“I don’t understand what they sent me.”

The four that start a deadline

A utilization reviewUR Utilization Review. The process that approves, modifies, or denies each treatment request. A modification is a denial of what it left out. decision — approving, modifying, or denying treatment.

A modification is a denial of what it left out, and it starts the same 30-day IMRIMR Independent Medical Review. The appeal from a UR denial. 30 days (10 if the dispute is only over drugs on the MTUS Drug List). clock as an outright denial. The letter will say “approved.” More.

A QMEQME Qualified Medical Evaluator. A state-certified physician who resolves disputes. Unrepresented workers get a panel of three by random draw. panel notice — naming evaluators or a specialty.

The panel process runs on short deadlines and missing one can cost you the choice of specialty. More.

A Declaration of Readiness to ProceedDOR Declaration of Readiness to Proceed. Forces the calendar. You have 10 calendar days to object, or objections to proceeding on its issues are waived. (DOR).

Ten calendar days to object, or you waive any objection to going ahead on the issues it lists.

A settlement document — Compromise and ReleaseC&R — Compromise and Release A lump sum that closes future medical treatment permanently. or Stipulations with Request for AwardStips — Stipulations with Request for Award An agreed percentage paid over time, with future medical left open, and reopening available within five years of the date of injury. These are not two prices for the same thing..

Read the title. One closes future medical permanently; the other does not. The difference.

The ones that matter but do not start a clock

Benefit notices — accepting, delaying, or denying. Keep every one, with its date. The 90-day presumption runs from your claim form, and these letters are how you prove the timeline.

The permanent and stationaryP&S / MMI Permanent and Stationary / Maximum Medical Improvement. Your condition has plateaued — not that you are healed. Temporary disability ends here. report. Long, medical, and the document your entire rating is built from. What to check in it.

Payment statements. Build the ledger — date issued, date received, period, amount. The law adds 10% to any late indemnity payment automatically.

What to do with all of it

Keep every envelope and every date. Date of mailing and date of receipt are different and both matter.

Photograph or scan each one.

And ask for documents in your language. Many DWCDWC Division of Workers’ Compensation, part of the Department of Industrial Relations. Administers the system. Information Services Center: 1-800-736-7401. notices and forms are available in Spanish, and a claims administratorClaims administrator / adjuster The person handling your claim for the insurer or self-insured employer.’s notice obligations are not satisfied by handing you something you cannot read.

You are entitled to an interpreter at no cost — a qualified interpreter at treatment appointments, a certified interpreter at an employer-requested or Board-requested medical examination, and one at your deposition, as well as at hearings. Your interpreter rights.

Free help exists

Every DWC district office has an Information & Assistance officer who answers questions and helps with forms at no cost. The DWC Information Services Center is 1-800-736-7401. Where the offices are.

And we will read anything you have received, for free, and tell you what it is and whether a clock is running.