WAC 296-19A-030
What are the responsibilities of the
parties? The attending health care provider, department,
self-insured employer, employer, worker and vocational
rehabilitation provider have the following responsibilities in
assisting the worker to become employable at gainful
employment:
(1) Attending health care provider. The attending health
care provider must:
(a) Maintain open communication with the worker's
assigned vocational rehabilitation provider and the referral
source.
(b) Respond to any request for information which is
necessary to evaluate a worker's:
(i) Ability to work;
(ii) Need for vocational services; and
(iii) Ability to participate in a vocational retraining
plan.
(c) Do all that is possible to expedite the vocational
rehabilitation process, including making an estimate of the
physical or mental capacities that affect the worker's
employability. If unable to provide an estimate, refer the
worker for the appropriate consultation or evaluation.
(2) Department.
(a) State fund claims. For state fund claims, the
department must:
(i) Obtain medical information required to initiate
vocational rehabilitation services before a referral is made
to a vocational rehabilitation provider.
(ii) Notify the chargeable employer(s), if any, at the
time any referrals are made to a vocational rehabilitation
provider.
(iii) Provide the vocational rehabilitation provider with
access to all reports and any other relevant documentation
generated during prior vocational rehabilitation services
including plans that have been provided on any claim.
(iv) Review the assessment report and determine whether
the worker is eligible for vocational rehabilitation plan
development services.
(v) Notify all parties of the eligibility determination
in writing. When the worker is eligible for plan development
services, the notification letter must advise that the
chargeable employer(s), if any, has fifteen calendar days from
the date of the letter to make a valid return to work offer.
However, should the employer attempt to make a valid
return-to-work offer within the fifteen calendar days, the
department may grant up to ten additional calendar days to
modify the offer if it does not meet all of the requirements
for approval.
(vi) Assign plan development services to the vocational
rehabilitation provider that completed the assessment report
unless the department decides the provider cannot complete the
required report.
(vii) Review the submitted vocational rehabilitation plan
within fifteen days of receipt at the department, and
determine whether to approve or deny the plan.
(viii) Notify all parties of plan approval or denial in
writing. Should the department fail to send a notification
letter within fifteen calendar days of the date the report is
received by the department, the plan is considered approved.
When a plan is approved, the notification must advise the
worker that he or she has fifteen calendar days from the date
of the notification letter to decline vocational services and
elect option 2 benefits as defined in RCW 51.32.099. However,
the department may approve an election submitted in writing
within twenty-five days of the date the plan is approved or is
determined valid following a dispute if the worker provides a
written explanation of why he or she was unable to submit the
election of option 2 benefits within fifteen days.
(b) Self-insured claims. For self-insured claims, the
department must:
(i) Review the assessment report and determine whether
the worker is eligible for vocational rehabilitation plan
development services.
(ii) Notify all parties of the eligibility determination
in writing.
When the worker is eligible for plan development
services, the notification letter must advise the employer it
has fifteen calendar days from the date of the letter to make
a valid return to work offer; and
(iii) Review the submitted vocational rehabilitation plan
within fifteen days of receipt at the department, and
determine whether to approve or deny the plan.
(iv) Notify all parties of plan approval or denial in
writing. Should the department fail to send a notification
letter within fifteen calendar days of the date the report is
received by the department, the plan is considered approved.
When a plan is approved, the notification letter must
advise the worker that he or she has fifteen calendar days
from the date of the letter to elect option 2 benefits as
defined in RCW 51.32.099. However, the department may approve
an election submitted in writing within twenty-five days of
the date the plan is approved or is determined valid following
a dispute if the worker provides a written explanation of why
he or she was unable to submit the election of option 2
benefits within fifteen days.
(3) Employer. The employer must:
(a) Assist the vocational rehabilitation provider in any
way necessary to collect data regarding the worker's gainful
employment at the time of the injury.
(b) Assist the vocational rehabilitation provider and
attending health care provider to determine whether a job
could be made available for employment of the worker.
(4) Worker. The worker must fully participate and
cooperate in all aspects of their vocational services
including determination of physical capacities, development of
vocational goals, and implementation of the rehabilitation
process. Examples include but are not limited to:
• Providing accurate and complete information regarding
his or her work history and educational background.
• Attending all scheduled appointments.
• Cooperating with return to work efforts when it is
determined return to work opportunities exist.
• Actively participating and cooperating in selecting a
job goal when it is determined retraining is necessary.
(5) Vocational rehabilitation provider. In assisting the
worker to become employable at gainful employment, the
vocational rehabilitation provider must:
(a) Follow the priorities in RCW 51.32.095 and the
requirements in this chapter.
(b) For state fund claims, immediately inform the
department orally if the worker:
(i) Returns to work;
(ii) Is released for work without restrictions;
(iii) Returns to work and is unsuccessful; or
(iv) Fails to cooperate.
Note:
Written notification and documentation must follow oral notification within two working days.
(c) Identify all vocational rehabilitation counselors and
interns who provided services in each reporting period.
(d) Provide copies of reports and attachments submitted
to the referral source to the employer (if different than the
referral source) and the worker or the worker's representative
when requested.
(e) Prior to a determination of eligibility, work with
the employer, if necessary, to develop job analyses for work
the employer is offering or has available and provide other
assistance necessary to facilitate return to work with the
employer.
(f) When providing plan development services, the
vocational rehabilitation provider should, whenever possible
and appropriate, focus on identifying goals and occupations
that are considered high demand in the workforce. High demand
occupations, as determined by the employment security
department, means the number of job openings in the labor
market for the occupation or with the required skill set
exceeds the supply of qualified workers.
(g) Should the employer choose to make a valid return to
work offer within fifteen calendar days of the date of the
notification letter approving plan development services, the
vocational rehabilitation provider may provide assistance
necessary to facilitate return to work with the employer. The
department may approve up to an additional ten days for an
employer to modify a job offer if it does not meet all of the
requirements. When this occurs, the vocational rehabilitation
provider may assist the employer in making the necessary
modifications.