Teddy Snyder

Category: Claim management

  • What You Don’t Know About EAMS

    eams logo

    The lawyer told me, “I can only see the cases where I’m the attorney of record.”

    The hearing rep told me, “I don’t have access to EAMS.”

    Wrong and wrong.

    It’s a Government Database

    EAMS is a PUBLIC database of filed California Worker Compensation cases. Anyone can log in to https://eams.dwc.ca.gov/WebEnhancement/ to see case information. You might only need the Applicant’s name at the initial search screen. Often, though, you need another piece of data, such as the Applicant’s date of birth, to distinguish among people with the same name. The system shows where the Applicant resides, so that might help you sort through Applicants with common names.

    The site requires users to identify themselves (though there does not seem to be any way to verify the i.d.) and choose from a list of reasons for making the request. I always choose Case Information Search, but you get the same information regardless of which reason you choose.

    The next screen shows you the employer, the Date of Injury including if it was cumulative, and the case location. You can then click through to see the next hearing date, the claimed body parts, and the parties of record including lien claimants. Clicking again on “View Events” will show you what has been filed and on what date, including stipulations and Compromise & Release documents.

    How EAMS Research Helps

    Workers Compensation professionals may want to check on other claims by the same Applicant for a number of reasons. Right at claim intake, attorneys may want to confirm whether the Applicant has prior (or later) filings, the claimed body part, and the case status. Perhaps you want to see if there were prior attorneys on the file, or just make sure you are aware of all the players. There is no reason to be unaware of apportionment issues when this data is publicly available. Once you realize the extent of information available, you will want to research the public EAMS database regularly.

  • How Did You Get To That Number?

    Case evaluation is part art and a lot of math. We’re not talking calculus; we’re talking arithmetic.

    A surprisingly large number of lawyers tell me they’re bad at math. They’re not alone. CNN anchor Chris Cuomo recently got his math corrected by his co-anchor Michaela Pereira while discussing Powerball lottery numbers.
     

    You can’t come up with a realistic evaluation of a Workers Compensation claim if you can’t quantify the component parts: Permanent Disability, Life Pension, and Medicare-eligible and non-Medicare-eligible Future Medical.

    In mediation caucus, when parties give me their offer or demand I often ask, “How did you come up with that number?” I want their best argument that will convince the other side. The first answer I get is often vague, like “We thought it would settle the case.” Workers compensation professionals often neglect running the numbers. Getting parties to see the same numbers moves them to settlement.

    I recently got a call about an offer in a personal injury case. I questioned the plaintiff’s attorney about what he thought this number represented. It didn’t sound right to me. “Did you ask them how they came up with that number?” No, he hadn’t. I suggested the attorney ask opposing counsel that question to allow movement forward toward settlement.

    Random demands and offers are unlikely to settle a claim. Before you assume the other side is being unreasonable or you respond, ask: How Did You Get To That Number?

  • 3 Signals It’s Time to Close the Claim

    Some Workers Compensation Claims seem to have a life of their own. Before you know it, years have passed since the Date of Injury. Here are 3 signals telling you to take a hard look at settling now.
    The Injured Workers is 61 years old.
    Once an injured worker reaches age 62½, any buy-out of future medical care must include a Medicare Set-Aside. (Buy-out of medical benefits for an injured worker already on Medicare also requires a Medicare Set-Aside.) This adds extra work and delay. Sometimes the MSA evaluation changes the parties’ view of the case. Stories abound about how the MSA process has torpedoed a settlement.

    Check your case inventory. If the injured worker is 61 years old, take steps now to close the claim before Medicare becomes a party to the proceedings.

    Litigation has become a way of life
    You’re in court every month. The number of claimed body parts keeps increasing; every treatment request is denied. Everyone mistrusts everyone else, including their own lawyers. Take a deep breath. Step back. This claim has a settlement value. The parties just need help figuring out what it is.

    Trial is Imminent
    Nothing makes people think about settlement more than an upcoming trial date. You’ve lived with these facts for a long time; how can you be sure the judge will see things your way in the limited time available to put on the case?  Often, a judge’s order is just the gateway to even more litigation.

    Going to trial is a risk.  Most people are uncomfortable with the lack of control. They are happier with a negotiated settlement reached through compromise. You won’t get everything your way, but you won’t lose on every issue either. Most importantly, litigation can end.

    Take the First Step
    Approach the other side about scheduling a mediation.  If communication has broken down, contact the mediator first, and let her work on bringing the parties together.

  • WHAT TO EXPECT AT MEDIATION

    Mediation remains unfamiliar to most California Workers Compensation professionals. To succeed, you– and your client– need to know what to expect. While all mediations share some similarities, each mediator has a unique style. Here’s what you can expect at one of my mediations.
    We usually start in joint session. The discussion might be limited to the logistical: introductions, bathrooms, lunch, etc.  People get to look each other in the eye.The first real step will be for the Applicant to tell how the injury happened and how things are going now. The purpose of this is to allow catharsis and to build empathy and trust between the injured worker and the mediator. Usually this is in a separate session known as a “caucus,” but if the defense needs to hear this information or wants to ask questions, it might happen while the parties are still in joint session. If the defense has heard the Applicant’s story many times, I may have Applicant do the venting in caucus.

    I usually start negotiations with the Applicant’s side. If there were prior offers and demands, I will review those to make sure we are all at the same starting point. Then comes exploring the positions which support those offers and demands. The parties’ briefs should explain the issues; the more complicated the case, the more important the briefs. Defining issues for the mediator in the brief makes for a more efficient mediation. But the briefs do not limit the number of issues; sometimes new issues emerge in mediation.

    I might speak with one or more attorneys outside the hearing of their clients, for example, to discuss a point of law.  All parties might reconvene to brainstorm solutions to an issue.  If parties are disrespectful of one another, I will stop a joint session.
    In the give and take of numbers, issues will be discussed and swapped.  Cases do not settle without compromise.  Parties should expect give and take to finalize the settlement terms.
    Participants may be surprised by the amount of time spent in caucus with the other side.  As mediator, my job is to give all parties adequate time to express their concerns.   While there are certainly exceptions, a typical workers compensation mediation lasts three to five hours.

  • YOU CAN’T SETTLE IF YOU DON’T KNOW THE ISSUES

    HOW MANY PIECES ARE THERE TO THE SETTLEMENT PUZZLE?  
    Answer:  Probably more than you think.

    The more issues there are in a negotiation, the greater the opportunity for give and take across issues. This adds flexibility for parties to shape a settlement acceptable to all. Trading across issues in negotiation is called “logrolling.”Every case has its own unique issues. Here is a partial list, some obvious, some I have seen people miss.

    INCOME ISSUES
    • Disability percentage, including whether the disability is caused by an industrial injury
    • Apportionment
    • Applicable Date of Injury
    • Past payments- when were Permanent Disability payments supposed to start? Was the right rate used? Were past payments properly characterized as PD- or should they have been TD, Temporary Disability. Is there a TD overpayment?
    • If Life Pension payments will be due, when should they start?
    • Average Weekly Wage- Have you taken into account overtime and the value of non-cash compensation?
    • Ability to perform future work
    • Return to Work issues- will the employer provide modified work?
    • What about training? Check the new California law about computer purchases.
    • Liens
    • Penalties
    MEDICAL ISSUES
    • What are the accepted body parts?
    • What expenses are reasonable and necessary? This can include issues about support services.
    • What is the appropriate medical specialty?
    • Is the treatment the Applicant wants compensable?
    • Is the Applicant’s over-all medical condition likely to shorten life expectancy?