Voc Rehab Observations

Friday, December 3, 2004 | 0

VR services for 2004 cases

Many physicians are not fully aware that they no longer should be making QIW determinations. These physicians still include language in P&S reports indicating a need for vocational rehabilitation where they deem the injured worker incapable of performing their usual and customary job duties.

Some claims examiners have reported demands for VR services from applicants' attorneys and one recently received a copy of an RU-103 Request for Dispute Resolution after declining to provide VR services. The Rehabilitation Unit issued a Data Mailer recognizing receipt of the RU-103 but the Unit will ultimately have to reject the attorney's request for dispute resolution.

All parties (including physicians) need to understand that the vocational rehabilitation benefit no longer exists for dates of injury on or after January 1, 2004.

L. C. section 139.5, as reinstated via SB 899, specifically applies to dates of injury prior to 1/1/2004. L. C. Section 139.5 also contains the authority for existence of the Rehabilitation Unit; the preceding limitation means that the Unit has no jurisdiction for dates of injury on pr after 1/1/2004. The Unit therefore cannot hear disputes of any sort for dates of injury on or after 1/1/2004 (this includes voucher disputes).

Where an examiner receives a demand for VR benefits and services for a 2004 case, s/he might want to send a brief letter to the attorney noting that VR is not due for dates of injury on or after 1/1/2004. If the attorney files an RU-103, simply send a copy of your letter to the Unit with a copy of the attorney's RU-103. The Unit will respond with a notice indicating that it lacks jurisdiction on the case.

"Forced" VR Settlements

Some claims examiners have advised that a few applicant attorneys have been very aggressive in demanding settlement of prospective VR benefits and services for their client pursuant to L.C. section 4646(b) and Pebworth.

These attorneys have threatened to file an RU-103 with the Unit if these examiners decline to sign an RU-122. One attorney apparently has acted upon his threat and filed with the Unit. I have not heard the outcome as yet.

Once again, the Unit should respond with a notice indicating that it lacks jurisdiction in this matter. L. C. section 4646(b) specifies that prospective VR benefits and services can be settled for represented injured workers by agreement. This means that neither party can be forced to sign an RU-122, even by the Unit.

Threats to seek action by the Unit should be considered as nothing more than a negotiating tactic.

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

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