Are you using the ADR Advantage? Alternative Dispute Resolution, a “carve out” of the statutory workers’ comp system, delivers w/c benefits to unionized employees in streamlined fashion. By replacing the WCAB’s normal statutory system with an Ombudsperson, Mediators and Arbitrators, ADR is less adversarial and allows claims to move through the system more expeditiously and economically: a “win win” for everyone! Learn how you can benefit from the ADR Advantage.

Long-term achievement of these goals

With the provision of prompt access to quality medical care and immediate access to an ombudsman (an individual appointed to receive, investigate and report details regarding a claim), injured union members will have immediate access to a workers’ compensation professional who will provide aid and counsel free of charge. Claims in the traditional system sometimes tend to drag on while the member is waiting to receive the medical treatment necessary to recover and return to work. These circumstances frequently lead to unnecessary antagonism between the parties and otherwise avoidable litigation.

The ombudsman provides a mechanism that is intended to accelerate the timeliness of treatment and benefits and shorten the resulting lost work time. Treatment and benefits are delivered promptly and are carefully monitored by the ombudsman who may intervene before things escalate. Less lost time means not only fewer lost wages for the injured worker, but a reduction in the losses applied to the employer’s account and, thus, a reduction in its loss ratio, experience modification and premium amounts in the coming years.

How are claims handled differently when using ADR?

You receive assistance from an ombudsman

The injured worker has the benefit of contacting an ombudsman, who is employed by a neutral joint labor-management trust, to have questions answered and communicate relevant information to the insurance company.

Prompt treatment from a quality physician

Employees under the ADR select from an exclusive list of medical providers who were jointly selected and approved by labor and management. Within this plan, there will be a wide range of choices within each medical specialty, and authorization for treatment will be promptly provided.

How are claims litigated differently under an ADR?

The ADR program replaces the State’s processes for resolving disputes by establishing through labor-management negotiation the method and means by which the substantive law is administered. When issues arise that cannot be resolved by the ombudsman, a party may request mediation, an informal process with a retired workers’ compensation judge. If the dispute is not resolved at mediation, a party may request arbitration and the matter will be set for trial before an arbitrator who will render a decision subject to a party’s right to appeal to the Workers’ Compensation Appeals Board in San Francisco.

No reduction of benefits

There are no reductions in benefits. Benefits cannot be reduced below the current levels as set by the Labor Code.

Who qualifies for an ADR program?

Only signatory employers and their employees in a participating craft qualify for the ADR program.