Pacific Post March 2020
Is the Wait on Your Claim Keeping You Up at Night?
When clients come to us, they’re passionate about their claim and getting what they deserve because of the injustices done to them. But as we open a case, we often get a very common question: “How long will my case take?” Depending on the situation, a case can take 1–3 years. Unfortunately, regardless of how fast we work, there will always be obstacles we have to overcome to win your case. But there are some ways to make the journey more bearable so you can focus on your well-being. Utilization Review If you’re unfamiliar, a utilization review (UR) is the process used to review the treatment a doctor has requested for the injured worker. This process determines whether or not to approve medical treatment recommended from a physician, which must be based on the medical treatment guidelines. Every workers’ compensation case in the state of California is required to go through this process. After you see your doctor, they send your medical documents and treatment recommendation to the insurance company for approval. Every treatment, however, needs to adhere to California’s medical treatment guidelines. The UR process, though, is governed by Labor Code Section 4610 and regulations written by the California Division of Workers’ Compensation (DWC). The DWC outlines the time frame for URs and other rules for the process.
appeal the decision. If your claim is denied, you will receive an “adverse determination” letter. This will come no later than three days after the review, and it will include the specific reasons for the denial. How to Handle theWaiting Game It’s important to remember that your health is worth more than any settlement. Continuing treatment and making sure you get the best possible care is crucial to your case. Don’t give the insurance companies any reason to deny treatment — go to every doctor appointment, keep track of any money you spend out of pocket, and see any QME/AME that needs to evaluate you. Your mental health is essential to your well-being too, so set aside time to relax and decompress at the end of every day. If you’re still feeling uneasy, reach out to loved ones. Express how you’re feeling because venting about your stress can actually help will always be obstacles we have to overcome to win your case. But there are some ways to make the journey more bearable so you can focus on your well-being.” “Unfortunately, regardless of how fast we work, there
reduce the tension. Your loved ones may have strategies for dealing with any anxiety as well.
Waiting is also less frustrating when you set realistic expectations on the timeline of your case. If the insurance company tries to settle quickly, chances are their offer is less than what you need. The right settlement takes time, and you need patience as we fight for what you deserve. Remember there is an end in sight. You will be fairly compensated, and you will be able to move forward. Stick with the process, never give up, and know you’ll get there eventually.
– The Lawyers For Injured Workers
If an insurance company denies your treatment due to the UR, you can always
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‘Dare to Lead’ Dar What Makes an
March 5 was World Book Day, and while the big day has passed, we want to share a book that has been circulating the office: “Dare to Lead” by Brené Brown, Ph.D. This book has given everyone in the office a fresh perspective on what it means to be a great leader. There is something in this book for everyone, whether you’re a leader in your family, work environment, or friend group! In her previous works, Brown has taught us what it means to challenge the things that get in the way of our dreams. Now, after seven years of research, she has determined the effective, actionable strategies you can execute to lead your team to success. To accomplish this, she conducted interviews with different leaders in a variety of businesses, including small startups and family- owned businesses to nonprofits, civic organizations, and Fortune 500 companies. She asked these leaders what they do differently to lead in the modern era. What she found was that they were ready to be vulnerable when the situation called for it and listened without interrupting. Modern leaders were also self-aware of their flaws and vices.
Staying Stateside for St. Paddy’s?
Celebrate With These Little-Known Festivities
There’s no place quite like Ireland on St. Patrick’s Day. What was once a purely religious holiday to honor the legend of St. Patrick chasing all the snakes out of the country has turned into a global celebration. But if a trip to Ireland isn’t in the budget, check out these three little- known stateside destinations that are just as festive. Short and Sweet in Arkansas Thanks to the clever thinking of some Irish friends meeting for a pint at a bar on one of the shortest streets in the world, Bridge Street in Hot Springs, Arkansas, the First Ever 17th Annual World’s Shortest St. Patrick’s Day Parade will travel 98 feet once again this year. Don’t assume the turnout isn’t robust just because the distance is staggeringly low. The parade lasts for hours, drawing thousands of people to watch celebrities, musicians, bands, floats, and Miss Arkansas glide by. The event also features a Blarney stone kissing contest and a parade king and queen. A Little Luck in America’s Heartland O’Neill, Nebraska, is home to the world’s largest shamrock and more unique St. Patrick’s Day traditions. This Irish community doubles down on its heritage every March with a traditional parade, music, and Irish dancing. But the town also hosts a popular dodgeball tournament and donkey basketball. What could be better than pummeling your opponents in dodgeball and outpacing the competition while riding a donkey in the school gymnasium? Perhaps enjoying a pint or two with your teammates afterward. And O’Neill is just the spot to do it. Ohio’s Little Piece of Ireland You may not be able to fly to Ireland, but you can visit a little piece of it right in the U.S. Head to Dublin, Ohio, this St. Patrick’s Day for a traditional celebration sure to put a wee bit o’ pep in your step. Partake in a traditional Irish breakfast or enjoy a parade complete with bagpipers and Irish dancers. Boasting one of the largest celebrations in the U.S., Dublin is an affordable alternative for those looking to celebrate the Irish way.
But there was one underlying characteristic in great leaders that Brown emphasizes: courage. She writes, “The courage to be
Pesto Chicken Wit Inspired by CookingLight.com Brighten up after a cold, dark winter with this fresh and flavorful springtime dish.
2 tbsp Parmesan cheese 1 tbsp unsalted butter, melted 6 tbsp spinach pesto 2 cups cherry tomatoes 1 garlic clove, thinly sliced 1 tsp red wine vinegar
2 1/2 tbsp olive oil, divided 4 boneless and skinless chicken breasts, pounded to a 1-inch thickness Salt and pepper to taste
• • • •
1/4 cup whole- wheat panko
Directions 1. In a large ovenproof skillet over medium-high heat, add 1 tbsp olive oil. 2. Season chicken with salt and pepper, and add it to pan. Cook chicken for 5 minutes on each side, then remove pan from heat. 3. In a bowl, combine panko, Parmesan cheese, and butter. 4. Spread pesto over chicken and top with panko mixture. 5. Broil chicken for 2 minutes on high heat until browned. 6. In a skillet, heat remaining oil over medium-high heat. 7. Add tomatoes and cook for 6 minutes. 8. Add garlic and cook for 30 seconds, stirring constantly. 9. Season tomato mixture with salt and pepper, and add red wine vinegar. 10. 1Serve tomatoes with broiled chicken. 11.
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s Us to Find Out ffective Leader?
Stipulations Causing You to Worry? KnowYour Settlement As we near the end of your case, it can be easy to get excited about the benefits you will receive. However, if you don’t understand the type of compensation you are receiving, it could complicate your recovery process. There are two distinct forms of workers’ compensation: stipulations (stips) and compromise and release (C&R). Here is a brief description of both and how to properly utilize them. Stipulations With this type of compensation, an injured worker gets some money and retains the right to seek future medical treatment for the parts of their body injured in the accident in question. When an injured worker settles their claim with stips, they get paid for the amount of permanent disability, but nothing more. Stips are usually paid at a rate of $290 per week or less depending on their pay prior to the accident. The amount of permanent disability the injured party is awarded is based on the type of permanent disability their physician feels they have. However, they will always receive free treatment for the parts of their body that were injured. Their treatment will still fall under workers’ comp, so the insurance company will continue to pay. However, it’s important to note that those treatments are still subject to approval by the insurance company, similar to how the treatment is handled prior to settlement. Compromise and Release With this type of compensation, the injured worker gets more money than with stipulations but doesn’t receive free treatment from the insurance company. A C&R pays the same amount of permanent disability but also adds more money for an estimate of how much it will cost for the future care of the injured parts of the body. This type of settlement effectively ends the injured worker’s right to any further free medical treatment
vulnerable is not about winning or losing; it’s about the courage to show up when you can’t predict or control the outcome.”
If you’re interested in learning more, be sure to check your local bookstore or find it on Amazon! Are you an avid reader? If so, what’s your favorite book, fiction or nonfiction? Let us know next time you’re in the office! We’re always looking for the next fun book to share around the firm.
for the injury sustained on the job. A C&R is paid in one lump sum rather than the $290 per week with stips. Unfortunately, in over 90% of C&R settlements, the insurance company will require the injured worker to resign from their position. This isn’t a punishment or penalty but rather a protection against fraud that was common before the resignation was required in C&Rs, and it is standard within almost every industry.
Navigating the various types of settlements can be challenging. If you have any questions or concerns regarding your case, never hesitate to reach out. Give us a call at 510-240-8710 so we can fight for you.
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Inside This Issue
Why Is My Case Taking So Long?
Stay Stateside With These Little-Known St. Patrick’s Day Celebrations
Modern Leadership Skills for the Modern Leader
Pesto Chicken With Blistered Tomatoes
Know Your Settlement
Boxing’s Greatest Battle
The Fight of the Century How a Battle of Boxers Captivated the World
On March 8, 1971, all eyes were on the world of boxing as people watched what
and Madison Square Garden sold out to a crowd of 20,455 spectators. The fighters possessed polar opposite tactics, backgrounds, and social impacts, but when
would become known as “The Fight of the Century.” It was one of the most anticipated matchups the sport had ever arranged: Current heavyweight champion Joe Frazier and former heavyweight champion Muhammad Ali were finally facing off, the first time two undefeated boxers would fight each other for the heavyweight title. Spectators were hungry for a battle. Both fighters held rightful claims to the title of world heavyweight champion. Ali won it in 1964 and successfully defended it for several years, but he was stripped of the
it came to skill, they were evenly matched. The fight captivated the nation. As Sports Illustrated put it at the time, “The thrust of this fight on the public consciousness is incalculable. It has been a ceaseless whir that seems to have grown in decibel with each new soliloquy by Ali, with each dead calm promise by Frazier.”
The fight exceeded all expectations with a fully engrossing 15 rounds. For the first
quarter of the match, it seemed Ali would best his opponent, but Frazier came back with fury. Even though Ali continued to rise to his feet round after round, Frazier emerged victorious by the slimmest of margins, dealing Ali his first professional loss ever.
title during a legal battle over his induction into the U.S. armed forces. In his absence from the sport, Frazier earned two championship belts through major knockout fights. But when Ali settled his court case and came to reclaim his title, Frazier wasn’t ready to give it up easily.
The landmark event highlighted an unforgettable night of skillful prowess like the world had never seen. Even though the title fight was only the beginning of the rivalry between the two boxers, the matchup rightfully took its place as one of the greatest fights in the history of the sport.
Ringside seats for the fight sold for today’s equivalent of over $1,000. Millions watched the broadcast in over 50 countries around the world,
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