1. Doctors Affect RTW And Your Bottom Line Norm Peterson, President, NPA Associates Jim Libien, Esq., Laughlin, Falbo, Levy, & Moresi Jack Blyskal, CPCU, ARM, CSAC EIA

2. Working Hypothesis Certain doctors treating 4850-eligible patients did not provide information to facilitate early RTW, including work restrictions. City of Oakland example Two physicians, firefighters only, cost the City $1.4M in 4850 costs

3. Formed Committee Committee Makeup RTW provider TPA provider Excess pool manager Legal counsel JPA Members Risk Managers for Public Entities, including City of Oakland

4. Ideas Considered Root causes Doctors affiliated with unions Doctors not specializing in Occ Med Patients eligible for 4850 benefits Possible approaches Legislation Get doctor association to oversee Approach DIR for oversight

5. Data Analysis (See handout) 4850 was NOT the driver of extended disability Difference lay between the Occ. Med doctors and Non-Occ. Med doctors Cost impacts were found as high as 8-9 times for Non-Occ. doctors

6. Solutions Considered Legislation Time consuming, complicated, difficult with Senate/Assembly makeup Regulatory Met with Director of DIR Inability to enforce requirements Informal Met with doctor association

7. Solutions Considered Administrative Implement report specifically addressing work limitations Allow $25 fee for form completion Implement on trial basis with three identified customers Results

8. Other Ideas Open Forum What do you think?????

9. Questions?