You, your claims supervisor and the treating physician must try to accomplish these goals as soon as possible, consistent with treatment requirements. Ensure that necessary medical attention is scheduled efficiently and that the employee keeps appointments and follows the physician’s instructions. Communicate with your claims supervisor so you are satisfied that the recovery process is moving ahead. If the employee is involved in temporary modified duty, make sure that individual is not exceeding the limitations to avoid aggravating the injury or prolonging recovery.

Fortunately, most claims close after a brief period of medical treatment, during which the employee is off work or participating in modified duty. These claims involve injury with no long-term impact on the employee’s health or physical condition.

Some claims involve more serious injury or chronic conditions that may never be fully reversed. At some point, the evaluating medical authorities may determine that the employee’s condition will not likely get better or worse. This is known as a “permanent and stationary” condition, or “P&S.” It may also be referred to as “Maximum Medical Improvement” (MMI).

At this point, determinations are made as to:

• The extent of any permanent disability.
• The need for continuing medical treatment.
• The ability to return to work.
• The need to modify the employee’s regular job.

If the injured employee is declared P&S or MMI at the earliest appropriate point in the treatment and recovery process, you avoid long periods of temporary disability payments.

If the limitations permit the employee to return to the pre-injury job, promptly make arrangements for them to do so.

Typically, a claim, especially one involving residual permanent disability and/or need for future medical treatment, formally resolves in one of two ways:

• A “Stipulation With Request for Award” settlement document, which provides a future medical award, if necessary; or
• A lump sum “Compromise and Release” settlement document which closes out the claim entirely (typically in cases when the employee does not return to work).

Ask the claims administrator for a copy of any settlement document or award that chronicles the resolution of the claim, assuming you were not served with a copy. You may need the settlement agreement in the future to document apportionment for any subsequent injury to the same or similar body parts. Labor Code sec. 4664 entitles the employer to a conclusive presumption that any award of permanent disability to a particular body part still exists at the time of any subsequent injury to the same body part. Provide any relevant prior award or settlement document to the claims administrator at the time of any new claim of injury to the same or similar body part.