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(� � I -- �, q <br /> 21. Vocational Rehabilitation: In accordance with all applicable California laws in <br /> place at the date of injury, the TPA shall: <br /> A. Determine the Qualified Injured Worker/Non Qualified Injured Worker status; <br /> B. Advise the injured worker of his/her right to rehabilitation benefits; <br /> C. Provide appropriate vocational rehabilitation benefits; <br /> D. Control rehabilitation costs; and <br /> E. Attempt to secure the prompt conclusion of vocational rehabilitation benefits. <br /> 22. Claim Reconciliation: All claim files shall be reconciled to ensure all, indemnity <br /> payments have been made correctly. The reconciliation should verify that payments were <br /> in the correct amount and from the correct claim file. The physical file should be verified <br /> with the computer information. All open claim files shall be reconciled at the time of a <br /> request for settlement authorization and at the time of submission for closure. Proof of <br /> the reconciliation should remain in the claim file. <br /> 23. Excess Insurance: Cases that have the potential to exceed the City's self-insured <br /> retention shall be reported in accordance with the reporting criteria established by the <br /> Local Agency Workers' Compensation Excess Joint Powers Authority (LAWCX) and <br /> any other excess insurance policies. All cases that meet the established reporting criteria <br /> are to be reported within five (5) days of the day on which it is known the criterion is <br /> met. <br /> 24. Award Pavment: Payments on awards, computations, or Compromise and <br /> Release agreements will be issued within ten (10) days, or sooner if necessary to ensure <br /> payment within twenty (20) days of the WCAB approval date, following receipt of the <br /> appropriate document. <br /> 25. Penalties: Late payment of all benefits must include the self-imposed penalty in <br /> accordance with California law. The City will be provided a listing of any administrative <br /> penalties paid during the quarter, which were the responsibility of the TPA, and a check <br /> from the TPA payable to the City for reimbursement. <br /> 26. Case Closure: The supervisor must review all Medical Only claims open beyond <br /> ninety (90) days from the date of entry by the TPA, for potential closure or conversion to <br /> Indemnity claim status. Claims with $3,000 (three thousand dollars) or more paid to date <br /> and any claim open beyond one hundred eighty days from date of entry must be <br /> converted to Indemnity status and a reasonable, precautionary indemnity reserve placed <br /> on the claim(s). All indemnity cases where permanent disability is not an issue will be <br /> closed within sixty (60) days of the final financial transaction or final correspondence to <br /> the injured worker as required by law. All indemnity claims where permanent disability <br /> is an issue will remain open for two (2) years from the last payment of benefit and then <br /> closed within sixty (60) days of that date. The TPA will monitor stipulated cases with <br /> future medical provisions. Reserves for future medical will be reviewed semi-annually <br /> and adjusted according to use. <br /> City of Redwood City - Perfmmance Standards Page 6 of 8 July 1, 2004 <br />