Current through Register Vol. XLI, No. 50, December 13, 2024
Section 85-27-3 - Definitions As used in this legislative rule the following terms have the stated meanings unless the context of a specific use clearly indicates another meaning is intended.
3.1. "Commission" means the West Virginia Workers' Compensation Commission as provided for by W. Va. Code § 23-1-1.3.2. "Insurance Commissioner" means the insurance commissioner of West Virginia as provided in section one, article two, chapter thirty-three of the West Virginia Code, or any third party administrator of the Insurance Commissioner.3.3. "Code of Professional Ethics" refers to the code or codes to which a qualified rehabilitation professional subscribes and must include at least one of the following: a. For certified rehabilitation counselors, the "Code of Professional Ethics for Rehabilitation Counselors" administered by the Commission on Rehabilitation Counselor Certification;b. For certified disability management specialists, the "Code of Professional Conduct" administered by the Certification of Disability Management Specialists Commission;c. For certified case managers, the "Code of Professional Conduct for Case Managers" administered by the Commission for Case Manager Certification;d. For certified vocational evaluators, the "Code of Professional Ethics" administered by the Commission on Certification of Work Adjustment and Vocational Evaluation Specialists;e. For certified rehabilitation registered nurses, the "Code of Ethics for Nurses with Interpretive Statements" administered by the American Nurses Association and endorsed by the Association of Rehabilitation Nurses;f. For West Virginia licensed professional counselors, the "Code of Ethics and Standards of Practice" promulgated by the American Counseling Association and administered by the West Virginia Examiners in Counseling;g. For members of the International Association of Rehabilitation Professionals, the "Code of Ethics, Standards of Practice and Competencies" administered by the International Association of Rehabilitation Professionals"; or h. For qualified rehabilitation professionals, a code of ethics or standards of practice published by a relevant professional organization to which the qualified rehabilitation professional is a member.3.4. "Vocational rehabilitation services" means professional counseling, consulting or rehabilitation case management services reasonably necessary to enable an injured worker to return to suitable gainful employment as soon as practical. This may include, but is not limited to, coordination of medical services, vocational assessment, vocational evaluation, vocational counseling, vocational rehabilitation plan development, vocational rehabilitation plan monitoring, job development, and job placement. Furthermore, "vocational rehabilitation services" means services covered by W. Va. Code § 23-4-9, which provide new skills or modified or alternative work to enable an injured worker to return to suitable gainful employment as soon as practical. Services may include, but are not limited to, adult basic education, vocational-technical training, college training, on-the-job training, travel expenses related to training, job modifications and placement tools.3.5. "Qualified Rehabilitation Professional" means a person who has the education, experience and skills necessary to provide vocational rehabilitation services as defined in 85 C.S.R. 15 and pursuant to the rehabilitation priorities set forth in 85 C.S.R. 15, to make recommendations consistent with medical documentation, concerning an injured worker's ability to accept and perform suitable gainful employment, and to design, implement and supervise programs to enhance an injured worker's capacity to accept and perform suitable gainful employment. A qualified rehabilitation professional need not personally have the ability to administer and interpret all medical, psychological or vocational testing, but must be able to evaluate the test results provided by other professionals. A qualified rehabilitation professional is required to consider all appropriate rehabilitation priorities in each case.3.6. "Supervised experience" means work in the field of vocational rehabilitation services in which the individual receives at least one (1) hour of formal instruction, case review, and case direction with a supervising professional for every twenty (20) hours worked. The Commission, Insurance Commissioner, private carrier or self-insured employer, whomever services are provided, may request documentation of such supervision. The supervised experience required by this rule must conform to the criteria for acceptable employment experience set forth in this rule.3.7. "Certified rehabilitation counselor" means that earned designation as awarded by the Commissioner on Rehabilitation Counselor Certification.3.8. "Certified disability management specialist" means that earned designation as awarded by the Certification of Disability Management Specialists Commission.3.9. "Certified case manager" means that earned designation as awarded by the Commission for Case Manager Certification. 3.10. "Certified rehabilitation registered nurse" means that earned designation as awarded by the Association of Rehabilitation Nurses.3.11. "Licensed professional counselor" means that earned designation as awarded by the West Virginia Board of Examiners in Counseling.3.12. "Certified vocational evaluation specialist" means that earned designation as awarded by the Commission on Certification of Work Adjustment and Vocational Evaluations Specialists.3.13. "Catastrophic injury" means an injury with one of the following diagnoses: quadriplegia, paraplegia, hemiplegia, traumatic brain injury (excluding mild brain injury or mild traumatic brain injury), major extremity amputation, or burns requiring admission to a specialized burn center.3.14. "Private Carrier" means any insurer, including the successor to the Commission, authorized by the insurance commissioner to provide workers' compensation insurance pursuant to chapters twenty-three and thirty-three of the West Virginia Code, but shall not include self-insured employers.3.15. "Self-insurer" and "self-insured employer" mean employers who are eligible and have been granted self-insured status under the provisions of W. Va. Code § 23-2-9.3.16. "Board" means the workers'' compensation board of managers created pursuant to the provisions of W. Va. Code § 23-1-1a.