CLM-14707
Valle Verde Foods, LLC· +12095550100·LM-WC-3308714-26(WC-CA)·Adjuster Sam Chen
- Intake
- Verify
- Assess
- Resolve
- Closed
Order selector Marcus Ellison sustained a right shoulder injury on 3/2/26 while pulling a 42 lb case off an overhead rack at Valle Verde Foods' dry goods warehouse in Modesto; he was seen same day and returned to light duty the next day. Three pending communications (two emails and one SMS) await adjuster approval. Reserves total $10,000 in expense; no indemnity reserved across three open exposures.
Pending approvals. Review and approve in the action tracker below.
Action Tracker
Pending approvals (3)
Send email — Re: New WC claim — Ellison, Marcus — DOI 3/2/26 — right shoulder
Rationale: Day-2 substantive employer three-point-contact ask: wage basis (field 39 gap), modified duty specifics, Barragán as witness of record, and MPN acknowledgment — the four items the Day-1 ack foreshadowed.
Send email — Records request — Ellison, Marcus — DOI 3/2/26 — CLM-14707
Rationale: Day-2 provider records request — the five-item ask that frames the 5021 return and the field-26 restrictions check.
Send SMS — Marcus T. Ellison (Employee)
Rationale: Deliver the promised post-call summary SMS — the prior send ("Feel better") was not a summary; this one covers what we confirmed, the §5402(c) authorization in plain language, and acknowledges his attorney question without taking a position.
Activity (15)
Send SMS — Marcus T. Ellison (Employee)
Deliver the promised post-call summary SMS — the prior send ("Feel better") was not a summary; this one covers what we confirmed, the §5402(c) authorization in plain language, and acknowledges his attorney question without taking a position.
Send email — Records request — Ellison, Marcus — DOI 3/2/26 — CLM-14707
Day-2 provider records request — the five-item ask that frames the 5021 return and the field-26 restrictions check.
Send email — Re: New WC claim — Ellison, Marcus — DOI 3/2/26 — right shoulder
Day-2 substantive employer three-point-contact ask: wage basis (field 39 gap), modified duty specifics, Barragán as witness of record, and MPN acknowledgment — the four items the Day-1 ack foreshadowed.
SMS to Marcus T. Ellison (demo-routed)
Promised SMS summary within the hour per the call; also surfaces the attorney question to the adjuster without taking a position on it.
Hey Marcus - Feel better.
Set claim field "preferred_contact_channel"
Marcus confirmed on the call that SMS is his preferred channel going forward.
→ sms
Set claim field "represented_flag"
Marcus confirmed on the call he has not spoken with an attorney; recording the state so the represented-party overlay stays off.
→ false
Set claim field "three_point_contact_ee_complete_at"
Day-1 employee three-point contact closed on the connected call; stamping the completion timestamp.
→ 2026-10-14T18:26:18.185Z
Set claim field "class_code"
Governing class code 8018 (Store: Wholesale, Groceries) extracted from the 5020 and policy — anchoring on the claim for wage-basis discussion.
→ 8018
Set claim field "mpn_id"
Larkspur Mutual MPN ID per the policy extended fields — recording on the claim for statutory reference.
→ 2519
Set claim field "preferred_contact_channel"
DWC-1 shows Marcus declined electronic notices — SMS is the standing preference until he says otherwise on the first call.
→ sms
Set claim field "modified_duty_status"
Priya's email states Marcus is "back today on light duty" but no written restrictions or written modified-duty assignment is on file yet — status is verbal-only until the 5021 restrictions addendum and employer's written assignment land.
→ offered_verbal_only
Set claim field "wage_basis_flag"
5020 field 39 (other payments including overtime) is blank for an order selector — a classification that typically works overtime — so the rate × schedule basis is deficient under LC §4453 and needs certified 52-week actual-gross earnings.
→ true
Outbound call to Marcus T. Ellison (demo-routed)
Day-1 employee three-point contact — initiated in parallel with the employer acknowledgment per the playbook; Marcus's number is already on his party record from the DWC-1.
Day-1 three-point contact with the injured worker. Confirm how he's doing, confirm the facts of the injury we already have, confirm he's on modified duty tod…
Email to Priya Raman: Re: New WC claim — Ellison, Marcus — DOI 3/2/26 — right shoulder (demo-routed)
Day-1 acknowledgment to the employer: claim number, assigned adjuster, §5402(c) posting, MPN name, and a direct answer to Priya's day-of-injury pay question — Day-2 ask is foreshadowed, not combined.
Priya, Confirming receipt of the new injury report for Marcus Ellison. The claim is set up as CLM-14707 under policy LM-WC-3308714-26, and Sam Chen is the assigned adjuster. Up to $10,000 in medi…
Match policy "LM-WC-3308714-26"
Linking the matched WC CA policy so the submission can convert.
Claim Data
Reserves
$10,000
Paid
$0
Recovered
$0
Days open
30
Phase
Intake
Status
Open
Exposures
3 open · 3 total
At a glance
- Claim #
- CLM-14707
- Cause of loss
- Overexertion Lifting
- Date of loss
- Oct 13, 2026
- Reported
- Oct 14, 2026
- Loss location
- —
- Jurisdiction
- CA
- Policy
- LM-WC-3308714-26
- Form
- WC-CA
- Insured
- Valle Verde Foods, LLC
- Adjuster
- Sam Chen
- Inspector
- Not assigned
- Policy verified
- Pending
- Inspection
- Not started
Policy verification
PendingThe Symphony Agent has not yet verified that the policy was in force at the time of loss.
Communication Hub
Marcus T. Ellison
+16164493314 · marcus.ellison@not-on-file.demoPrefers sms
Voice call · 92s
Day-1 three-point contact with the injured worker. Confirm how he's doing, confirm the facts of the injury we already have, confirm he's on modified duty today, and ask a few things not on the forms (symptoms today, prior shoulder issues, whether he has an attorney, preferred way for us to reach him).
Transcript
Agent: Hi Marcus, this is Jennie from Larkspur Mutual. I’m calling from Sam Chen’s office about your work injury — the right shoulder, back on March 2nd at Valle Verde Foods, pulling a case off the overhead rack. I already have your employer’s report, so you don’t need to go through all the details again. First off, are you on modified duty today, and how is your shoulder feeling right now? Caller: Yeah. I mean, my shoulder hurts, obviously. I got injured. But, yeah, I'm on modified duty. Caller: Just trying to get through this Agent: Got it, Marcus. Thanks for letting me know. I’m sorry you’re dealing with the pain. Just to confirm, you were seen at Valley Occupational Health that same afternoon, and they took an X-ray of your shoulder, right? Caller: That's right. Caller: right. Agent: Thanks, Marcus. One more thing—before this, have you ever had any injury or treatment to either shoulder? Caller: No. My shoulders have been great. Never have. Agent: Thanks, that helps. Have you spoken with an attorney about this claim at all? Caller: I have not spoken with an attorney, but should I get one? Agent: That’s totally your decision, Marcus. If you have questions about your rights or the process, your adjuster can walk you through what to expect. I’ll let Sam Chen know you asked, and he’ll follow up directly. What’s the best way for us to reach you going forward—would you prefer text, call, or email? Caller: Yeah. Just text me. That's fine. Agent: Perfect, I’ll send you a summary of this call by text within the hour. And just so you know, your treatment at Valley Occ Health is authorized up to $10,000 while your claim is being reviewed, so don’t hold off on care. Thanks for your time, Marcus. Take care and I’ll text you shortly. Caller: Alright. Sounds good. Bye bye.
Hey Marcus - Feel better.
Documents
02_DWC1_Claim_Form.pdf
dwc 1 · 4 pages
Source Submission
The intake record this claim was promoted from. Captured fields, the live transcript, and the original conversation thread live there.
- Reporter
- Priya Raman
- Phone
- +12095550182
- priya.raman@valleverdefoods.com
- Received
- Oct 14, 2026, 5:50 PM
- Converted
- Oct 14, 2026, 5:55 PM