Work comp: Rehabilitation, retraining benefits

Under Minnesota Statutes 176.102, vocational rehabilitation is designed to:

• restore the injured worker to a job related to his or her former employment; or

• return the injured worker to a job in another work area that produces an economic status as close as possible to what he or she would have enjoyed without a disability.

A rehabilitation consultation is required when requested at any time by any party and it must be provided under the disability status report circumstances.

Disability Status Report form

Minnesota Rules Part 5220.0100, subp. 7, requires the insurer to send the employee a Disability Status Report (DSR) form and file a copy with the Department of Labor and Industry (DLI) when any of the following conditions are met:

1. within 14 calendar-days of knowledge that the employee's temporary total disability (TTD) is likely to exceed 13 cumulative weeks;

2. within 90 calendar-days of the date of injury when the employee has not returned to work following a work injury; or

3. within 14 calendar-days after receipt of a request for a rehabilitation consultation, whichever is earlier.

The DSR must either refer the employee for a rehabilitation consultation or request a waiver. A waiver is granted when the employer documents a written offer of suitable, gainful employment, signed by the employer, that is within the treating doctor's restrictions and to which the employee will return within 90 calendar-days. If the department grants a waiver, it is only effective for 90 calendar-days and may not be renewed. A new DSR must be filed within 14 calendar-days of expiration of an approved waiver of rehabilitation services.

If a waiver is not granted, the insurer must provide a rehabilitation consultation. The insurer must send a copy of the DSR form, the First Report of Injury (FROI) form and the treating physician's Report of Work Ability (RWA) form to the qualified rehabilitation consultant (QRC) prior to the consultation. If the insurer does not comply, the department will order a consultation by the Vocational Rehabilitation unit or by the employee's choice of QRC.

Disputes about rehabilitation

Disputes can happen during a claim involving one or more of the following issues:

1. eligibility for a rehabilitation consultation;

2. eligibility for rehabilitation services;

3. the rehabilitation plan;

4. rehabilitation plan amendments;

5. retraining;

6. on-the-job training;

7. change of QRC;

8. rehabilitation plan closure; or

9. QRC fees.

Rehabilitation request, response

According to Minnesota Rules Part 5220.0950, subp. 1, a party may request assistance to resolve a dispute by filing a Rehabilitation Request form. A Rehabilitation Response form answers the request and the department decides how best to handle the dispute. The department may issue a Decision and Order resolving a rehabilitation dispute based on the written submission of the parties.

Alternatively, the department may order all parties to attend an administrative conference. This is a meeting during which a department representative listens to all parties' perspectives regarding the dispute and attempts to assist them in reaching an agreement. If no agreement is reached, a Decision and Order will be issued. All rehabilitation administrative conferences are expedited according to the needs and availability of the parties. A party that disagrees with a decision of the department may request a formal hearing at the Office of Administrative Hearings.

Parties sometimes use an independent vocational evaluation (IVE) to clarify an employee's job duties in relation to any physical limitations imposed by the injury. Minnesota Rules Part 5220.1801, subp. 5, permits an IVE to be performed by a registered rehabilitation provider other than the assigned QRC when litigation is pending at the Office of Administrative Hearings or when retraining has been recommended. In other rare circumstances, a request for an IVE is sent to the department by a party on a Rehabilitation Request form.

When requesting an IVE, the requesting party should be specific in the narrative portion of the form about the nature of the request, why the evaluation is necessary and how this relates to the rehabilitation plan.

Rehabilitation consultation and plan eligibility

The rehabilitation consultation is a meeting between the injured employee and the QRC. According to Minnesota Rules Part 5220.0100, subp. 22, an employee is eligible for a rehabilitation plan when (due to the injury or disease, or the effects of a prior injury or disability) the employee:

• is permanently precluded or is likely to be permanently precluded from engaging in the employee's usual and customary occupation or from engaging in the job the employee had at the time of injury;

• cannot reasonably be expected to return to suitable, gainful employment with the date-of-injury employer; and

• can reasonably be expected to return to suitable, gainful employment through the provision of rehabilitation services, considering the treating physician's opinion of the employee's work ability.

The QRC must disclose any affiliations with the employer or insurer and must discuss the information on the Rehabilitation Rights and Responsibilities of the Injured Worker form during the consultation. The QRC talks with the employee, the employer and the treating doctor. The QRC completes the Rehabilitation Consultation Report (RCR) form that spells out the likelihood the employee will return to the pre-injury employer or pre-injury occupation and gives an assessment. The RCR form is required within 14 days of the first in-person meeting with the employee. The QRC is required to provide copies of the RCR form, a signed Rehabilitation Rights and Responsibilities of the Injured Worker form and a narrative report explaining the basis for the determination to the employer, the employee or any attorney for the employee and the insurer (see Minnesota Rules Parts 5220.0130, subp. 3C(4), and 5220.0100, subp. 31).

Rehabilitation plan

When the employee is eligible for rehabilitation services, the QRC completes a rehabilitation plan that is signed by all parties and filed with the department. The QRC will then provide the services to the employee that may include:  vocational evaluation, counseling, job analysis, job modification, job development, job placement, labor-market survey, vocational testing, transferable skills analysis, work adjustment, job-seeking skills training, on-the-job training and retraining.