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<br />--- ---- <br /> <br />5. <br /> <br />Employee Cont3ct. In all non-litigated, lost time cases, where the employee has not returned to <br />work, telephone or personal contact will be established with the injured employee within two (2) <br />working days of receipt of notice of claim. Such contact will continue as often as necessary, but at <br />least monthly until the employee returns to work. Such contact with the employee shall be <br />documented in the computer notepad. <br /> <br />Return phone calls to employees will be accomplished within one (1) working day. <br /> <br />All correspondence from employees will be responded to within five (5) days of receipt. <br /> <br />6. <br /> <br />Reserves' Reserves shall be established based upon the ultimate probable cost of each claim. <br />All reserve categories shall be reviewed on a regular basis but at least every ninety (90) days. <br />Such review shall be indicated in the computer notepad. The examiner shall utilize a reserve <br />worksheet, which has been approved by the Local Agency Workers' Compensation Excess Joint <br />Powers Authority (LA WCX) pursuant to that JPA's Resolution Establishing a Claims <br />Management Policy. Any changes to reserves shall include an explanation for the change. <br /> <br />A claims assistant shall have authority to establish reserves not to exceed $3,000. An examiner <br />shall have authority to establish reserves not to exceed $50,000. A senior examiner shall have <br />authority to establish reserves not to exceed $75,000. The supervisor shall have authority to <br />establish reserves not to exceed $150,000. A director, vice president, or president of the TP A <br />shall review and approve all reserves in excess of $150,000. <br /> <br />7. <br /> <br />Medic31 AdministrMion' The TPA shall select a panel of general practitioners, specialists, <br />hospitals, and emergency treatment facilities to which injured employees should be referred, as <br />approved by the City, and the TP A shall regularly review and update the panel. <br /> <br />The physician's office will be contacted within five (5) days of notice of all indemnity claims. <br />Such contact will continue as needed during the continuation of temporary disability to assure <br />that treatment is related to a compensable injury or illness. <br /> <br />The TP A shall maintain contact with treating physicians to ensure employees receive proper <br />medical treatment and are returned to full or modified employment at the earliest possible date. <br /> <br />The TP A shall maintain direct contact with medical service providers to ensure their reports are <br />received in a timely manner. <br /> <br />The TP A shall arrange medical evaluations when needed, reasonable, and/or requested in <br />compliance with the current Labor Code. <br /> <br />The TP A shall ensure that medical bills are reduced to the recommended rates established by the <br />Administrative Director of Workers' Compensation. The use of a service contractor is <br />acceptable provided the City's approval is first obtained. The City shall pay for the use and <br />benefits of the services provided. <br /> <br />City of Redwood City Performance Standards <br /> <br />Page 2 of7 <br /> <br />April 28, 2006 <br />