Section 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: (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 employabil-ity. 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 can elect Option 2 at any point within the following time period:
* Beginning with the date of plan approval or the department's determination that a disputed plan is valid; and
* Ending the fifteenth day after completion of the first academic quarter or three months' training.
However, the department may approve an election submitted in writing within twenty-five days of the completion of the first academic quarter or three months' training 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 can elect Option 2 at any point within the following time period:
* Beginning with the date of plan approval or the department's determination that a disputed plan is valid; and
* Ending the fifteenth day after completion of the first academic quarter or three months' training.
However, the department may approve an election submitted in writing within twenty-five days of the completion of the first academic quarter or three months' training 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. The highest priority is returning a worker to employment.(b)For state fund claims, immediately inform the department orally if the worker: (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.Wash. Admin. Code § 296-19A-030
Amended by WSR 16-03-060, Filed 1/19/2016, effective 2/19/2016Statutory Authority: Chapter 51.32 RCW. 11-23-070, § 296-19A-030, filed 11/15/11, effective 12/16/11. Statutory Authority: RCW 51.04.020, 51.04.030, 51.32.095, 51.32.099 and 51.32.0991 (2007 c 72). 08-06-058, § 296-19A-030, filed 2/29/08, effective 3/31/08. Statutory Authority: RCW 51.04.020, 51.04.030, 51.32.095, 51.36.100, 51.36.110. 03-11-009, § 296-19A-030, filed 5/12/03, effective 2/1/04; 00-18-078, § 296-19A-030, filed 9/1/00, effective 6/1/01.