1. THE OKLAHOMA WORKERS’ COMPENSATION CODE THE NUTS AND BOLTS OF AVOIDING AND MITIGATING CLAIMS Madalene Witterholt Christina F. Toon CROWE & DUNLEVY 918-592-9800christina.toon@crowedunlevy.com

2. PREVENTION OF CLAIMS COVERING YOUR BASES PRE-EMPLOYMENT PHYSICAL CREATION OF A SAFE WORK PLACE-PROPER TRAINING

3. RESPONDING TO REPORTED INJURY EMPLOYER’S FIRST NOTICE OF INJURY PROMPT MEDICAL ATTENTION –Actual knowledge –7 days unless emergency –Not an admission of compensability –Selection of treating physician

4. FACTS TO DETERMINE AND EVALUATE CLAIM VERIFY EMPLOYMENT COVERAGE JURISDICTION ON-SITE INVESTIGATION (basic facts, medical treatment, employee interview, witness interview) WAGES-RATE DETERMINATION ADMIT OR DENY

5. COMPENSABLE INJURIES Arising out of and in the course and scope of employment Major cause now defined as “more than 50%” the fault of employment Single event vs. cumulative trauma injuries and the Statute of Limitations Consequential injury

6. DEFENSES 30 days notice The drug defense Preexisting condition Intentional injuries Horseplay Recreational activities Cumulative trauma-90 day rule Injuries not physical in nature

7. PROVIDING MEDICAL CARE Official Disability Guidelines “ODG” Physician’s Advisory Committee for spine and pain management 25% penalty for non-payment

8. TEMPORARY TOTAL DISABILITY BENEFITS TTD-time during which the injured worker is fully unable to work in any capacity Soft Tissue Light Duty Restrictions MMI-Maximum Medical Improvement Termination of Benefits- Prefiling Payment not an admission Employee notice

9. PERMANENT PARTIAL IMPAIRMENT Release at MMI Scheduled vs. non-scheduled members AMA Guides No treatment, no impairment Apportionment Unrepresented Settlement

10. AND NOW WE’RE IN ACTION- MITIGATING THROUGH THE LEGAL PROCESS 10-Judges Employees First Notice of Accidental Injury Pretrial Answer and Stipulation Motion for Prehearing Conference

11. TTD BENEFITS-LITIGATED CLAIM 10 days or 15% penalty 156 weeks with additional 52 7 and 21 day timeline Unemployment and short term disability Treating physician or CIME Non-compliance

12. THE LEGAL PROCESS CONTINUED Request for change of physician/CWMP Termination of TTD benefits/MMI Trial Motion PPI Trial Appeal

13. CONTINUING MEDICAL MAINTENANCE Treating physician or IME Physicians Advisory Committee Duration

14. PERMANENT TOTAL DISABILITY Vocational evaluation Loss of hands, feet, legs, eyes, or any combination of two PPD and PPI PTD and TTD Court review Suspension of benefits

15. VOCATIONAL RETRAINING Permanent restrictions and return to work Limited to 52 weeks but may be extended

16. CLAIM CLOSURE-GET CLAIMS OFF YOUR BOOKS! Reopen for change of condition Medical maintenanceReopen for change of condition Medical maintenance The Compromise SettlementThe Compromise Settlement Agreed OrderAgreed Order Voluntary MediationVoluntary Mediation Medicare ConcernsMedicare Concerns

17. RECENT CODE UPDATES-STAY ON TOP OF THE CHANGE Mileage Heart claims MRI testing units/Ownership interest Missed medical appointments Mediations Fees for uncontested death cases Client funds for political contributions Coming and going rule

18. THANK YOU FOR LISTENING! This presentation is provided by Crowe & Dunlevy for educational and/or informational purposes only and does not constitute legal advice. No attorney-client relationship is established by viewing this presentation. Copyright © 2012 Crowe & Dunlevy, P.C.