Alternative Dispute Resolution— A Different Approach for Injured Workers

An Alternative Dispute Resolution (ADR) program, also known as a "Carve Out," is designed to result in expeditious and equitable settlements between injured workers and their employer and/or insurance company outside of the state court system.

In order to participate in an ADR, the employer must be a trade association, a group of employers, a project with several employers, or a single large employer of sufficient size. In addition, employees must be in an organized labor union.  The employer and union must reach an agreement in principle that the ADR program serves both interests.

After an ADR program has been established, a labor management committee is formed to oversee it.   As the name implies, this committee is usually comprised of an equal number of appointees from management and labor. The committee approves the lists of treating doctors, neutral evaluators, and other vendors that can provide services to injured workers and approves the selection of the ombudsperson, mediators, and arbitrators.

An ADR must be approved by the state and cannot provide fewer benefits than the state system; it can, however, provide more benefits. The main goal of processing injured workers' claims through an ADR program is to provide better, faster medical care (with less denials), a more timely return to work and to minimize conflicts and delays, all while saving costs for the employers/insurance companies.  An ADR can be designed to provide access to impartial doctors and mediators/arbitrators to resolve disputes concerning all classes of Workers' Compensation benefits. 

A multitude of Workers' Compensation ADR programs exist in California, spanning many industries, from retail clerks to public safety.

The law firm of Gordon, Edelstein, Krepack, Grant, Felton & Goldstein, LLP has extensive knowledge and experience working with unions and associations to create ADR programs, in both the public and private sectors.