We are happy to provide you with this informative summarized booklet of the important changes and updates to both of these funds. Please feel free to contact us at anytime to get a hard copy of this booklet or answer questions you may have. We are always here to help in any way we can.

Laura M Wilson Associates Inc SB863 Supplemental Job Displacement benefit SJDB Voucher What you need to know CHANGES THAT APPLY TO ALL to the voucher unless the You will note the distinction that for DATES OF INJURY employer makes an offer or dates of injuries prior to January 1 Pursuant to Labor Code section regular modified or alternative 2013 the time period required for 4658 5 d a time limit is now work as defined by Labor Code the offer of work pursuant to Labor imposed on an applicant s use of the section 4658 1 that meets this Code section 4658 6 is 30 days It voucher For all vouchers issued criteria is important to refer to the date of injury to ensure that the proper after January 1 2013 a statutory time limit of two years after the 1 The offer is made no later than 60 date the voucher is furnished to days after receipt of the first report the employee or five years after received from either the primary If the employer does not make the the date of injury whichever is treating physician an agreed medical offer for regular modified or later Note that there is no time limit evaluator or a qualified medical alternative work the supplemental on vouchers issued before January evaluator finding that the disability job displacement benefit shall be 1 2013 from all conditions for which offered to the employee within 20 compensation is claimed has days after the expiration of the 60 CHANGES FOR DATES OF INJURY become permanent and stationary day period Labor Code ON OR AFTER JANUARY 1 2013 and that the injury has caused 4658 7 c Labor Code section 4658 7 b sets permanent partial disability forth the eligibility criteria for the supplemental job displacement 2 The offer is for regular modified or benefit for dates of injury after alternative work lasting at least 12 January 1 2013 A permanently months partially disabled worker is entitled www lauramwilson com deadlines are met
Laura M. Wilson   Associates, Inc.  SB863  Supplemental Job Displacement benefit  SJDB Voucher  What you need to know CHAN...
Laura M Wilson Associates Inc ALL CASES WILL WITH PERMANENT PARTIAL DISABILTY 6 000 VOUCHER All permanently partially disabled workers who are not returned to work are entitled to receive the same 6 000 00 voucher Labor Code 4658 7 d There are no longer varying amounts for the voucher based upon the level of permanent partial disability THE VOUCHER CAN NO LONGER BE CASHED OUT Section 4658 g does not permit settlement or commutation of a claim for the supplemental job displacement benefit Therefore the voucher may only be used as outlined in the statute THE USES FOR THE VOUCHER HAVE BEEN EXPANDED TO THE FOLLOWING 1 2 3 4 5 6 Payment for education related retraining or skill enhancement or both at a California public school or with a provider that is certified and on the state s Eligible Training Provider List EPTL as authorized by the federal Workforce Investment Act P L 105 220 including payment of tuition fees books and other expenses required by the school for retraining or skill enhancement Payment for occupational licensing or professional certification fees related examination fees and examination preparation course fees Payment for the services of licensed placement agencies vocational or return to work counseling and r sum preparation all up to a combined limit of 10 percent of the amount of the voucher Purchase of tools required by a training or educational program in which the employee is enrolled Purchase of computer equipment up to one thousand dollars 1 000 Up to five hundred dollars 500 as a miscellaneous expense reimbursement or advance payable upon request and without need for itemized documentation or accounting The employee shall not be entitled to any other voucher payment for transportation travel expenses telephone or Internet access clothing or uniforms or incidental expenses Labor Code 4658 7 e The employee shall not be entitled to payment or reimbursement of any expenses that have not been incurred and submitted with appropriate documentation to the employer prior to the expiration date two years after the date the voucher is furnished or five years after the date of injury whichever is later Labor Code 4658 7 f
Laura M. Wilson   Associates, Inc.  ALL CASES WILL WITH PERMANENT PARTIAL DISABILTY  6,000 VOUCHER All permanently partial...
Laura M Wilson Associates Inc NEW REQUIRED PHYSICIAN FORM The medical report that invokes the time period must be made on a specific form that is created by the administrative director Pursuant to Labor Code section 4658 7 h 2 the form must fully inform the employer of work capacities and of activity restrictions resulting from the injury that are relevant to the potential regular work modified work or alternative work Physician s Return to work Voucher Report Labor Code section 4658 7 b 1 A permits the employer to send the medical evaluator a job description for the applicant s regular work proposed modified or alternative work The physician is then to evaluate and describe in the form whether the work capacities and activity restrictions are compatible with the physical requirements set forth in that job description The form that is completed by the physician shall be forwarded by the carrier to the employer in order to fully inform the employer of work capacities and activity restrictions resulting from the injury that are relevant to potential regular modified or alternative work Labor Code 4658 7 b 1 B www lauramwilson com
Laura M. Wilson   Associates, Inc.  NEW REQUIRED PHYSICIAN FORM The medical report that invokes the time period must be ma...
Laura M Wilson Associates Inc SJDB Voucher Flow Chart PC LC 4658 SJDB LC 4658 5 4658 6 658 5 LC 4658 6 DOI 01 01 2004 TX No TD but EE has PD Send Mod Alt Offer DWC AD 10133 53 within 30 days from TD end File copy with AD 30 days P S Released to Regular Duties No PD Issue PD denial No voucher due PD TX No TD No PD TD Paid Send Regular Work Offer DWCAD 10118 EEs 50 DOI 01 01 05 only TD Ends PD or No PD No Notice or Voucher Required Send Notice of Rights 10133 52 within 10 days from TD end certified mail required once only Released to Mod Alt Work Reduce weekly PD 15 as of date of offer but within 60 days after P S LC 4658 d 3 A DOI 01 01 05 only Mod Alt Available No voucher due Send Mod Alt Offer DWC AD 10133 53 within 30 days from TD end File copy with AD 30 days If not P S yet send Mod Alt offer again within 60 days after P S LC 4658 d 3 A Reduce weekly PD 15 as of date of offer but within 60 days after P S LC 4658 d 3 A DOI 01 01 05 only No voucher due www lauramwilson com Mod Alt Reg Not Available Increase weekly PD 15 60 days after P S EEs 50 DOI 01 01 05 only Send Voucher 10133 57 within 25 days of approved award unless settled Pay voucher expenses within 45 days of invoice 10133 56 h
Laura M. Wilson   Associates, Inc.  SJDB Voucher Flow Chart  PC  LC 4658, SJDB  LC 4658.5   4658.6  658 5   LC 4658 6   DO...
Laura M Wilson Associates Inc 60 Days Form 10133 33 Description of Employee s Job Duties P S by treater with PD Mandatory for 1st P S report Form 10133 36 Physician s Return to Work Voucher Report 20 Days 2 years after furnished S O L 10133 34 b Notice of Offer Form 10133 35 Regular 10117 Modified Meet restrictions Alternative Last 12 months Reasonable commute at time of DOI 85 Pay 10133 54 Request for Dispute Resolution Form 10133 55 10133 31 Voucher Form 10133 32 Eligible for 5000 Return to Work Fund Benefit MUST BE SUBMITTED WITHIN 12 MONTHS FROM ISSUANCE OF SJDB VOUCHER NOTE THE RETURN TO WORK FUND BENEFIT WILL EXPIRE 12 MONTHS AFTER DATE OF ISSUANCE OF THE SJDB VOUCHER OR APRIL 13 2015 WHICHEVER IS LATER www lauramwilson com
Laura M. Wilson   Associates, Inc.  60 Days  Form 10133.33 Description of Employee   s Job Duties  P S by treater with PD....
Laura M Wilson Associates Inc all information below provided by the DIR Make sure you have all the following necessary documents and information Your DWC AD 10133 32 SJDB Form o Proof of Service Page page 6 Or o Entire SJDB Voucher Full Name Date of Birth SSN ITIN Address City State Zip Date of Injury Claim Number ADJ Number Previous RTWSP Benefit Payment Information if applicable Scan save your SJDB voucher you can do this yourself with any scanner or if you don t have access to one there is one located at the kiosks within the DIR offices Make sure you scan one of the following Proof of Service of the SJDB voucher form page 6 OR the entire SJDB voucher form 10133 32 fill out the individual information First Name Middile Initial Last Name Date of Birth SSN ITIN Address City State Zip Email Phone Number fill out the injury history Date of Injury Claim Injury SJDB Proof Of Service Date ADJ Number Previous RTWSP Benefit Payment RTWSP Date Upload sjdb voucher Click Upload Click Browse Click on your SJDB scanned file Click Open Click Add check boxes for certification Residency Certification Penalty of Perjury Review Submit Review all your information for accuracy If any changes are needed click on Edit Click the Submit button to complete your application An RTW number will be assigned to you on the last page Print a copy of your application for with rtw number Click on Click here to print this page On the Print menu click on Print button Collect your copy from the printer Keep your RTW number for your records finally click on logout and close your application www lauramwilson com
Laura M. Wilson   Associates, Inc.   all information below provided by the DIR   Make sure you have all the following nece...
Laura M Wilson Associates Inc Corporate Office 10350 Heritage Park Drive Santa Fe Springs CA 90607 Satellite Offices 12800 Center Court Drive Ste 500 Cerritos California 90703 11721 Whittier Blvd Suite 413 Whittier California 90601 7801 Mission Center Court Ste 400 San Diego CA 92108 Phone Numbers Toll Free 800 531 5608 Direct 818 359 SJDB 7532 562 458 SJDB 7532 619 325 0969 Fax 562 309 8142 or 888 389 SJDB 7532 www lauramwilson com
Laura M. Wilson   Associates, Inc.  Corporate Office  10350 Heritage Park Drive Santa Fe Springs, CA 90607 Satellite Offic...
Laura M Wilson Associates Inc Notes www lauramwilson com
Laura M. Wilson   Associates, Inc.  Notes   www.lauramwilson.com