Intake Checklist — John Marek

This is the information and documentation we need from you to build the strongest possible record. You don't need to have everything before we start, but each item we get sharpens the analysis. Send what you have, in any format.

1. Injury and Medical

• Dates of both on-duty injuries
• Brief description of how each happened (incident report numbers if you have them)
• Names and contact information of all treating physicians (orthopedist, neurosurgeon, pain management, primary care, anyone involved)
• Surgical reports and operative notes from your neck surgeries
• Most recent treatment notes and any prognosis or future-treatment recommendations from your treating physicians
• Any independent medical examination (IME) reports the Town has commissioned
• A list of your current and anticipated future treatments (medications, injections, physical therapy, additional surgery, hardware revision, etc.)

2. Town Communications

• Every written communication from the Town, Fire Chief, Town Manager, or HR about your injuries, return-to-work status, or retirement — letters, emails, text messages, memos
• Especially: any written statement that medical liability ends at retirement, or anything referencing "111F"
• Any administrative leave notices
• Any orders to undergo a physical examination (the CBA Article 23 procedure)
• Any documentation about light-duty offers (or lack thereof)

3. Pay and Benefits Records

• Your §111F payment history — pay stubs or a Town payroll summary showing IOD payments to date
• Records of any medical bills the Town has paid directly, or reimbursed you for, related to either injury
• Records of any medical bills you've paid out of pocket for the injuries
• Health insurance EOBs (Explanation of Benefits) for treatment related to the injuries

4. Retirement Process Status

• Has anyone — you, the Town, the Chief — filed an Accidental Disability Retirement (ADR) application yet? If so, who filed it and when?
• Any correspondence from the Danvers Contributory Retirement Board
• Any notice of a regional medical panel exam
• Any written statement from the Town about timeline or expectations for your retirement

5. Union and Representation

• Your union local number (the CBA refers to the "Danvers Permanent Firefighters Association" — confirm the IAFF local number if there is one)
• Name and contact for your union representative or president
• Whether the union has been involved in your case so far, and what they've said
• Whether the union has filed any grievances on your behalf, or anyone else's, on similar issues
• Any side letters, MOUs, or past-practice documents on IOD or post-retirement medical coverage

6. Service and Employment History

• Date of hire at Danvers Fire Department
• Years of creditable service for retirement purposes
• Rank
• Any prior IOD claims (resolved or open)
• Any disciplinary history (for context — the Town will use anything available)

7. Personal Considerations (for our planning, not for filing)

• Your preferred outcome — full retirement with continued §100 medical coverage? Return to light duty? §101 lump-sum settlement? Combination?
• Financial timeline — how soon do you need clarity on income (this affects strategy)
• Whether you've consulted an attorney yet, and if so, who

8. Authorization

• Confirm in writing (email is fine) that we can communicate about your case with [Mike to designate: union rep, attorney, family member, etc.]

You don't need a perfect file. Send what you have, even if it's incomplete or messy. We'll work with what's available and follow up on gaps.

Important: Do not sign any retirement paperwork, settlement, release, or waiver from the Town without first having a Massachusetts public-sector labor attorney review it. Anything you sign that purports to settle medical claims could be used against you later.

Reminder: This research support is not legal advice. Before any major decision — accepting retirement, signing settlement documents, missing a deadline — you need to be working with a Massachusetts attorney experienced in c. 41 / c. 32 firefighter matters. We'll help you arrive at that conversation as prepared as possible.