Qualified Rehabilitation Consultants (QRC) play an important role in workers’ compensation vocational rehabilitation programs. It is important to members of the claim management team to understand the proper role of a QRC or other vocational assistance representative and how to avoid problems with their involvement in a claim.
What is a QRC?
A QRC is the term used in most state workers’ compensation programs for a vocational expert who assists an injured party navigate the complexities of the medical and rehabilitation aspects of their industrial injury. In most instances, the QRC is a neutral party who has a unique background that includes social work activities, human resources or nursing.
The activities a QRC can perform vary. The most frequent use of a QRC is to assist an employee with job search activities. This can include simple tasks such as preparing a resume or interview. It can also include going to a doctor’s office appointment and asking questions the injured person might not be prepared to ask. In essence, they are the “jack of all trades” in the workers’ compensation system.
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QRC Selection and Reporting
In most jurisdictions, it is the right of the employee to select a QRC once they qualify or vocational rehabilitation services. Regardless of who has the right to select the QRC, there are limitations as to how a change in QRC can take place and when this can occur. It is often true that specific paperwork needs to be prepared and filed with a workers’ compensation division on all matters of QRC selection and change.
Once a QRC is selected, it is important to have an open line of communication with this individual. Some of the common required communications from a QRC include:
- Scheduled status reports. This will include information on activities and meetings held with or on behalf of the employee, including information on their progress toward return to work and maximum medical improvement;
- Required state forms. This often includes statutory requirements on proposed future activities, costs and other relevant information with the vocational rehabilitation process;
- Ongoing job search efforts and activities by the employee. Failure to conduct a diligent job search can result in the loss or suspension of various indemnity benefits.
Additional Resource:
Your Ultimate Guide To Mastering Workers Comp Excerpt …Rehabing the Injured Employee & The Three Indications of When to Use Vocational Rehab
Role of a QRC
The role of a QRC is typically set forth in statute or rule. Some of the more important rules generally include what role, if any, the QRC can perform as an advocate for the injured party. This area is often a flashpoint of contention and dispute in the workers ’ compensation process. A QRC is often prohibited from performing some of the following activities:
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- Claim investigation or participating in surveillance;
- Recommending entitlement to future workers’ compensation benefits;
- Authorizing or providing comment on the necessity of future medical care and treatment
- Assisting with or being a part of settlement negotiations; and
- Setting up future medical appointments or examinations.
Working with a QRC
As a member of the claim management team, it is important to have a professional relationship with a QRC. Some best practices may include developing an open line of communication with a QRC. It may also help by going beyond an “open door” mentality with a QRC by offering to meet at a convenient location for the QRC to discuss a claim.
Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, and founder of COMPClub an interactive training program teaching workers’ comp cost containment best practices. Through this platform he is in the trenches on a monthly basis with risk managers, brokers, consultants, attorney’s, and adjusters teaching timeless workers’ comp cost containment strategies, as well as working with members to develop new tactics and systems to address the issues facing organizations today. This unique position allows him to continuously be at the forefront of innovation and thought leadership in workers’ compensation cost containment. Contact: [email protected].
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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.
I’m kind of surprised that an ongoing job search is part of working with a QRC. I often assume that since the injury was sustained at work that the employee would be attempting to return to their former job, if possible. If that is not possible then I suppose searching for alternative work would be necessary. However, I still don’t quite get the connection.