What is Organizational Development and Training?

We are a department that strives to provide you, our City of Fresno employees, with a variety of innovative learning and development opportunities that encourage career advancement and succession planning efforts, that enable you to perform your job more effectively, and that inspire you to commit to your continuous growth and development.

How do I know where to go for training?

When your supervisor approves your training request, you will receive an email confirmation that lists the date/time/location of the training.

Where should I enter my education or training certificates?

You should enter all of your education, outside training, licenses or certificates, and languages into the Learning and Development section of PeopleSoft Self-Service. This will allow you to pull your information over to all of your City of Fresno Applications without having to re-enter it.

How do I reschedule a training I’ve already signed up for?

Call Jennifer at x6994 to reschedule or drop a course.

What do I do if I’m locked out of PeopleSoft?

If you have a City of Fresno network login, call the HelpDesk at x7100. If you don’t normally log into City of Fresno computers, call Personnel at x6930.

How do I know what classes I can sign up for?

You can look in PeopleSoft Self-Service Learning and Development.

Can I attend training if my supervisor hasn’t approved my training request?

It is your responsibility to get approval from your supervisor prior to attending a course.

How do I obtain a PeopleSoft account?

All City of Fresno employees have a PeopleSoft account. If you need help logging in, please call Personnel at x6930.

Can I just show up for a training?

We strongly encourage you to sign up for training ahead of time in order for us to have the appropriate number of seats and handouts. You are still responsible for obtaining your supervisor’s approval prior to attending the course.

Who can sign me up for training?

You can sign yourself up for training. See helpful handouts guides below.

Can I do this from home?

No, at this time PeopleSoft is only accessible from City of Fresno computers.

I don’t have a City of Fresno email?

You can enter your personal email address (Self-Service>Personal Information>Email addresses) in order to receive communication for City applications and training confirmations.

Do I need to fill out the claim form (DWC 1) my employer gave me?

Yes, if you want to make sure you qualify for all benefits. Your employer must give you a DWC 1 claim form within one day of knowing you were injured. Filling out the claim form opens your workers’ comp case. State law also lays out benefits beyond the basics you may qualify for once you file the claim form with your employer. Those benefits include, but are not limited to:

• A presumption that your injury or illness was caused by work if your claim is not accepted or denied within 90 days of giving the completed claim form to your employer
• Up to $10,000 in treatment under medical treatment guidelines while the claims administrator considers your claim
• An increase in your disability payments if they’re late
• A way to resolve any disagreements that might come up between you and the claims administrator over whether your injury or illness happened on the job, the medical treatment you receive and whether you will receive permanent disability benefits.

If you do not file the claim form within a year of your injury you may not be able get benefits.

What if my employer didn’t give me the DWC 1 claim form?

Ask your employer for the form or call the claims administrator to get it. The claims administrator is the person or entity handling your employer’s claims. The name, address and phone number of this person should be posted at your workplace in the same area where other workplace information, like the minimum wage, is posted. The City’s administrator is American All-Risk Loss Administrators (AARLA). You can call Karla Artist at (559) 271-3516 to obtain a claim form. You can also get the form from the DWC Web site. Click on “forms.”

I’ve been to the doctor. Why do I need to see a QME?

You and/or the claims administrator might disagree with what the doctor says. There could be other disagreements over medical issues in your claim. A doctor has to address those disagreements. You might disagree over:

• Whether or not your injury was caused by your work
• Whether or not you need treatment for your injury
• What type of treatment is appropriate
• Whether or not you need to stay home from work to recover
• A permanent disability rating

What qualifications do QMEs have?

The DWC Medical Unit certifies QMEs in different medical specialties. A QME must be a physician licensed to practice in California. QMEs can be medical doctors, doctors of osteopathy, chiropractors, psychologists or acupuncturists.

Who makes the decision about going to a QME?

Either you or your attorney (if you have one) or the claims administrator can request a QME exam. You might request a QME exam if:

• Your claim is delayed or denied and you need a medical exam to find out if the claim is payable
• You need to find out if you are permanently disabled in some way or if you’ll need future medical treatment
• You disagree with what your doctor says about your medical condition
• If you disagree with the results of utilization review.

The DWC Medical Unit will provide whoever makes the request with a list (called a panel) of three QMEs. One physician from the list is chosen to examine you and make a report on your condition. Each QME panel is randomly generated and the physicians listed are specialists of the type requested. Once a QME is chosen for your claim, all medical disputes must go to that QME.

What’s the difference between a QME and an AME?

If you have an attorney, your attorney and the claims administrator may agree on a doctor without going through the state system used to pick a QME. The doctor your attorney and the claims administrator agree on is called an agreed medical evaluator (AME). A QME is picked from a list of state-certified doctors issued by the DWC Medical Unit. QME lists are generated randomly.

How do I request a QME exam?

Complete the “Request for Qualified Medical Evaluator” form and submit it to the DWC Medical Unit. See Information & Assistance (I&A) guide 2 for help with this form.

NOTE: If your employer says there’s a problem with your claim and sends you a “Request for Qualified Medical Evaluator” form, you have 10 days from when you get the form to complete and submit the form to the DWC Medical Unit. If you do not submit the form within 10 days, the claims administrator will do it for you and will get to choose the kind of doctor you’ll see.

What difference does it make who submits the form to request the QME?

Whoever submits the request form picks the specialty of the doctor that does the exam. The DWC Medical Unit will issue a panel of three doctors in that specialty. The doctors are selected randomly and will be as close as possible to your home address. See I&A guide 2 for more information. When you receive the panel, you will also receive a letter that explains how to set up the QME appointment and how to provide the QME with important information about yourself.

Is there anything I can do if I disagree with what the QME says?

Yes, but you have a limited amount of time to decide if you agree with the QME’s report or if you need more information. When you receive the report, read it right away and decide if you think it is accurate. If not, and you have an attorney, you should talk to him or her about your options.

If you don’t have an attorney, first call the claims administrator. If that doesn’t help, contact an I&A officer at your local Workers’ Compensation Appeals Board office. The I&A officer can help you figure out what’s best in your case. See below for contact information.

If you are in a union, you may be able to see an ombudsperson or mediator under the terms of your collective bargaining agreement or labor-management agreement.

 I’m in a medical provider network (MPN). Does this process apply to me?

There are two tracks for resolving a medical dispute if you’re in an MPN, depending on the situation. If your MPN doctor requests treatment that you agree with and that treatment gets denied under utilization review (UR), you have the right to be evaluated by a QME. The claims administrator must advise you of this right. However, if you disagree with your MPN doctor about your diagnosis or treatment, you do NOT go to a QME – you have other options. First, you can change to another physician on the MPN list. You can also ask for a 2nd and 3rd opinion from a different MPN doctor. If you still disagree, you can have an independent medical review (IMR) to resolve the dispute. See the information on your MPN provided by your employer.

 I still have questions. Who do I contact?

If you have questions about requesting a QME panel, contact the DWC Medical Unit. Reach them by phone at (800) 794-6900 or by writing to:

Division of Workers’ Compensation Medical Unit
P O Box 71010
Oakland CA 94612

If you need an Information & Assistance (I&A) guide or other help, call an I&A office or attend a workshop for injured workers. The Fresno I&A office is located at 2550 Mariposa Street, Room 2035, Fresno, CA 93721-2280 and can be reached by phone at (559) 445-5355. You can also get information on local workshops and download the guides from the Division of Workers’ Comp Website.

Do I need to fill out the claim form (DWC 1) my employer gave me?

Yes, if you want to make sure you qualify for all benefits. Your employer must give you a DWC 1 claim form within one day of knowing you were injured. Filling out the claim form opens your workers’ comp case. State law also lays out benefits beyond the basics you may qualify for once you file the claim form with your employer. Those benefits include, but are not limited to:

• A presumption that your injury or illness was caused by work if your claim is not accepted or denied within 90 days of giving the completed claim form to your employer
• Up to $10,000 in treatment under medical treatment guidelines while the claims administrator considers your claim
• An increase in your disability payments if they’re late
• A way to resolve any disagreements that might come up between you and the claims administrator over whether your injury or illness happened on the job, the medical treatment you receive and whether you will receive permanent disability benefits.

If you do not file the claim form within a year of your injury you may not be able get benefits.

Download DWC1

What if my employer didn’t give me the DWC 1 claim form?

Ask your employer for the form or call the claims administrator to get it. The claims administrator is the person or entity handling your employer’s claims. The name, address and phone number of this person should be posted at your workplace in the same area where other workplace information, like the minimum wage, is posted. The City’s administrator is American All-Risk Loss Administrators (AARLA). You can call Karla Artist at (559) 271-3516 to obtain a claim form. You can also get the form from the Division of Workers’ Compensation (DWC) Web site. Click on “forms.”

Who determines if I should get permanent disability benefits? How is that done?

A doctor determines if your injury or illness caused permanent disability (PD). The doctor’s report is then turned into a PD rating. The process used to turn the doctor’s report into a rating can vary depending on your date of injury and other factors. The PD rating determines the benefits you’ll receive.

After your doctor decides your injury or illness has stabilized and no change is likely, permanent disability is evaluated. At that time, your condition has become permanent and stationary (P&S). Your doctor might use the term maximal medical improvement (MMI) instead of P&S.

Once you are P&S or have reached MMI, your doctor will send a report to the claims administrator telling them whether you have any PD. The doctor also determines if any of your disability was caused by something other than your work injury. For example, a previous injury or other condition. This is called apportionment.

What if I don’t agree with the doctor?

If you or the claims administrator disagrees with your doctor’s findings you can be seen by a doctor called a qualified medical evaluator (QME). You request a QME list (called a panel) from the Division of Workers’ Compensation (DWC) Medical Unit. The claims administrator will send you the forms to request a QME. Your employer will pay for the cost of the QME exam. You have 10 days from the date the claims administrator tells you to begin the QME process to submit your request form to the DWC Medical Unit. If you do not submit the form within 10 days, the claims administrator will do it for you and will get to choose the kind of doctor you’ll see.

There are other specific and strict timelines you must meet in filing your QME forms or you will lose important rights. Read DWC Information and Assistance (I&A) Unit guide 2 for more information.

When you receive the list of QMEs from the DWC Medical Unit you have to select a doctor, set up an exam and tell the claims administrator about your appointment. If you do not make the appointment within 10 days, the claims administrator may pick the doctor and make the appointment for you.

If you have an attorney, he or she can help you pick a QME or you can be evaluated by an agreed medical evaluator (AME). An AME is the doctor your attorney and the claims administrator agree on to do your medical examination. Discuss your options with your attorney.

What is a PD rating and how is it calculated?

First, after your examination, the doctor will write a medical report about your impairment. Impairment means how your injury affects your ability to do normal life activities. The report includes whether any portion of your disability was caused by something other than your work injury. The doctor’s report ends with an impairment number.

Next, the impairment number is put into a formula to calculate your percentage of disability. Disability means how the impairment affects your ability to work. Your occupation and age at the time of your injury and your future earning capacity are all also included in the calculation.

Then, any portion of your disability caused by something other than your work injury is taken out of the calculation.

Your disability will then be stated as a percentage. Your percentage of disability equals a specific dollar amount, depending on the date of your injury and your average weekly wages at the time of injury. A rating specialist from the DWC Disability Evaluation Unit (DEU) may help calculate your rating.

If you were injured on or after Jan. 1, 2005 your PD award may be increased or decreased by 15 percent, depending on whether your employer offers — and you accept or decline — regular, alternative or modified work.

How is PD paid?

Once your doctor says you have permanent disability, the claims administrator will estimate how much you should receive and begin making payments to you, even if the final percentage of disability has not been calculated. PD benefits are paid in addition to temporary disability (TD) benefits you received. The claims administrator must begin paying your permanent disability within 14 days after TD ends and continue the payments until a reasonable estimate of your disability amount has been paid. If you have not missed any work, PD payments are due from the date the doctor says you are P&S. PD benefits continue to be paid every two weeks on a day picked by the insurance company until a reasonable estimate of your disability amount has been paid. When the actual amount of PD due has been determined, the amount over the estimate must be paid.