Workers’ comp retraining claims made by injured workers can be expensive and time-consuming. When addressing retraining claims, it is important to members of the claim management team to evaluate the situation and make a reasoned response. This not only saves money in the long run, but promotes program efficiency.
What is Workers’ Comp Retraining?
Workers’ comp retraining is a vocational rehabilitation benefit available to an injured worker. In order to qualify, the employee usually is required to demonstrate they are not able to return to their pre-injury position and require additional education or instruction to achieve a wage comparable to their status prior to the injury. Permanent restrictions and attaining maximum medical improvement/need for future medical treatment are also important factors.
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The benefits to an employee (and underlying cost to a workers’ compensation program) involve the following:
- Payment for education or retraining to gain additional transferable skills. This is not limited to tuition at a school. It can also include the payment for books, materials, and other fees associated with a program; and
- Wage loss benefits during the retraining period. The rationale for paying an employee additional wage loss benefits beyond what is otherwise required while they go to school is to allow them to focus on their education and not worry about other matters of concern.
Properly Evaluating a Workers’ Comp Retraining Plan
A workers’ comp retraining plan will outline the coursework the employee will undertake, along with the skills they will gain upon completion. It will take into consideration the types of positions available to the employee following completion of a program and likely wages. This is an expensive proposition and should not be taken lightly.
Factors to consider vary in each jurisdiction. Some common themes to review when evaluating a retraining plan should include:
- The reasonableness of a plan compared to the employee’s ability to return to work with an employer through job placement services: Before retraining is considered, an injured worker should conduct some semblance of a job search. While this does not need to be exhaustive, an evaluation should be made as to whether the employee has sought work within their restrictions. This job search should also include a variety of different positions, and not necessarily within the area the employee was performing at the time of the work injury;
- The likelihood the employee will succeed in the formal course of study as part of the retraining plan: The cost of any retraining plan, even if it involves a two-year course of study is expensive. Part of the review should examine whether the employee can complete the desired course. A careful evaluation of any proposed program should include the employee’s prior education, how they performed in the classroom and if an absence from a formal learning environment will result in failure. It may be necessary for someone with a minimal educational history to take remedial courses;
- The likelihood as to whether the retraining program will result in reasonably attainable employment: This review should include a labor market survey of positions the employee will enter once they complete their retraining plan. Questions should be asked as to what jobs are open in the employee’s labor market and whether they will be around once the coursework is completed. While there are many unknowns given an ever-changing economy, this is an important factor to consider; and
- The likelihood as to whether the retraining will produce an economic status as close as possible to that which the employee would have enjoyed without the work injury/disability: It is important to determine what wages an employee will realistically receive following completion of a course. Areas to examine include job placement services of the educational institution the employee will attend and how they are viewed in the marketplace. It is also important to determine whether the employee will be eligible for only entry-level positions, and how quickly they may advance.
Conclusions
Vocational retraining is an expensive benefit available to injured workers. Given the dynamics and exposures, it is important for proactive members of the claim management team to pay close attention to when someone is making a claim. This review includes various factors regarding their efforts to find work before making a claim, their chances of success and the end result. Failure to take these steps can result in unnecessary steps to any workers’ compensation program.
Author Michael Stack, CEO Amaxx LLC. He is an expert in workers’ compensation cost containment systems and helps employers reduce their workers’ comp costs by 20% to 50%. He works as a consultant to large and mid-market clients, is a co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center.
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.
