Effectively Handling Retraining Claims

Under many workers’ compensation programs, injured parties have a statutory right to vocational rehabilitation benefits.  These benefits include the right to retraining when other efforts such as job placement and search are not successful.  Due to the significant costs associated with retraining, it is important to claim handlers to understand how to handle claims of this nature.



What is Retraining?


Retraining in a typical workers’ compensation program involves a formal course of study in a school setting.  The purpose is to return an injured worker to suitable gainful employment.  Retraining can also include a spouse of a deceased employee.


In most instances, a claimant seeking these benefits must demonstrate through prior efforts that they lack the transferable job skills to attain a comparable post-injury economic status.  Other factors that come into play include the inability of the claimant to successfully re-enter the labor market given other barriers, including economic factors within their community.



Retraining Limitations


Most jurisdictions impose limitations to a retraining program.  These limitations can include the following:


  • A specified number of weeks to complete a retraining program;
  • Receipt of other workers’ compensation benefits, including indemnity benefits; or
  • Payment for other associated expenses with the retraining program.


Understanding the scope of the laws and rules related to retraining are important as they vary by jurisdiction.



Retraining Eligibility


As a general rule, a retraining program will be evaluated under the following criteria:


  • Whether the proposed retraining program is reasonable to return the employee to comparable positions.
  • The likelihood that the employee with complete the program based on prior academic and vocational experiences, and their existing abilities and interests.
  • Whether there are existing employment opportunities available for the position they are retraining.
  • Potential future economic status once the employee has completed the retraining program.



Defending a Retraining Claim


In most jurisdictions, there are no statutory caps on the costs of a retraining program.  There are numerous workers’ compensation cases nationwide were an injured worker sought and was awarded advanced degrees, including a law school education.  It is important to review cases for potential future exposure and defend a claim properly from the onset.


  • Early identification is key. While most might assume retraining is something for older employees, it should also be something to evaluate in cases involving younger employees.


  • Investigate the employees past academic and vocational performance. This is especially true to people who may have dropped out of high school or failed to pursue a post-secondary education.  Retraining can also include vocational training, so never assume someone who does not graduate from a traditional four-year college will not seek retraining at a vo-tech institution.


  • Obtain an expert opinion on the proposed retraining plan and the likelihood the employee will successfully complete the program. As part of using an expert in this area, it is important to identify deficiencies in the employee’s rehabilitation attempts and to determine also other retraining alternatives.


  • Evaluate the costs of various options and seek opportunities to provide an equivalent program at a comparable, but cheaper institution. An example of this is whether a retraining candidate can receive a two-year education and have essentially the same outcome as if they would receive a four-year degree.





Retraining can be a costly part of any workers’ compensation claim.  Proper claim management, investigation and aggressiveness can help mitigate retraining costs.



Author Michael B. Stack, Principal, COMPClub, Amaxx Work Comp Solutions. He is an expert in employer communication systems and helps employers reduce their workers comp costs by 20% to 50%. He resides in the Boston area and works as a Qualified Loss Management Program provider working with high experience modification factor companies in the Massachusetts State Risk Pool.  He is co-author of the #1 selling book on cost containment, Your Ultimate Guide To Mastering Workers Comp Costs www.reduceyourworkerscomp.com, and Founder of the interactive Workers’ Comp Training platform COMPClub. Contact: mstack@reduceyourworkerscomp.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.


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