Tag Archives: return to work

Return to Work – Vocational Services

In Washington State, a worker injured on the job must return to work, or be found able to return to work, before the workers’ compensation claim can be closed. Vocational services may be needed to facilitate a return to work. In rare cases where the worker remains permanently unable to work, a total disability pension may be awarded.

The Department of Labor and Industries (DLI) is not required to find the injured worker a job, but is required to document that the worker has the ability to obtain and maintain employment. DLI is not required to return a worker to their pre-injury earnings, either. Minimum wage or better is all that’s needed to establish employability.

How Vocational Services Work

If an injured worker cannot return to their job of injury, a vocational counselor (VRC) is assigned. The VRC will research options to determine if the worker has the skills and physical ability to perform a modified job with the same employer or, if not, another job within the general labor market. This ability to work assessment follows WAC 296-19A-065 as it’s foundation.

The information provided to workers entering the ability to work assessment phase can be found, here.

If the worker does not possess the skills and abilities to obtain and maintain employment after an injury, vocational retraining services can be provided to return the worker to employability. The claim progresses to a Plan Development phase, during which specific retraining goals are evaluated.

Retraining benefits under a workers’ compensation claim are generally limited to two years and a budget of $18,660.46, total, for tuition and expenses. Time loss compensation continues to be paid under the claim while the worker is participating in retraining.

Possible retraining plans that fall within the time limit and budget and that lead to a job that is medically appropriate and is likely to result in the worker obtaining employment can be on the table.

There Are Options

Once a retraining plan is offered to an injured worker, they have a choice to make – whether to participate in the plan, known as Option 1, or to opt out and pursue other training or schooling on their own – Option 2. The worker can begin the plan and then change their mind, within defined time limits.

DLI has detailed information about training options, here.

How Legal Representation Can Help

We believe that we get the best outcomes when we are involved in a claim early in the return-to-work evaluation process.

There can be disagreements about a worker’s actual physical abilities and stamina, which are both important factors in an accurate determination of their ability to return to full employment. There can be disagreements about the worker’s transferable skills and whether they support their ability to return to work. There also can be disagreements about a worker’s ability to benefit from retraining services.

These and other disagreements over vocational conclusions can lead to disputes, protests, appeals and, sometimes, litigation. Determinations are often reached quickly. The deadline for filing a vocational determination dispute is very short – 15 days. While we are willing to get involved in cases at any stage, it is more difficult to address the many facets of a vocational determination late in the process.

If you have questions about vocational services, feel free to contact us. We would be happy to discuss the specific details of your case with you.

Prior Posts On Topic

Functional Capacities Evaluations Explained

Functional capacities evaluations (FCE’s) are used in many workers’ compensation claims and other legal cases. FCE’s can help determine functional ability, assess client effort, and determine appropriate work restrictions after an injury.

Unfortunately, there is no standardization for this type of examination. Many different systems and processes are used, some resulting in controversy in the overall effectiveness. Too often, the functional capacities evaluations provide inaccurate results. In some cases, this can be damaging to a legal case.

The objective of this article is to explain the functional capacities evaluation process, how the FCE is useful to you, as well as potential pitfalls to avoid.

The Functional Capacities Examination

A FCE can be performed in 4-8 hours, typically at a physical therapy facility where equipment is available for evaluating a variety of physical activities. Often, the examiner will have the patient perform tasks similar to the their job, simulating a day of work. Activities of daily living can also be simulated.

Tasks such as stair and/or ladder climbing, lifting, carrying, pushing and pulling of items at various weights will be tested to tolerance, possibly multiple times. Sitting and standing, crawling, and kneeling may be examined. Hand strength, keyboarding and fine-finger activities are also tested.

Throughout the evaluation process, the examiner will ask how the patient is feeling after each task, testing for whether the task meets or exceeds the limitations of the individual. The goal is to determine maximum abilities that can be sustained over a work day. This includes the ability to perform the tasks, as well as the stamina to do so repetitively.

See a sample functional capacities evaluation report, here.

Tips to Follow for an Accurate FCE

Put Forth a Good Effort

An FCE is typically scheduled to occur on one day, rarely over two days. It likely will not be an accurate reflection of your work ability if you try to breeze through the tests, which can seem simple.

The examiner will be tracking your heart rate, respiratory rate other indications of full effort. They will encourage you to do more, while noting signs of exertion, such as sweating or having you answer questions to see if your sentences are interrupted due to you breathing hard after the exercise.

Increase Activity Levels Prior to the Evaluation

Try to remember that the FCE is meant to test your ability to perform tasks over a full-time work week. In order to gain an accurate assessment, try to be active in the days leading up to your examination. Don’t knock yourself out, but don’t sit on the couch, either.

The day or two before your evaluation, try to perform activities that are similar to those you do at your job. If you spend all day at work on your feet, try going for a nice walk, or do a large grocery shop, on the day prior to the examination. If you sit at a desk all day when working, maybe go to a movie or spend a couple of hours at the library sitting at a desk or table prior to your evaluation.

Try to make sure that the examiner is able to determine what your condition would be like on Friday afternoon back on the job, after working all week. You don’t want to have their report reflect your ability on Monday morning after resting up all weekend.

Answer Questions Honestly and Thoroughly

The functional capacities evaluation takes place over the course of a day. The examiner’s report will be a better assessment of your abilities if you are forthright with your answers. If the examiner asks if you feel pain or some other sensation, this is not the time to exaggerate nor to minimize your symptoms.

Acting tough or pushing through pain may result in your exertion scores being high – you’re putting forth great effort! – but, if the results of this exertion are not accurately documented, you may be found able to perform at a level that is not realistic.

Over-stating your response to an activity also leads to a poor FCE result. If the examiner feels that you are capable of doing more than your test results reflect, or that you are complaining of difficulties out of proportion to your apparent levels of stress, this can be noted in the final report.

It may be helpful to let the examiner know the type of symptoms you generally experience, how long they last and what steps you take to reduce or alleviate those symptoms. This kind of openness and honesty will let the examiner know that you are in tune with your situation and are focused on improving your condition.

Usefulness of an FCE

An accurate functional capacity evaluation can be very useful to you in your claim or legal case. It can ensure appropriate treatment, vocational services and impairment awards are provided under your claim.

Medical Uses for a FCE

Your doctor may use the results to support that work restrictions are needed, or that a course of work conditioning treatment is needed to improve strength and stamina. An FCE can also help show that a certain rating of permanent impairment is appropriate.

The medical information within the final report, including symptoms present due to exertion and activity, allow your doctor to opine on your current condition and whether your condition could be improved with additional treatment.

Vocational Uses for a FCE

When a vocational counselor is assigned to a claim or case, they must make a determination of your ability to work. Typically, they will determine if you are able to return to work at your regular job, or a modified version of your job, with the same employer.

If not, they will look at your physical abilities together with your skills and education to determine if you could work in some other type of work. If you have transferable skills to another line of work, they will document the availability of these potential jobs and the willingness of employers to hire someone with your work restrictions.

Ultimately, the vocational counselor will write a report detailing your ability to obtain and maintain employment. The report will indicate whether you can return to work with your current skills and abilities, based on the functional capacity evaluation, or whether retraining services are needed.

Do you Need Legal Help?

You do not necessarily need legal advice when facing a FCE. If you have any concerns, questions, or if your instincts tell you that something doesn’t feel right, then talking with an attorney may be appropriate. Many firms, like ours, offer free consultations. Why not get answers to your questions before your evaluation?

See this prior post:

HOW CORPORATE MONEY POISONS “INDEPENDENT” MEDICAL EVALUATIONS

Back In The game Or Back To Work Too Soon?

Senator Dan Quick has introduced employee-friendly legislation

Today’s post comes from guest author Jon Rehm, from Rehm, Bennett & Moore.

Last weekend’s Big 10 Conference football championship game between Ohio State and Wisconsin contained some off-the-field controversy when former Wisconsin Badger and current Cleveland Browns player, Joe Thomas, criticized the fact that Ohio State starting quarterback J.T. Barrett was playing in the game six days after arthroscopic knee surgery.

While Barrett lead the Buckeyes to victory with 211 passing yards and 60 rushing yards, Thomas argued that college players should have the option of a second opinion when it comes to major surgeries like players do in the NFL. Thomas argued that team doctors are overly influenced by coaches who want players to return to action as soon as possible and that college players are over eager to return to the field.

A similar issue will be debated in Nebraska’s legislature next month. Senator Dan Quick of Grand Island has a bill on the floor that would require an employer to pay for a second opinion if an employee disputes a finding from a doctor paid for by the employer. Quick’s bill was inspired by his experience of being sent back to work prematurely by a doctor chosen by his employer’s workers compensation insurer.

Quick is an electrician by trade and is one of the few blue-collar workers who serves in the Nebraska Legislature. Another blue-collar worker, Lee Carter, was recently elected to the legislature in Virginia. Like Quick, Carter had a bad experience after a work injury. Carter had his hours reduced after his accident and was unable to find a lawyer because of confusion over which state had jurisdiction over his work injury.

Blue collar workers running for office may be a trend as iron worker Randy Bryce is running for Congress against House Speaker Paul Ryan and Wisconsin Firefighter’s union president Mahlon Mitchell is running for Governor of Wisconsin. I am encouraged that people like Dan Quick and Lee Carter have taken their bad experiences after work injuries and have gone into politics to directly address the problems they  faced first hand and make sure other workers will have better experiences if they get hurt on the job.

Inclusion Drives Innovation – National Disability Employment Awareness Month

Inclusion drives innovation.

In this spirit, throughout October, the Department of Labor will be recognizing the many ways disability inclusion benefits today’s innovative economy during this year’s National Disability Employment Awareness Month (NDEAM) 2017.

The USDOL highlights how inclusion drives innovation time and time again through advancements developed by and for people with disabilities that have widespread applicability. Some of the most common examples are things like curb cuts, automatic doors, and voice-recognition software that are now common in our daily lives but got their start from innovating for people with disabilities.

Technology corporations benefit from this kind of creative problem-solving, including IBM, Microsoft, and Apple. IBM includes people with a range of disabilities in its product development and testing processes. The result is an “accessibility mindset” that considers how best to deliver products and experiences in a usable way to every individual.

With more than 6 million jobs available across country, this is the time for job creators to realize the potential of the more than 500,000 Americans with disabilities who are looking for jobs right now. More than ever, job creators today can use resources and technology to include Americans of all abilities and benefit from more innovation.  Please, take time to review the companies recognized as “Best Places to Work” based on the 2017 Disability Equality Index. 

Americans with disabilities are a huge part of the American workforce, not only this month, but every month.

 

Photo credit: Foter.com

Return To Work is a Program; Return To Function is a Philosophy

Title: “Expression of pain” – Chris JL

Today’s post comes from workerscompensation.com, one of the blogs that I follow.  I am taking Bob’s advice and sharing his article with our network.  His concepts are spot-on.

I wish I had thought of the two concepts reflected in the title of this article. Alas, I did not. I did, however, once again take two dynamite ideas, combine them into one cohesive concept, thereby saving the universe while still managing to create an enticing, killer headline in the process.

I swear, sometimes it’s exhausting being me.

I now serve on the Disability Management & Return to Work Committee of the International Association of Industrial Accident Boards and Commissions (IAIABC). We met Tuesday during the associations 99th Annual Convention in San Diego, CA. Committee Chair Peter Federko tasked the group with defining a working strategy that would encourage and promote successful disability management and return to work programs for both the industry and injured workers. This prompted what I can best describe as a passionate discussion among the members, each with their own take and view on where barriers exist, and what segments should be targeted in any RTW effort. 

Federko, who by day is CEO of the Saskatchewan Workers’ Compensation Board, did a masterful job of keeping the conversation focused as we rambled about with our various opinions. Personally I believe that there are many “moving parts” within workers’ compensation that all must be aligned and engaged to effectively deploy any respectable RTW program. It requires a team effort from all players. Unfortunately, our current trend in claims management is taking us towards a dehumanization of the process, and this is not conducive for the development of such initiatives. 

Two members of this group gave what I believe to be stunning insight, and not just because they dovetail nicely with my beliefs (ok, mostly because they dovetail nicely with my beliefs). Joachim (pronounced Yoke-em) Breuer, with the German workers’ comp system and Chair of the ISSA Technical Commission on Accident Insurance, provided tremendous insight when he stated that Return to Work was not a program, but rather a philosophy; a philosophy that needed to be ingrained throughout the workers’ compensation system. He was followed in short order by Ken Eichler, Director of Government & Insurance Services, Guidelines Division, for Reed Group. Eichler, who is also Committee Vice Chair, talked of suspicion and resistance on the side of the injured worker. He suggested that, to allay fears that RTW was merely a cleverly disguised cost control scheme, the committee instead develop criteria for a “Return to Function” program. He correctly pointed out that “function” is at the core of all life necessities, and that if we can focus on improving that for injured workers, return to work would be a natural extension of any successful effort. 

Brilliant observations from both of them. Federko immediately instructed each to take an extra thousand out of petty cash for their input (not really – I made that up. Ever the cost control maven, Federko wouldn’t even open the committee liquor cabinet). Still, this theory was not quite complete. We haven’t quite finished mixing all ingredients for our RTW stew. We still have one more to add.

As you may notice, both suggestions by Eichler and Breuer fit quite nicely with my (as yet unsuccessful) effort to reposition and rebrand the workers’ compensation industry into the Workers’ Recovery industry. We will therefore include that as a third element in the recipe. This concoction produces the following final scrumptious result:

Successful Return to Function must be driven as an overriding philosophy ingrained throughout the Workers’ Recovery system.

There. Not too shabby if I do say so myself. 

The philosophy maintains that we must return as many people as possible to functional capacity for as normal a life as possible. Severely injured workers almost without exception wish to have some normalcy in their life. They have children or grandchildren they hope to hold. They want to dress, walk or go to the bathroom without assistance. They want to be able to do their own shopping, and they literally would like to be able to take a moment, bend over, and smell the roses. An entire system that embraces that knowledge, from employers, TPA’s, brokers, carriers, doctors, regulators and the workers themselves, can improve both outcomes and individual lives. With that return to function we offer a return to normalcy, a return to life, and indeed, a return to work. 

I cannot speak for the committee nor do I even wish to reveal the path we ultimately chose. Suffice it to say we’re on the right track, and have an amazing amount of work ahead of us. But it will be worth it, as it needs to happen. The current trends are not sustainable. Disability rates are on a dramatic rise, being completely dependent on others is becoming socially normalized, and as workers we are getting older by the day. Our knees are wearing out. Our backs are starting to fail. Many of us have no appreciable skills beyond our current jobs. It is a recipe for disaster if we don’t act, and act quickly.

Restoring life and viability by returning to function via the process of workers’ recovery must be the wave of the future. The choice is simple. Embrace the philosophy today or pay for the reality tomorrow. 

What choice will we make?

Photo credit: Chris JL / Foter.com / CC BY-NC-ND

How Does Social Security Help Me Get Back to Work?

The SSA has programs to help disabled people rejoin the workforce.

Today’s post comes from guest author Barbara Tilker from Pasternack Tilker Ziegler Walsh Stanton & Romano.

As I discussed in a previous post, you don’t have to be on Social Security Disability (SSD) forever. Many people find that their medical conditions improve and they want to try to get back to work. However, it’s hard to get back into the workforce after being out of it for a long time, and people are worried about losing their eligibility for benefits if they try to go back to work but are unsuccessful.

Social Security recognizes that it can be difficult for people to get back into the labor market and that people would be reluctant to go back to work if they would automatically lose entitlement to their disability benefits. To address these concerns, Social Security runs several programs to help people transition back into the workforce while maintaining financial eligibility.

Social Security has many programs and policies to help people return to work, but I will discuss two of these programs in some detail. These are the Ticket to Work program and the Trial Work Period.

The Ticket to Work program gives disabled individuals access to a network of services that offer retraining and vocational rehabilitation. This is a free, completely voluntary program. Once you reach out to them, you will Continue reading How Does Social Security Help Me Get Back to Work?