Note Type
Call to Linsey Vonn 888-999-1010 left message introducing myself and requesting return call regarding her 02/09/2010 DOI.
What is Claimant Contact?
Call to YouShoesYouLoose location 444-864-2131 spoke with Store manager Frank Whoseimawhatsit the employee returned to work today 03/21/21 full duties
What is Employer/Insured contact?
Petitions filed: Review petition, termination petition
Litigation status: Petitions filed 3/22/2024 and 4/15/2024
Litigation strategy: We have IME that found claimant not credible based on numerous prior injuries he could "not recall" during the IME.
Percentage of change to successfully prevail at hearing: 50%
Judge: Joseph Hakun
Hearing dates: 7/17/2024
Mediation dates: 2/13/2024
PC: Tom Kelly
DC: Larry Pitt
Estimated timeframe for litigation closure: 5/2025
What is Litigation?
Diagnosis: S/P Rotator cuff repair - left and right shoulders
Testing: 5/8/2023 MRI degenerative discs
Case management: TCM Cindy Carpenter - claim closed
Surgeries: Right shoulder surgeries 9/10/2019 and 1/30/2020. Left shoulder surgeries 1/12/2022 and 3/22/2023
LOV: 12/18/2023 - MMI. Complete PT and transfer to HEP.
NOV: 6/17/2024
What is Medical Management
4/13/2021 Northwest Community Immediate Care 847-618-9655
48yr old male presented to ICC toady to with bilateral upper arm pain which started 3 weeks ago. no injury or trauma but does heavy lifting at work. pain worse with lifting
What is Medical report review?
Received bill from DOS 10/01/21 for PT reopening file for payment of previously approved therapy, file to be closed following processing of same
What is reopen?
Sent request for anticipated litigation costs from defense counsel.
What is a legal budget?
Request sent to employer Kim Sanchez with Tek Corp for wages for 52 weeks prior to the 04/06/2021 DOI
What is AWW/Comp rate?
CSR sent to Betty White with Golden Girls Co-op and copy to file next CSR due 1/25/2025
What is Client Status Report?
Request sent for clerical to sent new claim packet, EFT, and mileage for to claimant
What is Claimant Contact?
AWW: $491.68 AWW Rate: $327.79 PPD Rate: $295.01
Received wage history. Year prior: $16225.39 without OT $18445.13 / 33 weeks worked = $491.68.
What is Aww/Comp rate?
This claim does not meet the criteria for excess reporting reportable at $500,000 to Safety National
What is Excess?
Letter of representation received 02/21/21 from Curtis McPhail, Bickers and McPhail PLC, 1095 Redline, Chicago IL 60663, 773-648-2131 C.mcphail@BMattorneysatlaw.com
What is Claimant attorney?
10/22/2024 Email from DC
What is Litigation - Defense Strategy?
Jurisdiction: Kentucky claimant lives, works in and injury occurred in KY
What is State/Regulatory Forms?
Adjuster response to supervisor review:
Correct the errors on the RTW screen-Done
Update the OSHA screen with the providers information-Done
Call the provider to obtain the next appointment date and update the file accordingly. Task set
What is File Review?
There is a different template for Hartford high deductible or excess/SIR.
Please see templates I couldn't fit it all on on here :-)
What is Coverage/policy?
Request to clerical to sent form 1043 - IN (1043) Agreement to Compensation TTD
Date disability began 04/16/2021
AWW $ 1141
TTD $760.66
Weekly or Biweekly Bi weekly
What is State/Regulatory Forms?
File review with client (name parties present) 04/29/21 discussed file and agreed to move forward with offer of 20k, reserve increase provided to same.
Defense counsel assigned, auth provided by client for same 03/16/21 Quilliam T Nibbles, Hedgehog and Whistlepig LLC, 333 Over the Hill Lane, Adventure MI 47321, QTNibbles@Lawforone.com
517-124-6791
What is Defense Attorney?
Report sent to Theodor Geisel at IAM Carrier (tgeisel@iamcarrier.com), copy to file, next report due 1/24/2025
What is Excess note?
PC: David Trammlel (dtrammlel@deweycheatemhowe.com)
109 Smith Ave. Anytown, PA 17902
570-491-5673
What is Claimant attorney?
CCRX closed: Yes
ISO reports stopped? Yes
Address permanency? Yes 0%
All known medical bills paid: Yes
MMI date: Claim denied
Exposure for future indemnity benefits: No
Subrogation resolved, if applicable? N/A
Outcomes tile updated in RTW Module (NO errors)? Done
State forms: PA - 496 filed 6/21/2024
Why recommending for closure at this time? No further action necessary at this time.
What is Closure?
What is Investigation?
Email with ER and bill attached has been sent to the Bill review supervisor Teresa Gauze dated 04/22/21: Hi Teresa, we received this bill for D.O.S 12/30/20 from Community Hospital South the bill was zeroed out as a duplicate. This is not a duplicate bill and it needs to be sent through for processing. Please advised if this bill can be reprocessed for payment. Thanks.
What is Medical Bill Process