Note Type
Call to Story Teller 888-999-1010 left message introducing myself and requesting return call regarding her 09/15/2024 DOI.
What is Claimant Contact?
Call to YouShoesyouloose location 444-864-2131 spoke with Store manager Sal Monella the employee returned to work today full duty. He does not know much about the incident and will have the manager on duty at the time of the incident call me with details.
What is Employer/Insured contact?
This is the note type you would use when providing an overview of litigation to date or to document no litigation in your initial date integrity note. This is also where decisions, hearing dates, and mediation dates can also be listed.
What is Litigation?
This is the note you use to document the overview of medical treatment to date
What is Medical Management?
4/13/2024 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?
Reviewed ISO report
10/19/2024 Auto – No injuries noted
No matching claims. No follow up required.
What is ISO Claim Search?
This note type is for an item you must request and receive this from defense within 30 days of assignment and then quarterly.
What is Legal Budget?
Request sent to employer Jed Dye with The Force for wages for 52 weeks prior to the 9/15/2025 DOI
What is AWW/Comp rate?
Employee is released to return to work with restrictions, however, the employer cannot accommodate the restrictions. Restrictions: Carrying: 20# max occasional carry; Lifting: 20# max occasional lift; Pulling: 20# max occasional pull; Pushing: 20# max occasional push; Walking: No more than 15 minutes of continuous standing/walking followed by 5 minutes of sedentary activity.
** THIS IS NOT A NOTE CATEGORY. **
Please use the Return to Work screen. You can select the option (Under "More Options") to Create Note once updated and CareMC will add a note for you.
Request sent for clerical to sent new claim packet
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 is not excess reportable as it does not meet reporting criteria at this time. Retention level is $2mil and reportable at $1mil as set forth by Indemnity Insurance Company of North America.
What is Excess Carrier?
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?
Any correspondence (including letters, emails, phone calls) with Defense counsel would be included under this note type.
What is Litigation - Defense Strategy?
Jurisdiction: Pennsylvania claimant lives, works in and injury occurred in PA
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?
Is the employee a covered class under this policy? Yes
If Large Deductible customer: XS Insurance Company, $500,000 deductible reportable at $250,000
What action to take if no coverage/declination? There are no issues of coverage with this claim.
Job class code number: 1234
Policy number and begin/end dates: 10/1/2024-10/31/2025
Jurisdiction: PA
What is Coverage/policy?
Request to clerical to file and send form 501 and 494C
Date disability began 9/21/2024
Weekly or Biweekly Bi weekly
What is State/Regulatory Forms?
File review with client (name parties present) 10/1/2024 discussed file and agreed to move forward with settlement evaluation after IME received.
What is File Review?
Quilliam T Nibbles, Hedgehog and Whistlepig LLC, 333 Over the Hill Lane, Adventure MI 47321, QTNibbles@Lawforone.com
Defense counsel assigned, auth provided by client for same 03/16/2024. Confirmed DC is on approved legal panel with carrier.
570-124-6791
What is Defense Attorney?
Claim Status Report sent to XS Insurance Company 9/15/2024. Next report due 12/15/2024. Task set.
What is Excess note?
Use this to document settlement evaluations, settlement authority when received, and settlements when approved by the state.
** THIS IS NOT A NOTE CATEGORY ** Please document all settlement activity using the Settlement screen. (This screen will update the notes for you.)
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 04/22/24: Hi Teresa, we received this bill for D.O.S 12/30/23 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?