Hawaii Regulations 12-14-4
From Wcc
§ 12-14-4 Initial evaluation required prior to submittal of vocational rehabilitation plan.
| A provider shall submit an initial evaluation report of the employee to the director and employer within forty-five days from the date of referral or selection. The evaluation shall determine whether the employee requires vocational rehabilitation services to return to suitable gainful employment, shall identify these services and shall state whether the provider can provide these services. The initial evaluation report shall contain:
(1) An assessment of the employee's: (A) Current medical status; (B) Primary disability; (C) Secondary disabilities; (D) Disabilities not related to the work injury; and (E) Physical or psychological limitations or both. In the event this information is not provided by the treating physician in a reasonable amount of time, information from another physician will be accepted. (2) A job analysis addressing the demands of the employee's employment; (3) A statement from the provider identifying the employee's vocational handicaps in relation to the employee's ability to: (A) Return to usual and customary employment; and (B) Participate in and benefit from a vocational rehabilitation program. (4) A statement from the provider determining the feasibility of vocational rehabilitation services, including: (A) The provider's ability to assist the employee in the employee's efforts to return to suitable gainful employment; (B) An outline of specific vocational rehabilitation services to be provided, justification for the necessity of the services, estimated time frames for delivery of services, and how the effectiveness of these services is to be measured; and (C) How the vocational rehabilitation services directly relate to the employee obtaining suitable gainful employment. (5) Enrollment form and Statement of Worker's Rights and Responsibilities form pursuant to section 12-14-35. [Eff. 1/l/81; am 1/28/85; am 4/12/93; am 11/08/99] |
