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claim delays

 

Avoiding Claim Processing Delays – Tips for Expediting Compensation Claims for the Savvy Biller

by Lisa Eger, Claims Processor & Laurel Thorpe, Executive Director

In the world of comp claims, time is money! These tips highlight common errors that may either slow down the processing of a claim, delay the claim while awaiting additional information, require a phone call or email from CCAP to the panel attorney, or require the claim to be unsubmitted for correction.

  1. Complete the Claim Form With Correct Information

    1. First things first: It is helpful to read our Line-by-Line Guide (PDF) for an understanding of what service or expense goes on which line on the claim form. For a full understanding of claim policies, read the statewide Panel Claims Manual (PDF).

      Second, return phone calls or emails regarding the claim from Lisa (our panel claims processor) or the staff attorney. We cannot transmit the claim for payment until it is "complete."

    2. Double check the correct rate of payment. The compensation rate is based primarily on two things: the date of your appointment on the case and the type of case. If the incorrect rate is claimed, CCAP must unsubmit the claim so you can correct the rate before we can proceed with processing that claim. While the case-offer rate is pre-populated into the WebClaims program, we are only human and on occasion that rate can be listed incorrectly. See our Rates Page to confirm the correct rate for your case.

    3. Photocopies: List only one rate for all photocopying charges. If copying was done at two or more different rates, then list an average for the cost per page. The data CCAP electronically transmits to the ACS must consist of a single rate per copy. List the total number of pages copied as one figure.

    4. Receipts: Although in most instances expense receipts need not be submitted with a claim, the projects or the JCC may request documentation with regard to claimed expenses for things such as travel or experts. The burden of proof rests with appointed counsel to substantiate the claim. For tax purposes, the California Franchise Tax Board suggests keeping such documentation for at least seven years, which would also cover AIDOAC audits of the CAC program (see Panel Claims Manual (PDF), "Receipts" topic).

    5. Submit final claims in a timely fashion! The ACS expects the final claim to be submitted to the project within 210 days following the issuance of the remittitur. If you need more time, please contact your assigned staff attorney to let him/her know.

    6. The sentence imposed: List only the determinate term in the "Years" and "Months" boxes. If there is an indeterminate life portion of the sentence, the number of those counts should be listed in the respective boxes. For example, a sentence of 30 years to life (for a three strikes sentence of 25-to-life plus a 5 year prior serious felony enhancement) is listed as 5 years in the "Years" box and a 1 in the "Non-LWOP life tops" box.

      Do not include jail time that is ordered as a condition of a grant of probation in the determinate term boxes. If jail time is imposed as a condition of probation, nothing goes into the determinate term box. Simply check mark the "Probation" box -- no more is required!

      Check mark only one box for commitments. If the appellant was not committed to state prison, only one of the boxes in the lower portion of item (D) should be checked: Criminal "Probation," "Civil Commit," or "Other." Examples of "Civil Commit" are commitments to CRC, an SVP commitment and commitments after a finding of not guilty by reason of insanity.

    7. Dependency cases: Fill in "WI 300" for the code and "dependency proceedings" for the description in dependency cases. Use these same descriptions regardless of the point in the dependency process when the appeal was taken.

    8. Delinquency cases: Fill in "WI 602" for the code and "delinquency proceedings" for the description in juvenile delinquency cases; don't separately list the criminal codes/counts/allegations of the petition.

  2. Other Helpful Hints to Get Paid in Full

    1. On the right line and supported by comments: It is important to the JCC that a service be placed on the right line, otherwise the claim may need to be unsubmitted by the project for correction. (See Line-by-Line Guide (PDF).) In addition, provide a complete comment regarding the time claimed, especially whenever it exceeds the guidelines. (See statewide guidelines.) It is very difficult for a staff attorney to recommend payment in excess of guidelines if he/she is not provided an explanation, especially where the extra time spent may not be evident from the briefing filed. The comment does not have to contain a time log. A short, simple explanation is usually sufficient. For instance, a comment is very helpful to assess issue classification where the argument required a great deal of federal research that did not show up in the final product. It is also very helpful if the explanation can be disclosed, if necessary, during an audit by AIDOAC. A copy of the claim is provided during an audit. For this reason do not include confidential or privileged information in comments nor mention adverse consequences. Including this sort of attorney/client strategic information in a public comment almost always requires the claim to be unsubmitted. In instances where the topic is confidential or a potential adverse consequence is investigated, the information can be imparted separately in communications with the assigned staff attorney. The claim comment can be sanitized to refer to confidential communications with CCAP with respect to a general subject area (like "sentencing").

    2. Give us multi-service line time breakdowns: When there is more than one service or task claimed on a single line (such as Lines 5, 23 and 24) provide a breakdown of the time claimed for each service. Also, make sure your comments add up to the total amount of time being claimed for the line.

    3. Prior briefing: Declare significant use of prior briefing. On the final claim, remember to update this information in light of the additional briefing filed including the reply, petition for rehearing/review, or any supplemental briefing. "Prior" means any sample or briefing, including within the same case, e.g., copying significant portions of the AOB into the petition for review. The failure to note use of prior briefing may require the claim to be unsubmitted for correction.

    4. Preliminary hearing pages: Include an explanation for any time claimed for review of the preliminary hearing transcript pages in the reading of the record. Because there is a presumption that the preliminary hearing transcript will not generally be reviewed by appellate counsel, counsel is encouraged to contact the staff attorney assigned to the case before claiming time for this service (exceptions may exist where that proceeding was the basis for a motion to suppress, used at trial for impeachment purposes, etc.).

    5. Preauthorization: Obtain prior authorization for any travel expenses other than travel for oral argument. This includes time for appearances in another court in a proceeding related to the appeal. Where time is claimed for travel or appearances without prior authorization, CCAP may recommend a belated request for approval, but this will delay the claim (and may not be approved). Accordingly, counsel should discuss with the staff attorney his or her options before proceeding with any travel.

      In the Third and Fifth Districts, obtain preauthorization for all writ work and extraordinary expenses. Preapproval is also needed to seek expenses for a translator. The CCAP staff buddy assigned to the case can provide assistance in applying for pre-authorization.
  3. Systemic Delays

    1. Claims with recommendations >$7500: The first review after the project transmits a claim recommendation is by Judicial Council/Appellate Court Services (ACS). ACS screens every claim recommendation totaling over $7,500, and a random sampling of smaller cases, before their approval is sent to JCC Accounting and the Controller to generate payment. The purpose of this review is to make sure the project has adequately justified an award of that size and added explanations where needed. The ACS reviewers are not lawyers, for the most part, and have access to just the project recommendation, not case materials, such as briefing. The ACS scrutinizes over guideline items looking for explanations for these items. For more information on these reviews, see the statewide Panel Claims Manual (PDF), Appendix A.

    2. Fiscal Year End: In favorable State budget years, the State may not be able to timely process payments while closing the accounting books for one year, awaiting the Governor’s signature on a new budget, and starting up the next years' accounting books. This annual fiscal year process may result in anywhere from a two to three week delay that starts usually around the last full week of June and into the first couple of weeks of July. Because typical project time for processing a claim is 7-10 business days, a claim that is submitted around the first week or two of June will more likely make it through to JCC accounting for payment before the inevitable blackout period begins. Conversely, claims that reach the project towards the end of June are likely to be caught in the blackout period. If this happens, there is nothing that the project or ACS can do to speed up payment. ACS typically will continue to process claims sent by the projects, but payments cannot be processed until the State blackout period ends. Longer delays may occur if the State budget is delayed and not signed.

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