A workers’ compensation case

One chain to a page, in the sequence a file actually moves: intake, the carrier’s answer, treatment, the medical-legal dispute, the Board case, resolution — then the five that recur throughout and belong to no point in it. Each page carries what happened, the clock it starts, who does what by when, the file note to record it, and every template in the library that serves it. Each page carries what happened, the clock it starts, who does what by when, the file note to record it, and every template in the library that serves it. 34 chains, printed 8.5×11 portrait. 2 run onto a second sheet — The case opens and The carrier answers the claim — and say so at the foot, so 36 sheets in all.

In the order a case runs

ChainDocClockPosture
1 The case opens APP-ADJ — Routine
2 The carrier answers the claim BENEFITS 75 days They moved
3 A letter arrives from the other side CORR — They moved
4 The treating doctor decides something PR2 20 days They moved
5 Treatment is refused UR-DENIAL 10 days They moved
6 The carrier defers the review UR-DENIAL — They moved
7 A panel is assigned QME 10 days They moved
8 No appointment can be had QME 90 days We moved
9 Records go to the evaluator MEDREC 20 days BEFORE Either side
10 The evaluator reports PQME 30 days They moved
11 The case opens at the Board APP-ADJ 1 year Fatal if late
12 Written discovery arrives DISCOVERY — They moved
13 A deposition is noticed DEPO-NOTICE not before 10 days They moved
14 Records are subpoenaed SDT not before 20 days We moved
15 Medical records come in MEDREC 20 days They moved
16 Work is offered BENEFITS — They moved
17 The case is set for hearing DOR — Either side
18 The case ends CR — We moved
19 The judge wants more before approving ORDER — They moved
20 The Board decides ORDER 20 days They moved
21 Is it final, or interlocutory? ORDER — They moved
22 Money moves BENEFITS — Routine
23 The fee is decided PET — We moved
24 A provider claims against the case LIEN 18 months They moved
25 The injury gets worse PET 5 years Fatal if late
26 A petition for serious and willful misconduct PET 1 year Fatal if late
27 The prior disability is at issue SIBTF — We moved
28 The injured worker dies APP-ADJ 1 year Fatal if late
29 The case closes and the file does not CORR — Routine
30 The client is kept told CORR — Routine
31 Something is served POS — Routine
32 Representation changes CORR — Routine
33 The Board sends paper NOH — Routine
34 Stationery and firm records AUTH — Routine

Or if something has just arrived

Find what is in your hand. The badge is how long you have; the chain is the page that says what to do. Shortest first.

DocumentTabTimeGo to
DEPO-NOTICEdeposition notice / transcript 12 10 days A deposition is noticed
DEPO-TXdeposition notice / transcript 12 10 days A deposition is noticed
QMEQME / panel QME report — PQME when the evaluator came from a panel, QME otherwise; also the panel, strike and appointment paper (Descriptor says which) 7/6 10 days A panel is assigned
UR-DENIALutilization review decision. Deferral and delay are filed as UR-DENIAL with Descriptor Deferral / Delay until the vocabulary gains their own codes (see gaps below). When several match, the most adverse wins: denial over modification over approval. 8 10 days Treatment is refused
UR-MODutilization review decision. Deferral and delay are filed as UR-DENIAL with Descriptor Deferral / Delay until the vocabulary gains their own codes (see gaps below). When several match, the most adverse wins: denial over modification over approval. 8 10 days Treatment is refused
MEDRECmedical records, imaging, operative reports, records returned on subpoena 5/13 20 days BEFORE Records go to the evaluator
OACRproposed order / award 14 20 days The Board decides
ORDERan order of the Board (approving, to show cause, dismissal, findings & award, the judge's Report & Recommendation — Board-issued paper on reconsideration) 2/14 20 days The Board decides
PR2treating physician progress / permanent & stationary reports 5/7 20 days The treating doctor decides something
SDTsubpoena duces tecum / subpoena 13 20 days Records are subpoenaed
SUBPOENAsubpoena duces tecum / subpoena 13 20 days Records are subpoenaed
AMEagreed medical evaluator report; AME agreement and appointment paper 7/6 30 days The evaluator reports
PQMEQME / panel QME report — PQME when the evaluator came from a panel, QME otherwise; also the panel, strike and appointment paper (Descriptor says which) 7/6 30 days The evaluator reports
BENEFITSbenefit notice (claim accepted/denied/delayed; TD/PD notices; offer of work; SJDB) 1/10/11 75 days The carrier answers the claim
APP-ADJapplication for adjudication (and amended) 2 1 year The case opens at the Board
LIENlien claim 15 18 months A provider claims against the case
PETpetition (reconsideration, reopen, removal, penalties…) — the exact petition in the Descriptor 2 5 years The injury gets worse
132ALabor Code §132a petition 2 — Is it final, or interlocutory?
ANSWERanswer to the application 2 — The case opens at the Board
AUTHHIPAA : the client's blanket release and representative designation signed at intake → cover. AUTH : an authorization executed for one specific records request → 13 13/cover — Stationery and firm records
CORRcorrespondence — a letter, or a document that has no code of its own yet (the gaps note) 4/2/6/7/11/12/13/14/15/cover — The client is kept told
CRcompromise and release 14 on its own date The case ends
DFRdoctor's first report 5 — The treating doctor decides something
DISCOVERYwritten discovery — interrogatories, requests for admission, requests for production served by a party 12 — Written discovery arrives
DORdeclaration of readiness to proceed (regular or expedited) 3 on its own date The case is set for hearing
HIPAAHIPAA : the client's blanket release and representative designation signed at intake → cover. AUTH : an authorization executed for one specific records request → 13 13/cover — Stationery and firm records
IMR-APPthe completed application — the firm's appeal packet (the blank served form stays with the UR decision at Tab 8 and takes no code) 9 — Treatment is refused
IMR-DETnotice of assignment / request for information / determination 9 on its own date The carrier defers the review
IMR-NOAnotice of assignment / request for information / determination 9 — The carrier defers the review
IMR-RFInotice of assignment / request for information / determination 9 — The carrier defers the review
MOHminutes of hearing 3 — The case is set for hearing
MSCpaper specific to a mandatory settlement conference that is neither the notice ( NOH ), the minutes ( MOH ) nor the statement ( PTCS ): a continuance request, an MSC-day settlement worksheet (an MSC order is ORDER , Tab 2) 3 — The case is set for hearing
NOHnotice of hearing (MSC, trial, expedited, lien conference) 3/15 — The Board sends paper
POSproof of service 3/6 — Something is served
PR3treating physician progress / permanent & stationary reports 5/7 — The treating doctor decides something
PR4treating physician progress / permanent & stationary reports 5/7 — The treating doctor decides something
PTCSpre-trial conference statement 3 — The case is set for hearing
RFArequest for authorization 5 — Treatment is refused
SIBTFSubsequent Injuries Benefits Trust Fund application 2 — The prior disability is at issue
STIPstipulations with request for award 14 — The case ends
UR-APPROVALutilization review decision. Deferral and delay are filed as UR-DENIAL with Descriptor Deferral / Delay until the vocabulary gains their own codes (see gaps below). When several match, the most adverse wins: denial over modification over approval. 8 — Treatment is refused

Or by posture — whose clock it is

Fatal if late 4

our filing, on a clock nobody chose — miss it and the claim is barred

We moved 5

the attorney picks the date; late here is a decision, not an accident

Either side 2

the same exchange whichever side began it, and both are on a clock

A case runs on several tracks at once

The claimFrom sign-up until the carrier answers.4 chains
TreatmentFrom the first report until the case resolves. It does not pause because a case has been filed — a PTP goes on writing while the Board litigates.4 chains
Medical-legalOpens when a party objects to a medical fact and closes on the report. Runs inside the litigation track, not after it.4 chains
LitigationFrom the Application to the order.11 chains
Resolution and moneySettlement, the award, the fee, the payment and the liens. Outlives the rest.5 chains
The fileThroughout, on every track: correspondence, service, representation, the Board's own paper.6 chains

True of every chain

A piece goes behind exactly one tab.A document that belongs to two — a settlement cheque — is filed once, under the tab where it is acted on, with a note naming the other.
The same letter twice is filed once.By mail and by fax, or a re-scan. The second is a note on the first. It never starts a second clock.
Nobody guesses which case it belongs to.No case found, or two cases fit → the pocket. Attaching a document to the wrong client is worse than leaving it unfiled.
A disagreement with the file is written down, never silently resolved.Where the letter and the file differ on body part, date of injury, claimant name or employer, it is filed WITH the disagreement recorded as a finding. Never quietly prefer one.
Every clock names the date it starts from.Letter date, mailing date, service date and receipt date are different dates, and the law picks one per clock. A clip that does not say which is not a clip.
A missing date is never a reason to withhold a filing.It is a reason to clip an item and put the question to a person.
Roles, not names.Attorney, case manager, paralegal, bookkeeping are roles. No staff name appears in a filename.
Nothing is written to a case without a proof.A filing is done when the document is on the case under its name, the note is there, and the clipped item exists. A step that fails leaves the piece where it stopped.
1 The case opens Routine The claim

no statutory clock; it supplies the dates the other clocks run from

The pathThe clockTasksThe paper

What happens

A client signs up

APP-ADJ · filed behind tab 2

Where it goes next

The carrier answers the claimthe claim form goes to the carrier

A letter arrives from the other sidethe other side begins writing to the firm

Why it is on the map

The authorisation and designation are the two that stop later work if missed — both go in every IMR packet, months later.

Tasks 17 · due from the day the questionnaire is received

  1. Open the matter and enter the clientCase managerSame day

    Create the contact — name, DOB, SSN, address, phone, email, preferred language; flag if an interpreter is needed. Create the matter — case type, jurisdiction, venue, side represented. Assign the handling attorney, paralegal and case manager. Record the referral source.

    Producesthe matter recordNeeds first
    • the completed intake questionnaire
    • the client's contact details and DOB
    from APP-ADJ — application for adjudicationrecords date
    Matter opened from the intake questionnaire dated {date}. Client, employer and carrier entered as parties.
  2. Enter the injury recordCase managerSame day

    Enter the date of injury, the injury type (cumulative trauma or specific), and the CT date range if cumulative. Enter every body part with laterality. Enter the occupation and the injury description in the client’s own words.

    Producesthe injury recordNeeds first
    • the date of injury, and on a CT both period dates
    • every body part with laterality
    • specific or cumulative
    from APP-ADJ — application for adjudicationrecords DOICT or specificbody parts
    Injury entered: {DOI}, {CT or specific}, {body parts}. Taken from the questionnaire; not yet verified against a medical record.
  3. Draft and send the client welcome packetCase manager2 days

    Assemble the client packet — welcome letter, what to expect, how to document expenses — and send it with the signed fee agreement.

    Producesthe welcome packet and fee agreementtemplate: Client welcome packetNeeds first
    • the client's address
    • the fee agreement for signature
    from APP-ADJ — application for adjudicationrecords datemail or email
    Welcome packet and fee agreement sent to the client {date}, by {mail or email}.
  4. Send the authorizations for signatureCase manager2 days

    Generate the authorizations, send them to the client for signature, and diary for their return. Nothing can be requested on the client’s behalf until they come back signed.

    Producesthe authorization settemplate: HIPAA authorization and medical releaseNeeds first
    • the client's full name and DOB
    • the providers to be named
    from APP-ADJ — application for adjudicationrecords date
    HIPAA, medical release and signature authorization sent for signature {date}. Diaried for return.
  5. Confirm the DWC-1 and record the return dateCase manager3 days

    Ask the client whether the employer gave them a DWC-1 and whether they returned it. If it was never given, generate it and serve it. Record the date the completed form went back to the employer.

    from APP-ADJ — application for adjudicationrecords given / not givendate
    DWC-1 {given / not given} to the client. Completed form returned to the employer {date}. 90-day presumption calendared from that date.
  6. Serve the notice of representationCase manager3 days

    Serve the employer and the carrier. Serve the treating doctor with a records request at the same time. File the proof of service.

    ProducesNotice of Representationtemplate: Notice of RepresentationNeeds first
    • the employer's legal entity name
    • the carrier or administrator
    from APP-ADJ — application for adjudicationrecords employercarrierdatedoctor
    Notice of representation served on {employer} and {carrier} {date}. Proof of service filed. Records request sent to {doctor}.
  7. Verify the wage and the employerParalegal5 days

    Check the average weekly wage against pay stubs or an employer wage statement. Confirm the employer’s legal name and address. Check the date of injury against a medical record. Check for concurrent employment, prior injuries to the same body parts, and other pending claims.

    from APP-ADJ — application for adjudicationrecords amountpay stubs / wage statementname
    Average weekly wage verified at {amount} against {pay stubs / wage statement}. Employer legal name confirmed as {name}.
  8. Request the recordsParalegal5 days

    Send a records release to every provider the client named. Request the personnel file and the wage records from the employer.

    Producesthe records requestsNeeds first
    • a signed authorization
    • the treating providers
    • the employer, for the personnel file
    from APP-ADJ — application for adjudicationrecords providersdate
    Records requested from {providers} {date}. Personnel file and wage records requested from the employer.
  9. Confirm the MPN and the treating physicianCase manager5 days

    Determine whether an MPN applies and write to the client explaining what it means. Check whether the client predesignated a personal physician. Confirm who is treating now.

    from APP-ADJ — application for adjudicationrecords applies / does not applyon file / nonedoctor
    MPN {applies / does not apply}. Predesignation {on file / none}. Treating physician confirmed as {doctor}.
  10. Calendar the statutes and the first reviewCase managerSame day

    Calendar the one-year statute and the five-year statute from the date of injury. Set a 30-day file review and a status call with the client.

    from APP-ADJ — application for adjudicationrecords date
    One-year statute calendared {date}. Five-year statute calendared {date}. 30-day review set.
  11. Establish whether the form was ever givenCase managerSame day

    Ask the client directly: did the employer hand you a claim form, and did you fill it in and give it back? Get the dates. An employer who never provided one has not started the clock, and the client may not know that.

    from APP-ADJ — application for adjudicationrecords given / never givendateCopy on file / none
    Client states the DWC-1 was {given / never given} on {date} and returned on {date}. {Copy on file / none}.
  12. Serve the form if it was never givenCase manager1 day

    If the employer never provided a claim form, generate one, have the client complete and sign the employee section, and serve it on the employer. Keep proof of how and when it went.

    ProducesDWC-1 Claim Formtemplate: DWC-1 Claim FormNeeds first
    • the client's completion of the employee section
    • the employer's address
    from APP-ADJ — application for adjudicationrecords employerdatemethod
    DWC-1 completed by the client and served on {employer} on {date} by {method}. Proof of service filed.
  13. Record the filing date on the injuryCase managerSame day

    Enter the date the completed form went back to the employer. Every clock on this page runs from it. If the date cannot be established, say so on the file rather than entering a guess.

    from APP-ADJ — application for adjudicationrecords datethe signed form / the client / the employer’s copy
    DWC-1 filing date recorded as {date}, taken from {the signed form / the client / the employer’s copy}.
  14. Calendar the ninety daysCase managerSame day

    Calendar the ninety-day presumption from the filing date, assigned to the attorney. Set a fourteen-day check that benefits have started. If this is a presumptive injury, ask the attorney whether the seventy-five day period applies before calendaring it.

    from APP-ADJ — application for adjudicationrecords dateyes — 75 days / no
    Ninety-day presumption calendared to {date}. Fourteen-day benefits check set. Presumptive injury: {yes — 75 days / no}.
  15. Confirm the employer sent it to the carrierCase manager5 days

    The employer must forward the completed form to the claims administrator within one working day. Confirm it arrived and get the claim number. A form sitting on a supervisor’s desk is a claim nobody is adjusting.

    from APP-ADJ — application for adjudicationrecords carrierdatenumber
    Employer forwarded the DWC-1 to {carrier} on {date}. Claim number {number} obtained.
  16. Enter the claim number and the adjusterCase manager5 days

    Add the carrier as a party with the claim number and policy number. Add the adjuster with a direct line. Take these from the carrier’s own paper — the delay letter, the benefit notice — not from what the client remembers.

    Producesthe carrier recordNeeds first
    • the claim number
    • the adjuster's name and contact
    from APP-ADJ — application for adjudicationrecords namenumberphone
    Carrier {name} added with claim number {number}. Adjuster {name}, {phone}.
  17. Diary for the carrier’s decisionCase manager14 days

    Check whether benefits have started, whether treatment is being authorized, and whether a delay or denial letter has arrived. If nothing has happened and the ninety days are running, tell the attorney.

    from APP-ADJ — application for adjudicationrecords datestarted / not startedauthorized / notdelay / denial / nothing
    Carrier status at {date}: benefits {started / not started}, treatment {authorized / not}, {delay / denial / nothing} received.

Templates 25

  • Case Demographic Sheet
  • Case Initiation Document
  • Client Demo Sheet
  • CLIENT-ADA Referral (Generic)
  • CLIENT-Enclosure Letter for Client (Generic)
  • CLIENT-Letter Medicare
  • CLIENT-Medicare Information Form
  • CLIENT-Potential Client
  • CLIENT-Potential Client Appointment
  • CLIENT-QME Defense with Questionnaire (Generic)
  • Description of Employees Job Duties
  • Employees Permanent Disability Questionnaire
  • HIPAA AUTHORIZATION FORM
  • MISC-Intake Packets Documenting Your Expenses (Generic)
  • MISC-Intake Packets Golden Rules (Generic)
  • MISC-Intake Packets Workers Comp Info (Generic)
  • MISC-Phone Intake (Generic)
  • MISC-SPANISH Intake Packets Documenting Your Expenses (Generic)
  • MISC-SPANISH Intake Packets Golden Rules (Generic)
  • MISC-SPANISH Intake Packets Workers Comp Info (Generic)
  • Notice of rep
  • Notice of Representation
  • NOTICE OF REPRESENTATION
  • PLEADS-Proof_of_Service-Notice_of_Representation
  • Venue Authorization
The case opens continues →
2 The carrier answers the claim They moved The claim 75 days

the clock started before this reached the desk — how much is left?

The pathThe clockTasksThe paper

What led here

The case opensthe claim form goes to the carrier

What happens

Acceptance, denial or delay

BENEFITS · filed behind tab 1 by default

1, 10, 11 — the claim itself (acceptance, denial, delay) → 1; a rate, an offer or a voucher → 10; a check → 11

Where it goes next

The case opens at the Boarddenied, delayed, or benefits are disputed

The injured worker diesthe injured worker dies

The treating doctor decides somethingaccepted — treatment proceeds

The clock

90 days — 75 for the presumptive injuries of LC 3212–3213.2

from the date the claim form (DWC-1) is filed with the employer

LC 5402(b)

90 days ordinarily · 75 days as the exception. Ninety days is the ordinary period. Seventy-five applies ONLY to the presumptive injuries of LC 3212–3213.2 — the safety-member presumptions. The badge shows the shorter because it is the one that can be missed; the tasks describe the ninety because that is the usual case.

Tasks 26 · due from the day the acceptance arrives

  1. Read what was actually acceptedCase managerSame day

    An acceptance is rarely unqualified. Read which body parts are admitted and which are not, whether the acceptance is for medical treatment only, and whether any period is disputed. Enter only what the letter admits.

    from BENEFITS — benefit noticerecords datebody partsFull acceptance / medical only / period disputed
    Acceptance received {date}. Admitted: {body parts}. Not admitted: {body parts}. {Full acceptance / medical only / period disputed}.
  2. Close the ninety-day clockCase managerSame day

    Mark the presumption satisfied and record the date it closed. Keep the closed record; do not delete it.

    from BENEFITS — benefit noticerecords date
    Ninety-day presumption satisfied by acceptance dated {date}. Statute closed, record retained.
  3. Confirm the benefit rateParalegal3 days

    Check the temporary disability rate on the notice against the average weekly wage the file already verified. A rate set from the carrier’s wage figure rather than the true earnings is the most common and most quietly costly error in an accepted claim.

    from BENEFITS — benefit noticerecords amountAgrees / disputed — objection sent
    TD rate on the notice: {amount}. Rate from the file’s verified AWW: {amount}. {Agrees / disputed — objection sent}.
  4. Diary the first paymentCase manager3 days

    Set the fourteen-day check for the first payment, and a recurring fourteen-day diary after it. Confirm the client received it and knows what it is.

    from BENEFITS — benefit noticerecords date
    First TD payment due {date}. Diary set. Client told what to expect and when.
  5. Tell the client what acceptance meansCase manager3 days

    Write to the client: the claim is accepted, what that does and does not mean, what benefits should now start, and what to do if a payment does not arrive. Acceptance is the moment a client is most likely to think the case is over.

    from BENEFITS — benefit noticerecords date
    Client written to {date} explaining the acceptance and the benefits that follow.
  6. Confirm treatment is being authorizedCase manager5 days

    An accepted claim should mean authorized treatment. Confirm the treating physician can get requests approved and that the MPN, if one applies, has a doctor the client can actually see.

    from BENEFITS — benefit noticerecords providerdateapplies / does not
    Treatment authorization confirmed with {provider} on {date}. MPN {applies / does not}.
  7. Set the file’s next postureAttorney5 days

    With liability admitted, the case turns on permanent disability and future medical care. Decide whether to file the Application now, whether a panel is needed, and when the client should be evaluated.

    from BENEFITS — benefit noticerecords file Application / holdrequested / not yetdate
    Posture after acceptance: {file Application / hold}. Panel {requested / not yet}. Next review {date}.
  8. Tell the attorney, the day it arrivesCase managerSame day

    A denial is one of the few documents that is never filed silently. The attorney is told the day it lands, before anything else is done with it, because the decisions that follow are theirs and some of them are time-sensitive.

    from BENEFITS — benefit noticerecords date
    Denial dated {date} received {date}. Attorney notified {date}.
  9. Read the denial against the ninety daysCase managerSame day

    Compare the date on the denial with the date the claim form went to the employer. Record which side of the ninety days it falls on and put the comparison on the file. This is arithmetic, not judgement — what the firm does about it is the attorney’s call.

    from BENEFITS — benefit noticerecords dateNattached / did not attach
    Claim form filed {date}; denial dated {date}; {N} days. Presumption {attached / did not attach} — for the attorney.
  10. Record what was denied, and on what groundCase managerSame day

    A denial is rarely total. Record it per body part and per benefit: what is rejected, what is still admitted, and the ground the carrier gives — AOE/COE, no employment, late notice, post-termination, statute. The ground is what the later case answers, and it should be legible from the file without re-reading the letter.

    from BENEFITS — benefit noticerecords body parts / benefitsgroundanything
    Denied: {body parts / benefits}. Ground stated: {ground}. Still admitted: {anything}.
  11. Check the letter is a proper noticeCase manager1 day

    A benefit notice has to say what it decides, why, and what the worker can do about it. Note anything missing — no date, no ground, no appeal language, no claim number, the wrong worker. Do not argue with it; record the defect so the attorney can decide whether it matters.

    from BENEFITS — benefit noticerecords list, or none
    Notice defects noted: {list, or none}.
  12. Tell the client, plainlyCase manager2 days

    The client is told what the letter says and what happens next, in plain language. Not an opinion on the merits, not a prediction — the fact of the denial and that the firm is handling it. This call is the one the client will remember.

    from BENEFITS — benefit noticerecords datecall / letter
    Client advised of the denial {date}, by {call / letter}.
  13. File the Application for AdjudicationAttorneyThe attorney sets it

    A denied claim is a disputed claim, and the dispute is decided at the Board. The Application commences proceedings and satisfies the one-year statute. The firm’s practice on when to file it is the attorney’s to set — this page records that it must be filed, not when.

    Producesthe decision that the claim goes to the Board, recordedNeeds first
    • the denial, delay or dispute that makes it a Board matter
    • the attorney’s direction to proceed
    from BENEFITS — benefit noticerecords datenumber
    Application filed {date}, ADJ {number}.
  14. Get the treatment movingCase manager5 days

    A denial does not stop treatment; it stops the carrier paying for it under the claim. Confirm what the client is receiving and where, and put lien letters out to the providers who are treating. Record which providers are on notice.

    ProducesLien letters to the providersNeeds first
    • which providers are treating
    • the denial or delay letter to attach
    from BENEFITS — benefit noticerecords providersdate
    Lien letters sent to {providers} {date}.
  15. Start the proofAttorneyThe attorney sets it

    The denial names a ground; the ground names what has to be proved. Records, a panel request, the employer’s own documents — the shape depends on the ground and it is the attorney’s to direct. What the file must show is that it was directed, and when.

    Producesthe proof plan, recordedNeeds first
    • the attorney's direction on what to prove
    from BENEFITS — benefit noticerecords datewhat was directed
    Proof plan noted {date}: {what was directed}.
  16. File it as a delayCase managerSame day

    Behind Tab 1, named as a delay. The distinction from a denial is the whole point of this page: a denial is a decision the firm answers, a delay is an absence of one the firm waits out. Filing it under the wrong word turns the second into the first.

    Producesthe delay notice, filed at tab 1Needs first
    • the notice with its own date
    • the date it was received
    from BENEFITS — benefit noticerecords date
    Delay notice dated {date} received {date}. No decision made; the claim remains undecided.
  17. Clip the date the letter promisesCase managerSame day

    Read the date the carrier gives itself and clip a follow-up on it. If the letter gives no date, say so on the file and set one — a delay with no end named by anybody is the one that runs longest.

    from BENEFITS — benefit noticerecords dateOr: no date stated — follow-up set at {date
    Delay promises a decision by {date}; follow-up clipped. {Or: no date stated — follow-up set at {date}.}
  18. Check the ninety days against itCase managerSame day

    Work out how much of the ninety days is left from the claim form. The delay does not extend it. If the promised decision falls after the ninety days expire, that is worth the attorney knowing now rather than then.

    from BENEFITS — benefit noticerecords dateNinside / outside
    Claim form filed {date}; {N} days of the ninety remain as at {date}. Promised decision {date} falls {inside / outside} the period.
  19. Record what the carrier says it is waiting onCase manager1 day

    A delay letter names what it lacks — a recorded statement, records, an investigation, a panel. Record it, because it is the list the firm can shorten. A delay waiting on something the firm can send is a delay the firm can end.

    from BENEFITS — benefit noticerecords whatItems the firm can supply: …
    Carrier is waiting on: {what}. {Items the firm can supply: …}
  20. Send what we can sendCase manager5 days

    Where the carrier is waiting on something the firm holds — an authorisation, a report, a wage record — send it and record that it went. Where it is waiting on the client, arrange it. This is the one task on this page that changes the outcome rather than watching it.

    Producesthe carrier’s requested materialNeeds first
    • what the carrier asked for
    • what the file actually holds
    from BENEFITS — benefit noticerecords Whatdatewhat remains
    {What} sent to the carrier {date}. Outstanding: {what remains}.
  21. Tell the client what a delay isCase manager2 days

    Clients read a delay as a refusal. Tell them plainly that no decision has been made, what the carrier says it is waiting for, and that the firm is handling it. Nothing about the merits and nothing about what the case is worth.

    from BENEFITS — benefit noticerecords date
    Client advised of the delay {date}. Explained no decision has been made.
  22. Watch the promised dateCase managerThe date the letter names

    When the date passes with nothing, that silence is the event. Tell the attorney and record that the promised date came and went — a carrier that delays past its own date and past the ninety days has made a decision by not making one.

    from BENEFITS — benefit noticerecords date
    Promised decision date {date} passed with no determination. Attorney told {date}.
  23. On the ninetieth day with no decision, escalate to the attorneyAttorneyThe ninetieth day

    Not the case manager. The manual says so in terms — a task at ninety days, set to the attorney — because a substantive right coming into existence is not a diary note. The task fires on the DATE, not on a letter arriving: the whole point is that nothing arrived. Where the injury is one of the presumptive ones under LC 3212–3213.2 the period was seventy-five days and this fired a fortnight ago; whether it is one of them is the attorney’s call, not the clerk’s.

    Producesthe escalation, recorded — with the two dates the period is computed fromNeeds first
    • the date the claim form was filed with the employer, which is the date the period runs from and exists nowhere but on the file
    • whether anything at all arrived — an acceptance, a denial, a delay, or nothing
    from BENEFITS — benefit noticerecords datedate
    Ninety days ran {date} from the claim form filed {date}. No acceptance, denial or determination received. Escalated to the attorney {date}. {Ordinary 90 / presumptive 75 per LC 3212–3213.2}.
  24. Say on the file that the presumption attached, and on what datesCase managerSame day

    A right that exists and is written nowhere is indistinguishable from one that does not. The file states the arithmetic — the filing date, the ninetieth day, and that nothing was received — and states no conclusion about what follows. The determination is the attorney’s and the Board’s; the record is the firm’s.

    Producesthe record that the period ran, filed at tab 1Needs first
    • the filing date
    • the ninetieth day computed from it
    from BENEFITS — benefit noticerecords datedate
    Claim form filed {date}; ninety days ran {date}; nothing received. Recorded {date}. No determination made by the firm.
  25. Stop the file treating liability as openCase manager2 days

    Diaries, letters and clips written while the claim was undecided assume it still is. Review what is outstanding and what the client was last told — a client told the claim is 'pending’ after the period has run is being told something the file no longer supports. What changes is the firm’s own paper, not a position taken against the carrier.

    Producesthe review, recordedNeeds first
    • what is still diarised on the assumption liability is undecided
    • what the client was last told, and when
    from BENEFITS — benefit noticerecords Ndate
    File reviewed {date}: {N} clips and letters written on an undecided claim, {updated / left with a reason}. Client last told {date}.
  26. Hold the position if a decision arrives lateCase managerSame day it arrives

    A late acceptance does not undo a presumption that has already attached, and neither does a late denial — the manual says both. So a letter arriving on day ninety-five is filed, its date recorded against the ninetieth day, and the attorney told. What the file must not do is quietly re-date the statute record to the letter and let the earlier fact disappear.

    Producesthe late decision, filed with the comparison on its faceNeeds first
    • the date on the decision
    • the ninetieth day, already computed above
    from BENEFITS — benefit noticerecords datedateN
    Decision dated {date} received {date}, {N} days after the period ran. Filed and compared to the ninetieth day {date}. Attorney told {date}.

Templates 1

  • Workers Compensation Claim Form
The carrier answers the claim continues →
3 A letter arrives from the other side They moved The claim

the clock started before this reached the desk — how much is left?

The pathThe clockTasksThe paper

What led here

The case opensthe other side begins writing to the firm

What happens

Correspondence from the carrier, defence counsel or a third-party administrator

CORR · filed behind tab 4 by default

4 unless the letter is about one of these: to the judge → 2; to, from or about the evaluator → 6; a rating letter → 7; a payment, EOB or bill → 11; written discovery → 12; a records request → 13; an MSA → 14; a lien claimant → 15; intake, fee or address → cover

Where it goes next

Written discovery arrivesit is a written discovery request

The treating doctor decides somethingit objects to a treating physician’s report

A panel is assignedit concerns the panel, a strike or an evaluator

Records are subpoenaedit demands records or answers a subpoena

A deposition is noticedit notices or reschedules a deposition

The case endsit makes or answers an offer

Money movesit concerns a payment, a rate or a benefit

The trap

A letter is not an objection because it disagrees, and it IS an objection when it says so however politely. Which it is decides whether a statutory clock has started, and that reading belongs to the attorney — the file records what the letter says and the date it was served, not a conclusion about it.

Why it is on the map

Most defence mail says something and starts nothing. Some of it carries a period on its face or triggers one by what it asks for, and the two are indistinguishable in the envelope — a demand to settle and an MPN notice arrive on the same letterhead in the same week. Reading it is the work.

Tasks — written for this map 6 · due from the day the letter arrives

No page in the procedure manual covers this chain yet. These tasks were written for this map because the chain routes work to others and had no owner on any step — they need an attorney’s reading before they are relied on.

  1. Date-stamp it and record how it arrivedCase managerSame day

    Mail, fax, e-mail, e-service or a portal. How it arrived can decide a period — five days for mail, none for personal service — and it is read off the envelope or the header, not assumed.

    from CORR — correspondencerecords whodatemail / fax / e-mail / e-service
    Letter from {who} dated {date}, received {date} by {mail / fax / e-mail / e-service}.
  2. Read what it actually asks forCase managerSame day

    Not what it is headed. A letter titled a status enquiry can contain an objection, and a letter titled an objection can ask for nothing at all. What it ASKS decides where it goes.

    from CORR — correspondencerecords objection / demand / discovery / notice / nothing asked
    Reads as: {objection / demand / discovery / notice / nothing asked}.
  3. If it names a date, clip it and say where the date came fromCase managerSame day

    A date on a letter is not a statutory period, and the file must not make it look like one. Clip it, and record that it came from the letter rather than from a statute.

    from CORR — correspondencerecords date
    Clipped {date}, from the letter itself. Not a statutory period.
  4. Route it to the chain it belongs toCase managerSame day

    An objection to a treating report goes to that chain; a records demand to the subpoena chain; an offer to settlement. Correspondence is what is left after those questions, not the first place a letter is put.

    Producesthe routing decision, recorded on the fileNeeds first
    • what the letter asks for
    • which chain owns that question
    from CORR — correspondencerecords chainreason
    Routed to {chain} because {reason}.
  5. Tell the attorney the same day if it names a periodCase managerSame day

    Whether the letter IS an objection, and whether a statutory clock has started, is the attorney’s reading. The file records what the letter says and when it was served, and states no view about it.

    from CORR — correspondencerecords dateperiod / no period
    Attorney told {date}: letter names {period / no period}.
  6. Read whether it is an objection, and say so on the fileAttorneySame day

    Whether a letter IS an objection decides whether a statutory clock has started. Politeness is not the test and the heading is not the test. The answer goes on the file in one word, because everything downstream reads it rather than re-reading the letter.

    from CORR — correspondencerecords an objection / not an objectiondatestarted {date
    Read as {an objection / not an objection} {date}. Clock {started {date} / not started}.

Templates

No template in the library. This is written from scratch, on a clock somebody else started.

4 The treating doctor decides something They moved Treatment 20 days

the clock started before this reached the desk — how much is left?

The pathThe clockTasksThe paper

What led here

A letter arrives from the other sideit objects to a treating physician’s report

The carrier answers the claimaccepted — treatment proceeds

What happens

A report that changes what the worker gets — P&S, work status, a treatment the carrier will refuse

PR2 · filed behind tab 5 by default
also on this chain: PR3 (tab 5/tab 7), PR4 (tab 5/tab 7), DFR (tab 5)

PR2 → 5; PR3, PR4 (a P&S report) → 7

Live at the same time

The case opens at the Boarda filed case does not stop treatment

The case is set for hearingthe doctor goes on reporting after the case is set

The case endstreatment continues until the settlement is approved

Where it goes next

Treatment is refusedthe treating doctor requests authorization

A provider claims against the casea provider treated and can claim against the case

A panel is assigneda party objects to the treating doctor’s finding

Work is offeredthe doctor releases to modified or regular work

The clock

20 days if represented, 30 if not

from receipt of the report

LC 4062(a)

20 days represented ordinarily · 30 days unrepresented as the exception. Twenty days where the employee is represented, thirty where they are not. The badge shows twenty because a represented file is this firm’s ordinary case and the shorter period.

The trap

TWENTY days, not thirty. The thirty-day figure everyone carries is the QME report window under 8 CCR 31.5(a) — a different document by a doctor who may be the same person. The form number decides it: a PR-4 is med-legal, a PR-2 is not.

Tasks 9 · due from the day the report is received

  1. File it, quietlyCase manager2 days

    Behind Tab 5, named for the provider and its own date. Most treating reports need nothing else, and adding a notification to each of them is how the ones that matter get missed.

    Producesthe report, filed at tab 5Needs first
    • the report type — PR-2, PR-3, PR-4
    • the provider and the report date
    from PR2 — treating physician progress / permanent & stationary reportsrecords Report typeproviderdate
    {Report type} from {provider} dated {date}, filed.
  2. Read whether it decides anythingCase manager2 days

    Permanent and stationary, a change in work status, a new body part, a treatment the carrier is likely to refuse. Any of those and the attorney is told; none of them and it is filed and left.

    from PR2 — treating physician progress / permanent & stationary reportsrecords is / is notwhat it decides
    Report {is / is not} a determination: {what it decides}.
  3. Where it decides something, tell the attorney and clip twenty daysCase managerSame day

    With the objection window computed from receipt. Twenty days on a represented case.

    from PR2 — treating physician progress / permanent & stationary reportsrecords date
    Determination told to the attorney {date}; objection window to {date}.
  4. Record new body partsCase manager2 days

    A body part treated but never pleaded is a gap in the Application, and this is where it first becomes visible.

    from PR2 — treating physician progress / permanent & stationary reportsrecords partdatePleaded / not pleaded
    New body part {part} appears in treatment {date}. {Pleaded / not pleaded}.
  5. Keep the treatment picture currentCase managerOngoing

    Who is treating, for what, and how recently. It is the answer to the question the client asks most often and the one the attorney needs before any conference.

    from PR2 — treating physician progress / permanent & stationary reportsrecords providersdate
    Treating: {providers}, most recent {date}.
  6. File it and record what it says about the injuryCase manager2 days

    The mechanism described, the body parts, the doctor’s view on whether it arose at work. This is the earliest medical account and everything later is compared with it.

    ProducesDoctor’s First Report, filed at tab 5Needs first
    • the mechanism of injury as stated
    • the body parts named
    from PR2 — treating physician progress / permanent & stationary reportsrecords providerdatemechanismbody partsstated view
    First report by {provider} dated {date}: {mechanism}, {body parts}, causation {stated view}.
  7. Compare it with the claimCase manager2 days

    Against the Application and the intake account. Where the body parts or the mechanism differ, that is a fact the attorney needs before the defence finds it.

    from PR2 — treating physician progress / permanent & stationary reportsrecords consistent with / differs fromdetail
    First report {consistent with / differs from} the claim: {detail}.
  8. Record any body part not pleadedCase manager2 days

    A part appearing here but not in the Application is a gap, and this is the earliest point it can be seen.

    from PR2 — treating physician progress / permanent & stationary reportsrecords list, or none
    Body parts in the first report not pleaded: {list, or none}.
  9. Record the work status it givesCase manager2 days

    Off work, modified, full duty — with the date. It is often the start of the temporary disability question.

    from PR2 — treating physician progress / permanent & stationary reportsrecords datestatus
    Work status from {date}: {status}.

What this produces

Objection to a Treating Physician’s Determination

signed by attorney

goes to defence, served

starts the panel process — the request for a panel follows the objection

LC 4062(a), 4062.2

Templates 13

  • 4600 LETTER - DENIED CASES
  • 4600 Letter MPN + Request for Auth
  • 4600 Letter MPN RFA POS
  • 4600 Letter MPN+ Request for Autho
  • 4600 Letter Stp
  • 4600 Ltr MPN+RFA
  • 4600 Ltr MPN+RFA
  • 4600 Ltr MPN+RFA+POS
  • CLIENT-Client Letter Re MPN (Generic)
  • DEFENSE-MPN List 15 Days (Generic)
  • Request for Authorization (RFA)
  • DWC Form RFA
  • Objection to Treating Physician’s Recommendation for Spinal Surgery
The library cannot produce this
  • Objection to reporting, reserving the right to cross-examine
5 Treatment is refused They moved Treatment 10 days

the clock started before this reached the desk — how much is left?

The pathThe clockTasksThe paper

What led here

The treating doctor decides somethingthe treating doctor requests authorization

The carrier defers the reviewliability resolves and review resumes

What happens

A utilization review decision refusing a treatment

UR-DENIAL · filed behind tab 8
also on this chain: UR-APPROVAL (tab 8), UR-MOD (tab 8), RFA (tab 5), IMR-APP (tab 9)

Live at the same time

The case opens at the Boardauthorisation disputes run while the case is litigated

Where it goes next

The carrier defers the reviewthe carrier defers instead of deciding

A panel is assignedthe dispute is not medical necessity

The clock

30 days — 10 for a formulary dispute

from service of the UR decision on the employee

LC 4610.5(f), (h)(1)–(3); 8 CCR 9792.10.1

30 days ordinarily · 10 days for a formulary dispute as the exception. Thirty days is the ordinary period. Ten applies to a formulary dispute only. The badge shows ten because it is the shorter and the one missed.

does not run when the descriptor is a Deferral or a Delay — they decide no medical necessity, so nothing attaches

Supporting records after a Notice of Assignment

15 days — 12 if the notice was sent electronically, 10 for a formulary drug, 24 HOURS on an expedited review

from the NOA

8 CCR 9792.10.5

Tasks 10 · due from the day the decision was SERVED on the employee

  1. Read the descriptor firstCase managerSame day

    Denial, modification, deferral, delay or approval — before anything else, because it decides whether there is a clock at all. Write which it is on the file in that word. Everything downstream reads it rather than re-reading the letter.

    from UR-DENIAL — utilization review decisionrecords datedenial / modification / deferral / delay / approvalClock runs / no clock
    UR decision dated {date}: {denial / modification / deferral / delay / approval}. {Clock runs / no clock}.
  2. Find the service dateCase managerSame day

    The clock runs from service on the employee. Take it off the document — the proof of service, the cover, the fax header if that is all there is — and record which one was used. Where the document does not say, that is a question, not an assumption.

    from UR-DENIAL — utilization review decisionrecords datewhere
    Service date {date}, taken from {where}. IMR window closes {date}.
  3. Clip the IMR window to a personCase managerSame day

    Thirty days from service on the employee, or TEN where the dispute is over the formulary — and which it is comes off the denial, not from habit. The closing date is computed on the task above; this one puts it in the diary with a name against it, because a date in a memo is a date nobody owns.

    Producesthe the imr request clip, with an assigneeNeeds first
    • the date the period runs from
    • which branch of imr_appeal applies
    from UR-DENIAL — utilization review decision. Deferral and delay are filed as UR-DENIAL with Descriptor Deferral / Delay until the vocabulary gains their own codes (see gaps below). When several match, the most adverse wins: denial over modification over approval.records datewho
    IMR window {30 / 10} days from {date}, closes {date}. Assigned to {who}.
  4. File the denial or modification under its tabCase manager2 days

    Under its OWN date, at tab 8. The TYPE code decides the tab, which is what the code is for. A document acted on before it is filed is a document somebody is working from a copy of, and the copy is the one that gets annotated.

    Producesthe denial or modification, filed at tab 8Needs first
    • the document's own date, read off its face
    • its TYPE code — UR-DENIAL — which is what decides the tab
    from UR-DENIAL — utilization review decision. Deferral and delay are filed as UR-DENIAL with Descriptor Deferral / Delay until the vocabulary gains their own codes (see gaps below). When several match, the most adverse wins: denial over modification over approval.records tabdate
    Filed tab {tab} under its own date {date}.
  5. Tell the attorneyCase managerSame day

    Every denial and every modification, the day it arrives. Not because the attorney does the appeal, but because a denied treatment is a fact about the case they need before somebody asks them about it.

    from UR-DENIAL — utilization review decisionrecords date
    Attorney told {date}.
  6. Check the letter carries what IMR needsCase manager1 day

    The treatment at issue, the determination, the dates, and the firm’s current address. A stale address is corrected on the document. A letter missing what IMR requires stops the packet — say so rather than sending an incomplete one.

    from UR-DENIAL — utilization review decisionrecords dateComplete / missing: …current / corrected
    Letter checked {date}. {Complete / missing: …}. Address {current / corrected}.
  7. Build the packetCase manager3 days

    One PDF, in this order: the served Application for IMR completed and signed; the UR letter; the client’s authorization and representative designation; the demographics sheet on a first denial only; then the supporting reports. One attachment, never several — that is the review organization’s submission requirement, not a preference.

    ProducesIMR Application Packettemplate: Application for Independent Medical ReviewNeeds first
    • the served IMR application
    • the UR letter with a current address
    • a signed authorization and representative designation
    • the demographics sheet (first denial only)
    • the RFA and the PTP report
    from UR-DENIAL — utilization review decisionrecords dateNcomponents
    IMR packet assembled {date}: {N} pages, {components}.
  8. A person approves the sendAttorneyBefore it goes

    The packet is sent under a person’s approval. The signature on the application is the client’s or the representative’s, and who signs is settled before the packet is built, not after.

    Producesthe approval itself, recorded on the fileNeeds first
    • the assembled packet
    • who is authorised to approve it
    from UR-DENIAL — utilization review decisionrecords whodate
    Packet approved by {who} {date}.
  9. Send it and file the copyCase managerSame day as approval

    To the Administrative Director with a copy of the decision attached, and a copy to the claims administrator. The sent packet is filed at Tab 9 beside the denial it answers.

    Producesthe sent packet, filed at Tab 9Needs first
    • a person's approval on the send
    • the address for the AD
    • the claims administrator's address
    from UR-DENIAL — utilization review decisionrecords date
    IMR application sent {date} to the AD; copy to the administrator. Filed Tab 9.
  10. Watch for the assignmentCase manager15 days

    What comes back lands on Tab 9. The Notice of Assignment opens a short window for supporting records; a Request for Information carries its own date; the determination is routed, never re-appealed here.

    from UR-DENIAL — utilization review decisionrecords received {datedate
    NOA {received {date} / not received as at {date}}.

What this produces

IMR Application Packet

signed by client or representative

goes to the Administrative Director, copy to the claims administrator

starts assignment by the review organization, then the supporting-records window

8 CCR 9792.10.1, 9792.10.5

ONE PDF, in that order — a submission requirement of the review organization, not a preference. The demographics sheet goes on a first denial only. Never a blank IMR form: use the copy served with the decision.

Assembled in this order
  1. Application for Independent Medical Reviewthe copy the claims administrator served with the decisionThe served copy, completed and signed — not a blank downloaded form.
  2. The UR denial or modification letterTab 8Check it names the treatment, the determination, the dates and the firm’s current address. A stale address is corrected on the document before it goes.
  3. The client’s signed authorizationCoverSigned by the client. Who signs the application is settled before the packet is built, not after.
  4. Authorized Representative DesignationCoverGoes with the authorization; the two travel together.
  5. The firm’s demographics sheetCoverFIRST UR denial on the case only. On a later denial it is already on file with the review organisation.
  6. Supporting medical reportsTabs 5 and 7The request for authorization and the treating physician’s report behind it. What the reviewer needs to decide the treatment, not the whole file.

One PDF, in this order — one attachment, never several. That is the review organisation’s submission requirement, not a filing preference.

Templates 9

  • DWC Form IBR-1
  • Utilization Review (UR) Complaint Form
  • Application for Independent Medical Review
  • AUTHORIZED REPRESENTATIVE DESIGNATION FOR INDEPENDENT MEDICAL REVIEW
  • Petition Appealing Administrative Director’s Independent Medical Review Determination
  • REQUEST FOR INDEPENDENT MEDICAL REVIEW
  • Complaint Form
  • Application for Spinal Surgery 2nd Opinion Physician List
  • Request for Dispute Resolution Before the Administrative Director
6 The carrier defers the review They moved Treatment

the clock started before this reached the desk — how much is left?

The pathThe clockTasksThe paper

What led here

Treatment is refusedthe carrier defers instead of deciding

What happens

A UR decision whose descriptor is Deferral or Delay

UR-DENIAL · filed behind tab 8
also on this chain: IMR-NOA (tab 9), IMR-RFI (tab 9), IMR-DET (tab 9)

Where it goes next

Treatment is refusedliability resolves and review resumes

The clock

no clock

from —

LC 4610(l), (m)

The trap

This is the one that produces a confident wrong deadline. A deferral or delay looks like a denial and is not: nothing attaches and no appeal window runs. Clipping it as a denial creates a real, cited, diarised deadline for an appeal that does not exist.

Not verified against the standard

LC 4610.6(h) — the thirty days to seek review of an IMR determination at the Board — is not in AAI-STD 1, so it has not been through the standard’s verification against primary text. It is NOT the same section as the appeal to IMR (LC 4610.5(h)(1)); both are thirty days about the same treatment, which is exactly why the section number is worth confirming before anyone relies on it.

Tasks 8 · due from the day each document arrives

  1. File each for what it isCase managerSame day

    Assignment, request, determination. They arrive from the same sender about the same dispute and they are not interchangeable — one opens a window, one asks a question, one ends the matter.

    Producesthe IMR paper, filed at tab 9 beside the denialNeeds first
    • which document it is — NOA, RFI or determination
    • its own date
    from UR-DENIAL — utilization review decisionrecords Documentdate
    {Document} dated {date} received {date}, filed Tab 9 beside the application.
  2. On the assignment: clip the right windowCase managerSame day

    Read whether the notice went electronically, whether this is a formulary dispute, whether the review is expedited. Then clip fifteen, twelve, ten days or twenty-four hours accordingly, and write on the file which branch was used.

    from UR-DENIAL — utilization review decisionrecords dateelectronic / formulary / expedited / ordinary
    NOA dated {date}; {electronic / formulary / expedited / ordinary}; supporting records due {date}.
  3. On the assignment: send what supports itCase managerWithin the window

    The reports that support the treatment — the same ones that went in the packet, plus anything since. The window is the employee’s and the administrator’s alike; nothing waits for their submission.

    from UR-DENIAL — utilization review decisionrecords datewhat
    Supporting records sent {date}: {what}.
  4. On a request for information: answer it by its own dateCase managerThe date it states

    Read what is being asked, get it, and send it. An unanswered request is decided without the answer.

    from UR-DENIAL — utilization review decisionrecords datewhat
    RFI dated {date} asking {what}; answered {date}.
  5. On a determination: read the outcome per line itemCase managerSame day

    Overturned, upheld, or partial — and a partial is per treatment, not per letter. Record the outcome for each item requested, because a determination that overturns one thing and upholds another is two results in one envelope.

    from UR-DENIAL — utilization review decisionrecords dateitemoverturned / upheld
    Determination dated {date}: {item} {overturned / upheld} · {item} {overturned / upheld}.
  6. Route itCase managerSame day

    An overturn goes to the attorney — the treatment is authorised and someone has to make it happen. An uphold goes to the case manager, unless the treatment was surgery, homecare or a device, in which case it goes to the attorney too. The stakes decide the routing, not the outcome alone.

    Producesthe routing decision, recordedNeeds first
    • whether the determination overturned or upheld
    from UR-DENIAL — utilization review decisionrecords attorney / case manageroverturn / uphold on {surgery|homecare|device
    Routed to {attorney / case manager} because {overturn / uphold on {surgery|homecare|device} / uphold}.
  7. On an overturn: get the treatment movingCase manager2 days

    An overturned denial means the treatment is authorised. Tell the treating physician and the client, and record that it went — an authorisation nobody acts on is the same as a denial to the person waiting for it.

    from UR-DENIAL — utilization review decisionrecords providerdate
    Overturn communicated to {provider} and client {date}.
  8. On an uphold: put the appeal question to the attorneyCase manager2 days

    The determination is not re-appealed to IMR. The only route is review at the Board within thirty days on narrow grounds. Give the attorney the date and the document; whether any ground exists is theirs.

    from UR-DENIAL — utilization review decisionrecords date
    Uphold dated {date}; window to {date} per LC 4610.6(h). For the attorney.

Templates

No template in the library. This is written from scratch, on a clock somebody else started.

7 A panel is assigned They moved Medical-legal 10 days

the clock started before this reached the desk — how much is left?

The pathThe clockTasksThe paper

What led here

A letter arrives from the other sideit concerns the panel, a strike or an evaluator

The treating doctor decides somethinga party objects to the treating doctor’s finding

Treatment is refusedthe dispute is not medical necessity

No appointment can be hada replacement panel is requested

What happens

The administrative director assigns three evaluators

QME · filed behind tab 7 by default

a report → 7; anything else → 6

Live at the same time

A deposition is noticeddiscovery and the evaluation proceed together

Where it goes next

No appointment can be hadno appointment inside the statutory window

Records go to the evaluatorthe panel is assigned and records go out

The clock

10 days, +5 when served by mail

from assignment of the panel by the administrative director

LC 4062.2(c)

10 days ordinarily · 15 when the panel was served by mail as the exception. Ten days from assignment, plus five when the panel was served by mail. The badge shows ten; how it was served is read off the document, not assumed.

Scheduling the QME after the strike

10 BUSINESS days

from the date the evaluator is selected from the panel

8 CCR 31.3(d)

Tasks 10 · due from the day the panel is assigned

  1. Record how the panel arrivedCase managerSame day

    By mail or otherwise, and on what date the administrative director assigned it. Both go on the file before the strike date is computed, because both are inputs to it. This is the one task on the page that is pure clerical work and changes a deadline by five days.

    from QME — QME / panel QME reportrecords datemail / other
    Panel assigned {date}, received {date}, served by {mail / other}. Strike due {date}.
  2. File the panel under its tabCase manager2 days

    Under its OWN date, at tab 6. The TYPE code decides the tab, which is what the code is for. A document acted on before it is filed is a document somebody is working from a copy of, and the copy is the one that gets annotated.

    Producesthe panel, filed at tab 6Needs first
    • the document's own date, read off its face
    • its TYPE code — QME — which is what decides the tab
    from QME — QME / panel QME report — PQME when the evaluator came from a panel, QME otherwise; also the panel, strike and appointment paper (Descriptor says which)records tabdate
    Filed tab {tab} under its own date {date}.
  3. Tell the attorney the day it landsCase managerSame day

    The strike is the attorney’s choice and the window is ten days. Nothing about a panel waits.

    from QME — QME / panel QME reportrecords namesdate
    Panel of {names} told to attorney {date}.
  4. Put the three evaluators in front of the attorneyCase manager1 day

    Names, specialties, locations. Whatever the firm knows about each. The choice is the attorney’s and it is made once — the file’s job is to make it an informed one rather than a hurried one.

    from QME — QME / panel QME reportrecords date
    Panel detail assembled {date}.
  5. Serve the strikeAttorneyWithin the window

    A served letter is the practice; no rule prescribes a form. Serve it and file the proof — a strike nobody can prove was served is a strike that may not have happened.

    ProducesThe strike lettertemplate: Letter striking one evaluator from the panelNeeds first
    • the panel list with the assignment date
    • the attorney's choice of strike
    • how the panel was served — mail adds five days
    from QME — QME / panel QME reportrecords datepartiesname
    Strike served {date} on {parties}; POS filed. Evaluator remaining: {name}.
  6. Schedule within ten business daysCase manager10 business days from selection

    Business days. If the firm does not schedule, the claims administrator may — and then the appointment is theirs to arrange rather than ours.

    Producesthe appointment, calendared with an assigneeNeeds first
    • the evaluator selected after the strike
    • the evaluator's scheduling contact
    from QME — QME / panel QME reportrecords evaluatordate
    Appointment with {evaluator} set for {date}, arranged {date}.
  7. Calendar the appointment with an assigneeCase managerOn scheduling

    The appointment is a calendar entry and it must belong to a person. An event with no assignee is owned by nobody and appears on nobody’s calendar.

    from QME — QME / panel QME reportrecords datewho
    Appointment {date} calendared to {who}.
  8. Arrange the client’s side of itCase manager5 days before

    Tell the client where and when, arrange an interpreter if one is needed, and transport if that is the firm’s practice. An evaluation the client cannot get to is an evaluation that has to be scheduled again.

    Producesthe client’s appointment letterNeeds first
    • the appointment date and address
    • whether an interpreter is needed
    • how the client travels
    from QME — QME / panel QME reportrecords datearranged / not needed
    Client notified {date}; interpreter {arranged / not needed}; transport {arranged / not needed}.
  9. Serve the records twenty days aheadAttorney20 days before they go

    Decide when the records go to the evaluator, then work backwards. Serve the other side twenty days before that date and hold the records until it passes. Anything to an AME needs the parties’ agreement.

    ProducesRecords Set for the EvaluatorNeeds first
    • the records proposed, from tabs 5, 7 and 13
    • every party's address
    • a cover letter naming what is enclosed
    from QME — QME / panel QME reportrecords partiesdate
    Records served on {parties} {date}; earliest send to evaluator {date}.
  10. Read what they serve, within ten daysAttorney10 days from their service

    Their proposed records arrive with a ten-day objection window, and an objection not made at the first opportunity is taken as agreement. Read them and put the question to the attorney with days still on the clock.

    from QME — QME / panel QME reportrecords dateobjected {date
    Their records served {date}; objection window to {date}; {objected {date} / no objection}.

What this produces

QME Panel Strike

signed by attorney

goes to defence, served

LC 4062.2(c)

No rule prescribes the form — a served letter is the practice. Ten days from assignment, plus five by mail.

Templates 18

  • ADDITIONAL PANEL REQUEST
  • Online QME Form 106 Panel Request (Online Only)
  • Replacement Panel Request
  • Request for QME Panel Under Labor Code §4062.2 - Represented (PAPER ONLY)
  • Request for Qualified Medical Evaluator Panel - Unrepresented Employee
  • Request for Factual Correction of an Unrepresented Panel QME Report
  • CLIENT-QME Client
  • CLIENT-SP QME Not
  • CLIENT-AME Notification (Choose Specialty)
  • DEFENSE-AME Confirmation Letter to Defendant (Generic)
  • DEFENSE-AME Procedure Agreement Letter
  • MED-ACOEM 1st Doctor Letter (Generic)
  • MED-ACOEM AME On Case (Generic)
  • MED-AME Letter Head (Generic)
  • MED-AME Med Advocacy Letter
  • MED-AME Med Short (Generic)
  • MED-Fax Request For Medical Exam QME-AQME-AOE-COE-AME
  • DEFENDANT-ACOEM Objection (Generic)
8 No appointment can be had We moved Medical-legal 90 days

the attorney picks the date; late here is a decision, not an accident

The pathThe clockTasksThe paper

What led here

A panel is assignedno appointment inside the statutory window

What happens

The evaluator has no appointment within ninety days

QME · filed behind tab 7 by default

a report → 7; anything else → 6

Where it goes next

A panel is assigneda replacement panel is requested

The clock

90 days — a party may waive to accept one within 120

from the party’s request for an appointment

8 CCR 31.3(e)–(f), 31.5(a)(2) · Vazquez (WCAB en banc, 2025)

90 days ordinarily · 120 if a party waives to accept a later date as the exception. Ninety days from the request for an appointment. A party may waive to accept one within a hundred and twenty — a choice, not an extension, and one the attorney makes.

The trap

Waiting is a decision. At ninety days the firm may waive to accept a later date; past a hundred and twenty either party may report it. Whether to replace for good cause is the Board\u2019s call, weighed on delay, prejudice, efforts to cure and case-specific reasons — not automatic.

Tasks — written for this map 5 · due from the date the appointment was requested

No page in the procedure manual covers this chain yet. These tasks were written for this map because the chain has a date somebody must act on and named nobody — they need an attorney’s reading before they are relied on.

  1. Record the date the appointment was requestedCase managerSame day

    Ninety days runs from the REQUEST, not from the panel or the strike. It is the one date this chain turns on and the one most easily lost, because nothing arrives to mark it.

    from QME — QME / panel QME reportrecords dateevaluator
    Appointment requested {date} from {evaluator}. Ninety days to {date}.
  2. Diary the ninety and the hundred and twentyCase managerSame day

    Two dates, not one. At ninety the firm may waive to accept a later appointment; past a hundred and twenty either party may report it. Both go on the file when the request goes out.

    from QME — QME / panel QME reportrecords date
    Ninety days to {date}; hundred and twenty to {date}. Both diarised.
  3. Put the choice to the attorney at ninety daysCase manager90 days

    Waiting is a decision and it is the attorney’s. Accept a later date, or seek a replacement panel — and whether a replacement is granted is the Board’s, weighed on delay and prejudice, not automatic.

    from QME — QME / panel QME reportrecords datewaive / replacement panel / wait
    Choice put to the attorney {date}: {waive / replacement panel / wait}.
  4. Decide: wait, waive, or seek a replacement panelAttorneyWithin the ninety days

    Three choices and no default. Waiting is one of them and is recorded as a decision, not left as what happened because nobody chose.

    from QME — QME / panel QME reportrecords wait / waive to a later date / replacement paneldate
    At ninety days: {wait / waive to a later date / replacement panel} {date}.
  5. Report it past a hundred and twenty if the attorney directsCase managerOn the attorney’s direction

    Reporting is a step, not an outcome. It records that the appointment could not be had; what follows is the Board’s.

    Producesthe report of unavailabilityNeeds first
    • the date the appointment was requested
    • the attorney's direction to report
    from QME — QME / panel QME reportrecords datewho
    Unavailability reported {date} to {who}.

Templates 2

  • Appointment Notification Form
  • QME Notice of Unavailability
9 Records go to the evaluator Either side Medical-legal 20 days BEFORE

the same exchange whichever side began it, and both are on a clock

The pathThe clockTasksThe paper

What led here

A panel is assignedthe panel is assigned and records go out

What happens

either side proposes records for the evaluator

MEDREC · filed behind tab 5 by default

5 (returned on a subpoena → 13)

Where it goes next

The evaluator reportsthe evaluation happens

The clock

20 days BEFORE — the only clock that counts backwards

from the date the firm proposes to send them

LC 4062.3(a)–(g); 8 CCR 35(d) · Maxham (en banc, 2017); Suon (en banc, 2018)

Counts BACKWARDS. Nothing reaches the evaluator until the twenty days have run from service on every other party.

One window

Serve the proposed records. The other side has TEN days to object to anything in them; that period runs inside ours. Nothing reaches the evaluator until the TWENTY days are up — the objection window closing early does not release the records.

Decided en banc

“Information” served on an evaluator is not only records — it is anything communicated to them. A letter to the evaluator is information and is served on every other party the same way the records are.Maxham v. CDCR (WCAB en banc, 2017)

A dispute about what may go to the evaluator is for the Appeals Board. Neither side resolves it by agreeing between themselves or by sending the disputed material anyway.Suon v. California Dairies (WCAB en banc, 2018)

Tasks — written for this map 7 · due from the date the firm proposes to send the records

No page in the procedure manual covers this chain yet. These tasks were written for this map because the chain routes work to others and had no owner on any step — they need an attorney’s reading before they are relied on.

  1. Fix the send date and count backwards from itCase managerOn the attorney’s direction

    This clock runs BACKWARDS. The service date is twenty days before the records may go, so the send date is chosen first and the service date is computed from it — not the other way round.

    from MEDREC — medical records, imaging, operative reports, records returned on subpoenarecords date
    Records to go {date}; served on all parties by {date}, twenty days before.
  2. Assemble exactly what is proposedParalegal3 days

    From tabs 5, 7 and 13. Anything added after service must be served again and restarts the twenty days, so the set is settled before it goes out.

    Producesthe proposed records setNeeds first
    • the attorney's direction on what is proposed
    • the treating and med-legal reports from tabs 5 and 7
    • any subpoenaed records from tab 13
    from MEDREC — medical records, imaging, operative reports, records returned on subpoenarecords datelistN
    Proposed records assembled {date}: {list}, {N} pages.
  3. Serve every other party and file the proofCase managerSame day as assembly

    Every party, not only the defence. The proof of service carries the date the twenty days run from, which makes it the most consequential document on this chain.

    Producesthe served set and its proof of serviceNeeds first
    • the assembled records
    • every party's address of record
    • a cover letter naming what is enclosed
    from MEDREC — medical records, imaging, operative reports, records returned on subpoenarecords dateparties
    Proposed records served {date} on {parties}; POS filed.
  4. Read what they serve, within ten daysCase manager10 days from their service

    Their ten days to object runs inside our twenty. An objection to what they propose is ours to make in the same window, and it is the attorney’s call.

    from MEDREC — medical records, imaging, operative reports, records returned on subpoenarecords date
    Their proposed records received {date}; objection window to {date}. Attorney told.
  5. File what they propose at tab 6Case manager2 days

    Their proposed records are a med-legal SCHEDULING document, not records the firm holds — tab 6, not tab 5. The standard names this as the one case that is expressly not a question for a person to decide: it is filed to tab 6, the ten days are clipped, and the attorney is told. All three, or the ten days run against a document nobody can find.

    Producestheir proposed records, filed at tab 6Needs first
    • the date they served them, which is what the ten days run from
    • what they propose to send, item by item
    from the other side’s proposed records to the evaluatorrecords datetab
    Their proposed records served {date}, filed tab 6. Ten days close {date}.
  6. Decide whether to object to what they proposeAttorneyWithin their ten days

    Their ten days runs inside our twenty. An objection to what the other side proposes to send is made in that window or not at all, and a dispute about what may go to the evaluator is for the Board rather than the parties.

    from MEDREC — medical records, imaging, operative reports, records returned on subpoenarecords objected to / accepteddate…
    Their proposed records {objected to / accepted} {date}. Reason: {…}.
  7. Send nothing before the twenty days are upCase managerOn the send date

    The objection window closing early does not release the records. The evaluator receives ONE document, and it goes on the date computed at the start, not sooner.

    Producesthe records, sent to the evaluator as ONE documentNeeds first
    • the twenty days run from service
    • any objection they made, resolved
    from MEDREC — medical records, imaging, operative reports, records returned on subpoenarecords date
    Records sent to the evaluator {date}. Twenty days ran from {date}.

What this produces

Records Set for the Evaluator

signed by attorney

goes to the evaluator, served on every party twenty days before

starts the other side’s 10 days to object; nothing goes to the evaluator before the 20 days run

LC 4062.3(b), (e); 8 CCR 35(d)

The evaluator receives ONE document. Anything to an AME needs the parties’ agreement.

Assembled in this order
  1. The cover letterthe firmNames what is enclosed and the date it was served on every other party.
  2. The proposed recordsTabs 5, 7 and 13Exactly what the firm proposes to send — nothing added after service without serving that too.
  3. The proof of servicethe firmThe date it carries is the date every other clock on this chain runs from.

The evaluator receives ONE document. Nothing reaches them until the twenty days run, and anything added after service must be served too.

Templates 3

  • AME or QME Declaration of Service of Medical - Legal Report [Lab. Code §4062.3(i)]
  • QME Declaration of Service
  • Declaration Regarding Protection of Mental Health Record
The library cannot produce these
  • Letter to the panel QME
  • Letter to the QME
10 The evaluator reports They moved Medical-legal 30 days

the clock started before this reached the desk — how much is left?

The pathThe clockTasksThe paper

What led here

Records go to the evaluatorthe evaluation happens

What happens

The report the case turns on

PQME · filed behind tab 7 by default
also on this chain: AME (tab 7/tab 6)

a report → 7; anything else → 6

Where it goes next

The case is set for hearingthe reporting supports setting the case

The case endsthe report supports a settlement value

The clock

30 days, +15 for good cause

from the examination, or when the evaluation procedure began

LC 139.2(j)(1), 4062.5 · Vazquez (WCAB en banc, 2025)

30 days ordinarily · 45 with good cause as the exception. Thirty days, extendable by fifteen for good cause. The extension is not automatic and is not assumed; the badge shows the period as it stands.

Tasks 10 · due from the day the report is served

  1. Tell the attorneyCase managerSame day

    Always, without a condition. This is the report the case is valued from and the attorney reads it themselves — the file does not summarise it for them.

    from PQME — QME / panel QME reportrecords evaluatordate
    Report by {evaluator} dated {date}, exam {date}, served {date}. Attorney told {date}.
  2. Record the three datesCase managerSame day

    Examination, report, service. Each is a different clock: the exam date is what the thirty days ran from, the report date is what it produced, the service date is what any objection runs from. A file that holds one of them holds none of the answers.

    from PQME — QME / panel QME reportrecords dateN
    Exam {date}; report {date}; served {date}. Report was {N} days after the exam.
  3. File the report under its tabCase manager2 days

    Under its OWN date, at tab 7. The TYPE code decides the tab, which is what the code is for. A document acted on before it is filed is a document somebody is working from a copy of, and the copy is the one that gets annotated.

    Producesthe report, filed at tab 7Needs first
    • the document's own date, read off its face
    • its TYPE code — PQME — which is what decides the tab
    from PQME — QME / panel QME report — PQME when the evaluator came from a panel, QME otherwise; also the panel, strike and appointment paper (Descriptor says which)records tabdate
    Filed tab {tab} under its own date {date}.
  4. Check whether the report was lateCase manager1 day

    Thirty days from the exam, plus fifteen if good cause was claimed. Work out the gap and put it on the file. A late report is a statutory ground to replace the evaluator — whether the firm wants that is entirely the attorney’s question.

    from PQME — QME / panel QME reportrecords NWithin / beyond
    Exam to report: {N} days. {Within / beyond} the period. For the attorney.
  5. Record the findings, not the ratingCase manager2 days

    Whole-person impairment per body part, apportionment per body part, the maximum-medical-improvement status and date, work restrictions, and the page each was found on. What the report concludes about a percentage is recorded as what the report says — never adopted as the file’s own figure.

    from PQME — QME / panel QME reportrecords reportparts and WPI…status / date
    Findings recorded from {report}: {parts and WPI}, apportionment {…}, MMI {status/date}.
  6. Flag what the report does not coverCase manager2 days

    Compare the body parts evaluated against the body parts pleaded and the body parts treated. A part that was treated but not evaluated, or pleaded but not addressed, is a gap — and it is far cheaper to notice now than after the conference.

    from PQME — QME / panel QME reportrecords parts
    Evaluated: {parts}. Pleaded but not addressed: {parts}. Treated but not evaluated: {parts}.
  7. Put the objection question to the attorneyCase manager3 days

    Whether to object, ask for a supplemental, or accept it. There is no statutory clock, which is precisely why it needs a date — an open question with no deadline is the one that reaches the conference unanswered.

    from PQME — QME / panel QME reportrecords date
    Objection question put to the attorney {date}; their date {date}.
  8. Decide whether to object, and record it either wayAttorneyWithin the thirty days

    Whether the report is objectionable, and on what. A decision not to object is recorded — the report stands as evidence either way, and the file must show that was a choice.

    from PQME — QME / panel QME reportrecords datemade / not made…
    Objection to the {date} report {made / not made} {date}. Reason: {…}.
  9. Clip whatever they decide against the conferenceCase managerOn the attorney’s decision

    A supplemental request, a deposition of the evaluator, further records — each gets a date that falls before the conference, not on it. The conference is the wall; everything is scheduled to land before it.

    from PQME — QME / panel QME reportrecords Whatdate
    {What} clipped for {date}, ahead of the conference on {date}.
  10. Tell the client where the case standsCase manager5 days

    The report has been received and the attorney is reviewing it. Not what it says about their percentage, not what the case is now worth — those are the attorney’s to discuss and premature from anyone else.

    from PQME — QME / panel QME reportrecords date
    Client advised the report was received {date}.

Templates 17

  • Request for Consultative Rating
  • Request for Consultative Rating - San Bernardino WC-1284
  • Request for Consultative Rating [RCR]
  • Request for Summary Rating Determination
  • Request for Summary Rating Determination - of AME\
  • Request for Summary Rating Determination - Primary Treating Physician Report
  • Request for Summary Rating Determination of Primary Treating Physician Report
  • Request for Summary Rating Determination of Qualified Medical Evaluator’s Report
  • Request for Summary Rating Determination of Qualified or Agreed Medical Examiner’s Report
  • MED-AME Request Supp for Denied Treatment (Generic)
  • Physician’s PR4 - PTP P & S Report
  • QME/AME Report Time Frame Extension Request
  • Request for Informal Rating by Insurance Carrier or Self-insurer
  • Apportionment
  • Request for Reconsideration of Summary Rating by the Administrative Director
  • Request for Reconsideration of Summary Rating by the Administrative Director
  • CLIENT-Forwarding Med Legal Report
11 The case opens at the Board Fatal if late Litigation 1 year

our filing, on a clock nobody chose — miss it and the claim is barred

The pathThe clockTasksThe paper

What led here

The injured worker diesthe dependants file their own application

The carrier answers the claimdenied, delayed, or benefits are disputed

The injury gets worsea petition to reopen restarts the case

What happens

The attorney directs the filing

APP-ADJ · filed behind tab 2
also on this chain: ANSWER (tab 2)

Live at the same time

The treating doctor decides somethinga filed case does not stop treatment

Treatment is refusedauthorisation disputes run while the case is litigated

Where it goes next

The case is set for hearingthe case is ready to be heard

A petition for serious and willful misconductthe facts support serious and willful misconduct

The prior disability is at issuea prior permanent disability is in play

A deposition is noticedthe defense wants the applicant’s testimony

Records are subpoenaedrecords are needed from a third party

The clock

one year

from the date of injury, the end of the last indemnity period, or the last medical furnished — whichever is latest

LC 5405

Already runningThis period did not start when this chain did. It has been running since the date of injury — before the case reached this page, and in most files before the firm was retained. What is left is what matters, and the answer is on the file, not on this page.

On a CUMULATIVE TRAUMA this phrase names two dates. The injury has a period start and a period end, and anything computed from the date of injury uses the END date. Both dates go on the file; neither is used silently.

Disclosure of the liable entity and the policy

no period — the responsible entity "must be divulged at the earliest opportunity, and certainly no later than the commencement of the litigation process and formal proceedings" (Coldiron I)

from the commencement of the case

Coldiron I & II (WCAB en banc, 2002) · DiFusco (WCAB en banc, 2025) · 8 CCR 10390, 10400, 10401 · CCP 2017.210

If this is late

Filed after the period, the claim is barred and no diligence afterwards recovers it. The period is not extended by the carrier’s delay in answering.

The trap

THREE candidate dates, and the latest governs: the date of injury, the end of the last indemnity period, or the last medical treatment furnished. A file that looks a year stale under one of them may be current under another, and the usual error is computing from the date of injury alone because that is the date everybody knows.

Decided en banc

Pleadings are read for substance, not form. A technical defect in a filing is not a reason to treat it as a nullity — which matters most here, where the filing is what keeps the claim alive.Perez v. Chicago Dogs (WCAB en banc, 2025)

Not verified against the standard

CCP 2017.210 is not in AAI-STD 1. It is quoted in DiFusco (WCAB en banc, 2025) as the discovery route to insurance information, and the disclosure duty itself rests on Coldiron I & II (WCAB en banc, 2002), which DiFusco Holding No. 3 reaffirms. Binding precedent, from a corpus the published standard does not carry.

Tasks 12 · due from the day the attorney directs it

  1. Confirm the case is ready to be filedAttorneyBefore anything is drafted

    Whether and when to file is the attorney’s decision, not a step that follows automatically from a denial. What this page records is that the decision is made deliberately and that the file shows who made it.

    from APP-ADJ — application for adjudicationrecords date
    Attorney directed the Application be filed {date}.
  2. Check every field against a documentCase manager2 days

    The Application states the worker, the employer, the insurer, the date of injury, the body parts and the venue. Each is checked against a record rather than against the intake questionnaire — the questionnaire is the client’s account, and the Application is a pleading. A wrong employer or a wrong date of injury on a filed Application is corrected by amending it, which is a filing of its own.

    from APP-ADJ — application for adjudicationrecords sourcesdate
    Application fields verified against {sources} {date}.
  3. Draft itCase manager3 days

    Prepare it on the Board’s own form. Body parts are pleaded as they are alleged, with laterality; the venue follows the rule for the case, not convenience.

    ProducesApplication for Adjudication of Claimtemplate: Application for Adjudication of Claim (WCAB 1)Needs first
    • the date of injury, and on a CT both period dates
    • every body part with laterality
    • the employer's legal entity name
    • the carrier or administrator
    • the client's signature
    from APP-ADJ — application for adjudicationrecords date
    Application drafted {date} for attorney review.
  4. The attorney signs itAttorneySame day as filing

    A pleading is signed by the attorney. Nobody signs it on their behalf, and the file records who signed and when.

    Producesthe signed ApplicationNeeds first
    • the drafted application, every field checked against a document
    from APP-ADJ — application for adjudicationrecords attorneydate
    Application signed by {attorney} {date}.
  5. File it and serve itCase managerSame day as signing

    Filed with the Board, then served on every party with a proof of service. The proof of service is a sworn statement in the first person — it carries the name of whoever actually served it, never someone else’s.

    Producesthe filed Application and its proof of serviceNeeds first
    • the signed application
    • every party's address of record
    from APP-ADJ — application for adjudicationrecords dateparties
    Application filed {date}; served on {parties} {date}; POS filed.
  6. Close the statute clip against the filing dateCase managerSame day as filing

    The reason this task exists as its own line is that it is the one most often missed. The Application is filed, the case moves on, and a satisfied one-year clock sits open on the file for years afterward looking like a live deadline.

    from APP-ADJ — application for adjudicationrecords date
    LC 5405 satisfied by the filing of {date}. Clock closed against that date.
  7. Record the ADJ number everywhere it belongsCase managerOn the conformed copy

    The Board returns a conformed copy with the ADJ number. That number is the case’s identity at the Board and it goes on the case record — not only inside the PDF, where nothing can search it.

    from APP-ADJ — application for adjudicationrecords numberdate
    ADJ {number} assigned; conformed copy filed {date}; case record updated.
  8. Watch for the answerCase manager30 days

    A follow-up so that silence is noticed. There is no clock the firm holds against a defence that does not answer, but the fact of it belongs on the file.

    from APP-ADJ — application for adjudicationrecords received {datedate
    Answer {received {date} / not received as at {date}}.
  9. Close the answer follow-upCase managerSame day

    A watch was set when the Application was filed. It has been answered; close it against the date rather than leaving it to expire.

    from APP-ADJ — application for adjudicationrecords date
    Answer received {date}. Follow-up closed.
  10. Record what is put in issueCase manager2 days

    Injury arising out of employment, the employment relationship, the body parts, apportionment, the statute of limitations, post-termination. What is denied is what has to be proved, and it should be legible from the file without re-reading the pleading.

    from APP-ADJ — application for adjudicationrecords list
    Defences raised: {list}.
  11. Tell the attorney what is deniedCase manager2 days

    Not the document — the list. An answer that denies employment is a different case from one that admits it and disputes apportionment.

    from APP-ADJ — application for adjudicationrecords datesummary of what is in issue
    Attorney told {date}: {summary of what is in issue}.
  12. Check the parties against oursCase manager2 days

    Whom the answer is filed for, and whether that matches the carrier and employer on the file. A discrepancy here is worth resolving before anything is served.

    from APP-ADJ — application for adjudicationrecords partiesconsistent / discrepancy: …
    Answer filed for {parties}; {consistent / discrepancy: …}.

What this produces

Application for Adjudication of Claim

signed by attorney

goes to the Board, then served on every party

starts proceedings are commenced — the one-year statute is satisfied

LC 5405

Templates 6

  • Addendum to Application for Adjudication of Claim to Identify Legal Entity Employing Injured Worker
  • Answer to Application for Adjudication of Claim
  • Application For Adjudication of Claim
  • Letter to WCAB_Amended App
  • Special Notice of Lawsuit
  • Answering Defendants Deny the Alligations of the Application
12 Written discovery arrives They moved Litigation

the clock started before this reached the desk — how much is left?

The pathThe clockTasksThe paper

What led here

A letter arrives from the other sideit is a written discovery request

What happens

Interrogatories, requests for admission or requests for production, served by a party

DISCOVERY · filed behind tab 12

Where it goes next

Records are subpoenaedanswering it needs records from a third party

The case is set for hearingdiscovery closes at the conference

The trap

The response date comes from the request itself. Where the request names none, the attorney sets one rather than the file assuming a period — and a request that names an impossible date is answered by saying so, not by treating it as void.

Why it is on the map

The period is on the document, not in a statute. That is why it is easy to miss: a deposition notice announces itself and a set of interrogatories looks like more mail. The date the request carries is the date the file clips.

Tasks — written for this map 7 · due from the day the request is served

No page in the procedure manual covers this chain yet. These tasks were written for this map because the chain has a date somebody must act on and named nobody — they need an attorney’s reading before they are relied on.

  1. Date-stamp it and record how it was servedCase managerSame day

    How it arrived can change what is left of the period, and a written discovery request is easy to mistake for ordinary mail.

    from DISCOVERY — written discoveryrecords whodatemethod
    Discovery request from {who}, dated {date}, served {date} by {method}.
  2. File the request under its tabCase manager2 days

    Under its OWN date, at tab 12. The TYPE code decides the tab, which is what the code is for. A document acted on before it is filed is a document somebody is working from a copy of, and the copy is the one that gets annotated.

    Producesthe request, filed at tab 12Needs first
    • the document's own date, read off its face
    • its TYPE code — DISCOVERY — which is what decides the tab
    from DISCOVERY — written discovery — interrogatories, requests for admission, requests for production served by a partyrecords tabdate
    Filed tab {tab} under its own date {date}.
  3. Find the response date the request statesCase managerSame day

    It is printed on the request. This is the one period on the map that is in no statute, which is exactly why it must be read off the document rather than assumed from a rule.

    from DISCOVERY — written discoveryrecords date
    Response date on the request: {date}. Source: the request itself.
  4. Tell the attorney the same day, with that dateCase managerSame day

    Whether the request is answerable, objectionable or impossible on its own date is the attorney’s. The file records the date and who was told.

    from DISCOVERY — written discoveryrecords date
    Attorney told {date}; response date {date}.
  5. Clip the response date and say it came from the requestCase managerSame day

    A clip that does not say where its date came from cannot be checked later. Where the request names no date, the attorney sets one and the file records that it was set rather than found.

    from DISCOVERY — written discoveryrecords datefrom the request / set by the attorney
    Clipped {date}, {from the request / set by the attorney}.
  6. Decide what is answered and what is objected toAttorneyBefore the response date

    Which requests are answered, which are objected to, and on what ground. A request that names an impossible date is answered by saying so rather than treated as void.

    from DISCOVERY — written discoveryrecords dateanswer / object…
    Response directed {date}: {answer / object} per request. Grounds: {…}.
  7. Assemble what answering it needsParalegalOn the attorney’s direction

    What the request asks for, from the file. Where answering needs records the firm does not hold, that is a subpoena and a different chain.

    Producesthe material the response will draw onNeeds first
    • what the request asks for
    • what the file already holds
    • the attorney's direction on what is objectionable
    from DISCOVERY — written discoveryrecords datewhat
    Assembled for the response {date}: {what}. Outstanding: {what}.

Templates

No template in the library. This is written from scratch, on a clock somebody else started.

The library cannot produce these
  • Response to interrogatories
  • Response to requests for admission
  • Response to a request for production
  • Objection to written discovery
13 A deposition is noticed They moved Litigation not before 10 days

the clock started before this reached the desk — how much is left?

The pathThe clockTasksThe paper

What led here

A letter arrives from the other sideit notices or reschedules a deposition

The case opens at the Boardthe defense wants the applicant’s testimony

What happens

Notice that a party is to be deposed

DEPO-NOTICE · filed behind tab 12
also on this chain: DEPO-TX (tab 12)

Live at the same time

A panel is assigneddiscovery and the evaluation proceed together

Where it goes next

The case is set for hearingdiscovery closes

The clock

the noticed date — at least 10 days after service, or 20 after issuance of the subpoena where consumer or employment records are subpoenaed

from service of the notice

LC 5710(a)–(b); CCP 2025.270(a), (c)

A FLOOR. The noticed date must be at least ten days after service — twenty where consumer or employment records were subpoenaed for it. A notice giving less is answered, not accommodated.

The trap

A notice giving less than ten days is answered, not accommodated. Twenty if records were subpoenaed for it. And the applicant is OWED transportation, lost wages, one transcript, a fee and a certified interpreter — claimed as a matter of course, not when someone remembers.

Tasks 7 · due from the day the notice is served

  1. Check the date is far enough outCase managerSame day

    At least ten days after service; twenty after issuance where records were subpoenaed for it. Work it out and record it — a short notice is answered, not accommodated.

    from DEPO-NOTICE — deposition notice / transcriptrecords dateNSufficient / short — attorney told
    Notice served {date} for {date}: {N} days. {Sufficient / short — attorney told}.
  2. Tell the attorneyCase managerSame day

    Whether to object, seek a different date, or accept it. And whether the attorney is available, which is not a detail.

    from DEPO-NOTICE — deposition notice / transcriptrecords date
    Deposition notice told to the attorney {date}.
  3. Calendar it with an assigneeCase manager1 day

    It is a date somebody has to attend. An event owned by nobody appears on nobody’s calendar.

    from DEPO-NOTICE — deposition notice / transcriptrecords datewho
    Deposition {date} calendared to {who}.
  4. Arrange the clientCase manager5 days before

    Tell them when and where, arrange an interpreter if one is needed, arrange transport. Confirm the day before — a deposition the client does not attend is rescheduled at cost.

    Producesthe client’s confirmation letterNeeds first
    • the noticed date and address
    • whether an interpreter is needed
    from DEPO-NOTICE — deposition notice / transcriptrecords datearranged / not needed
    Client confirmed {date}; interpreter {arranged / not needed}; transport {arranged / not needed}.
  5. Prepare the clientAttorneyBefore the date

    The attorney’s work, and the file records that it happened.

    Producesthe preparation session, recordedNeeds first
    • the attorney's time
    • the file the client will be asked about
    from DEPO-NOTICE — deposition notice / transcriptrecords attorneydate
    Client prepared by {attorney} {date}.
  6. Claim what is owedCase manager5 days after

    Transportation, lost wages, meals and the interpreter are known on the day and are claimed now — waiting on the transcript to claim any of it is how a claim goes stale. The TRANSCRIPT cost is not known yet; it is claimed when the transcript arrives, and the file says which items are outstanding.

    Producesthe LC 5710 costs claimNeeds first
    • transportation and lost wages
    • the interpreter's invoice
    • the attorney's fee figure
    from DEPO-NOTICE — deposition notice / transcriptrecords datetransportation, wages, interpreter, meals
    LC 5710 costs claimed {date}: {transportation, wages, interpreter, meals}. Transcript cost outstanding.
  7. File the transcript when it comesCase managerOn receipt

    It goes behind Tab 12 with its own date. And it carries the last LC 5710 item: the transcript cost, which could not be claimed when the rest was.

    Producesthe transcript, filed at tab 12Needs first
    • the transcript as delivered
    • the date it was received
    from DEPO-NOTICE — deposition notice / transcriptrecords date
    Transcript received {date}, filed. Transcript cost claimed {date}.

Templates 9

  • CLIENT-DEPO Notice (Generic)
  • CLIENT-Errata Sheet (Generic)
  • Compex Deposition Request
  • LETTER TO DA - 5710 BILLING LETTER
  • Notice of Representation w depo
  • Notice of Representation w depo
  • Notice of Representation w depo
  • notice_of_representation w Depo
  • Applicant’s Objection to Request For Production of Documents at Deposition
14 Records are subpoenaed We moved Litigation not before 20 days

the attorney picks the date; late here is a decision, not an accident

The pathThe clockTasksThe paper

What led here

Written discovery arrivesanswering it needs records from a third party

A letter arrives from the other sideit demands records or answers a subpoena

The case opens at the Boardrecords are needed from a third party

What happens

The attorney directs a subpoena to a custodian

SDT · filed behind tab 13
also on this chain: SUBPOENA (tab 13)

Where it goes next

Medical records come inthe custodian produces

The clock

no earlier than 20 days after issuance or 15 after service — WHICHEVER IS LATER

from issuance and service of the subpoena

LC 130, 5710; CCP 2020.410(c); Evid. Code 1560(b)(2)

A FLOOR, not a deadline. Twenty days from ISSUANCE or fifteen from SERVICE, WHICHEVER IS LATER — so the governing date is the later of the two, and the badge shows the shorter branch only as a reminder that neither alone is the answer. Served sooner, the subpoena is defective rather than early.

Objecting to the other side’s nonmedical records

10 days

from service of their proposed records or information

LC 4062.3(b); 8 CCR 35(d) · Suon (2018)

The trap

Twenty days from ISSUANCE or fifteen from SERVICE — whichever is LATER. Using one of the two produces a date that is too early, which is a defective subpoena rather than an aggressive one.

Tasks 7 · due from the day the subpoena is served

  1. Confirm what is being sought and from whomParalegalOn direction

    The custodian, the records, the date range. A subpoena that asks for everything from everybody returns a packet nobody can use and costs the same as a precise one.

    from SDT — subpoena duces tecum / subpoenarecords custodianrecordsdate range
    SDT to {custodian} for {records}, {date range}.
  2. Compute the production date properlyParalegalOn issuance

    Twenty days from issuance, fifteen from service, and take the later. Record both computations so the date on the document can be checked rather than trusted.

    ProducesSubpoena Duces Tecumtemplate: Subpoena Duces TecumNeeds first
    • the date of issuance
    • the date of service on the custodian
    • the custodian's correct name and address
    from SDT — subpoena duces tecum / subpoenarecords datethe later
    Issued {date} +20 = {date}; served {date} +15 = {date}. Production date {the later}.
  3. Serve it and file the proofParalegalOn issuance

    On the custodian and on every party. The proof of service is sworn in the first person by whoever served it.

    Producesthe served subpoena and its proof of serviceNeeds first
    • the issued subpoena
    • the custodian's address
    • every party's address of record
    from SDT — subpoena duces tecum / subpoenarecords datecustodianparties
    SDT served {date} on {custodian} and {parties}; POS filed.
  4. Log it as outstandingParalegalSame day

    A records request that nobody is tracking is a records request that arrives after the conference or not at all. The log is what makes chasing possible.

    from SDT — subpoena duces tecum / subpoenarecords date
    Added to the records log {date}; due {date}.
  5. Follow up the day after production was dueParalegalThe day after

    Not a week later. A custodian that has not produced is either not going to or has not received it, and both are worth knowing early.

    from SDT — subpoena duces tecum / subpoenarecords dateresponse
    Follow-up {date}: {response}.
  6. When the packet arrives, split itParalegal2 days

    A subpoena return is several documents in one envelope — a cover letter, the custodian’s declaration, the subpoena, the records themselves. Each is filed as its own thing, because each is findable only under its own name.

    from SDT — subpoena duces tecum / subpoenarecords dateNcomponents
    Return received {date}: {N} pages, split into {components}.
  7. Check it is completeParalegal2 days

    The declaration signed, the pages continuous, the date range covered. Gaps in the numbering and an unsigned declaration are both worth raising before the records are relied on.

    from SDT — subpoena duces tecum / subpoenarecords signed / unsignedcontinuous / gaps at …covered / short
    Return checked: declaration {signed / unsigned}; pages {continuous / gaps at …}; range {covered / short}.

What this produces

Subpoena Duces Tecum

signed by attorney

goes to the custodian, served on every party

starts the custodian’s production

CCP 2020.410(c); Evid. Code 1560(b)(2)

Templates 10

  • Description of Documents to Produce
  • Pleading Objection to Order Quashing Subpoena duces tecum with POS
  • Subpoena Duces Tecum
  • Compex Applicant Attorney Request
  • Compex Defense Attorney Request
  • Platinum Copy
  • Platinum Copy Request
  • Response to MTQ
  • Response to MTQ - Order
  • DEFENSE-Letter to Atty Carrier Right to Our Own Discovery
The library cannot produce this
  • Subpoena — WCAB 30 (the legacy form)
15 Medical records come in They moved Treatment 20 days

the clock started before this reached the desk — how much is left?

The pathThe clockTasksThe paper

What led here

Records are subpoenaedthe custodian produces

What happens

Reports, records and provider paper

MEDREC · filed behind tab 5 by default

5 (returned on a subpoena → 13)

Where it goes next

The treating doctor decides somethinga report decides something the worker’s benefits turn on

The clock

20 days if represented, 30 if not

from receipt of the report

LC 4062(a)

20 days represented ordinarily · 30 days unrepresented as the exception. Twenty days where the employee is represented, thirty where they are not. The badge shows twenty because a represented file is this firm’s ordinary case and the shorter period.

Why it is on the map

Most treating reports need nothing. The judgement is spotting the one that changes what the worker gets — that one starts a twenty-day clock and belongs on the defensive chain.

Tasks — written for this map 8 · due from the day the report is received

No page in the procedure manual covers this chain yet. These tasks were written for this map because the chain names a period in its own prose and owned nobody — they need an attorney’s reading before they are relied on.

  1. Date-stamp it on RECEIPT, not on its own dateCase managerSame day

    The twenty days run from receipt. A report dated three weeks before it arrives has not been sitting on a running clock, and a report that arrived before it was date-stamped has. Receipt is the date the period is computed from and it exists nowhere but on the stamp.

    from MEDREC — medical records, imaging, operative reports, records returned on subpoenarecords dateprovidermethod
    Report of {date} from {provider} received {date} by {method}.
  2. File it behind the treating medicalCase manager2 days

    Tab 5 by default; tab 13 where it came back on a subpoena, because how it arrived is what a later reader needs to know about it.

    Producesthe report, filed at tab 5 — or tab 13 where it returned on a subpoenaNeeds first
    • the provider and the report date
    • how it arrived — direct from the provider, or on a subpoena, which is what decides the tab
    from MEDREC — medical records, imaging, operative reports, records returned on subpoenarecords 5 / 13date
    Filed tab {5 / 13} under {date}.
  3. Read whether it DECIDES anythingCase managerSame day

    Most reports continue treatment and need nothing. A report that changes work restrictions, states maximum medical improvement, apportions, or releases the worker DECIDES something — and that one starts twenty days to object. Spotting it is the whole job of this chain; the reading of what follows is the attorney’s.

    from MEDREC — medical records, imaging, operative reports, records returned on subpoenarecords datecontinues treatment / decides {what
    Report of {date}: {continues treatment / decides {what}}.
  4. Clip the twenty days where it decides somethingCase managerSame day

    Twenty days from RECEIPT, not from the report’s own date, and only where the report decides something — most do not. A report that decides nothing is filed and needs no clip; clipping every report buries the one that matters.

    Producesthe objecting to a treating physician’s determination clip, with an assigneeNeeds first
    • the date the period runs from
    • which branch of ptp_objection applies
    from MEDREC — medical records, imaging, operative reports, records returned on subpoenarecords datewho
    Report of {date} received {date}; objection window closes {date}. Assigned to {who}.
  5. Tell the attorney the same day where it decides somethingCase managerSame day

    With the receipt date, because that is what the twenty days count from. The file records the date it went and no view on whether an objection lies.

    from MEDREC — medical records, imaging, operative reports, records returned on subpoenarecords date
    Attorney told {date}; report received {date}; twenty days to {date}.
  6. Decide whether to object, and record it either wayAttorneyWithin the twenty days

    Twenty days from receipt where the worker is represented. A decision not to object is recorded with its date and its reason — the report stands as evidence either way, and the file must show that was a choice rather than a period that ran out.

    from MEDREC — medical records, imaging, operative reports, records returned on subpoenarecords datemade / not made…
    Objection to the {date} report {made / not made} {date}. Reason: {…}.
  7. Record new body parts against what was pleadedCase manager2 days

    A body part treated but never pleaded is a gap in the Application. This is where it first becomes visible, and it is visible nowhere else — the pleading is not re-read every time a report arrives.

    from MEDREC — medical records, imaging, operative reports, records returned on subpoenarecords datelistwhat
    Body parts in the {date} report: {list}. Pleaded: {list}. Gap: {what}.
  8. Keep the running list a demand is built fromParalegalOn each report

    Providers, dates of service, findings. Assembling this at the point a demand is made means assembling it from a file nobody indexed, months later.

    from MEDREC — medical records, imaging, operative reports, records returned on subpoenarecords date
    Treatment list current to {date}.

Templates 4

  • Doctors First Report of Occupational Injury or Illness
  • MED-Reporting Req. For All Med Services By The PTP
  • QME Disclosure of Specified Financial Interests
  • Treating Physician’s Report of Disability Status
16 Work is offered They moved Resolution and money

the clock started before this reached the desk — how much is left?

The pathThe clockTasksThe paper

What led here

The treating doctor decides somethingthe doctor releases to modified or regular work

What happens

An offer of regular, modified or alternative work

BENEFITS · filed behind tab 1 by default

1, 10, 11 — the claim itself (acceptance, denial, delay) → 1; a rate, an offer or a voucher → 10; a check → 11

Where it goes next

The case endsthe voucher and return-to-work bear on value

The clock

depends on the DATE OF INJURY

from the offer — the employer’s window is 60 days

LC 4658(d)(2)–(3); 4658.1(a)–(c); 4658.7(b)(1)–(2) · Dennis (WCAB en banc, 2020)

The trap

The same letter does two different things. Injuries 2005–2012: it moves permanent disability by ±15%. Injuries from 2013: it decides the SJDB voucher instead, and only an offer lasting at least twelve months counts. Read the date of injury before anything else.

Tasks 7 · due from the day the offer arrives

  1. Check the date of injury firstCase managerSame day

    Before anything else, because it decides which statute the document is read under. The same offer is a fifteen per cent adjustment on one case and a voucher question on another.

    from BENEFITS — benefit noticerecords dateLC 4658(d) / LC 4658.7
    Offer dated {date}; DOI {date}; read under {LC 4658(d) / LC 4658.7}.
  2. Tell the attorneyCase managerSame day

    Every offer of work, the day it arrives, whichever rule applies.

    from BENEFITS — benefit noticerecords date
    Attorney told {date}.
  3. Record what is actually offeredCase manager1 day

    Regular, modified or alternative; the duties, the wage, the hours, and — for a post-2013 injury — whether it is for at least twelve months. The twelve months is what decides the voucher and it is often not stated plainly.

    from BENEFITS — benefit noticerecords typedutieswagehoursN months
    Offered: {type}, {duties}, {wage}, {hours}, duration {N months}.
  4. File the offer letter under its tabCase manager2 days

    Under its OWN date, at tab 10. The TYPE code decides the tab, which is what the code is for. A document acted on before it is filed is a document somebody is working from a copy of, and the copy is the one that gets annotated.

    Producesthe offer letter, filed at tab 10Needs first
    • the document's own date, read off its face
    • its TYPE code — BENEFITS — which is what decides the tab
    from BENEFITS — benefit notice (claim accepted/denied/delayed; TD/PD notices; offer of work; SJDB)records tabdate
    Filed tab {tab} under its own date {date}.
  5. Compare it with the work restrictionsCase manager2 days

    Against the restrictions in the most recent report. Where the offer exceeds them, that is a fact worth putting in front of the attorney rather than in front of the client.

    from BENEFITS — benefit noticerecords dateconsistent / exceeds in …
    Offer compared with restrictions of {date}: {consistent / exceeds in …}.
  6. Tell the client and get their instructionsAttorney3 days

    What is offered, what accepting or declining does. On a post-2013 injury that includes what happens to the voucher. This conversation is the attorney’s because the consequences are legal ones.

    from BENEFITS — benefit noticerecords date…
    Offer discussed with the client {date}; instructions {…}.
  7. Record the response and its dateCase managerOn the client’s decision

    Accepted, declined, or no response — with the date. It is the fact everything afterwards turns on.

    from BENEFITS — benefit noticerecords accepted / declined / no responsedate
    Offer {accepted / declined / no response} {date}.

Templates 16

  • DEFENSE-VRE Evaluation Notice to Carr Def (Generic)
  • Medical and Vocational Statement
  • Notice of Termination of Vocational Rehabilitation
  • Notice of Termination of Vocational Rehabilitation Services
  • Physician Return-to-Work and Voucher Report
  • Request for Conclusion of Rehabilitation Benefits
  • Vocational Rehabilitation Plan - 10122-13
  • Voluntary Directive for Alternate Service of Medical - Legal Evaluation Report on Disputed Injury to Psyche [Unrepresented Employees Only]
  • Notice of Offer of Modified or Alternative Work
  • Notice of Offer of Regular Work
  • Notice of Offer of Regular, Modified, Or Alternative Work for Injuries
  • Petition to Terminate Liability for Temporary Disability Indemnity
  • Request for Dispute Resolution - 10133-14
  • Request for Dispute Resolution Before Admin Director (DWC-AD 10133.55)
  • Supplemental Job Displacement Non-Transferable Voucher Form for Injuries Occurring on or After 1/1/13
  • Supplemental Job Displacement Nontransferable Training Voucher
17 The case is set for hearing Either side Litigation

the same exchange whichever side began it, and both are on a clock

The pathThe clockTasksThe paper

What led here

Written discovery arrivesdiscovery closes at the conference

The case opens at the Boardthe case is ready to be heard

The evaluator reportsthe reporting supports setting the case

A deposition is noticeddiscovery closes

A petition for serious and willful misconductthe petition is set for hearing

The prior disability is at issuethe Fund claim is set for hearing

A provider claims against the casethe lien is set for conference

What happens

Either side declares the case ready

DOR · filed behind tab 3
also on this chain: MSC (tab 3), MOH (tab 3), PTCS (tab 3)

Live at the same time

The treating doctor decides somethingthe doctor goes on reporting after the case is set

Where it goes next

The Board decidesthe matter is heard and decided

The case endsthe case resolves at the conference

The clock

the date on the notice

from the notice

—

Discovery closes at the conference

the conference date

from the mandatory settlement conference

LC 5502(d)(3)

Decided en banc

A decision rests on the admitted record. What was said at a conference is not evidence unless it was put in — so what the file can prove is what the file filed.Gaines v. ABM Aviation (WCAB en banc, 2026)

Tasks 18 · due from the day the DOR is filed or received

  1. Establish which side filed itCase managerSame day

    Everything on this page turns on it. Ours means the firm chose this; theirs means the firm is answering. Record it on the file in words, not by inference from who signed.

    from DOR — declaration of readiness to proceedrecords us / the defencedate
    DOR filed by {us / the defence}, dated {date}, received {date}.
  2. Tell the attorneyCase managerSame day

    A DOR moves a case whichever side files it. The attorney is told the day it arrives, because the decisions that follow — object, agree, or use the time — are theirs and the window on the first of them is short.

    from DOR — declaration of readiness to proceedrecords date
    Attorney told {date}.
  3. If it is theirs: put the objection window on the fileCase managerSame day

    Clip the twenty-five days from service and note the rule it comes from. Whether to object is the attorney’s call; having the date is the file’s job.

    from DOR — declaration of readiness to proceedrecords date
    Objection window to {date} per WCAB Rule 10417, from service {date}. For the attorney.
  4. If it is ours: confirm the case is actually readyAttorneyBefore filing

    A DOR says discovery is done. Filing one before it is done is how a case arrives at a conference without the report it needs — and the cutoff the conference brings is what makes that permanent. What is outstanding, and whether it matters, is the attorney’s judgement; the file records that the question was asked.

    from DOR — declaration of readiness to proceedrecords dateitems, or none
    Attorney confirmed readiness {date}. Outstanding at filing: {items, or none}.
  5. List what is still outstandingCase manager2 days

    Records not returned, a report not received, a deposition not taken, a supplemental not answered. One list, on the file, before the conference date is known — because once it is known the list becomes a deadline.

    from DOR — declaration of readiness to proceedrecords datelist
    Outstanding as at {date}: {list}.
  6. Watch for the notice of hearingCase manager30 days

    The follow-up. If nothing has come, that is worth raising rather than waiting further — a DOR that produced no date usually means something about the filing, not about the Board.

    from DOR — declaration of readiness to proceedrecords received {datedate
    Notice of hearing {received {date} / not received as at {date}}.
  7. When the date comes, clip the cutoffCase managerOn the notice of hearing

    The conference date is the discovery cutoff. Clip it, and clip against it everything the outstanding list still holds — each one dated before the conference, not on it.

    from DOR — declaration of readiness to proceedrecords date
    Conference {date}; discovery closes that day. Outstanding items clipped against it.
  8. Tell the attorney and calendar itCase managerSame day

    The date, the type, the judge and the venue. Calendared as an event with an assignee — an appearance nobody is assigned to is an appearance nobody makes.

    from DOR — declaration of readiness to proceedrecords Hearing typedatenamevenuewho
    {Hearing type} {date}, Judge {name}, {venue}. Calendared to {who}; attorney told {date}.
  9. Work out what is still outstandingCase manager2 days

    Records not returned, reports not received, depositions not taken, objections not answered. Against the conference date, each becomes a date rather than an intention.

    from DOR — declaration of readiness to proceedrecords datelist
    Outstanding as at {date}: {list}, all against the conference of {date}.
  10. Clip each outstanding item before the conferenceCase manager3 days

    Not on the conference date — before it, with enough time for the thing to actually arrive. A subpoena issued a fortnight out will not produce records in time and the clip should say so.

    from DOR — declaration of readiness to proceedrecords itemdate
    Clipped: {item} for {date}; {item} for {date}.
  11. PrepareAttorneyA week before

    The attorney’s work. The file’s job is that it is scheduled rather than remembered.

    ProducesDeclaration of Readiness to Proceedtemplate: Declaration of Readiness to ProceedNeeds first
    • what is still outstanding, and whether it can be closed
    • the attorney's confirmation that discovery is done
    from DOR — declaration of readiness to proceedrecords date
    Preparation task set for {date}.
  12. Confirm the client knowsCase manager1 week before

    Whether they need to attend, where, and when. And an interpreter if one is needed.

    from DOR — declaration of readiness to proceedrecords daterequired / not requiredarranged / not needed
    Client told {date}; attendance {required / not required}; interpreter {arranged / not needed}.
  13. Record what happenedCase managerAfter the hearing

    Continued, settled, tried, taken off calendar. The minutes arrive later and separately; this is the note that says what the file should expect.

    from DOR — declaration of readiness to proceedrecords dateoutcome
    Hearing {date}: {outcome}.
  14. Prepare the statement against the outstanding listCase manager1 week before

    Issues, exhibits, witnesses, stipulations. What is not listed may not be usable, so the statement is built from the outstanding list rather than from memory.

    ProducesPre-Trial Conference Statementtemplate: Pre-trial conference statementNeeds first
    • the outstanding list
    • what is agreed and what is in issue
    • every exhibit the firm intends to offer
    from DOR — declaration of readiness to proceedrecords date
    PTCS prepared {date} for the conference of {date}.
  15. The attorney settles the issuesAttorneyBefore the conference

    What is in dispute and what is agreed. The statement is signed and it binds.

    from DOR — declaration of readiness to proceedrecords attorneydate
    Issues settled by {attorney} {date}.
  16. File the minutes when they comeCase managerOn receipt

    Board-issued, under their own date. They are the record of what the conference decided and they are read rather than filed blind.

    Producesthe minutes, filed at tab 3Needs first
    • the minutes as served
    • what they decided or set
    from DOR — declaration of readiness to proceedrecords datewhat was decided
    Minutes of {date} received {date}: {what was decided}.
  17. Act on what the minutes setCase manager2 days

    A trial date, a further conference, an order to do something by a date. Each becomes a clip.

    from DOR — declaration of readiness to proceedrecords whatdate
    From the minutes: {what}, clipped for {date}.
  18. On a continuance, move every clipCase managerSame day

    The new conference date is the new cutoff and everything scheduled against the old one moves. Leaving a clip on a superseded date is how an item quietly stops being tracked.

    from DOR — declaration of readiness to proceedrecords dateN
    Conference continued from {date} to {date}; {N} clips moved.

What this produces

Declaration of Readiness to Proceed

signed by attorney

goes to the Board, served on every party

starts a hearing is set by the Board; discovery closes at the MSC it sets

LC 5502(d)(3)

Templates 12

  • 10770.6 Verification of Filing of Declaration of Readiness By or on Behalf of Lien Claimant
  • Declaration of Readiness To Proceed (DOR)
  • Declaration of Readiness To Proceed To Expedited Hearing (DOR) (Trial)
  • PLEADS-Order Denying Defendants DOR
  • CLIENT-MSC Notice Generic
  • CLIENT-Not Hearing Generic
  • CLIENT-Notice of Expedited Hearing
  • CLIENT-Trial Notice (Generic)
  • DEFENSE-Trial Notice to Opposing
  • Arbitration Submittal Form
  • DEFENSE-MSC Not (Generic)
  • Request to Serve Witness for Appearance at Trial
18 The case ends We moved Resolution and money

the attorney picks the date; late here is a decision, not an accident

The pathThe clockTasksThe paper

What led here

The injured worker diesthe dependency claim resolves

A letter arrives from the other sideit makes or answers an offer

The evaluator reportsthe report supports a settlement value

The case is set for hearingthe case resolves at the conference

The judge wants more before approvingthe defect is cured and it is resubmitted

Work is offeredthe voucher and return-to-work bear on value

What happens

The parties agree

CR · filed behind tab 14
also on this chain: STIP (tab 14)

Live at the same time

The treating doctor decides somethingtreatment continues until the settlement is approved

Where it goes next

The judge wants more before approvingthe judge wants more before approving

The Board decidesthe judge approves

The clock

—

from the filing

8 CCR 10700(a) · Gaines v. ABM Aviation (WCAB en banc, 2026)

Payment after an award or order approving

the date the order sets — where it sets none, the attorney sets a 30-day check

from service of the award or order

LC 5814

Tasks 16 · due from the day the settlement is signed

  1. Assemble every relevant reportCase manager5 days

    Every AME, QME and treating report bearing on adequacy. Not a selection — the rule is that they go, and withholding them or saying none exist when they do is prohibited. Build the list before the settlement is drafted, because the list is part of what makes it approvable.

    Producesthe report set filed with the settlementNeeds first
    • every AME, QME and treating report bearing on adequacy
    • confirmation that none is withheld
    from CR — compromise and releaserecords list
    Reports assembled for filing: {list}. None withheld.
  2. Confirm the client understands itAttorneyBefore signature

    What is being released, what is not, and that it is final. This is the attorney’s conversation and the file records that it happened, not what was said.

    from CR — compromise and releaserecords attorneydate
    Terms explained to the client by {attorney} {date}.
  3. Get it signedCase managerOn the attorney’s direction

    The client signs. Nobody signs on the client’s behalf, and an unsigned settlement is not filed to be fixed later.

    ProducesCompromise and Release, or Stipulations with Request for Awardtemplate: Compromise and ReleaseNeeds first
    • every med-legal and treating report relevant to adequacy
    • the client's understanding of what is given up
    • any lien claimant's position
    • Medicare's interest, where one exists
    from CR — compromise and releaserecords date
    C&R signed by the client {date}.
  4. File the settlement and its award under its tabCase manager2 days

    Under its OWN date, at tab 14. The TYPE code decides the tab, which is what the code is for. A document acted on before it is filed is a document somebody is working from a copy of, and the copy is the one that gets annotated.

    Producesthe settlement and its award, filed at tab 14Needs first
    • the document's own date, read off its face
    • its TYPE code — CR — which is what decides the tab
    from CR — compromise and releaserecords tabdate
    Filed tab {tab} under its own date {date}.
  5. File it with the reportsCase managerSame day as signature

    The settlement and everything that explains its value, together. A filing the judge cannot value from the record is a filing that comes back.

    Producesthe filed Compromise and ReleaseNeeds first
    • the signed C&R
    • the assembled reports
    from CR — compromise and releaserecords dateN
    C&R filed {date} with {N} reports.
  6. Clip the approval follow-upCase manager30 days

    Nothing has happened until the order comes. Thirty days of silence is worth chasing rather than waiting out.

    from CR — compromise and releaserecords received {datedate
    Approval {received {date} / outstanding as at {date}}.
  7. On the order: clip payment and reconsiderationCase managerOn the order

    Two clocks from one document. The payment date the order sets, or thirty days if it sets none; and the twenty-day reconsideration window, computed from how the order was served.

    from CR — compromise and releaserecords datemethod
    Order approving served {date} by {method}. Payment due {date}; recon window to {date}.
  8. Tell the client it is approvedCase manager2 days

    And what happens next — when payment is expected and what they need to do. This is the call the client has been waiting for.

    from CR — compromise and releaserecords date
    Client told of approval {date}.
  9. Watch the paymentCase managerThe payment date

    When it does not arrive, that is the attorney’s question — an unreasonable delay carries a penalty and the file records the dates that show it.

    from CR — compromise and releaserecords received {datedate
    Payment {received {date} / not received as at {date}}.
  10. Confirm what stays openAttorneyBefore signature

    Future medical, and the five-year right to reopen. These are the reasons a case is stipulated rather than released, and the client should understand what they are keeping.

    from CR — compromise and releaserecords dateopen / closed
    Terms explained {date}: future medical {open / closed}; reopener rights explained.
  11. Assemble the supporting recordCase manager5 days

    The reports that explain the agreed rating. Stipulations need information rather than the full evidentiary record a C&R needs — but the judge still has to see how the figure was reached.

    Producesthe report set filed with the stipulationsNeeds first
    • the reports the rating rests on
    • the rating itself
    from CR — compromise and releaserecords list
    Supporting reports filed with the stipulations: {list}.
  12. Check the rating against the findingsCase manager3 days

    The stipulated percentage is compared with what the reports actually found. If the firm rates the case it rates from the findings, and any discrepancy is surfaced to the attorney rather than resolved on the file.

    from CR — compromise and releaserecords pctAgreed / discrepancy raised {date
    Stipulated {pct}; findings support {pct}. {Agreed / discrepancy raised {date}}.
  13. Get it signed and file itCase managerOn the attorney’s direction

    Signed by the client, filed with the supporting record.

    ProducesStipulations with Request for Awardtemplate: Stipulations with Request for AwardNeeds first
    • the agreed rating and terms
    • the client's signature
    from CR — compromise and releaserecords date
    Stipulations signed {date}, filed {date}.
  14. Clip the award follow-upCase manager30 days

    Nothing is decided until the award issues.

    from CR — compromise and releaserecords received {datedate
    Award {received {date} / outstanding at {date}}.
  15. On the award: clip payment and reconsiderationCase managerOn the award

    Both clocks, computed from service. And leave the five-year clock open — the award does not close it.

    from CR — compromise and releaserecords datemethod
    Award served {date} by {method}. Payment {date}; recon to {date}. Five-year clock remains open to {date}.
  16. Tell the client what they still haveCase manager2 days

    The award, the payment, and — plainly — that future medical and the reopener remain. Clients routinely believe a stipulated case is finished.

    from CR — compromise and releaserecords date
    Client told of the award {date}; open rights explained.

What this produces

Compromise and Release

signed by client

goes to the Board, with every relevant report

starts the judge’s review — approval, an Order Suspending Action, or a hearing

8 CCR 10700, 10789(e)

Every AME, QME and treating report relevant to adequacy is filed with it. Withholding them, or misstating that none exist, is prohibited.

Templates 27

  • Compromise and Release
  • Compromise and Release [Third Party]
  • Compromise and Release Continuation Sheet Characterization of Settlement Proceeds
  • Compromise and Release Dependency Claim
  • DEFENSE-Compromise Release and Order Approving Transmittal Letter
  • Joint Order Approving Compromise And Release (OACR)
  • OACR Order Approving Compromise and Release
  • OACR Order Approving Compromise and Release
  • Order Approving C&R Rodgers Thomas Sumner
  • Order Approving Compromise and Release (DIA)
  • Stipulation and Award and or Order
  • Stipulation And Award And/Or Order
  • Stipulation and Order to Pay A Lien Claimant
  • Stipulations for Award WC3 (Pre 2005)
  • Stipulations With Request For Award
  • Stipulations With Request for Award - Award Page Only
  • Stipulations With Request for Award [Death Case]
  • Commutation Request Form
  • Settlement of Prospective Vocational Rehabilitation Services 10122-22
  • Stipulation And Order (Replacement PQME List)
  • Summary of Settlement Conference Proceedings
  • CLIENT-C and R Client (Generic)
  • CLIENT-C and R Sign Letter Client (Generic)
  • CLIENT-Settle (Generic)
  • CLIENT-Stip Sol six Months
  • DEFENSE-Stip
  • DEFENSE-Stip sign
The library cannot produce this
  • Letter to the WCAB re a Compromise and Release
19 The judge wants more before approving They moved Litigation

the clock started before this reached the desk — how much is left?

The pathThe clockTasksThe paper

What led here

The case endsthe judge wants more before approving

What happens

An Order Suspending Action on a settlement

ORDER · filed behind tab 2 by default

2, 14 — an order or award approving or disapproving a settlement → 14; everything else → 2

Where it goes next

The case endsthe defect is cured and it is resubmitted

The clock

the attorney sets the date

from the OSA

8 CCR 10700(b), 10789(e) · Gaines v. ABM Aviation (WCAB en banc, 2026)

The trap

A judge may NOT use an OSA to compel an evaluation, dismiss with prejudice, or cut a fee without notice and a record (Gaines, en banc 2026). Answer what it asks; do not read it as a refusal.

Tasks — written for this map 5 · due from the day the Order Suspending Action is served

No page in the procedure manual covers this chain yet. These tasks were written for this map because the chain routes work to others and had no owner on any step — they need an attorney’s reading before they are relied on.

  1. Read what the order actually asks forCase managerSame day

    An OSA names what is missing — a report, a fee declaration, a civil-case fact, a signature. It is a list, and it is answered item by item rather than by resubmitting the same settlement.

    from ORDER — an order of the Boardrecords dateitems
    OSA served {date}. Asks for: {items}.
  2. File the Order Suspending Action under its tabCase manager2 days

    Under its OWN date, at tab 2. The TYPE code decides the tab, which is what the code is for. A document acted on before it is filed is a document somebody is working from a copy of, and the copy is the one that gets annotated.

    Producesthe Order Suspending Action, filed at tab 2Needs first
    • the document's own date, read off its face
    • its TYPE code — ORDER — which is what decides the tab
    from ORDER — an order of the Board (approving, to show cause, dismissal, findings & award, the judge\'s Report & Recommendation — Board-issued paper on reconsideration)records tabdate
    Filed tab {tab} under its own date {date}.
  3. Tell the attorney and put the settlement back on the file as pendingCase managerSame day

    The settlement is not approved and is not dead. It sits pending, and anything that assumed approval — a payment diary, a closing letter — is held.

    from ORDER — an order of the Boardrecords dateitems
    Attorney told {date}. Settlement of {date} pending; {items} held.
  4. Assemble what it asks forParalegalOn the attorney’s direction

    Medicals, civil-case facts, fee support. What the judge asked for and not more — an OSA is not an invitation to refile the whole thing.

    Producesthe items the order namedNeeds first
    • the order's own list
    • the attorney's direction on each item
    from ORDER — an order of the Boardrecords datewhat
    Assembled for the OSA {date}: {what}.
  5. Resubmit, and record what changedAttorneyThe attorney sets the date

    The amended settlement goes back with the items supplied. What changed between the version the judge suspended and this one is recorded, because the file must be able to show it.

    Producesthe amended settlementNeeds first
    • the assembled items
    • the settlement the judge suspended
    • the attorney's signature
    from ORDER — an order of the Boardrecords datewhat
    Resubmitted {date}. Changed from the {date} version: {what}.

Templates

No template in the library. This is written from scratch, on a clock somebody else started.

20 The Board decides They moved Litigation 20 days

the clock started before this reached the desk — how much is left?

The pathThe clockTasksThe paper

What led here

The case is set for hearingthe matter is heard and decided

The case endsthe judge approves

Is it final, or interlocutory?the Board acts on the petition

What happens

An order, award or findings

ORDER · filed behind tab 2 by default
also on this chain: OACR (tab 14)

2, 14 — an order or award approving or disapproving a settlement → 14; everything else → 2

Where it goes next

Is it final, or interlocutory?a party challenges the decision

The injury gets worsean award exists, so new and further disability can be claimed

Money movesthe award is payable

The fee is decidedthe fee is decided with the award

The clock

20 days — +5 by mail, fax, e-mail or any method other than personal service to a California address; +10 elsewhere in the United States; +20 outside it, measured by the party’s Official Address Record. Only personal service gets the bare 20

from service of the final order, decision or award

LC 5903; 8 CCR 10605(a)–(b), 10940, 10945

20 days on personal service ordinarily · 25, 30 or 40 by other methods as the exception. Only personal service to a California address gets the bare twenty. Mail, fax or e-mail adds five; elsewhere in the United States ten; outside it twenty. The method is read off the proof of service.

The Board’s time to act on reconsideration

60 days

from transmission of the case to the Appeals Board — service of the judge’s Report & Recommendation is the notice of it

LC 5909(a)–(b) · Perez v. Chicago Dogs (WCAB en banc, 2025)

Tasks 8 · due from the day the order is served

  1. Tell the attorney the day it arrivesCase managerSame day

    Every order, without exception. The window is short and it starts from service, which may already have been some days ago.

    from ORDER — an order of the Boardrecords Order typedate
    {Order type} dated {date}, served {date}, received {date}. Attorney told {date}.
  2. Record the service date and the methodCase managerSame day

    Both. The method decides whether the window is twenty, twenty-five, thirty or forty days, and it is read off the proof of service rather than assumed from the envelope.

    from ORDER — an order of the Boardrecords datemethodaddress type
    Served {date} by {method} to {address type}. Window closes {date}.
  3. Read what it actually decidesCase managerSame day

    In plain terms, on the file: what was ordered, in whose favour, and on what issues. An order nobody can summarise is an order somebody has to re-read every time it comes up.

    from ORDER — an order of the Boardrecords what
    Order decides: {what}.
  4. File the decision or award under its tabCase manager2 days

    Under its OWN date, at tab 2. The TYPE code decides the tab, which is what the code is for. A document acted on before it is filed is a document somebody is working from a copy of, and the copy is the one that gets annotated.

    Producesthe decision or award, filed at tab 2Needs first
    • the document's own date, read off its face
    • its TYPE code — ORDER — which is what decides the tab
    from ORDER — an order of the Board (approving, to show cause, dismissal, findings & award, the judge\'s Report & Recommendation — Board-issued paper on reconsideration)records tabdate
    Filed tab {tab} under its own date {date}.
  5. Put the reconsideration question to the attorneyCase manager1 day

    With the computed date attached. Whether to seek reconsideration, whether it is removal instead, or whether to accept it — all theirs. The file supplies the date and the document.

    from ORDER — an order of the Boardrecords date
    Recon window to {date} put to the attorney {date}.
  6. Decide whether to seek reconsideration, and record it either wayAttorneyWithin the twenty days

    Final or interlocutory, and whether a ground exists. A decision NOT to seek reconsideration is recorded with its date and its reason — an unrecorded decision is indistinguishable from a missed deadline, and the twenty days do not come back.

    from ORDER — an order of the Boardrecords sought / not soughtdate…
    Reconsideration {sought / not sought} {date}. Reason: {…}.
  7. If an award: clip the paymentCase managerOn the order

    The date the award sets, or a thirty-day check where it sets none.

    from ORDER — an order of the Boardrecords date
    Payment due {date} per the award.
  8. Tell the clientCase manager2 days

    What the order says, in plain language. Not what it means for their case going forward — that is the attorney’s conversation and often depends on decisions not yet made.

    from ORDER — an order of the Boardrecords date
    Client advised of the order {date}.

Templates 3

  • Minutes of Hearing
  • Minutes of Hearing
  • Minutes of Hearing/Order/Order and Decision on Request for Continuance/Order Taking Off Calendar/Notice of Hearing
21 Is it final, or interlocutory? They moved Litigation

the clock started before this reached the desk — how much is left?

The pathThe clockTasksThe paper

What led here

The Board decidesa party challenges the decision

What happens

An order that decides something

ORDER · filed behind tab 2 by default
also on this chain: 132A (tab 2), SIBTF (tab 2)

2, 14 — an order or award approving or disapproving a settlement → 14; everything else → 2

Where it goes next

The Board decidesthe Board acts on the petition

The clock

—

from —

Vazquez v. Renteria (WCAB en banc, 2025); 8 CCR 10955(a)

The trap

Two different routes with different timetables, and the file cannot tell which. A final order decides a substantive right or a threshold issue — injury arising out of employment, jurisdiction, employment, the statute. Evidence, discovery, trial setting and venue are interlocutory. The attorney decides.

Tasks 9 · due from the day the petition is filed or served

  1. Name which petition it isCase managerSame day

    Reopen, reconsideration, removal, terminate, commutation, penalties. Everything else on this page depends on it, and the file name should carry it.

    from ORDER — an order of the Boardrecords typepartydate
    Petition {type} filed by {party} {date}.
  2. Tell the attorneyCase managerSame day

    Ours or theirs. A petition is always attorney work.

    from ORDER — an order of the Boardrecords date
    Attorney told {date}.
  3. If theirs: clip whatever answer period appliesCase managerSame day

    An answer to a petition for reconsideration is ten pages and has its own period. Put the date in front of the attorney with the document.

    from ORDER — an order of the Boardrecords date
    Answer window to {date}; attorney told.
  4. If ours: verify it and serve itCase managerOn the attorney’s direction

    A petition for reconsideration is verified and served with a proof of service. File it in EAMS or with the district office.

    from ORDER — an order of the Boardrecords dateparties
    Petition filed {date}, verified, served on {parties}; POS filed.
  5. Watch for the Report and RecommendationCase manager30 days

    On a reconsideration petition its service is notice that the case went up, and it starts the Board’s own sixty days.

    from ORDER — an order of the Boardrecords served {datedate
    R&R {served {date} → Board’s 60 days to {date} / not served as at {date}}.
  6. File it as its own proceedingCase manager2 days

    Behind the pleadings, named for what it is. It is not correspondence and it is not part of the Application.

    Producesthe 132a petition or SIBTF applicationNeeds first
    • the attorney's direction on which it is
    • the facts it pleads
    from ORDER — an order of the Boardrecords 132a petition / SIBTF applicationdate
    {132a petition / SIBTF application} filed {date}.
  7. Assemble what it rests onCase managerOn direction

    A §132a rests on what the employer did and when — termination dates, communications, the timing against the claim. A SIBTF application rests on the earlier disability: its records, its ratings, its dates. Both are evidence-gathering the file can do while the attorney frames the pleading.

    Producesthe exhibit set for the proceedingNeeds first
    • what the petition asserts
    • the documents that prove each assertion
    from ORDER — an order of the Boardrecords proceedingwhat
    Assembled for {proceeding}: {what}.
  8. Record the dates it turns onCase managerOn direction

    For a §132a, the date of the act complained of. For a SIBTF application, the dates of the prior injury and its resolution.

    from ORDER — an order of the Boardrecords list
    Key dates: {list}.
  9. Keep it visibleCase managerOngoing

    A collateral proceeding is the thing most easily forgotten on a busy file, because nothing routine touches it.

    from ORDER — an order of the Boardrecords date…
    Status as at {date}: {…}.

Templates

No template in the library. This is written from scratch, on a clock somebody else started.

22 Money moves Routine Resolution and money

no statutory clock; it supplies the dates the other clocks run from

The pathThe clockTasksThe paper

What led here

A letter arrives from the other sideit concerns a payment, a rate or a benefit

The Board decidesthe award is payable

The fee is decidedthe fee is paid from the award

What happens

Checks, EOBs, mileage, bills

BENEFITS · filed behind tab 1 by default

1, 10, 11 — the claim itself (acceptance, denial, delay) → 1; a rate, an offer or a voucher → 10; a check → 11

Where it goes next

The case closes and the file does notthe last payment clears and no clock is left running

The first temporary disability payment

14 days — thereafter a ten per cent self-imposed increase attaches to the late payment

from the fourteenth day after the employer learns of the injury

LC 4650(a), (d)

Not verified against the standard

LC 4650(a) and (d) are not in AAI-STD 1. They are stated in The Blackletter on California Workers’ Compensation (2026), which quotes the Appeals Board’s en banc decisions verbatim — Farris and Messele both discuss the LC 4650(d) increase. The fourteen days and the ten per cent are the statute’s; the firm should confirm the current text before relying on either.

Why it is on the map

No deadline attaches to a payment record, and that is deliberate — tasking somebody on every cheque stub buries the tasks that matter. But a demand or a penalty is built from this ledger, so a gap in it is a gap in the argument.

Tasks 4 · due from the day it arrives

  1. Log itCase manager2 days

    Amount, date, what it was for, who paid it. That is the whole routine task on this tab and it is the one that makes the rest possible.

    from BENEFITS — benefit noticerecords amountdatewhatpayer
    Payment {amount} dated {date} for {what}, from {payer}. Logged.
  2. File the payment record under its tabCase manager2 days

    Under its OWN date, at tab 11. The TYPE code decides the tab, which is what the code is for. A document acted on before it is filed is a document somebody is working from a copy of, and the copy is the one that gets annotated.

    Producesthe payment record, filed at tab 11Needs first
    • the document's own date, read off its face
    • its TYPE code — BENEFITS — which is what decides the tab
    from BENEFITS — benefit notice (claim accepted/denied/delayed; TD/PD notices; offer of work; SJDB)records tabdate
    Filed tab {tab} under its own date {date}.
  3. Note anything that looks wrongCase manager2 days

    A rate that changed without explanation, a gap in a run of payments, a payment for something the file does not recognise. Not an argument — a note, for whoever asks later.

    from BENEFITS — benefit noticerecords what looks irregular
    Noted: {what looks irregular}.
  4. Keep the history current for a demandCase managerOngoing

    A demand about temporary disability or a penalty is built from this ledger. It is only useful if it is right on the day the demand is drafted.

    from BENEFITS — benefit noticerecords dateN
    Payment history current as at {date}: {N} entries.

Templates 12

  • Application for Discretionary Payments from the Uninsured Employers’ Fund
  • DEFENSE-C and R Signature Demand
  • DEFENSE-Demand (Generic)
  • DEFENSE-Demand Letter Short but Sweet (Generic)
  • DEFENSE-PD Advance (Generic)
  • DEFENSE-Temporary Disability Demand
  • DECLARACIÓN SOBRE COBRO DE HONORARIOS
  • DEFENSE-Late Check
  • DEFENSE-Mileage
  • DEFENSE-Rx
  • MISC-Prescription Reimbursement Form (blank)
  • Request for Reimbursement of Accommodation Expense
23 The fee is decided We moved Resolution and money

the attorney picks the date; late here is a decision, not an accident

The pathThe clockTasksThe paper

What led here

The Board decidesthe fee is decided with the award

What happens

A settlement or award is filed

PET · filed behind tab 2

Where it goes next

Money movesthe fee is paid from the award

The clock

—

from —

LC 4906(a), (d); 8 CCR 10844 · Gaines (en banc, 2026)

The trap

No fee is demanded or accepted until the Board approves it. A disputed fee does not have to hold up the settlement.

Tasks — written for this map 3 · due from the day the fee question arises

No page in the procedure manual covers this chain yet. These tasks were written for this map because the chain has a date somebody must act on and named nobody — they need an attorney’s reading before they are relied on.

  1. Assemble the fee supportParalegalOn the attorney’s direction

    What the firm did, and when. The support is the record of the work, not an assertion about its value.

    Producesthe fee supportNeeds first
    • the record of what the firm did and when
    from PET — petitionrecords datewhat
    Fee support assembled {date}: {what}.
  2. The attorney sets the requestAttorneyThe attorney sets it

    What is asked for is the attorney’s. No fee is demanded or accepted before the Board approves it, and a disputed fee does not have to hold up the settlement — it can be held in trust and heard later.

    from PET — petitionrecords amountdatefiled with the settlement / deferred
    Fee request set at {amount} {date}; {filed with the settlement / deferred}.
  3. Watch for the order and record what was approvedCase managerOn the order

    The approved figure, not the requested one. They are frequently different and the file must show which is which.

    from PET — petitionrecords amountdate
    Fee approved {amount} by order of {date}. Requested was {amount}.

Templates 8

  • Petition for Order Allowing Attorney’s Fees
  • Attorney-Client Agreement
  • Compliance with Labor Code §4906(g)
  • Compliance with Labor Code §4906(h)
  • Declaration of Itemized Statement of Costs
  • Fee Disclosure Statement
  • Fee Disclosure Statement
  • SPANISH Compliance With Labor Code §4906(g)
24 A provider claims against the case They moved Resolution and money 18 months

the clock started before this reached the desk — how much is left?

The pathThe clockTasksThe paper

What led here

The treating doctor decides somethinga provider treated and can claim against the case

What happens

A lien for services the provider says it gave

LIEN · filed behind tab 15

Where it goes next

The case is set for hearingthe lien is set for conference

The case closes and the file does notthe liens are resolved and nothing is outstanding

The clock

18 months for services on or after 1 July 2013; 3 years for earlier services

from the date the services were provided

LC 4903.5(a), 4903.05

Already runningThis period did not start when this chain did. It has been running since the date the services were provided — before the case reached this page, and in most files before the firm was retained. What is left is what matters, and the answer is on the file, not on this page.

18 months ordinarily · 3 years for services before 1 July 2013 as the exception. Eighteen months for services on or after 1 July 2013. Three years for earlier services — which still arrive on old cases. The DATE OF SERVICE decides, not the date of the lien.

The lien conference

the date on the notice

from the notice

8 CCR 10875, 10888

The trap

Eighteen months from the SERVICE date, not from anything the case did — and 548 days is the longest period in the standard. Without the declaration under penalty of perjury the lien is dismissed by operation of law, which is worth noticing early rather than at the conference.

Tasks 8 · due from the day the lien is served

  1. Log it against the caseParalegal2 days

    Claimant, amount, the services claimed and their dates. Liens are managed as a list, and a lien not on the list is a lien discovered at settlement.

    from LIEN — lien claimrecords claimantamountdates
    Lien logged: {claimant}, {amount}, services {dates}.
  2. File the lien under its tabCase manager2 days

    Under its OWN date, at tab 15. The TYPE code decides the tab, which is what the code is for. A document acted on before it is filed is a document somebody is working from a copy of, and the copy is the one that gets annotated.

    Producesthe lien, filed at tab 15Needs first
    • the document's own date, read off its face
    • its TYPE code — LIEN — which is what decides the tab
    from LIEN — lien claimrecords tabdate
    Filed tab {tab} under its own date {date}.
  3. Check it was filed in timeParalegal3 days

    Compare the service dates against the filing date — eighteen months for services from July 2013, three years before that. Record the comparison; whether to act on it is the attorney’s.

    from LIEN — lien claimrecords datesdatewithin / beyond
    Services {dates}; lien filed {date}; {within / beyond} the period. For the attorney.
  4. Decide whether to act on a lien filed out of timeAttorneyBefore the lien conference

    The file records whether the lien was filed inside its period and whether the declaration under penalty of perjury is there. Whether to raise either is the attorney’s, and a lien not objected to is a lien that stands.

    from LIEN — lien claimrecords datetimely / out of timepresent / absentObjection raised {date
    Lien of {date}: {timely / out of time}, declaration {present / absent}. {Objection raised {date} / no objection}.
  5. Check the declaration is thereParalegal3 days

    Without the declaration under penalty of perjury the lien is dismissed by operation of law. Its absence is worth noticing early rather than at the conference.

    from LIEN — lien claimrecords present / absentpaid / not evidenced
    Declaration {present / absent}; filing fee {paid / not evidenced}.
  6. Check the services against the caseParalegal5 days

    Do the dates fall in the treatment period? Are the body parts the ones in issue? A lien for treatment on a body part never pleaded is a different conversation from one that is simply large.

    from LIEN — lien claimrecords consistent / inconsistentdetail
    Services {consistent / inconsistent} with the treatment record: {detail}.
  7. Calendar any lien conference with an assigneeParalegalOn the notice

    It is an appearance and somebody has to make it.

    from LIEN — lien claimrecords datewho
    Lien conference {date} calendared to {who}.
  8. Keep the list current for settlementParalegalOngoing

    Liens are what a settlement has to deal with. The list is only useful if it is right on the day the settlement is drafted.

    from LIEN — lien claimrecords dateNtotal
    Lien list current as at {date}: {N} liens, {total}.

Templates 10

  • 10770.5 Verification fo Filing of Lien Claim or Application by Lien Claimant
  • Notice and Request for Allowance of Lien
  • Notice and Request for Allowance of Lien
  • Supplemental Lien Form and Section 4903.05(c)Declaration
  • EDD LIEN CLEARANCE SHEET
  • EDD Lien Inquiry Fax Form
  • Lien Affidavit
  • Pre-Trial Conference Statement Lien Issues Addendum
  • Affidavit of Applicant/Defendant RE: Liens, Medical Providers, and Miscellaneous Bills
  • Resolution of Liens - Affidavit of Good Faith
25 The injury gets worse Fatal if late Litigation 5 years

our filing, on a clock nobody chose — miss it and the claim is barred

The pathThe clockTasksThe paper

What led here

The Board decidesan award exists, so new and further disability can be claimed

What happens

New and further disability appears after an award

PET · filed behind tab 2

Where it goes next

The case opens at the Boarda petition to reopen restarts the case

The clock

five years

from the date of injury

LC 5410

Already runningThis period did not start when this chain did. It has been running since the date of injury — before the case reached this page, and in most files before the firm was retained. What is left is what matters, and the answer is on the file, not on this page.

On a CUMULATIVE TRAUMA this phrase names two dates. The injury has a period start and a period end, and anything computed from the date of injury uses the END date. Both dates go on the file; neither is used silently.

If this is late

After five years from the date of injury the Board loses jurisdiction to award new and further disability. An award already made does not extend it.

The trap

Five years from the DATE OF INJURY, not from the award. It survives a stipulated award, which is why stipulations were chosen over a release — and clients routinely believe a stipulated case is finished.

Tasks — written for this map 4 · due from the date of injury — the five-year jurisdictional date

No page in the procedure manual covers this chain yet. These tasks were written for this map because a limitation period with no owner and no due date is the one place that gap is not survivable — they need an attorney’s reading before they are relied on.

  1. Fix the five-year date at the awardCase managerOn the award

    Five years from the DATE OF INJURY, not from the award — and on a cumulative trauma from the period end date. It survives a stipulated award, which is why the diary is set when the case appears to close.

    from PET — petitionrecords datedate of injury
    LC 5410 jurisdiction ends {date}, five years from {date of injury}. Diary set.
  2. Review the file against the dateCase manager1 year before the date

    Whether anything has changed since the award — new treatment, a worsening, a new body part. A year is enough time to obtain a report if there is one to obtain.

    from PET — petitionrecords datechanged / no changeAction
    Five-year review {date}: {changed / no change}. {Action}.
  3. Tell the client the date is approachingCase manager1 year before the date

    Clients routinely believe a stipulated case is finished. The letter states the date and asks whether anything has changed — it states no view about whether a petition lies.

    from PET — petitionrecords date
    Client told {date} that the five-year period ends {date}.
  4. The attorney directs the petition, or records that none is filedAttorneyBefore the date

    New and further disability is the attorney’s judgement on the medical evidence. A decision not to petition is recorded with its date.

    from PET — petitionrecords filed / not fileddate…
    Petition to reopen {filed / not filed} {date}. Reason: {…}.

What this produces

Petition (reconsideration, removal, reopen, penalties)

signed by attorney

goes to the Board, served with a proof of service

starts reconsideration: the Board’s 60 days from transmission; the answer is due within its own period

LC 5909; 8 CCR 10940

A petition for reconsideration is VERIFIED. The verification is its own page with its own caption and a declaration under penalty of perjury, and a proposed order travels with it as a separate document.

Templates 2

  • Petition to Reopen
  • Petition to Reopen - With Proof of Service
26 A petition for serious and willful misconduct Fatal if late Litigation 1 year

our filing, on a clock nobody chose — miss it and the claim is barred

The pathThe clockTasksThe paper

What led here

The case opens at the Boardthe facts support serious and willful misconduct

What happens

the attorney decides the facts may support a petition under LC 4553

PET · filed behind tab 2

Where it goes next

The case is set for hearingthe petition is set for hearing

The clock

one year

from the date of injury

LC 5407(a)

Already runningThis period did not start when this chain did. It has been running since the date of injury — before the case reached this page, and in most files before the firm was retained. What is left is what matters, and the answer is on the file, not on this page.

On a CUMULATIVE TRAUMA this phrase names two dates. The injury has a period start and a period end, and anything computed from the date of injury uses the END date. Both dates go on the file; neither is used silently.

If this is late

A petition filed after the year is barred. The underlying case is not — it continues under its own period — but the additional 4553 recovery is gone.

The trap

The one-year period runs from the DATE OF INJURY and is not extended by the statute that extends the ordinary claim period. A case still perfectly alive under LC 5405 can be too late for a 4553 petition.

Not verified against the standard

LC 5407(a) and LC 4553 are not in AAI-STD 1. Unlike every other citation on this page, they have not been checked against primary text by the standard’s verification record. Confirm the period against the Labor Code before relying on it.

Tasks — written for this map 4 · due from the date of injury — the limitation date, not the day anything arrives

No page in the procedure manual covers this chain yet. These tasks were written for this map because a limitation period with no owner and no due date is the one place that gap is not survivable — they need an attorney’s reading before they are relied on.

  1. Fix the date the year runs fromCase managerOn opening

    The date of injury, and on a cumulative trauma the period END date. LC 5407 is not extended by the statute that extends the ordinary claim period, so this date is computed once and diarised, not recomputed later.

    from PET — petitionrecords date of injurydate
    S&W period: one year from {date of injury}. Diary set for {date}.
  2. Put the question to the attorney earlyCase manager6 months before the date

    Whether the facts may support a petition is the attorney’s, and it needs deciding while there is still time to investigate. Six months before is a diary entry, not a deadline.

    from PET — petitionrecords datepleading / not pleading / to review
    S&W question put to the attorney {date}; {pleading / not pleading / to review}.
  3. Assemble the facts if the attorney directs itParalegalOn the attorney’s direction

    What the employer knew, and when. Statements, prior incidents, safety records. The petition is a pleading of facts, not an assertion.

    Producesthe factual record behind the petitionNeeds first
    • what the employer knew and when
    • statements, prior incidents, safety records
    from PET — petitionrecords datesources
    S&W facts assembled {date}: {sources}.
  4. File and serve, or record the decision not toAttorneyBefore the date

    A decision not to plead it is recorded with its date and reason. An unrecorded decision is indistinguishable from a missed one.

    ProducesPetition for serious and willful misconduct, or the recorded decisiontemplate: Petition for Benefits for Serious and Willful Misconduct (LC 4553)Needs first
    • the assembled facts
    • the attorney's decision, either way
    • every party's address of record
    from PET — petitionrecords filed / not pleadeddate…
    S&W petition {filed / not pleaded} {date}. Reason: {…}.

Templates 2

  • Petition for Benefits for Serious and Willful Misconduct of Employer Pursuant to Labor Code Section 4553
  • Petition for Penalties
27 The prior disability is at issue We moved Litigation

the attorney picks the date; late here is a decision, not an accident

The pathThe clockTasksThe paper

What led here

The case opens at the Boarda prior permanent disability is in play

What happens

a prior permanent disability combines with this injury

SIBTF · filed behind tab 2

Where it goes next

The case is set for hearingthe Fund claim is set for hearing

Why it is on the map

A separate claim against the Fund, filed against a different party. It has its own application and its own notice of representation, which is why they belong on their own chain rather than in with intake.

Tasks 4

No page in the procedure manual covers this chain yet, so these tasks carry no owner and no due date. They are the steps the statute requires; who does them, and by when, is a decision the firm has not recorded.

  1. establish the prior permanent disability
  2. obtain the combined rating
  3. file the application against the Fund
  4. serve the Fund and all parties

Templates 2

  • NOTICE OF REPRESENTATION FOR SUBIN
  • Application for Subsequent Injuries Fund Benefits
28 The injured worker dies Fatal if late The claim 1 year

our filing, on a clock nobody chose — miss it and the claim is barred

The pathThe clockTasksThe paper

What led here

The carrier answers the claimthe injured worker dies

What happens

The firm learns the injured worker has died

APP-ADJ · filed behind tab 2

Where it goes next

The case opens at the Boardthe dependants file their own application

The case endsthe dependency claim resolves

The clock

one year from death, and no later than 240 weeks from the injury

from the date of death

LC 5406(b)

Already runningThis period did not start when this chain did. It has been running since the date of death — before the case reached this page, and in most files before the firm was retained. What is left is what matters, and the answer is on the file, not on this page.

If this is late

A dependants’ claim filed after the period is barred. It is a separate claim with its own applicants; the injured worker’s own case ending does not preserve it, and nothing about the existing file extends it.

The trap

This is NOT the same case. The applicants are the DEPENDENTS, the benefit is theirs, and who is a dependent — and whether wholly or partially — is a question of fact at the date of injury, not of who survives. Continuing the existing case in the deceased’s name is the error.

Not verified against the standard

LC 5406(b) and the death-benefit provisions are not in AAI-STD 1. Unlike every other period on this map they have not been checked against primary text by the standard’s verification record. Confirm the period and the dependency rules before relying on them.

Tasks — written for this map 5 · due from the date of death

No page in the procedure manual covers a death claim. These tasks were written for this map because the library can produce the settlement and nothing described the claim — they need an attorney’s reading before they are relied on.

  1. Record the date of death and how the firm learned itCase managerSame day

    The date is the one the limitation period runs from, and where it came from matters — a family telephone call is not a certificate. The certificate is requested the same day.

    from APP-ADJ — application for adjudicationrecords datehowrequested / held
    Death recorded {date}, learned {how} on {date}. Certificate {requested/held}.
  2. Stop anything that assumes a living applicantCase managerSame day

    A deposition, an evaluation, a scheduled appointment. They are cancelled or held, not left to fail on the day.

    Producesthe cancellations, recordedNeeds first
    • every scheduled deposition, evaluation and appointment
    from APP-ADJ — application for adjudicationrecords itemsdate
    Held pending death claim: {items}, {date}.
  3. Tell the attorney the same dayCase managerSame day

    Whether a death claim lies, who may bring it and what becomes of the existing case are all the attorney’s. The file records the death and the date; it states no view on any of that.

    from APP-ADJ — application for adjudicationrecords date
    Attorney told {date}.
  4. Identify who may claim, on the attorney’s directionParalegalOn direction

    Dependency is decided at the date of injury, and total and partial dependants are treated differently. This is fact-gathering — relationships, household, support — not a conclusion about who qualifies.

    Producesthe dependency factsNeeds first
    • relationships and household at the DATE OF INJURY
    • who was supported and to what extent
    from APP-ADJ — application for adjudicationrecords datewho, relationship, household
    Dependency facts gathered {date}: {who, relationship, household}.
  5. Diary the period from the date of deathCase managerSame day

    One year from death, and the 240-week outer limit from the injury. Both dates go on the file because the earlier of the two governs.

    Producesthe diary entry, not a filingNeeds first
    • the date of death from a certificate, not a telephone call
    • the date of injury for the 240-week limit
    from APP-ADJ — application for adjudicationrecords date
    Death claim period: one year to {date}; 240 weeks from injury to {date}.

Templates

No template in the library. This is written from scratch, on a clock somebody else started.

The library cannot produce these
  • Application for Adjudication of Claim — Death
  • Notice and request for allowance of lien for burial expenses
  • Dependency questionnaire
29 The case closes and the file does not Routine The file

no statutory clock; it supplies the dates the other clocks run from

The pathThe clockTasksThe paper

What led here

Money movesthe last payment clears and no clock is left running

A provider claims against the casethe liens are resolved and nothing is outstanding

What happens

The last clock has run, or the firm withdraws, or the client leaves

CORR · filed behind tab 4 by default

4 unless the letter is about one of these: to the judge → 2; to, from or about the evaluator → 6; a rating letter → 7; a payment, EOB or bill → 11; written discovery → 12; a records request → 13; an MSA → 14; a lien claimant → 15; intake, fee or address → cover

The trap

Closed is a status on the cover, never a reason to withhold a filing or a send. A UR denial arriving on a closed case is filed and appealed inside its own clock, and the note says the case was closed when it came. The reopening follows the filing rather than gating it.

Why it is on the map

A case closes when the last clock has run — the award paid, the appeal window passed, the liens resolved — or when the firm withdraws or the client leaves. The FILE does not close with it. Documents keep arriving on closed cases and some of them still carry a clock.

Tasks — written for this map 6 · due from the day the case closes

No page in the procedure manual covers this chain yet. These tasks were written for this map because the chain names a period in its own prose and owned nobody — they need an attorney’s reading before they are relied on.

  1. Record what closed the case and whenCase managerSame day

    The last clock run, the firm’s withdrawal, or the client leaving. Which it was decides what has to be served and what is still owed, and it is a fact the file will be asked for years later when nobody remembers.

    from CORR — the closing letter and what the cover recordsrecords datelast clock run / withdrawal / client left
    Case closed {date}: {last clock run / withdrawal / client left}.
  2. File the closing document under its own tabCase manager2 days

    Closing is a document — the closing letter, the substitution, the final award with its payment proved. It is filed like any made document, under its own date, and the cover records the closing date.

    Producesthe closing document, filed at its own tab with the cover updatedNeeds first
    • which document closed the case — the letter, the substitution, or the award with its payment proved
    • its own date, which is the date the cover records as the closing date
    from CORR — the closing letter and what the cover recordsrecords whatdatetab
    Closing document {what} dated {date}, filed tab {tab}. Cover updated.
  3. Clip the two retention dates to the coverCase manager5 days

    Two dates, not one: the end of the firm’s retention period, and the end of any LONGER period a document in the file requires — a minor’s matter, a future-medical award, a lien still open. The longer date governs the whole file. Nothing arrives to say this was missed, which is why it is clipped at closing rather than remembered.

    from CORR — the closing letter and what the cover recordsrecords datewhy
    Retention: firm period to {date}; longest document period to {date} ({why}). Governing date {date}.
  4. Empty the pocket before the file is closedCase managerBefore closing

    A piece the procedure could not finish is not closed with the case. Each one is finished or its reason is recorded on the cover.

    from CORR — the closing letter and what the cover recordsrecords Nfinished / recorded on the cover
    Pocket at closing: {N} pieces, {finished / recorded on the cover}.
  5. Keep answering the three questions on anything that arrives afterCase managerOngoing

    A closed case still runs the standard. A document arriving on one is placed, named, clipped and reported exactly as on an open case, and the note says the case was closed when it came. A UR denial on a closed case carries its own window whatever the cover says; the reopening follows the filing rather than gating it.

    from CORR — the closing letter and what the cover recordsrecords whatdatetab
    Document {what} received {date} on a closed case; filed tab {tab}, clipped {date}, attorney told {date}.
  6. Record any destruction as a person’s actCase managerOn the retention date

    Nothing is destroyed by the procedure. Destruction is a person’s decision under the firm’s retention rule and the client’s rights, and it is recorded on the cover with its date and its authority. The index survives the file — it is the record of what the file held.

    from CORR — the closing letter and what the cover recordsrecords returned to client / destroyeddateauthority
    Paper originals {returned to client / destroyed} {date} under {authority}. Index retained.

Templates

No template in the library. This is written from scratch, on a clock somebody else started.

The library cannot produce these
  • Closing letter to the client
  • Notice of withdrawal
  • File retention and destruction record
30 The client is kept told Routine The file

no statutory clock; it supplies the dates the other clocks run from

The pathThe clockTasksThe paper

What happens

Anything happens the client should know

CORR · filed behind tab 4 by default

4 unless the letter is about one of these: to the judge → 2; to, from or about the evaluator → 6; a rating letter → 7; a payment, EOB or bill → 11; written discovery → 12; a records request → 13; an MSA → 14; a lien claimant → 15; intake, fee or address → cover

Why it is on the map

Facts only. No view on the merits, no estimate of value, and no deadline quoted to the client.

Tasks 6 · due from the day the letter arrives

  1. Decide whether it belongs hereCase managerSame day

    A letter about the evaluator belongs with the med-legal scheduling; about money, with the money; about records, with the subpoenas; about a settlement, with the settlement. Correspondence is what is left after those questions are asked, not the first place a letter is put.

    from CORR — correspondencerecords senderdatereason
    Letter from {sender} dated {date}; filed at Tab 4 because {reason}.
  2. Answer what is a position on the caseAttorneyBy the reply date

    An administrative question is answered by the case manager. A question about what the case is worth, what to accept, or what happens next is a position on the case and is the attorney’s. The file records which it was.

    Producesthe reply to the clientNeeds first
    • what the client asked
    • the attorney's position on it
    from CORR — correspondencerecords dateattorney / case manageradministrative / a position on the case
    Client question of {date} answered {date} by {attorney / case manager}: {administrative / a position on the case}.
  3. Read what it asks for and by whenCase managerSame day

    Most correspondence asks for something. Record what, and the date it wants it by — or set one where the letter does not.

    from CORR — correspondencerecords whatdate, or none stated — set {date
    Asks for {what} by {date, or none stated — set {date}}.
  4. If an administrator does not name its clientCase manager1 day

    Ask, at the earliest opportunity. Who actually pays is not a detail — an award against an entity nobody identified may be unenforceable, and the duty to say is theirs, not ours to investigate.

    from CORR — correspondencerecords namedate
    Administrator {name} did not identify its principal. Disclosure requested {date}; attorney told.
  5. Answer it or route itCase managerBy the reply date

    Where the answer is administrative, answer it. Where it is a position on the case, it is the attorney’s. Do not let a letter sit because it is not obvious which.

    Producesthe reply, or the routing noteNeeds first
    • what the client asked
    • whether answering it states a legal view
    from CORR — correspondencerecords date
    Answered {date} / referred to the attorney {date}.
  6. Update the contacts if it changes themCase manager2 days

    A change of defence counsel, adjuster or address goes on the contact record the day it is known. The next document served on a stale address is a document that did not arrive.

    from CORR — correspondencerecords what changed
    Contact updated: {what changed}.

Templates 23

  • CLIENT-Appointment Conf. Phone Conference Set by Assistant (Generic)
  • CLIENT-Appointment in Office Set by Assis (Generic)
  • CLIENT-Case Overview Sheet
  • CLIENT-Case Summary Form
  • CLIENT-Confirm Rejection of Legal Advice - CYA
  • CLIENT-Decline Letter Referral to Another Attorney (Generic)
  • CLIENT-Fire Nurse (Generic)
  • CLIENT-Invoice for SS
  • CLIENT-Letter Blank
  • CLIENT-Letter Mileage Return
  • CLIENT-Missed Doctors Appointment
  • CLIENT-Missed Telephone Conference
  • CLIENT-Office Decline Case General
  • CLIENT-Records rel
  • CLIENT-Unable to Reach (Voice Phone Correspondence)
  • CLIENT-VR Feas Eval Notice
  • LETTER TO CLIENT - PTP APPT - EN
  • LETTER TO CLIENT - PTP APPT - SP
  • LETTER TO CLIENT - QME APPT - EN
  • Letter to client_-_ptp_appt_-_en
  • Letter to client_-_ptp_appt_-_sp
  • Ptp appt to C-Spanish
  • PTP appt to Clt
31 Something is served Routine The file

no statutory clock; it supplies the dates the other clocks run from

The pathThe clockTasksThe paper

What happens

The firm serves any document

POS · filed behind tab 3 by default

Why it is on the map

It starts no clock of its own and it SUPPLIES the date most other clocks run from. Sworn in the first person by whoever actually served it — never the attorney\u2019s name over another person\u2019s declaration.

Tasks 4 · due from the day the document is served

  1. File it with what it servesCase managerSame day

    Behind the same tab as the document, named so the pairing is obvious. A proof of service filed apart from its document is a proof of nothing anybody can find.

    Producesthe proof of service, filed with its documentNeeds first
    • the document served
    • the date and method of service
    • every party's address of record
    from POS — proof of servicerecords documentdate
    POS for {document} filed {date}.
  2. Record the date and the method on the served documentCase managerSame day

    This is the task that makes the rest of the manual work. Every deadline that runs from service needs both, and both live on this document.

    from POS — proof of servicerecords documentdatemethodaddress type
    Service of {document}: {date} by {method} to {address type}.
  3. On ours: check who is signingCase managerBefore service

    The declarant is the person who actually puts it in the post or sends it. Their name, in the first person. Not the attorney’s by default and not whoever prepared the document.

    from POS — proof of servicerecords namedate
    POS declarant {name}, served {date}.
  4. Check the service list is completeCase managerBefore service

    Every party and every representative, at their current addresses. A party left off is a party who can say they never got it.

    from POS — proof of servicerecords listdate
    Served on: {list}. Addresses checked {date}.

Templates 22

  • Notice and Acknowledgment of Receipt - WCAB
  • Notice and Acknowledgment of Recept --Civil
  • Pleads - Proof of Service (Generic)
  • PLEADS-Proof of Service-Personal Service Hand Delivery
  • PLEADS-Proof_of_Service_Generic_with_email
  • PLEADS-Proof_of_Service-Application
  • PLEADS-Proof_of_Service-Declaration_of_ReadinessDOR
  • PLEADS-Proof_of_Service-Expedited_Hearing_DOR_EH
  • PLEADS-Proof_of_Service-Notice_of_App
  • PLEADS-Verification_LC5814.5_4607Applicant
  • POS E-SERVICE
  • POS-with two column cc section
  • POS-with two column cc section(and email)
  • POS-with two column cc section(and phone no. and email)
  • POS-with two column cc section(and phone no.)
  • PROOF OF SERVICE
  • PROOF OF SERVICE
  • PROOF OF SERVICE -EAMS
  • proof of service application
  • PROOF OF SERVICE APPLICATION
  • PROOF OF SERVICE EAMS
  • Verification
32 Representation changes Routine The file

no statutory clock; it supplies the dates the other clocks run from

The pathThe clockTasksThe paper

What happens

A party changes attorney, or the firm does

CORR · filed behind tab 4 by default

4 unless the letter is about one of these: to the judge → 2; to, from or about the evaluator → 6; a rating letter → 7; a payment, EOB or bill → 11; written discovery → 12; a records request → 13; an MSA → 14; a lien claimant → 15; intake, fee or address → cover

Why it is on the map

The next document served on a stale address is a document that did not arrive.

Tasks — written for this map 4 · due from the day the change is made or received

No page in the procedure manual covers this chain yet. These tasks were written for this map because the chain has a date somebody must act on and named nobody — they need an attorney’s reading before they are relied on.

  1. File the substitutionCase managerSame day

    Ours or theirs. Whose representation changed decides who must be served and what stops arriving.

    Producesthe substitution of attorneysNeeds first
    • which party changed representation
    • the incoming firm's details
    from CORR — correspondencerecords filed / receiveddatepartywho
    Substitution {filed / received} {date}: {party} now represented by {who}.
  2. Update the contact record the same dayCase managerSame day

    This is the chain that decides where the mail goes. A stale contact record sends a document to the wrong firm and starts no clock at all — and nothing arrives to say it happened.

    from CORR — correspondencerecords datewho
    Contacts updated {date}: {who} added, {who} removed.
  3. Ask the prior attorney for the fileParalegal5 days

    What they hold that the firm does not. A gap in the file discovered at a conference is a gap that should have been asked about here.

    from CORR — correspondencerecords whodate
    File requested from {who} {date}. Received {date} / outstanding.
  4. Check nothing was clipped to the old representationCase manager2 days

    A diary entry assigned to a person who has left, or a service list naming a firm no longer in the case. Both fail silently.

    from CORR — correspondencerecords dateN
    Clips reviewed {date}; {N} reassigned.

Templates 13

  • LETTER TO DA - SUB AND DISMISSAL OF ATTY
  • LETTER TO PAA - SUB AND DISMISSAL OF ATTY
  • Notice of Dismissal of Attorney
  • CHANGE OF ADDRESS
  • CHANGE OF ADDRESS
  • CHANGE OF ADDRESS
  • CLIENT Sub Out Incomplete
  • Disclosure Statement Withdrawl
  • Letter to PAA asking for Clt file
  • MISC-Address Change Applicant (Generic)
  • Substitution of Attorneys
  • Substitution of Attorneys - Defendant
  • Substitution of Attorneys - SubOut Only
33 The Board sends paper Routine The file

no statutory clock; it supplies the dates the other clocks run from

The pathThe clockTasksThe paper

What happens

Minutes, notices, acknowledgments

NOH · filed behind tab 3 by default

3 (a lien conference → 15)

Why it is on the map

Board paper is read before it is filed. Minutes can set a trial date; a notice can set the conference that closes discovery.

Tasks — written for this map 5 · due from the day the Board’s paper arrives

No page in the procedure manual covers this chain yet. These tasks were written for this map because the chain has a date somebody must act on and named nobody — they need an attorney’s reading before they are relied on.

  1. Read what it decided or setCase managerSame day

    Minutes, a notice, an acknowledgment, an order taking off calendar. What it IS decides whether anything runs from it, and the descriptor on the face is not always the answer.

    from NOH — notice of hearingrecords datewhat it iswhat it decided
    Board paper dated {date} received {date}: {what it is}, {what it decided}.
  2. Act on any date it names, the same dayCase managerSame day

    The Board sets hearing dates, conference dates and dates to comply. A date the Board names is not a suggestion, and it is diarised with an assignee before the paper is filed.

    from NOH — notice of hearingrecords datewhatwho
    Date named: {date} for {what}. Calendared to {who}.
  3. Tell the attorney where it decides somethingCase managerSame day

    An acknowledgment tells nobody anything. An order taking a case off calendar changes what happens next, and the difference is the attorney’s to read.

    from NOH — notice of hearingrecords datereason
    Attorney told {date} / no notice needed: {reason}.
  4. Say what the Board’s paper changes, if anythingAttorneySame day where it names a date

    An acknowledgment changes nothing. An order taking a case off calendar changes what happens next and what must be re-set. The file records which it was.

    from NOH — notice of hearingrecords datechanges {what
    Board paper of {date} {changes {what} / changes nothing}.
  5. File it under its own dateCase manager2 days

    The date on the document, not the date it arrived. A minute order filed under the receipt date sorts wrongly against everything else on the tab.

    Producesthe Board’s paper, filed on its own tabNeeds first
    • the date printed on the document, not the date it arrived
    • which tab it belongs behind
    from NOH — notice of hearingrecords tabdate
    Filed tab {tab} under its own date {date}.

Templates 13

  • MISC-Misdirected Mail Forward to Def Carr (Generic)
  • MISC-Serious Chronic Adjuster (Generic)
  • MISC-Serious Chronic Med (Generic)
  • Notice of Hearing
  • Pre-Trial Conference Statement
  • Pre-Trial Conference Statement - Exhibits
  • Pre-Trial Conference Statement (10500)
  • Pre-Trial Conference Statement (10629)
  • Pre-Trial Conference Statement with Exhibits
  • Pretrial Conference Statement Addendum
  • Supplement To Minutes of Hearing
  • WCAB 20 Minutes of Hearing
  • WCABForm27
34 Stationery and firm records Routine The file

no statutory clock; it supplies the dates the other clocks run from

The pathThe clockTasksThe paper

What happens

The firm needs a letterhead, envelope or cover sheet

AUTH · filed behind tab 13 by default
also on this chain: HIPAA (tab 13/tab cover)

Why it is on the map

Not case work. Listed because a template library holds a great many of them and a map that omits them is not a map of the library.

Tasks 5 · due from the day it is signed

  1. Get both signed at intakeCase managerDay one

    The release and the designation. Chasing a signature months later, when a records request or an appeal is waiting on it, costs far more than getting it at the start.

    Producesthe signed authorization and representative designationNeeds first
    • the client in the room, or a reliable route to a signature
    from AUTH — HIPAA : the client\records date
    Authorization and representative designation signed {date}.
  2. Check both are actually signedCase managerDay one

    Signed, dated and complete. An unsigned form in the file looks like a signed one at a glance and is worth nothing.

    from AUTH — HIPAA : the client\records date
    Both forms verified signed and dated {date}.
  3. File the blanket ones on the coverCase manager2 days

    Where anything that needs them can find them — a records request, an IMR packet, a subpoena.

    Producesthe cover authorizationsNeeds first
    • the signed originals
    from AUTH — HIPAA : the client\records date
    Filed to the cover {date}.
  4. File a specific authorization with its requestCase managerOn execution

    An authorization executed for one custodian belongs with that request, not with the intake papers.

    Producesthe authorization, filed with its records requestNeeds first
    • the custodian named on it
    • the request it accompanies
    from AUTH — HIPAA : the client\records custodiandate
    Authorization for {custodian} filed with the request {date}.
  5. Watch for expiry or revocationCase managerOngoing

    An authorization can lapse or be withdrawn. Where that happens, everything relying on it stops until it is replaced.

    from AUTH — HIPAA : the client\records current / expired {datedate
    Authorization {current / expired {date} / revoked {date}}.

Templates 21

  • DEFENSE-Carrier Letter Head
  • Batch Scan Separator Sheet
  • Cover Sheet (Letter Size / Style #1)
  • Cover Sheet 2
  • Document Cover Sheet
  • DOCUMENT COVER SHEET
  • Document Separator Sheet
  • Envelopes - Firm Return Address (Generic)
  • Envelopes - Multiparty with return address (generic)
  • ENVELOPES-Multiparty (Generic)
  • GENERIC-Fax Cover Sheet Any Party
  • Information Request Form
  • Information Response Form
  • Letterhead and Date Template
  • Letterhead Template
  • Firm blank letterhead
  • Firm general letter
  • Firm sample letter
  • Firm sample letter (newer)
  • MED-Letter to Doctor with Envelopes (Generic)
  • WC Cover Sheet (Legal Size / Style #2)