Current through Register Vol. 48, No. 39, March 25, 2024
Subpart
1.
Reasons for amendment.
Whenever circumstances indicate that the rehabilitation plan
objectives are not likely to be achieved, proposals for plan amendment may be
considered by the parties. A rehabilitation plan may be amended for good cause,
including but not limited to:
A. a new
or continuing physical limitation that significantly interferes with the
implementation of the plan;
B. the
employee is not participating effectively in the implementation of the
plan;
C. a need to change the
vocational goal of the rehabilitation plan;
D. the projected rehabilitation cost or
duration, as stated in the rehabilitation plan, will be exceeded; or
E. the employee feels ill-suited for the type
of work for which rehabilitation is being provided.
Subp. 2.
Procedure and
responsibilities.
The assigned qualified rehabilitation consultant shall
recommend a plan amendment when reasons for amendment are present. Parties
other than the assigned qualified rehabilitation consultant may propose
amendments. It is the responsibility of the assigned qualified rehabilitation
consultant to facilitate discussion of proposed amendments.
Subp. 2a.
Process.
Upon preparation of the proposed plan amendment the assigned
qualified rehabilitation consultant shall provide a copy to the employee, the
insurer, and any attorneys representing the employee or insurer. The qualified
rehabilitation consultant shall also provide a copy to the date of injury
employer if the goal of the rehabilitation plan is to return the employee to
work with that employer.
Subp.
2b.
Party's response.
Upon receipt of the proposed rehabilitation plan amendment,
the employee, insurer, and qualified rehabilitation consultant must, within 15
days, either:
A. sign the plan
amendment signifying agreement and return it to the assigned qualified
rehabilitation consultant; or
B.
promptly notify the assigned qualified rehabilitation consultant of any
objection to the plan amendment and work with the assigned qualified
rehabilitation consultant to resolve the objection by agreement.
However, if the objection is not resolved, the objecting
party must file a rehabilitation request for assistance with the commissioner
within 15 days of receipt of the proposed amendment. These disputes will be
resolved according to part
5220.0950.
If no rehabilitation request for assistance objecting to the
plan amendment is filed within 15 days of the party's receipt, the approval
process will occur as provided in subpart
2d.
Subp. 2c.
Filing.
The assigned qualified rehabilitation consultant shall file a
copy of the rehabilitation plan amendment with the commissioner within 15 days
of circulation to the parties.
Subp.
2d.
Approval.
A rehabilitation plan amendment that all parties have signed
is deemed approved by the commissioner upon filing.
If a party fails to sign the plan amendment or fails to file
a rehabilitation request for assistance objecting to the proposed plan within
the 15 days specified in subpart
2b, it shall be presumed
that the party is in substantial agreement with the plan amendment's vocational
objective and the services that are proposed. In this event the assigned
qualified rehabilitation consultant shall file the plan amendment with the
commissioner along with evidence of the date the plan amendment was sent to
each party and, upon receipt, the plan amendment will be deemed approved. The
insurer is liable for reasonable fees for a rehabilitation plan that is deemed
approved under this subpart until a further plan amendment is filed or ordered
by the commissioner or compensation judge. A party's failure to sign a plan
amendment shall not constitute a waiver of any right to subsequently dispute it
or to dispute whether the rehabilitation fees relative to it are
reasonable.
Subp. 3.
Requirements.
The rehabilitation plan amendment shall be filed on the form
prescribed by the commissioner. The prescribed form shall contain substantially
the following:
A. identifying
information on the employee, employer, insurer, the assigned qualified
rehabilitation consultant, and any change of qualified rehabilitation
consultant;
B. the proposed
amendment;
C. a rationale for the
amendment;
D. if the amendment adds
rehabilitation services, an itemization of each additional rehabilitation
service to be provided including any registered rehabilitation vendor names,
dates of initiation and completion, and estimated costs of each
service;
E. if the amendment will
result in a change in the projected plan completion date, the new completion
date;
F. if the amendment will
result in a change in the projected plan cost, the new estimated
cost;
G. employee comments, if any;
and
H. the dated signatures of the
employee, insurer, and assigned qualified rehabilitation consultant.
Subp. 3a.
Reporting a change
of qualified rehabilitation consultant.
A. When the employee has the right to change
qualified rehabilitation consultants without approval under part
5220.0710, subpart
1, the plan amendment form is
not required to be circulated to the parties for signature under subparts
2b,
2c, and
2d, but the new qualified
rehabilitation consultant shall notify the department of the change by filing a
plan amendment form with the commissioner. The plan amendment shall be filed
with the commissioner within 15 calendar days of receipt of information
transferred by the former qualified rehabilitation consultant as required by
part
5220.1802, subpart 4a. The new
qualified rehabilitation consultant shall also send a copy of the form to the
parties as specified in subpart
2a when it is sent to the
commissioner for filing.
B. If
approval of a change of qualified rehabilitation consultants is required under
part
5220.0710 and the insurer has
approved the change, the new qualified rehabilitation consultant shall reflect
the change on the plan amendment form, circulate the form for signatures, and
file the form with the commissioner within 15 calendar days of obtaining the
signatures. The former qualified rehabilitation consultant shall transfer
information to the new qualified rehabilitation consultant as required by part
5220.1802, subpart 4a. If approval
is required and the insurer has not agreed to the change, the employee shall
proceed according to part
5220.0710, subpart
3.
C. If a qualified rehabilitation consultant
elects to withdraw as the assigned qualified rehabilitation consultant under
subpart
7a, item C, the consultant
shall document the withdrawal on the plan amendment form. The qualified
rehabilitation consultant shall file the plan amendment form with the
commissioner and send a copy to the parties as specified in subpart
2a and the department's
vocational rehabilitation unit when it is sent to the commissioner for
filing.
Subp. 4.
Amendment by commissioner.
If a plan is modified for good cause pursuant to Minnesota
Statutes, section
176.102,
subdivision 8, or as a result of an administrative conference pursuant to
Minnesota Statutes, section
176.106,
the commissioner shall notify all interested parties of the modification and
the reasons for the modification.
Subp.
5.
Request for closure before plan completion by filing
request for assistance.
At any time, the insurer or employee may request the closure
or suspension of rehabilitation services by filing a rehabilitation request for
assistance with the commissioner. The commissioner or a compensation judge may
close or suspend rehabilitation services for good cause, including, but not
limited to:
A. a new or continuing
physical limitation that significantly interferes with the implementation of
the plan;
B. the employee's
performance indicates that the employee is unlikely to successfully complete
the plan;
C. the employee is not
participating effectively in the implementation of the plan; or
D. the employee is not likely to benefit from
further rehabilitation services.
Subp. 6.
Commissioner's authority to
initiate closure.
If the commissioner initiates the termination of
rehabilitation services pursuant to Minnesota Statutes, section
176.102,
subdivision 6, or through an administrative conference pursuant to Minnesota
Statutes, section
176.106,
all interested parties shall be provided written notice of the proposed
decision and an opportunity to be heard either in person or through the
submission of written information.
Subp.
7.
Closure report by assigned qualified rehabilitation
consultant.
The assigned qualified rehabilitation consultant shall file a
rehabilitation plan closure report on a form prescribed by the commissioner
within 30 calendar days of knowledge that:
A. the employee has been steadily working at
suitable gainful employment for 30 days or more, or the time period provided
for in the plan;
B. the employee's
rehabilitation benefits have been closed out by an award on stipulation or
award on mediation;
C. the employee
and insurer have agreed to close the rehabilitation plan;
D. the qualified rehabilitation consultant
has been unable to locate the employee following a good faith effort to do
so;
E. the employee has died;
or
F. the commissioner or a
compensation judge has ordered that the rehabilitation plan be closed and there
has been no timely appeal of that order.
The form reporting plan closure must be sent to the employee
and the insurer when filed with the commissioner. The form shall contain
substantially the following:
(1)
identifying information on the employee, employer, insurer, and assigned
qualified rehabilitation consultant;
(2) the reason for closure of the
rehabilitation plan;
(3) if the
employee is working, information identifying the employer with whom the
employee returned to work, the job title, the return to work date, the weekly
wage upon return to work, and whether the employee has continued working for 30
calendar days;
(4) a summary of the
rehabilitation services provided and rehabilitation costs by all rehabilitation
providers;
(5) the assigned
qualified rehabilitation consultant's dated signature and a statement that the
qualified rehabilitation consultant certifies that the form was served on the
employee and insurer, any attorneys representing them, and the vocational
rehabilitation unit, if applicable, on the date specified; and
(6) notice to the employee about how to
contact the department with questions or concerns about the closure.
Subp. 7a.
Plan
closure report; insurer's denial of further liability.
A. The qualified rehabilitation consultant
shall also file the plan closure report form specified in subpart
7 if the consultant decides
to withdraw as the assigned qualified rehabilitation consultant after the
insurer has provided written notice to the employee, the employee's attorney,
the commissioner, and the qualified rehabilitation consultant that the insurer
is denying further liability for the injury for which rehabilitation services
are being provided. The qualified rehabilitation consultant shall attach a copy
of the insurer's notice to the plan closure form and shall provide a copy of
the form and notice to the employee, any attorney for the employee, and the
vocational rehabilitation unit established under Minnesota Statutes, section
176.104.
B. The qualified rehabilitation consultant
shall continue to provide services according to the approved plan until the
plan closure report form is filed and provided to the parties and the
vocational rehabilitation unit as specified in item A.
C. This subpart does not apply if a claim
petition, objection to discontinuance, request for an administrative
conference, or other document initiating litigation has been filed on the
liability issue. Where any of these litigation documents have been filed and
the qualified rehabilitation consultant decides to withdraw as the assigned
qualified rehabilitation consultant, the consultant shall document the
withdrawal on the rehabilitation plan amendment form according to subpart
3a, item C.
Subp. 8.
Disputes.
In the case of a dispute about a plan amendment or closure,
any party may file a rehabilitation request for assistance according to
Minnesota Statutes, chapter 176, and part
5220.0950.
Statutory Authority: MS s
176.102;
176.83