The ADR program is designed to provide:
- A better method to resolve disputes that is intended to reduce the number and severity of disputes between employees and employers regarding work-related injury claims
- Improved access to quality medical treatment and prompt compensation to employees with work-related injury claims
- Workers’ compensation insurance coverage that improves labor-management relationships, job security and organizational effectiveness
Learn how the ADR process (Alternative Dispute Resolution) benefits both labor and management. Gain a better understanding from legal experts Jeannine M. Lewis, WCCLA, SIP and Michael D. Peabody, Esq., Bradford & Barthel LLP – Chris R. Reinhardt, CIC, ADR Program Administrator
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.