There are the claims where the employee will not be able to return to the original job they held at the time of injury. This may be due to physical disabilities, environmental conditions, or medical restrictions. As soon as this becomes evident there is need for vocational rehabilitation coordination.
Most jurisdictions have some provision for vocational rehabilitation in their workers compensation laws. Some states have departments devoted to it. Others require the employer to provide it. Some states are very proactive and have benefit adjustments and require compliance from employee and employer. At the same time other states may take mediocre or no actions at all. As stated by Workers Compensation Judge and Medical Fee Review Hearing Officer, David Torrey, “Oddly, in Pennsylvania, we have no such provision. In reaction, the Supreme Court created same via common law (1987), but same was abolished in 1996 by the legislature. As to the lack of vocational rehab in PA, see Torrey, “The Common Law of Partial Disability and Vocational Rehabilitation Under the Pennsylvania Workmen’s Compensation Act: Kachinski and the Availability of Work Doctrine,” 30 Duquesne Law Review 515 (1992).
There are professional vocational counselors working with workers compensation cases. Some work for the state. Others are employed by private vendors and some are available for use by employers.
Most Vocational Counseling Experts are former Registered Nurses, Physicians Assistants, or Nurse Practitioners. They work with the doctor in determining the Functional Capacity Evaluation. They seek jobs with the employer or the open job market which meet these Functional Capacities. They arrange for necessary formal educational needs and costs. They obtain appropriate prosthetic devices. They may provide some forms of physical-therapy or other minor medical attentions. They arrange for home modification when needed.
Due to the length and complexities of Vocational Rehabilitation, it is becoming more important to have someone perform as a coordinator between the employer and the Professional Vocational Counselor.
A vocational coordinator provides oversight and expedites the vocational program on behalf of the employer. The coordinator works with employer, employee, claim adjuster, vocational counselor, and the medical provider to determine the need, and a plan of action that best warrants returning the employee to gainful employment. The counselor will have strong experience and background in workers compensation medical and claim management.
- The coordinator will know the employer’s business operations and employee policies.
- The coordinator will provide regular reports to the employer on vocational progress, will bring to attention any problems or issues related to claim handling, medical needs and employee compliance.
- The coordinator will ensure the employee receives excellent care, and that requests for rehab are not unduly submitted to UR. For example, if an employee wants a cane for $20, it is in the best interest of both employee and employer to provide the cane.
- Will be in continued contact with the counselor to be sure the agreed plan of action stays on a timely and progressive movement toward conclusion.
- Will resolve any issues between employee, employer, vocational counselor, medical provider and claim adjuster.
- Will keep adjuster apprised of vocational costs in order to have proper reserves
- Will provide vocational progress reports to claim adjuster to report to re-insurers.
- Constantly monitors vocational rehabilitation for compliance with state law and reporting.
- Supplies reports on vocational rehabilitation cost and evaluation that may impact funding or insuring renewals.
- Recognizes the claim where vocational rehabilitation is not cost effective and
- Intercedes on behalf of the employer to avoid costly exposures, and suggests with the employer and claim adjuster alternate plans of disposition.
- Keeps the claim file posted on all activity for proper documentation.
There are claim where the employee requires vocational rehabilitation. This can become a heavy expense to the employer if left unchecked. The Vocational Counselor usually may not have the employer’s best financial interest in focus. A Vocational Rehabilitation overseer acting on behalf of the employer is a must in today’s complexity of workers compensation claim handling.
Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact:RShafer@ReduceYourWorkersComp.com.
Editor Michael B. Stack, CPA, Principal, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. www.reduceyourworkerscomp.com. Contact: email@example.com.
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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.