The case lifecycle, end to end

Each piece of this course — compensability, causation, permanent disability, the instruments, the documents, the clocks, confidentiality, and treatment standards — is one part of a single arc. Seen end to end, a case moves through six phases, each carrying the clock that disciplines it.

1. Referral & intakeDay 0–5

   The case is routed in and the member completes intake — history, scales, and the events of employment that the causation analysis will rest on.
2. EvaluationDFR within 5 working days

   The evaluation session: MSE, diagnosis, the four-factor causation opinion, and the care plan. The Doctor's First Report is due within 5 working days of first treatment.
3. TreatmentPR-2 at least every 45 days

   The LPCC carries the therapy sessions — trauma-focused CBT for Sofia — with progress documented in a PR-2 at least every 45 days.
4. RFA / UR5-business-day decision

   When more sessions are needed, an RFA goes to utilization review, which must decide within 5 business days under §4610.
5. MMI / dischargePR-3 / PR-4 within 20 days

   At MMI: final GAF, WPI rating, and §4663 apportionment of permanent disability. The Permanent & Stationary report is due within 20 days of the determination.
6. Reports filed & outcomes trackedOngoing

   Reports are served under §36.5 and the outcome trajectory is preserved as the case's evidentiary record.

The teaching case runs the whole arc cleanly. Sofia is referred and completes intake; the evaluation yields a PTSD diagnosis and the 70/10/15/5 causation split — industrial. Seven sessions of trauma-focused CBT are authorized; when more are needed an RFA requests six additional sessions and is approved through UR. Her measures move — PHQ-9 17 → 13 → 8, GAD-7 16 → 12 → 7, GAF 52 → 63 → 70 — and she reaches MMI and returns to modified duty, with the P&S report and §4663 apportionment closing the clinical record.