Every chain in a workers’ compensation case and every path between them, on one sheet.
Print at 100% (no “fit to page”) on 4 sheets of 8.5×11 landscape and tape them
together in the lettered order — the grid reference is printed in the corner of each.
Row A is the whole sequence of a case, left to right; row B is the recurring work.
A node is a chain. The badge is the shortest branch of its clock. The line into a node
is what led there, labelled with the condition that sends a case down it; a dashed line curving
back is a loop — review resuming, a settlement returning from the judge, a replacement panel.
ColourDark red: miss it and the case is over. Red: they moved, the clock runs.
Green: we move, the date is ours. Purple: either side. Grey: routine.
Starts hereThe case opens
Foot of the chartThe 5 chains that recur throughout a case and belong
to no single point in it.
† Not verifiedA citation marked † is not in
AAI-STD 1 and has not been checked against primary text. Confirm it before relying on it.
DetailTasks, owners, due dates, file-note templates and all 341 templates
are on the screen version. This is the map, not the manual.
the carrier defers instead of deciding
the dispute is not medical necessity
no appointment inside the statutory window
the panel is assigned and records go out
the evaluation happens
the reporting supports setting the case
the report supports a settlement value
denied, delayed, or benefits are disputed
the injured worker dies
accepted — treatment proceeds
the case is ready to be heard
the facts support serious and willful misconduct
a prior permanent disability is in play
the defense wants the applicant’s testimony
records are needed from a third party
the matter is heard and decided
the case resolves at the conference
a party challenges the decision
an award exists, so new and further disability can be claimed
the award is payable
the fee is decided with the award
the judge wants more before approving
the judge approves
the treating doctor requests authorization
a provider treated and can claim against the case
a party objects to the treating doctor’s finding
the doctor releases to modified or regular work
discovery closes
the custodian produces
the voucher and return-to-work bear on value
the lien is set for conference
the liens are resolved and nothing is outstanding
a petition to reopen restarts the case
the defect is cured and it is resubmitted
the Board acts on the petition
a replacement panel is requested
liability resolves and review resumes
the fee is paid from the award
the claim form goes to the carrier
the other side begins writing to the firm
a report decides something the worker’s benefits turn on
the last payment clears and no clock is left running
the dependants file their own application
the dependency claim resolves
answering it needs records from a third party
discovery closes at the conference
it is a written discovery request
it objects to a treating physician’s report
it concerns the panel, a strike or an evaluator
it demands records or answers a subpoena
it notices or reschedules a deposition
it makes or answers an offer
it concerns a payment, a rate or a benefit
the petition is set for hearing
the Fund claim is set for hearing
Recurring — no place in the sequence
Treatment is refused10 days
A utilization review decision refusing a treatment
LC 4610.5(f), (h)(1)–(3); 8 CCR 9792.10.1
UR-DENIALtab 810 tasks9 tpl
A panel is assigned10 days
The administrative director assigns three evaluators
LC 4062.2(c)
QMEtab 7/610 tasks18 tpl
Records go to the evaluator20 days BEFORE
either side proposes records for the evaluator
LC 4062.3(a)–(g); 8 CCR 35(d)
MEDRECtab 5/137 tasks3 tpl
The evaluator reports30 days
The report the case turns on
LC 139.2(j)(1), 4062.5
PQMEtab 7/610 tasks17 tpl
The carrier answers the claim75 days
Acceptance, denial or delay
LC 5402(b)
BENEFITStab 1/10/1126 tasks1 tpl
The case opens at the Board1 year
The attorney directs the filing
† LC 5405
APP-ADJtab 212 tasks6 tpl
The case is set for hearing
Either side declares the case ready
—
DORtab 318 tasks12 tpl
The Board decides20 days
An order, award or findings
LC 5903; 8 CCR 10605(a)–(b), 10940, 10945
ORDERtab 2/148 tasks3 tpl
The case ends
The parties agree
8 CCR 10700(a)
CRtab 1416 tasks27 tpl
The treating doctor decides something20 days
A report that changes what the worker gets — P&S, work status, a treatment the carrier will refuse