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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