stewshe@comcast.net
Senior Member
Posts: 1381
Joined: Jun 2002
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Saturday January 21, 2006 8:33 PM
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All,
I'm roughly half way through my 24th year in W/C claims on the applicant side, and prior to that spent 8 years as a claims adjuster/examiner/supervisor. What follows are some gems which I garnered from various seminars. My hope is that others will add to this list...so we can all benefit.
California Compensation Cases: If you have a "CCC" cite, take the first number in the cite, add 35, and that is the year of the decision....most of the time. A low "second number" could be from the prior year, just as a "high" one could be from the following year, but usually the "add 35" works. Example: Wilkinson 42 CCC 406. Add 35 to the first number, 42, and the result is "77," i.e., 1977.
If you have a California Workers' Compensatio Reporter cite (CWCR), add 72. For example, Wilkinson 5 CWCR 87. Add 72 to the first number and you get "77," just as the prior example.
Hint from Mike Rucka at a CAAA seminar 20+ years ago. I'm putting it in quotes, but the words are mine...my summary of what I came away with from the seminar: "If you represent injured workers, ask them what they want you to accomplish for them. They are your boss. Your job is to get for them what they want to the extent that it is possible, and if it is not, then to explain it to them so they understand."
Easier said than done! Also good for a CA to understand.
A defense attorney at a Christmas party in a doctor's office (Defense mill) MANY years ago got tired of my "ragging" on him about rehab and his client's failings. He grabbed me by my tie and pulled me into an examining room, closed the door and, in my face told me, "Dammit, Stew, I know what I'm doing with rehab....and by the way, who the hell do you think taught you rehab? I did, right!
"You have clients who are sometimes unreasonable...right? Well, so do I!!!
"We each have an obligation to our clients to represent their best interests and try to get for them what they tell us they want. Sometimes what they want us to get for them is simply not possible, but they want it anyway.
Our job is to be advocates for our clients...we present arguments as best we can to try to obtain what our clients want. Often even our best efforts will seem....unreasonable, expecially if our client is being unreasonable and not following our advice!
Bottom line: Don't try to tell me how to do my job!
After several years in the business it finally dawned on me "we," i.e., claims adjusters, legal assistants, attorneys, we are all advocates for a "client," and our own, personal opinions, etc., don't really matter, but rather the interests of the particular client we serve, be it an injured worker, employer, insurance company, or medical provider.
On this entire listserv, perhaps only York represents himself...and does a damned good job from what I see here!
One last tip. If you turn to the Table 2 or 3 in the "Labor Code Book" you can easily calculate the present value of a life pension or Permanent Total Disability claim. The quick way is to look at, e.g., Table 2 for a male, and then, go down the age column on the far left to the age today, e.g., 35.
The number to the immediate right under the "0" colums is "1168.82."
This number, multiplied by the comp rate, is the present value of a life pension or total disability award for a male age 35. It is easy to "adjust" this by taking an average between age 35 and age 36. This is for someone 35 and 1/2 years old.
The complicated procedure in the examples which follow in the tables show a method to calculate present value on a "date of commutation," or DOC usually the date of a WCJ's order, however, for compromise purposes, I frequently will round up or down to give myself an easy calculation and then approximate the value for settlement purposes.
The tables should be used for paying awards....or a software program which gives essentially the same answers.
Life Expectancy? These tables are actually harder to use for quick and dirty estimates and almost always give higher values. Not a problem if you work the applicant's side of the street, but since I revise the tables for the "Labor Code Book" (properly, the "Workers' Compensation Laws of California," by Mathew Bender/LexisNexis) I feel duty bound to discuss the subject fairly.
There's a lot more, I just can't think of it now.
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Stew (James T. Stewart) e-mail: stewshe@comcast.net
Author: Work Comp Index & Tables & Schedules in "The Labor Code Book," by LexisNexis/Matthew Bender.
7th ed. Work Comp Index (912 pgs), $119.00 ea; next ed. summer, 2010 {Discounts for orders of 12 or more}
Send check or money order & shipping info. (I cannot take credit cards.)
Prices INCLUDE sales tax, and shipping.
James T. Stewart; 1937 Santa Ana; Clovis, CA 93611
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