W.C. - Overview

4/22/02

D.O.I.   Specific Injury                     Permanent & Stationary

            *________________ T.D. * ____________ P.D.

               Cumulative Trauma

            *________________

               medical treatment 

D.W.C.-1 (Claim Form)       - Filed within 30 days

            Application                            - Filed within 1 year of D.O.I. S.O.L.

                                                            - Filed within 5 years of receiving last medical treatment

                        Answer                                  - Filed within 6 days of receipt of Application

This process can take one year or many years. The average Workers’ Compensation case takes about two (2) years.

“Most people just want the medical treatment.”

                                    D.O.R. - Declaration of Readiness - Usually filed when one side or the other has a Permanent & Stationary medical report and wants the level of permanent disability assessed

                                                                                    - Usually get a hearing date set within the next 3-4 weeks

                                                M.S.C. - Mandatory Settlement Conference - “A conference in which we hope the parties settle.”

                                                                                                - Discovery closes, though the parties can agree to leave discovery open

                                                                                                - Must have a trial date set within 75 days of the D.O.R.

                                                            Trial                           - Judge has 60-90 days to render an

opinion

“Parties can make a settlement, even when it (the case) has gone up on appeal.”

“The judge has to rely on the participation of the parties, and vis-a-versa.”

                                                            Decision                     - Finding & Award - preferred

                                                                                                - Finding & Order - usually means that something more is needed

                                                            Appeal                       - Petition for Reconsideration - filed

within 20 days of judge’s decision at the Board where the decision was rendered ~> all goes with any further comment from the judge to San Francisco

Rating - informal

            - consultative (objectionable & appealable)

            - formal (rating after trial, usually rating of the judge’s language used to interpret the medical reports)

Employer and employee have five (5) years from Finding & Award to reopen for “new & further disability,” as well as lessened disability.

“Pain is an indication of a work restriction.”

“Disability monies are not taxed.”

Constant = 100% of the time

Frequent = 75% of the time

Intermittent = 50% of the time

Occasional = 25% of the time

add the objective and subjective factors = disability

“We are looking to see the consistency between the Applicant’s subjective complaints and the doctor’s objective findings.”

Compare the work restrictions to objective and subjective factors & take the rating of whichever is higher.

“You only rate Permanent & Stationary reports.”

If unclear, you can ask the doctor to clarify work restrictions or subjective factors.

100-500 ~> the higher the number, the more physically demanding the occupation

“If they are a working supervisor, they get the job code for the work they are supervising.”

A letter code of “F” (the occupational code), does not effect the standard rating.