Current through Register Vol. 47, No. 17, September 10, 2024
15-1 STATEMENT OF BASIS AND PURPOSE
The rules of procedure governing the vocational
rehabilitation component of worker's compensation as originally promulgated
pursuant to §8-49-101(4), C.R.S 1973 (repealed 1987) provide a qualified
worker an opportunity to re-enter the workforce by establishing guidelines for
vocational rehabilitation.
15-2 DEFINITIONS
In addition to the definitions already adopted in the rules,
the following definitions apply to vocational rehabilitation procedures:
(A) "Job Modification" is the adaptation of a
job either through the use of aids or devices or the alteration of the physical
environment of the job, or both, to allow an impaired individual to perform
within the scope of tasks originally designed for the job flow.
(B) "Qualified Worker" means a claimant who
because of the effects of a work-related injury or occupational disease, (a) is
permanently precluded from engaging in his/her usual and customary occupation
and is unable to perform work for which the individual has previous training or
experience, and (b) can reasonably be expected to attain suitable, gainful
employment upon successful completion of a vocational rehabilitation
program.
(C) "Qualified
Rehabilitation Consultant" means a person authorized by a rehabilitation vendor
to conduct a vocational evaluation and develop a rehabilitation plan for a
qualified worker.
(D)
"Rehabilitation Vendor" means an individual, firm or facility which exists to
provide any or all of the services necessary to determine a claimant's
eligibility as a qualified worker, and/or provide those services designed to
return an individual to work.
(E)
"Suitable Gainful Employment" means employment which is reasonably attainable
and which offers an opportunity to restore the qualified worker as soon as
possible and as nearly as possible to employment with the claimant's
qualifications, including but not limited to the claimant's age, education,
previous work history, interests and skills. Special consideration shall also
be given to the economic level of the claimant at the time of injury and to the
present and future labor markets, to attempt to restore him/her to the maximum
level attainable.
(F) "Transferable
Skills" means those skills an individual possesses which were attained through
previous training or experience and are readily marketable and a need for them
exists in the current labor market and would provide suitable gainful
employment.
(G) "Vocational
Evaluation" means the rehabilitation services and testing required by the
Director to determine a claimant's eligibility as a qualified worker.
(H) "Vocational Rehabilitation Plan" means a
written document completed and signed by a qualified rehabilitation consultant
which describes the manner and means by which it is proposed that a qualified
worker may be returned to suitable gainful employment through the participation
in a rehabilitation program.
(I)
"Vocational Rehabilitation Program" means the actual providing of services as
prescribed in the vocational rehabilitation plan and approved by the Director
as reasonably necessary to restore a qualified worker to suitable gainful
employment.
15-3
INITIATION OF VOCATIONAL EVALUATION AND DIRECTOR'S DETERMINATION OF ELIGIBILITY
(A) A vocational evaluation shall be provided
by a rehabilitation vendor designated by the insurer, or upon failure of such
designation, by the Division in consultation with the claimant, immediately
upon knowledge that a claimant is unlikely to be able to return to his/her
usual and customary occupation on a permanent basis as determined by competent
medical evidence and opinion.
(B) A
vocational evaluation summary report shall be submitted to the Director on a
form prescribed by the Director and shall include the minimum elements listed
on the form. The Director may request additional information necessary to
determine eligibility.
(C) The
vocational evaluation summary report shall be signed by a qualified
rehabilitation consultant responsible for the evaluation and shall contain a
recommendation by the consultant whether the claimant is eligible for a
vocational rehabilitation program. If the recommendation indicates the claimant
is in need of vocational rehabilitation and would benefit from vocational
rehabilitation, the summary shall include a description of suggested
occupation(s) that would be considered for plan development.
(D) A vocational evaluation shall be
completed within sixty (60) days of assignment to the rehabilitation
vendor.
(E) Upon submission of the
vocational evaluation summary report, the insurer shall indicate whether it is
providing vocational rehabilitation voluntarily or is requesting that the
Director determine eligibility. Upon a request to determine eligibility the
Director shall issue a "Notice of Determination of Eligibility for Vocational
Rehabilitation Benefits" within twenty days.
(F) A party may object to the determination
of eligibility by filing an application for hearing with the Office of
Administrative Courts within fifteen (15) days of the date of the Director's
determination.
15-4
SUBMISSION AND IMPLEMENTATION OF THE VOCATIONAL REHABILITATION PLAN
(A) If the claimant is determined a qualified
worker, the Director shall order that a vocational rehabilitation plan be
developed. The plan shall be developed and submitted to the Director and the
parties within forty-five (45) days of the Director's determination of
eligibility, unless said determination has been contested.
(B) In developing the plan, the
rehabilitation vendor shall strive to return the qualified worker to suitable
gainful employment within the qualified worker's medical and physical
limitations as determined in the vocational evaluation in the following
priorities:
(1) Return to work for the same
employer to a modified job requiring rehabilitation services.
(2) Return to work for the same or a new
employer in a related occupation, for which the individual has received
rehabilitation services to upgrade skills attained from previous training or
experience.
(3) Return to work in
an on-the-job training capacity.
(4) Return to work after the completion of a
vocational program into a new occupation.
(C) Once developed, the proposed plan shall
be written and submitted to the parties on the form prescribed by the Director.
The written plan shall include the minimum elements listed on the form. All
parties shall sign the vocational plan prior to submitting the plan to the
Director for approval. The Director may request additional information
necessary to determine if the plan should be approved.
(D) The Director, upon receipt of a proposed
vocational rehabilitation plan and upon review, shall order the plan either
approved or disapproved or modified. Implementation of the plan may begin as
soon as the qualified worker is capable of participating in the program, as
indicated by competent medical evidence. The plan shall begin upon the
Director's approval or the date specified in the plan as applicable, whichever
is later. The insurer shall continue to provide temporary disability benefits,
if applicable, until implementation of the plan and the employee begins his
vocational rehabilitation program.
(E) All matters regarding rehabilitation
plans or programs shall be initially submitted to the Director except in those
cases where the question of need for vocational rehabilitation first arises
during the course of a hearing or hearings on other issues.
(F) If there is a dispute regarding the
vocational rehabilitation plan, the disputing party shall request a hearing by
filing an application for hearing at the Office of Administrative
Courts.
(G) If the qualified worker
does not choose to enroll in a vocational rehabilitation program, nothing in
these rules and regulations shall require the qualified worker to do
so.
15-5 MODIFICATION,
SUSPENSION OR TERMINATION OF THE VOCATIONAL REHABILITATION PLAN OR VOCATIONAL
EVALUATION
(A) If a vocational evaluation or
an approved vocational plan is modified, terminated or suspended for any
reason, and the parties are in agreement, the Director shall be notified. Plan
modifications shall be submitted to the Director for approval on the prescribed
form for vocational plans.
(B) If
there is a dispute regarding the progress of a vocational evaluation or
vocational rehabilitation plan, the disputing party shall request a hearing by
filing an application for hearing at the Office of Administrative
Courts.
15-6 REPORTING
REQUIREMENT
All vocational rehabilitation forms and reports based upon an
injury occurring on or prior to July 2, 1987 at 4:16 P.M. shall be filed with
the Division and all parties copied.
15-7 QUALIFIED REHABILITATION VENDOR
(A) A vendor will be considered qualified by
the Director if the vendor has the services of a consultant who had previously
registered with the Division when the registration program existed or can
demonstrate one of the following credentials:
(1) The individual is a Certified
Rehabilitation Counselor under the guidelines of the Commission on
Rehabilitation Counselor Certification or can demonstrate equivalent
credentials.
(2) The individual has
a Master's degree in Vocational Rehabilitation, Guidance and Counseling,
Psychology, or in a related field or can demonstrate equivalent work experience
on a year for year basis for formal education. The individual must also have
one (1) year of experience as a practitioner in the field of vocational
rehabilitation.
(3) The individual
has a Bachelor's degree in Vocational Rehabilitation, Guidance and Counseling,
Psychology, or a related field or can demonstrate equivalent work experience on
a year for year basis for formal education. The individual must also have two
(2) years experience as a practitioner in the field of vocational
rehabilitation.
(B) If a
dispute occurs concerning a counselor's credentials, the counselor shall submit
to the Director a resume, transcripts, diploma and any other requested
documentation. The Director will determine whether the counselor is
qualified.