Workers' compensation is the oldest social insurance program; it was adopted in most states including California, during the second decade of the 20th century. It is a no-fault system, meaning that injured employees need not to prove the injury was someone else's fault in order to receive workers' compensation benefits for an on-the-job injury.
The California Labor Code §3201.7 allows employers and labor organizations to carve out alternative ways to deliver workers’ compensation benefits to injured employees and resolve disputes rather than utilizing the State System. Injured employees receive the same benefits they would receive in the State Workers’ Compensation System, including medical treatment, temporary disability benefits, permanent disability benefits, and supplemental job displacement benefits. The only difference is that disputes are resolved utilizing the steps described in the ADR Program, instead of litigating them with the Workers’ Compensation Appeals Board (WCAB).
The goals of the ADR Programs are to avoid the unnecessary misunderstandings and disputes, improve the speed and quality of medical care, improve claim resolution time, reduce workers’ compensation claims costs, reduce litigation, and increase injured employees satisfaction.
The City uses neutral third parties to administer the Civilian and Police Sworn ADR Programs.
City of Los Angeles (City) and Service Employees International Union (SEIU) Local 721 entered into an agreement establishing a Civilian ADR Program on July 1, 2008 covering employees in MOUs 4, 14, 15, and 18. On May 1, 2018 the program was expanded to include employees under MOUs 2, 3, 6, 7, 8, 9, 10, 11, 12, 13, 16, 17, 34, 36, 37, 62, and 63. The Civilian ADR program utilizes a program manager, ombudspersons, mediators, arbitrators, and nurses to resolve disputes related to the workers’ compensation claim. Ombudspersons answer claimants’ questions, provide unbiased explanations of the law, and resolve problems before they become formal disputes. Mediators hold settlement meetings to help the parties reach mutually acceptable solutions. Arbitrators review settlement awards, as well as conduct formal hearings to receive formal testimonies from all parties and witnesses, and make decisions that are binding for the parties. Nurses answer questions that require medical expertise.
The City of Los Angeles and the Los Angeles Police Protective League (LAPPL), MOU 24 Active and Retiree members entered into an agreement on May 1, 2018 establishing the Police Sworn ADR Program. The Police Sworn Program utilizes an ADR Coordinator, Member Advocates, Mediators, and Arbitrators. Member Advocates are proactive and seek to identify disputes before they occur where possible and attempt to assure that all injured members are receiving quality medical care and the compensation to which they are entitled. Mediators hold settlement meetings to help the parties reach mutually acceptable solutions. Arbitrators review settlement awards, conduct formal hearings to receive formal testimonies from all parties and witnesses, and make decisions that are binding for the parties.