When Placement Before a Plan is Appropriate

Monday, September 2, 2002 | 0

Some VR counselors bill substantial amounts for placement activity before a plan is ever implemented. The practice results from failure to exercise case control or occasionally from a blatant attempt to maximize billing under the $4500 cap.

It is sometimes appropriate to involve an injured worker in a very limited amount of placement activity prior to plan implementation. For example, the worker's employment history may suggest that s/he is a good candidate for direct placement or an On the Job Training and the Qualified Rehabilitation Representative (QRR) wants to "test the waters" to insure developing that plan type is sensible. Skilled QRR's will limit such activity to a maximum of two weeks before either developing a plan or choosing a different plan objective. Less skilled counselors (and the few who are just "bad apples") will allow placement activity to continue for a month or two. Whatever the motivation, the practice wastes resources for both the injured worker and the employer/carrier.

What can you do? Any placement activity provided before plan implementation should be discussed with the claims examiner before the activity begins. If the QRR's rationale makes sense, agree to specific time frame (1-2 weeks). If you are billed for placement time that occurred without agreement or that exceeds your agreement, object to the billing in writing within 60 days. QRR's who wish to collect their billing in this situation will have to present their case to the Rehabilitation Unit and explain to a Consultant why they used a limited resource in this manner. Expect such conferences to be very rare.

Contributed by Allan Leno, Leno & Associates, (818) 370-8859 allanleno@leno-assoc.com.