Using Vocational Rehabilitation to Resolve Work Comp Cases: Dealing with Retraining

Retraining is the final prominent issue members of the claim management team, and other interested stakeholders must deal with regarding vocational rehabilitation in workers’ compensation. This is one of the more complex benefit schemes, costly but can be used to drive claims toward settlement.

Retraining: Background

Every attempt should be made to return an injured employee back to work with the employer. This needs to start after the employee is stabilized following an injury. Attempts to return an employee to work should include a point of contact within an employer to coordinate efforts.

Other opportunities should be a part of returning to work and avoiding retraining:

• On-The-Job Training: These efforts can include working within the employer to help the employee gain additional job skills. Creativity and work with vocational counselors, treating doctors, and other stakeholders are essential to creating employment opportunities.

• Job Placement: While job placement is never required before taking steps to retrain an injured employee, proactive claims handlers should demand it. Job placement includes assistance with job interview skills, completing applications to answer questions about restrictions, and finding positions of interest. This can sometimes include working with an additional vocational specialist who understands the labor market and trends.

Once these efforts have been undertaken, the next likely step is exploring retraining options and developing a plan. Retaining usually includes the placement of the employee in a technical trade school or four-year college/university to gain an educational background where they would shift their career priority into a different job class or field.

What Makes Retraining So Expensive

Formal retraining is generally expensive in terms of the costs associated with these programs. These usually include:

• Payment of tuition in a formal trade school or college/university where the employee will pursue a degree or certificate.

• Payment of wage loss benefits in addition to what has already been paid. As a general rule, employees involved in a retraining program are entitled to wage loss benefits even if they have already been paid statutory maximums.

• Payment of additional expenses such as room/board (where necessary), books and supplies, and mileage.

The bottom line is that retraining, once approved, can be expensive and significantly burden a claim. Claim handlers and other interested stakeholders need to be creative.

Thinking Outside the Box

Retraining is generally approved once the employee has demonstrated the following factors:

• Reasonableness of the plan compared to other options: This is an opportunity to explore options available to an employee unable to return to work with any employer. An employee may focus on a costly four-year program. This is the chance to determine if there are comparable technical or trade school options that are generally no more than two years in length.

• Whether the employee will complete the program: This requires focusing on the employee’s educational background. Typical focus areas include how they performed in the past within the classroom. This can also be a sensitive area when the employee has learning disabilities or identified problems with their chances to complete even the most basic four-year college programs.

• Likelihood the program will help the employee attain employment in their new field: There are several factors to consider. Employees in urban areas generally have better chances of becoming employed than similarly situated employees in rural areas. Scrutinize their job search conducted in the past and what their chances are of employment following completion of a desired course. A high level of scrutiny should take place regarding economic data from a locale or state. The use of an expert should be considered when examining this factor.

• Likelihood the employee will enjoy an economic status as close to their pre-injury condition: A similar level of scrutiny should be used when analyzing this factor. A review of reported salary data should be reviewed and is usually found with a state economist.

Proactive stakeholders should work with vocational experts regarding costly retraining programs. This will allow for the opportunity to offer options that move a claim toward settlement and avoid litigation.

Conclusions

Retraining is a costly vocational rehabilitation benefit but can create opportunities to be creative and drive claims toward settlement. It starts with cooperation between the claim team and the employer, research, and the use of experts. It can also create chances to think outside the box through the use of experts to create less costly plans that meet the employee’s needs.

Michael Stack, CEO of Amaxx LLC, is an expert workers’ compensation cost containment systems and provides education, training, and consulting to help employers reduce their workers’ compensation costs by 20% to 50%. He is co-author of the #1 selling comprehensive training guide “Your Ultimate Guide to Mastering Workers’ Comp Costs: Reduce Costs 20% to 50%.” Stack is the creator of Injury Management Results (IMR) software and founder of Amaxx Workers’ Comp Training Center. WC Mastery Training teaching injury management best practices such as return to work, communication, claims best practices, medical management, and working with vendors. IMR software simplifies the implementation of these best practices for employers and ties results to a Critical Metrics Dashboard.

Contact: [email protected].

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