FAQ
What is an ADR program?
An Alternative Dispute Resolution (ADR) program in workers’ compensation is what has been referred to as a Carve-Out. In 1993, the state legislature allowed construction trade unions and construction employers to collectively bargain over the creation of a separate dispute resolution system as an alternative to the state workers’ compensation courts. An ADR is the product of that collective bargaining and ordinarily involves:
1) an ombudsman who acts as a liaison between the injured worker and the insurance company,
2) a mediator who will meet with the parties if a dispute cannot be resolved by the ombudsman and a grievance is filed, and
3) an arbitrator who will hear the case and make a decision if the matter cannot be resolved through mediation.
An arbitrator’s decision can be appealed by filing a Petition for Reconsideration with the Workers’ Compensation Appeals Board, just as one would under the state system.
How are claims handled differently under an ADR?
Assistance from an Ombudsman
The injured worker has the benefit of contacting an ombudsman, who is employed by a neutral joint labor-management trust, in order to have questions answered and communicate relevant information to the insurance company.
Prompt Treatment from a Quality Physician
Employees under an ADR are limited to selecting a physician from within a particular medical plan. Within this plan there will be a wide range of choice within each medical specialty, and authorization for treatment will be promptly provided.
Easy Access to Medical-Legal Opinions
Rather than navigating the complex requirements of the Labor Code, medical-legal issues can be addressed by physicians, either by selecting a forensic doctor of your own, or by selecting a doctor by reaching an agreement between the parties. The physician’s used must be selected from a list of Qualified Medical Evaluators.
How are claims litigated differently under an ADR?
The ADR program leaves the State’s substantive workers’ compensation law in place, but replaces the dispute resolution law with its own. When disputes arise that cannot be resolved by the ombudsman, a grievance may be filed and an informal conciliation session will promptly be set before a mediator. If the matter cannot be resolved at the informal conciliation, the matter will be set before an arbitrator who will hear the case and render a decision within 30 days. Either party may appeal the arbitrator’s decision to the Workers’ Compensation Appeals Board in San Francisco.
Who qualifies for an ADR program?
Only signatory employers and their employees in a participating craft qualify for the ADR program.
Who do I contact if I have questions about the ADR Program?
Employers who have questions about, or wish to join the ADR Program should call 510-568-5920, Ext. 7 for Marketing Representative-Mason Gunn.
Employers or employees who have questions about the ADR Program should call 510-568-5920. Ext. 1 for Executive Director-Rick Pires.
Employees who qualify for the program and have been injured on the job should call 510-568-5920, Ext. 3 for Ombudsman-Arthur Scears.
Si usted habla espanol y usted califica para el progama y se ha lastimado en el trabajo debe llamar a Teresa Alvarado al numero 510-568-5920, Ext. 4.
An Alternative Dispute Resolution (ADR) program in workers’ compensation is what has been referred to as a Carve-Out. In 1993, the state legislature allowed construction trade unions and construction employers to collectively bargain over the creation of a separate dispute resolution system as an alternative to the state workers’ compensation courts. An ADR is the product of that collective bargaining and ordinarily involves:
1) an ombudsman who acts as a liaison between the injured worker and the insurance company,
2) a mediator who will meet with the parties if a dispute cannot be resolved by the ombudsman and a grievance is filed, and
3) an arbitrator who will hear the case and make a decision if the matter cannot be resolved through mediation.
An arbitrator’s decision can be appealed by filing a Petition for Reconsideration with the Workers’ Compensation Appeals Board, just as one would under the state system.
How are claims handled differently under an ADR?
Assistance from an Ombudsman
The injured worker has the benefit of contacting an ombudsman, who is employed by a neutral joint labor-management trust, in order to have questions answered and communicate relevant information to the insurance company.
Prompt Treatment from a Quality Physician
Employees under an ADR are limited to selecting a physician from within a particular medical plan. Within this plan there will be a wide range of choice within each medical specialty, and authorization for treatment will be promptly provided.
Easy Access to Medical-Legal Opinions
Rather than navigating the complex requirements of the Labor Code, medical-legal issues can be addressed by physicians, either by selecting a forensic doctor of your own, or by selecting a doctor by reaching an agreement between the parties. The physician’s used must be selected from a list of Qualified Medical Evaluators.
How are claims litigated differently under an ADR?
The ADR program leaves the State’s substantive workers’ compensation law in place, but replaces the dispute resolution law with its own. When disputes arise that cannot be resolved by the ombudsman, a grievance may be filed and an informal conciliation session will promptly be set before a mediator. If the matter cannot be resolved at the informal conciliation, the matter will be set before an arbitrator who will hear the case and render a decision within 30 days. Either party may appeal the arbitrator’s decision to the Workers’ Compensation Appeals Board in San Francisco.
Who qualifies for an ADR program?
Only signatory employers and their employees in a participating craft qualify for the ADR program.
Who do I contact if I have questions about the ADR Program?
Employers who have questions about, or wish to join the ADR Program should call 510-568-5920, Ext. 7 for Marketing Representative-Mason Gunn.
Employers or employees who have questions about the ADR Program should call 510-568-5920. Ext. 1 for Executive Director-Rick Pires.
Employees who qualify for the program and have been injured on the job should call 510-568-5920, Ext. 3 for Ombudsman-Arthur Scears.
Si usted habla espanol y usted califica para el progama y se ha lastimado en el trabajo debe llamar a Teresa Alvarado al numero 510-568-5920, Ext. 4.