Preparing for a Formal Conference

Sunday, August 18, 2002 | 0

When an applicant attorney files an RU-103 requesting dispute resolution by the Unit, many claims examiners assume the attorney submitted copies of all documents relevant to the dispute. While they should do so, many attorneys file only those documents supporting their position; the obligation to insure the Unit has all relevant documents lies with the defendant.

The examiner should therefore file with the Unit copies of all pertinent medical reports, job descriptions or analyses, notice letters, vocational reports, and correspondence related to the pending dispute(s). Service of these items help insure a thorough review of the defense position by the Unit Consultant.

It is also a defense responsibility to insure an interpreter is present for the conference where the employee is not fluent in English. It is usually possible to find an interpreter at the Board who can be pressed into service on short notice, but at two recent conferences, we were unable to find a certified interpreter. In one case, we were able to find a non-certified person to serve as the (agreed) interpreter. In the other, there were no interpreters available so it was necessary to re-schedule the conference for a later date. With the expected "down-sizing" of the Unit, re-scheduling a conference may require a six-month delay, while benefits accrue and/or are being paid, so insuring the availability of an interpreter represents a significant cost savings for the defense.

Finally, many disputes can be resolved prior to (sometimes at) the formal conference if the parties are willing to negotiate. Upon receiving the RU-103 and/or the conference notice, the examiner should consider the strength of the applicant attorney's case; the examiner may be correct in his/her belief that the injured employee isn't entitled to the benefit or service requested but the issue is what can be proven at conference.

Keep in mind that the "benefit of the doubt" will always go to the employee; unless the defense position is a sure "winner," it usually will be financially advantageous for the insurer/employer to negotiate a resolution to the dispute. We must also keep in mind that the Unit's "down-sizing" means it may soon take six months to get to a formal conference and an additional three months to receive the Decision & Order. A negotiated resolution may be substantially cheaper than the 6-9 months of retro VRMA (at the TD rate) at risk.

Contributed by Allan Leno, Leno & Associates, (818) 370-8859. E-mail: allanleno@leno-assoc.com.