Agmt04 Claims Management Inc - Laserfiche WebLink

Browse Search

15. Return to Work: The TP A shall provide assistance to the member cities in returning injured employees to modified duty while recovering and prior to their return to regular duties. The TP A shall consult frequently with the member city in those cases where the injury residuals might involve permanent work restrictions and/or retirement potential. 16. Transportation Expense: Transportation reimbursement will be mailed within five (5) days of the receipt of the claim for reimbursement. Advance travel expense payments will be mailed to the injured employee ten (10) days prior to the anticipated date of travel. 17. Permanent Disability: The TP A shall explain and assist injured employees in completing the necessary forms to obtain a permanent disability rating. The TP A shall determine the nature and extent of permanent disability and arrange for an informal disability rating whenever possible to avoid Workers' Compensation Appeals Board litigation. All permanent disability benefit notices shall be sent to the employee as required by the Labor Code. 18. Litigated Cases: The TP A shall promptly initiate investigation of issues identified as material to potential litigation. The member city shall be alerted to the need for an outside investigation as soon as possible and the examiner shall appoint an investigator who is acceptable to the member city. The member city shall be kept informed on the scope and results of all investigations. When defense counsel is not necessary, the TPA shall work closely with the applicant's attorney in informal disposition of litigated cases. The member city shall be alerted to the need for an outside counsel as soon as possible and the examiner shall appoint an attorney who is acceptable to the member city. Settlement proposals directed to the member city shall be forwarded by the TP A or defense counsel in a concise and clear written form with a reason(s) for such recommendation. All preparation for a trial shall involve the member city so that all material evidence and witnesses are utilized to obtain a favorable result for the defense. The supervisor or the examiner shall attend Workers' Compensation Appeals Board hearings, rehabilitation hearings, meetings with defense counsel, and meetings with member cities' staff, departments, and employee groups as necessary and as requested to do so. 19. Settlements: The TPA shall obtain the member city's written authorization on all settlement or stipulations within the member city's retained limit. Settlement authority above the member city's retained limit must be requested from the AUTHORITY's Workers' Compensation Program Manager. All requests for settlement authority shall include a written claim summary, current financial information, estimate of permanent disability, and the defense counsel's comments and recommendations, if any. BCJPIA PWCP Performance Standards Page 4 of 7 February 11, 2004 -.----