FIRST AND LANDING ON H $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1421001032094 CHANEY, JOHANNA 9/12/2016 Closed EE TRIPPED OVER A CHAIR AND FELL ON TOP OF A DESK WHICH BROKE FALLING ON HER INJURING HER RIGHT S $1,146.90 $0.00 $0.00 $1,146.90 1 9/1/2016 1422001032014 HINOJOSA, JUAN CARLOS 9/12/2016 Closed EE WAS WITH STUDENT ASSISTING STUDENT WITH A CLOTHING CHANGE AS EE LIFTED STUDENT HE FELT A SHARP $566.08 $0.00 $0.00 $566.08 1 9/1/2016 1424001037875 BOTELLO, DONNA 9/10/2016 Closed She bent over to pick up child that was crying and felt pain in R knee $3,191.17 $0.00 $0.00 $3,191.17 1 Employee turned on left foot to pick up tennis rackets and stepped, slipped on the 9/1/2016 1421001032958 Colin, Lee Ellen 9/9/2016 Closed bag with right $27,699.35 $0.00 $0.00 $27,699.35 1 9/1/2016 1420001031184 VELOZ, MARIA 9/8/2016 Closed Employee arrived to work in the morning and tripped in the parking lot. $283.20 $0.00 $0.00 $283.20 1 9/1/2016 1420001031787 OLGUIN, VIRGINIA 9/8/2016 Closed Ms. Olguin Vehicle was rear ended upon returning to campus from a home visit injuring her left sid $1,969.16 $0.00 $0.00 $1,969.16 1 9/1/2016 1423001035993 Cruz Saenz, Nora Elsa 9/8/2016 Closed Ms. Nora Cruz Saez was dismissing students, tripped on a speed bump and fell injuring her right kn $1,088.00 $0.00 $0.00 $1,088.00 1 9/1/2016 1424001031467 Cazares, Margarita 9/7/2016 Open THE EMPLOYEE LIFTED A HEAVY BAG OF TRASH AND HEARD A POP ON HER LOWER BACK. $10,341.89 $5,597.27 $0.00 $15,939.16 1 9/1/2016 1425001031270 Gonzalez, Juan F 9/6/2016 Closed Mr. Juan Gonzalez was at a red light when the vehicle he was in was hit from behind. $3,395.50 $0.00 $0.00 $3,395.50 1 9/1/2016 1426001032468 GONZALEZ, MARIA DE LA L 9/6/2016 Closed LEAVING THE ROOM TO RUN AFTER A STUDENT THAT HAD LEFT THE CLASSROOM, EE CUT HER LEFT HAND MIDDLE F $0.00 $0.00 $0.00 $0.00 1 9/1/2016 1426001031541 MARTINEZ, MARIO 9/5/2016 Closed Employee was conducting traffic when he tripped on the curb & fell backwards onto his buttocks. $3,938.13 $0.00 $0.00 $3,938.13 1 9/1/2016 1420001031418 GARCIA, JESUS 9/2/2016 Closed WHILE CLEANING THE AUDITORIUM HE WENT TO PUT BACK THE BUCKET ON STAGE AND WAS TO CLOSE TO THE EDGE $233.08 $0.00 $0.00 $233.08 1 9/1/2016 1424001032421 LOZANO, HECTOR V 9/1/2016 Closed Contusion to upper back. A special ed student came from behind and hit the employee on the back. $0.00 $0.00 $0.00 $0.00 1 9/1/2016 9/1/2015 1424001029532 TELLO, NORA 8/30/2016 Closed 9/1/2015 1420001029528 VALDEZ, SILVIA ADRIANA 8/29/2016 Closed 9/1/2015 1428001029365 Tobias, Jose Samuel 8/29/2016 Closed 9/1/2015 1428001029545 JUAREZ, REBECCA 8/29/2016 Closed 9/1/2015 1421001029556 MARTINEZ, LYDIA 8/26/2016 Closed $433,231.70 $70,716.40 ($595.82) $503,352.28 264 EE opened the door to the classroom and she hit her right hand, two middle fingers with bookshelf. $0.00 $0.00 $0.00 $0.00 1 ONE OF THE STUDENTS HAD A CRISIS AND EE AND TWO OTHER EMPLOYEES WERE TRYING TO CONTROL A STUDENT B $0.00 $0.00 $0.00 $0.00 1 Mr. Jose Tobias was bitten on the left forearm by a student as he attempted CPI technique on stude $439.81 $0.00 $0.00 $439.81 1 The employee was walking out of the main building and tripped on her pants and fell backwards sust $0.00 $0.00 $0.00 $0.00 1 EMPLOYEE FELL ON HER WAY BACK FROM THE FIRE DRILL. SHE TRIPPED AND FELL HURTING HER RIGHT KNEE. $590.56 $0.00 $0.00 $590.56 1 G:\#clients\Laredo ISD\2018\s PC\Misc\Loss Runs\WC 7.3.18 req\laredo ISD WC 15-17 valued 7.10.18 Page 10 of 20