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FAMILY FEUD FAMILY FEUD FAMILY FEUD FAMILY FEUD FAMILY FEU

FAMILY FEUD FAMILY FEUD FAMILY FEUD FAMILY FEUD FAMILY FE

35

28

20

12

5Training with StateCertified providers

A computer up to$1,000

VR counselor services

$500 for expense

Total cost no moreThan $6,000

Cheer SilenceLoseWin Boo

Round 1

20

11

11

9

Slip and fall

Lifting

Continuous trauma

Contact with

Cheer SilenceLoseWin Boo

Round 2

28

20

10

9

Slip and fall

Continuous Trauma

Lifting

Overexertion

Cheer SilenceLoseWin Boo

Round 3

28

20

10

9

DOI on or after 1/1/13

Job offer not timely forDOI 2004-2012

Timely modified dutyOffered for DOI

2004-2012

No PD and returns toRegular work

Cheer SilenceLoseWin Boo

Round 4

31

25

18

14

9

3

Fixed known cost

Cannot reopen for newAnd further disability

No future medicalbenefits

Can structure to Reduce costs

Avoid trial

All parties agree

Cheer SilenceLoseWin Boo

Round 5

60

33

32

10

7Reduce most UR reviewIn the first 30 days

Suspends medicalProvider convicted

Of fraudStays liens of providers

Charged with WC, Medicare,Medi-Cal fraud

Prohibits assigning liensTo 3rd parties

Unless provider out of business

New lien filingrequirements

Cheer SilenceLoseWin Boo

Round 6

31

25

18

14

9

3

Hospitalization

Surgery

Psych treatment

Home health care

Imaging and radiology

DME>$250

Cheer SilenceLoseWin Boo

Round 7

65

33

25

Minor child

Financial dependent

State of California

Cheer SilenceLoseWin Boo

Round 8

28

20

10

9

Optum RX

Quovant Legal Bill

Genex

JD Wesson

Cheer SilenceLoseWin Boo

Round 9

28

20

10

9

Preauthorization of medsFor surgery

Exempt drugs do not needpreauthorization

Non-exempt drugs do Require preauthorization

Brand name drugsRequire preauthorization

Cheer SilenceLoseWin Boo

Round 10

52

47

45

Within 30 days of theDecision thru IMR

Within 30 days of theDecision thru physician

Within 30 days of theDecision thru attorney

Cheer SilenceLoseWin Boo

Round 11

60

33

32

10

7Stipulated Award

Findings and Award

Compromise & Release

Compromise & ReleaseWith FM

Findings & AwardTake Nothing

Cheer SilenceLoseWin Boo

Round 12

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