Frequently Asked Questions – Page Five of Six

Workers Compensation Frequently Asked Questions – Page Five of Six

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What happens at a Workers’ Compensation Mandatory Settlement Conference?

A mandatory settlement conference is an event that traditionally takes place with the workers’ compensation judge. It is a conference in which the injured employee, insurance adjuster, and attorneys are required to attend, or in some cases be available by telephone. At the conference, the judge requires the attorneys to review the facts and laws with each other and their respective clients. The court encourages the parties to discuss the matter in detail and hopefully come to a resolution. Attendance at the settlement conference is generally mandatory. Resolution at the settlement conference is completely voluntary.

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What does Maximum Medical Improvement (MMI) mean?

MMI means your condition has reached a plateau and/or stabilized. There may be some minor improvement or deterioration expected in the future, but generally speaking, your condition has reached a phase where major changes are not expected. This is a critical juncture in your case as, once you have reached Maximum Medical Improvement, a doctor can assess how much impairment and/or disability you have and hopefully have your disability rated, and your case resolved. Settling a workers’ compensation case before you have reached MMI is futile and typically a bad idea absent extenuating circumstances.’-perception

What is a mediation conference?

A mediation conference is much like a mandatory settlement conference. The major distinction is that the mediation conference is voluntarily attended by all parties and usually only involves an injured employee who does not have an attorney. It is traditionally held before an Information and Assistance Officer.

What is a Med-Legal or Medical Legal Report?

Disputed medical treatment and/or diagnosis issues often arise. A Med-Legal or Medical Legal Report is a written report by a doctor that describes your condition in a way that can help clarify the legal disputes for the injured employee, attorneys, adjusters, and the workers’ compensation judge.

What is a Medical Treatment Utilization Schedule (MTUS)?

Conventional and alternative medicines are not always in agreement. Because of the complexities of the workers’ compensation system, the law only requires insurance companies to provide evidence-based medical treatment. Stated differently, they only have to provide treatment that has been proven by science to cure or relieve injuries. Consequently, some alternative medicines are not approved, and some experimental or cutting edge treatments can also be denied. The Medical Treatment Utilization Schedule (MTUS) is a set of written guidelines that details what types of treatments insurance has to pay.

What is the Workers’ Compensation Medical Unit?

The Medical Unit used to be referred to as the Industrial Medical Council. It is a unit within the Department of Workers’ Compensation that provides oversight and acts as the watchdog for matters including medial provider networks, health care organizations, qualified medical evaluators, and utilization review.

What does it mean to have Modified Work?

Modified work means your doctor has determined you are able to return to your prior job, but you need some job changes to be able to perform your duty. Employers are encouraged to find modified work for employees, and if they cannot, you may be entitled to vocational rehabilitation and/or job placement benefits.

What is a Non-transferable voucher?

If you are unable to return to your prior job, you may be entitled to a non-transferable voucher. It is a document you use to provide payment for education under the supplemental job displacement benefit program.

What is the difference between Objective and Subjective Factors for Workers’ Compensation Benefits?

Subjective factors are your personal descriptors of your injuries and/or condition (e.g. rating pain on a scale of 1-10).

Objective factors are scientific test results, measurements, and direct observations made by the examiner – either the treating doctor or an Agreed or Qualified Medical Examiner.

What does it meant to take a matter OTOC?

If you had previously filed a petition or notice before the WCAB and that matter is removed from calendar, it is often referred to as “Off Calendar”, or “OTOC”.

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