What Is Vocational Rehabilitation?
 
PLEASE NOTE THAT THIS BENEFIT WAS DISCONTINUED FOR ALL INJURIES
WHICH OCCURRED ON OR AFTER JANUARY 1, 2004.
If your workers' compensation injury causes enough disability that you are
prevented from returning to the job you were doing at the time of your injury,
you are entitled to vocational rehabilitation benefits. These benefits consist
of some sort of help in re-entering the labor market and a small amount of
financial support during that time. This may include training in a new job, but
not necessarily so.
How Do I Know If I Am Entitled To Vocational Rehabilitation?
Your primary treating doctor should tell you if you are entitled to vocational
rehabilitation. You will prepare a description of your job duties with your
attorney and this job description will be sent to the primary treating doctor
for his/her opinion as to whether you can return to that job. If your doctor
tells you that you have been released or are being found Permanent and
Stationary ("P&S"), you should be sure to ask him/her if you are eligible for
vocational rehabilitation. If the doctor believes you need vocational
rehabilitation, ask for something in writing which says that you are Permanent
and Stationary and that you need vocational rehabilitation. A simple note will
do.
How Do I Ask For Vocational Rehabilitation?
As soon as you know that you are entitled to vocational rehabilitation you
should call your attorney and, if you can, provide the attorney with a note from
the doctor stating that you are eligible for vocational rehabilitation. Your
attorney will promptly demand vocational rehabilitation from the insurance
company. If your doctor releases you and you begin receiving "Permanent
Disability Advances" (PPD or PDA) rather then "Vocational Rehabilitation
Maintenance Allowance" (VRMA), you should let your attorney know immediately.
You should receive a letter from the insurance company when they know that you
are eligible for vocational rehabilitation. That letter may include a "Reply
Card" which asks you to check a box as to whether you want vocational
rehabilitation. As usual, when you are represented by an attorney, do not send
anything directly back to the insurance company. You should complete the card
and send it to your attorney. In most cases, by the time you receive the letter
from the insurance company, your attorney has already requested vocational
rehabilitation for you.
What If My Doctor Says I Do Not Need Vocational Rehabilitation?
If you agree with your doctor that you can do the job you were doing at the time
of the injury, then you should continue to do that job. If you do not agree with
the doctor, there is a process for objecting and having a subsequent
determination as to whether you are eligible. If your primary treating doctor
said that you are not eligible for vocational rehabilitation, you will not be
paid Vocational Rehabilitation Maintenance Allowance during the period we are
contesting his/her decision. However, if we succeed in proving that you are
eligible for vocational rehabilitation, you will be paid back to the date of the
request.
What If The Insurance Company Does Not Want To Give Me Vocational
Rehabilitation?
Sometimes the insurance company will not agree with the primary treating doctor
and will request another medical evaluation to see if you are eligible for
vocational rehabilitation. If the primary treating doctor said that you are
eligible for vocational rehabilitation then the law requires that you be paid
Vocational Rehabilitation Maintenance Allowance during the period that the
dispute is being resolved. The legislature hopes that this will encourage
insurance companies to provide you with Vocational Rehabilitation Maintenance
Allowance rather then incur greater costs in fighting about it.
What If I Can Do Most Of My Job But Not Some Of The duties?
If you cannot do all of the duties of your job your employer is required to
determine whether they can modify your job so that you can do it. They are
required to promptly determine whether they are able to modify the job. If they
can, and they offer you modified work, then you are not entitled to any other
vocational rehabilitation benefits, even if you do not accept the modified work.
Can I Get A Different Job With The Same Company?
Your employer also may offer you an alternate job. This would be a different job
than you were doing before but one which does not require you to work outside of
your restrictions. The job must be guaranteed to last at least one year and to
pay you at least 85% of your previous earnings. If your employer offers you
alternate work, then you are not eligible for any other vocational
rehabilitation benefits, even if you do not accept the alternate work.
What Happens If My Employer Cannot Take Me Back?
If your employer cannot take you back to modified or alternate work, then you
are eligible for further vocational rehabilitation services. These are usually
in the form of "direct placement" or "training." Direct placement means that
your vocational rehabilitation plan is simply to help you find another job. This
is usually the solution if you have other skills which you can use or merely
need to work at a similar job with a different employer. If you have no
transferable skills and are not a good candidate for direct placement, then you
will probably be provided with some training. Training programs are usually
brief because of the financial limitations described hereafter.
What Are The Financial Limitations In Vocational Rehabilitation?
The entire vocational rehabilitation portion of your case is limited to
$16,000.00. That is, your employer's insurance does not have to spend more then
$16,000.00 on the vocational rehabilitation portion of your claim. This includes
the money paid to you, the money paid to any school, the money paid to any
vocational rehabilitation counselor and all other expenses of vocational
rehabilitation. There are some exceptions to this rule but they are very
limited. If your employer creates a delay, the money paid to you during that
delay is not counted against the $16,000.00 "cap." The "cap" is not supposed to
begin until your employer has told you that they have no modified or alternate
work for you. So any money paid as Vocational Rehabilitation Maintenance
Allowance before that should not be included in the "cap."
Your benefits under Vocational Rehabilitation Maintenance Allowance are limited
to $246.00 per week and from this, attorney's fees are usually withheld in the
amount of 15% so the net to you is $209.10 per week. You may be eligible for a
supplement to your Vocational Rehabilitation Maintenance Allowance which comes
from your permanent disability. That is, you may supplement your VRMA up to the
rate you were receiving when you were under total temporary disability, but the
supplemental payments will be subtracted from any settlement you obtain in the
future.
Who Chooses The Vocational Rehabilitation Counselor?
The vocational rehabilitation counselor must be selected in consultation with
your attorney. Therefore, if anyone contacts you as your vocational
rehabilitation counselor, you should ask them if they have your attorney's
permission to speak to you. Your attorney will only agree to vocational
rehabilitation counselors which the attorney believes to be effective and caring
counselors. Be sure to let your attorney know of any problems you have with your
vocational rehabilitation counselor.
What Kind Of Training Can I Get?
If you are eligible for training, there are a number of schools which provide
brief training programs to fit into the parameters required by the system. Your
vocational rehabilitation counselor will discuss with you your interests and
abilities and try to recommend a training program that is suitable for you. It
is good to begin thinking as early as possible about what kind of things you
would like to learn. Since money is limited and the counselor's time is limited,
it is in your best interest to do as much research as you can about what type of
schools there are which appeal to you or what type of occupation you would like
to learn.
How Long Will I Have To Make Up My Mind?
The sooner you can decide on a plan, the sooner you can get started. You do not
want to waste all of your $16,000.00 making up your mind and have nothing left
to spend on the school. That is why we encourage you to have an idea what you
want to do before you even see the rehabilitation counselor.
What If I Do Not Like The School?
You will usually have a chance to visit schools before you begin training.
However, you will have only one Rehabilitation Plan. You will not be able to
change your mind in the middle of the training program so choose wisely and
stick to your decision.
What If I Cannot Make As Much Money As I Did Before I Got Hurt?
It is usually the case that you will not be making as much money in your new
occupation as you were in your old. Hopefully you will receive training in
something that will provide you with an opportunity to advance and eventually
return to your pre-injury earnings. Do not expect to make as much money right
away. Your permanent disability award is intended to compensate you for the
decreased future earnings. Permanent Disability benefits are paid even if you
are working, unless you accept a lump sum settlement and get the money all at
once.
What If I Get Injured During Vocational Rehabilitation?
If you are injured during vocational rehabilitation, this injury is considered
to be related to your work injury and is compensable under workers' compensation
laws. You would receive the same benefits that you receive for injuries incurred
at work. However, if you settle your case and get a lump sum of money before you
begin vocational rehabilitation or before you are injured in vocational
rehabilitation, then you would have closed your ability to claim benefits for an
injury during vocational rehabilitation. You should discuss this with your
attorney and be very careful about settling your case before you have completed
vocational rehabilitation. Defendants routinely require a waiver of your right
to receive benefits for injuries incurred during vocational rehabilitation as
part of a Compromise and Release. This is known as a Rogers waiver.
Can I Just Get The Money And Forget About Vocational Rehabilitation?
It is now possible to settle vocational rehabilitation for "up to $10,000.00.
If there is a dispute as to the compensability of your injury, then it is
possible to settle your vocational rehabilitation case along with the rest of
your case. The courts decided in the case of Thomas vs. Sports Chalet that if
there was a dispute which if resolved against you would prevent you from getting
any workers' compensation benefits, then you could settle your claim including
vocational rehabilitation benefits. In order to obtain approval of such a
settlement, the judge must be presented with facts which would defeat your claim
to any workers' compensation benefits. Therefore, if you have already received
benefits and the insurance company admits that you were hurt at work, this type
of settlement is not available to you.
As usual, if you have any questions about vocational rehabilitation or any other
topic, be sure to ask your attorney.
© Robert S. Havens, 2005
This article is for general information, and not meant as
specific legal advice. You should always see an attorney for specific legal
questions.
|
