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<br /> 20. Subrogation: In all cases where a third party is responsible for the injury to the employee, the TP A <br /> shall contact the member city indicating they will pursue subrogation unless instructed otherwise by <br /> the member city. When subrogation is to be pursued, the third party shall be contacted within ten <br /> (10) days of identification, with notification of the member city's right to subrogation and the <br /> recovery of certain claim expenses. If the third party is a governmental entity, a claim shall be filed <br /> with the governing board within six (6) months of the injury or notice of injury. <br /> Periodic contact shall be made with the responsible party and/or insurer to provide notification of <br /> the amount of the estimated recovery to which the member city will be entitled. <br /> Ifthe injured worker brings a civil action against the party responsible for the injury, the TPA <br /> shall consult with the member city about the value of the subrogation claim and other <br /> considerations. Upon the member city's authorization, subrogation counsel shall be assigned to <br /> file a Lien or a Complaint in Intervention in the civil action. <br /> Whenever practical, the TP A should take advantage of any settlement in a civil action by <br /> attempting to settle the workers' compensation claim by means of a Third Party Compromise and <br /> Release. If such attempt does not succeed, then every effort should be made through the WCAB <br /> to offset claim expenses through a credit against the proceeds from the injured worker's civil <br /> action. <br /> 21. Vocational Rehabilitation: In accordance with all applicable California laws in place at the date of <br /> injury, the TPA shall: <br /> A. Determine the Qualified Injured WorkerlNon 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 payments have <br /> been made correctly. The reconciliation should verify that payments were in the correct amount <br /> and from the correct claim file. The physical file should be verified with the computer <br /> information. All open claim files shall be reconciled at the time of a request for settlement <br /> authorization and at the time of submission for closure. Proof of the reconciliation should <br /> remain in the claim file. <br /> 23. Excess Insurance: Cases that have the potential to exceed the AUTHORITY's self-insured <br /> retention shall be reported in accordance with the reporting criteria established by the Local Agency <br /> Workers' Compensation Excess Joint Powers Authority (LA WCX) and any other excess insurance <br /> policies. All cases that meet the established reporting criteria are to be reported within five (5) days <br /> of the day on which it is known the criterion is met. <br /> 24. A ward Payment: Payments on awards, computations, or Compromise and Release agreements will <br /> be issued within ten (10) days, or sooner if necessary to ensure payment within twenty (20) days of <br /> the WCAB approval date, following receipt of the appropriate document. <br /> BCJPIA pWCP Performance Standards Page 5 of 7 February 11, 2004 <br />