Using Vocational Rehab in Workers’ Comp Return to Work

Vocational rehabilitation is a benefit provided to employees in most jurisdictions to help injured employees recover from their work injuries. Through the assistance of a Qualified Rehabilitation Consultant (QRC), the injured worker will receive assistance with both employment and medical issues. Members of the claim’s management team should avoid unnecessary litigation when it comes to workers’ compensation claims. The focus should instead be on leverage in getting the employee back to work.

Threshold Issues in Vocational Rehabilitation

The threshold issue in vocational rehabilitation matters generally starts with a vocational rehabilitation consultation. This consultation is conducted by a QRC that the employee typically selects. The question is then whether the employee is a “qualified employee” to receive rehabilitation services. Consultations of this nature are conducted in-person but can be accomplished remotely. The QRC will “interview” the employee about the following matters:

• Education history and specialized training;

• Employment history that would include why the employee left a position, wages, and duties performed;

• Medical history; and

• Information concerning the work injury and subsequent disability and wage loss.

Defenses to the vocational rehabilitation consultation are limited. Instead of seeking to litigate these fundamental threshold issues, the defense attorney and claim handler can use it as an opportunity for claim investigation:

• Better understand the employee background and barriers to gainful employment;

• Information concerning the employee’s medical history, including the names of medical providers to obtain medical records; and

• Additional background on the work injury.

Using the Rehabilitation Plan as Part of Defense Strategy

It is common for defense attorneys and members of the claim team to fight the implementation of vocational rehabilitation benefits at every step. This is time-consuming and costly, but it can cause the defense interests to lose credibility and goodwill by the employee. It can also reinforce negative stereotypes employees often have about the workers’ compensation process. It is important to remember that a QRC can help develop a claim, defenses and force the employee to settle their claim.

Part of the vocational rehabilitation process includes using the QRC to assist the employee in returning to work. Return to work should be the goal of all interested stakeholders in the workers’ compensation process. This is because studies demonstrate that employees who return to work quicker seek less medical care. There are also savings in terms of wage loss benefits paid to the employee.

Employers play a pivotal role in returning the employee to work. The claim handler and defense attorney should take the following steps when this is part of the vocational rehabilitation plan:

• Identify a contact within the employer who can identify positions the employee can work in based on their restrictions;

• The point of contact can also receive updated restrictions and monitor the employee’s activities at work; and

• Understand any barriers the employee may have when it comes to return to work and coordinate with the defense interests in terms of an overall claim strategy.

Returning an employee to work following a work injury should be a “win-win” for all parties.

Using Other Vocational Experts

The claiming team may also consider using an independent vocational consultant to counter the vocational rehabilitation plan. This can include the following functions:

• Conduct an independent vocational consultation to identify the employee’s functional ability. The results of this can be used when crafting a written job offer to the employee;

• Review the labor market in the employee’s home area for other job placement opportunities if return to work is not an option or not having its desired impact; and

• Providing an expert opinion regarding the job search activities concerns sincerity and diligence of the employee’s efforts.

In most instances, QRC’s assigned and/or selected by the employee is required to remain neutral parties and not allowed to provide legal advice. If the QRC becomes an advocate for the employee, steps can be taken to remove them from the file.

Conclusions

It is not wise to challenge vocational rehabilitation benefits at every step of the process. Instead of turning everything part of the process into a litigation nightmare, interested defense interest should seek to use it to their advantage when it comes to defending a workers’ compensation claim. Vocational rehabilitation benefits can also promote return to work interests, which have been found to reduce the money spent on medical and indemnity benefits. By taking these steps, parties can reduce workers’ compensation program costs.

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 the founder & lead trainer of Amaxx Workers’ Comp Training Center, which offers the Certified Master of Workers’ Compensation national designation.

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.