Common use of PROCEDURES FOR INJURY ON DUTY AND RECURRENCE CLAIMS Clause in Contracts

PROCEDURES FOR INJURY ON DUTY AND RECURRENCE CLAIMS. A Captain who has been certified as injured on duty shall be provided the current Medical Services Section referral list of available physicians who are members in good standing of the Workers’ Choice Network or its successor and who are qualified to render appropriate medical care for the injury claimed in accordance with the parties’ letter of understanding executed on July 29, 2009 and captioned “Medical Services Section Physician Referral List.” The Captain will select a physician from the list provided by the Medical Services Section for evaluation and/or treatment. The Medical Services Section will refer the Captain to the physician selected by the Captain. A Captain may only claim a recurrence of a certified injury on duty if that injury on duty occurred less than ten (10) years from the date of the recurrence claim, unless the Captain’s injury on duty required surgery or medical treatment beyond any initial emergency room treatment for the injury on duty. A Captain who is able to claim a recurrence of an injury on duty under Appendix K will have his/her claim evaluated by the Medical Services Section. If the Medical Services Section finds the condition complained of is not a recurrence of an injury on duty, the Medical Services Section will provide the Captain with the current Medical Services Section referral list described above. The Captain will select a physician from the list provided by the Medical Services Section. The Medical Services Section will refer the Captain to the physician selected by the Captain for a relatedness opinion. Should the Captain or the Medical Services Section not agree with the medical finding of the referral physician, either party may seek another opinion. The Captain will select another physician from the current Medical Services Section referral list of physicians described above. The Medical Services Section will refer the Captain to the physician selected by the Captain. Should that physician’s opinion agree with the finding of the first referral physician, it will be binding on both the Captain and the Employer. Should that medical opinion disagree with the first opinion, the parties may accept the second opinion or seek a third opinion. The process for obtaining a third opinion shall follow the same procedure for the selection of the second opinion. The finding of the third physician agreeing with either of the previous opinions shall be binding on both the Captain and the Employer. APPENDIX L

PROCEDURES FOR INJURY ON DUTY AND RECURRENCE CLAIMS. A Captain An Officer who has been certified as injured on duty shall be provided the current Medical Services Section referral a list of available physicians who are for treatment. The list of available physicians shall indicate the physicians’ medical specialties and the physicians shall be members in good standing of the Workersa network of worker’ Choice Network or its successor and who are compensation physicians qualified to render appropriate medical care for the injury claimed in accordance with claimed. The Officer will select a physician from the parties’ letter of understanding executed on July 29, 2009 and captioned “list provided by the Employer. The Medical Services Section Physician Referral List.” will refer the Officer to the physician selected by the Officer. An Officer claiming a recurrence of an injury on duty will have his or her claim evaluated by a physician from the Medical Services Section. A claim of a recurrence of an injury on duty includes a claim by an Officer that an injury, illness or condition is related to an injury on duty. If the Medical Services Section physician finds the injury, illness or condition complained of is not a recurrence of or related to an injury on duty, the Medical Services Section will provide the Officer with the list of physicians described above. The Captain Officer will select a physician from the list provided by the Medical Services Section for evaluation and/or treatmentand the Medical Services Section will refer the Officer to the physician selected by the Officer (Referral Physician). The parties may accept the Referral Physician’s finding, which shall be final and binding on both the Officer and the Employer, or either party may seek an Independent Medical Examination (IME). The physician conducting the IME (IME Referral Physician) shall be certified in the appropriate medical specialty(ies) and shall be selected by the Officer from a list of physicians provided by the Employer, which shall indicate the physicians’ certified medical specialty(ies), who are members in good standing of a network of physicians qualified to render XXXx. The Medical Services Section will refer the Captain Officer to the physician IME Referral Physician selected by the CaptainOfficer for an examination. A Captain may only claim a recurrence of a certified injury on duty if that injury on duty occurred less than ten (10) years from The IME Referral Physician shall consider all documents and medical records considered by the date Referral Physician as well as the Referral Physician’s finding. The IME Referral Physician’s finding shall specify the reasons for the finding and shall be supported by the evidence in the documents and medical records. The finding of the recurrence claim, unless IME Referral Physician shall be final and binding on both the Captain’s injury on duty required surgery or medical treatment beyond any initial emergency room treatment for Officer and the injury on dutyEmployer. A Captain who is able to claim a recurrence of an injury on duty under Appendix K will have his/her claim evaluated by the Medical Services Section. If The following shall apply if the Medical Services Section finds that the injury, illness or condition complained of is not a recurrence of or related to an injury on duty and it is later determined, pursuant to the process described above, that the injury, illness or condition complained of is a recurrence of or related to an injury on duty. Under these circumstances, the twelve (12) month period of time for which an Officer receives full pay and benefits as set forth in Section 18.1 shall be extended and the Officer shall receive, in addition to the twelve (12) month period of time set forth in Section 18.1, full pay and benefits from the date the Medical Services Section will provide initially found that the Captain with injury, illness or condition complained of was not a recurrence of or related to an injury on duty through the current Medical Services Section referral list described above. The Captain will select a physician from the list provided date it is later certified by the Medical Services SectionSection that the injury, illness or condition complained of is a recurrence of or related to an injury on duty. APPENDIX O SUBROGATION LANGUAGE FOR CITY OF CHICAGO In the event the Plan provides benefits for injury, illness, medical care or other loss (the "Injury") to any person, the Plan is subrogated to all present and future rights of recovery that person, his or her parents, heirs, guardians, executors, or other representatives (individually and collectively called the "Participant") may have arising out of the Injury. The Medical Services Section will refer Plan's subrogation rights include, without limitation, all rights of recovery a Participant has: 1) against any person, insurance company or other entity that is in any way responsible for providing or does provide damages, compensation, indemnification or benefits for the Captain Injury; 2) under any law or policy of insurance or accident benefit plan providing No Fault, Personal Injury Protection or financial responsibility insurance; 3) under uninsured or underinsured motorist insurance; 4) under motor vehicle medical reimbursement insurance; and, 5) under specific risk or group accident and health coverage or insurance, including, without limitation, premises or homeowners medical reimbursement, athletic team, school or workers compensation coverages or insurance. Upon notice of an Injury claim, the Plan may assert a subrogation lien to the physician selected extent it has provided, or may be required to provide, Injury-related benefits. Notice of either the Plan's right of subrogation or the Plan's subrogation lien is sufficient to establish the Plan's rights of subrogation and entitlement to reimbursement from insurers, third parties, or other persons or entities against whom a Participant may have an Injury-related right of recovery. The Plan shall be entitled to intervene in or institute legal action when necessary to protect its subrogation or reimbursement rights. The Participant and anyone acting on his or her behalf shall promptly provide the Plan or its authorized agents with information it deems appropriate to protect its right of subrogation and shall do nothing to prejudice that right and shall cooperate fully with the Plan in the enforcement of its subrogation rights. Reasonable attorney's fees and costs of Participant's attorney shall be paid first from any recovery by or on behalf of a Participant, and the amount of the Plan's subrogation claim shall be paid next from such recovery. Neither a Participant nor his or her attorney or other representative is authorized to accept subrogation or other Injury- related reimbursement payments on behalf of the Plan, to negotiate or compromise the Plan's subrogation claim, or to release any right of recovery prior to the payment of the Plan's subrogation claim. The Participant and all other parties to a recovery are required to contact the Plan to determine, and arrange to pay the Plan's subrogation claim at or prior to the time an Injury-related payment or settlement is made to or for the benefit of the Participant. If the Participant obtains a payment or settlement from a party without the Plan's knowledge and agreement, the Plan shall be entitled to immediate reimbursement of its total subrogation claim from the Participant or any party providing any Injury-related payment. In the alternative, the Plan, in its sole discretion, may deny payment of benefits to or on behalf of the Participant for any otherwise covered claim incurred by the Captain for a relatedness opinion. Should Participant until the Captain or the Medical Services Section not agree with the medical finding amount of the referral physician, either party may seek another opinionunpaid coverage is equal to and offset by the unrecovered amount of the Plan's subrogation claim. The Captain will select another physician from Plan Administrator or its authorized agents are vested with full and final discretionary authority to construe subrogation and other Plan terms and to reduce or compromise the current Medical Services Section referral list amount of physicians described abovethe Plan's recoverable interest where, in the sole discretion of the Plan Administrator or its authorized agents, circumstances warrant such action. The Medical Services Section will refer Plan shall not be responsible for any litigation-related expenses or attorney fees incurred by or on behalf of a Participant in connection with an Injury claim unless the Captain Plan shall have specifically agreed in writing to the physician selected by the Captainpay such expenses or fees. Should that physician’s opinion agree with the finding The payment of benefits to or on behalf of the first referral physician, it will be binding Participant is contingent on both the Captain and the Employer. Should that medical opinion disagree Participant's full compliance with the first opinionPlan's provisions, including the subrogation provision, and, when the Plan deems appropriate, the parties may accept Participant's signing of a reimbursement agreement. However, the second opinion Participant's failure to sign this reimbursement agreement will not affect the Plan's subrogation rights or seek its right to assert a third opinion. The process for obtaining a third opinion shall follow lien against any source of possible recovery and to collect the same procedure for the selection amount of the second opinion. The finding of the third physician agreeing with either of the previous opinions shall be binding on both the Captain and the Employer. APPENDIX Lits subrogation claim.

PROCEDURES FOR INJURY ON DUTY AND RECURRENCE CLAIMS. A Captain Lieutenant who has been certified as injured on duty shall be provided the current Medical Services Section referral list of available physicians who are members in good standing of the Workers’ Choice Network or its successor and who are qualified to render appropriate medical care for the injury claimed in accordance with the parties’ letter of understanding executed on July 29, 2009 and captioned “Medical Services Section Physician Referral List.” The Captain Lieutenant will select a physician from the list provided by the Medical Services Section for evaluation and/or treatment. The Medical Services Section will refer the Captain Lieutenant to the physician selected by the CaptainLieutenant. A Captain Lieutenant may only claim a recurrence of a certified injury on duty if that injury on duty occurred less than ten (10) years from the date of the recurrence claim, unless the CaptainLieutenant’s injury on duty required surgery or medical treatment beyond any initial emergency room treatment for the injury on duty. A Captain Lieutenant who is able to claim a recurrence of an injury on duty under Appendix K will have his/her claim evaluated by the Medical Services Section. If the Medical Services Section finds the condition complained of is not a recurrence of an injury on duty, the Medical Services Section will provide the Captain Lieutenant with the current Medical Services Section referral list described above. The Captain Lieutenant will select a physician from the list provided by the Medical Services Section. The Medical Services Section will refer the Captain Lieutenant to the physician selected by the Captain Lieutenant for a relatedness opinion. Should the Captain Lieutenant or the Medical Services Section not agree with the medical finding of the referral physician, either party may seek another opinion. The Captain Lieutenant will select another physician from the current Medical Services Section referral list of physicians described above. The Medical Services Section will refer the Captain Lieutenant to the physician selected by the CaptainLieutenant. Should that physician’s opinion agree with the finding of the first referral physician, it will be binding on both the Captain Lieutenant and the Employer. Should that medical opinion disagree with the first opinion, the parties may accept the second opinion or seek a third opinion. The process for obtaining a third opinion shall follow the same procedure for the selection of the second opinion. The finding of the third physician agreeing with either of the previous opinions shall be binding on both the Captain Lieutenant and the Employer. APPENDIX L

PROCEDURES FOR INJURY ON DUTY AND RECURRENCE CLAIMS. A Captain An officer who has been certified as injured on duty shall be provided the current Medical Services Section referral list a group of three available physicians for treatment. Groupings of three available physicians will be randomly selected from a pool of physicians who are members in good standing of the Workers’ Choice Network or its successor and who are a network of xxxxxxx’x compensation physicians qualified to render appropriate medical care for the injury claimed claimed. The groupings of physicians will be rotated on a weekly basis until all members of the pool have appeared in accordance with a group which was available for officer selection, at which point the parties’ letter of understanding executed on July 29, 2009 and captioned “Medical Services Section Physician Referral List.” process will repeat itself. The Captain officer will select a physician from the list group provided by the Medical Services Section for evaluation and/or treatmentEmployer. The Medical Services Section will refer the Captain officer to the physician selected by the Captainofficer. A Captain may only claim a recurrence of a certified injury on duty if that injury on duty occurred less than ten (10) years from the date of the recurrence claim, unless the Captain’s injury on duty required surgery or medical treatment beyond any initial emergency room treatment for the injury on duty. A Captain who is able to claim An officer claiming a recurrence of an injury on duty under Appendix K will have his/his or her claim evaluated by a physician from the Medical Services Section. If the Medical Services Section that physician finds the condition complained of is not a recurrence of an injury on dutyrecurrence, the Medical Services Section will provide the Captain officer with a list of three physicians chosen in the current Medical Services Section referral list manner described above. Should the physician who treated the original injury on duty be a member in good standing of the pool of xxxxxxx’x compensation physicians from which the group of three physicians was chosen, then that physician will be added to the group of three physicians provided to the officer. The Captain officer will select a physician from the list group provided by the Medical Services SectionEmployer. The Medical Services Section will refer the Captain officer to the physician selected by the Captain for a relatedness opinionofficer. Should the Captain officer or the Medical Services Section Department not agree with the medical finding finding, of the referral physician, either party may seek another opinion. The Captain officer will select another physician from a different group of three physicians chosen in the current Medical Services Section referral list of physicians manner described above. The Medical Services Section will refer the Captain officer to the physician selected by the Captainofficer. Should that physician’s opinion agree with the finding of the first referral physician, it will be binding on both the Captain officer and the Employer. Should that medical opinion disagree with the first opinion, the parties may accept the second opinion or seek a third opinion. The process for obtaining a third opinion shall follow the same procedure for the selection of the second opinion. The finding of the third physician agreeing with either of the previous opinions shall be binding on both the Captain officer and the Employer. APPENDIX LO

PROCEDURES FOR INJURY ON DUTY AND RECURRENCE CLAIMS. A Captain who has been certified as injured on duty shall be provided the current Medical Services Section referral list of available physicians who are members in good standing of the Workers’ Choice Network or its successor and who are qualified to render appropriate medical care for the injury claimed in accordance with the parties’ letter of understanding executed on July 29, 2009 and captioned “Medical Services Section Physician Referral List.” The Captain will select a physician from the list provided by the Medical Services Section for evaluation and/or treatment. The Medical Services Section will refer the Captain to the physician selected by the Captain. A Captain may xxx only claim a recurrence of a certified injury on duty if that injury on duty occurred less than ten (10) years from the date of the recurrence claim, unless the Captain’s injury on duty required surgery or medical treatment beyond any initial emergency room treatment for the injury on duty. A Captain who is able to claim a recurrence of an injury on duty under Appendix K will have his/her claim evaluated by the Medical Services Section. If the Medical Services Section finds the condition complained of is not a recurrence of an injury on duty, the Medical Services Section will provide the Captain with the current Medical Services Section referral list described above. The Captain will select a physician from the list provided by the Medical Services Section. The Medical Services Section will refer the Captain to the physician selected by the Captain for a relatedness opinion. Should the Captain or the Medical Services Section not agree with the medical finding of the referral physician, either party may seek another opinion. The Captain will select another physician from the current Medical Services Section referral list of physicians described above. The Medical Services Section will refer the Captain to the physician selected by the Captain. Should that physician’s opinion agree with the finding of the first referral physician, it will be binding on both the Captain and the Employer. Should that medical opinion disagree with the first opinion, the parties may accept the second opinion or seek a third opinion. The process for obtaining a third opinion shall follow the same procedure for the selection of the second opinion. The finding of the third physician agreeing with either of the previous opinions shall be binding on both the Captain and the Employer. APPENDIX L