UCR Ext
5/15/02
WC – Rehab
Recommended checking out http://www.cwci.org
Talked about AB 749 – rehab cap it $16,000 and now there is the option to settle rehab for $10,000 cap, but only if applicant is represented by an attorney.
Recommended getting applicant a rehab. evaluation first to see the applicant’s situation and potential.
“This change has nothing to do with return to work.”
Is afraid that available services will not be fully explained.
Reasons for setting out rehab.
1. Applicant needs money or finds other, physically appropriate work.
2. Carrier can close out issue.
Reasons to keep voc. rehab.
1. Applicant needs assistance in retraining or job seeking.
2. Carrier aids applicant so they won’t later return to carrier for benefits.
“What I worry about is the person willing to settle because they are desperate.”
Feels rehab. counselor should advise applicant’s of potential rehab. services.
Admin. Rule 10125 – Pg. 57
1. Notice of Potential Eligibility – sent 10 days from first indication of medical eligibility.
2. Notice of Alt/Mod Work – needs to be in writing to applicant.
“Cannot be assumed.”
3. Request for rehab. by applicant.
All three things must have happened for voc. rehab. to start counting against the cap.
Pg. 68 – Fee Schedule
$16,000 cap – includes things such as VRMA, mileage reimbursement, schooling, tools, day care, counseling etc.
$4,500 cap – on rehab. counseling (ave. $2,800 – 3,200)
Fee set in ’91 – rehab. billed at $65 per hour, and the total hours will vary by plan.
$16,000 – is a finite number and applicant is done.
“There is not a lot of room to play here.”
Can waive QRR if - more than 2/3 thru program
- attending a Cal State Institution
- have identified a goal
“Getting them approved is rough.”
$4,500 – is a counseling cap, but it is not always within the $16,000 total.
“The injured working can really get caught if there isn’t a timely referral.”
C.R.C. – certified rehab. counselor, passed national exam and have master’s degree.
There are 14 themes in counseling.
Gestalt – everything has to have closure
Rogerian – reflect back what applicant is saying
Adlerian – this is reality, deal with it
“It is very focused.”
“Concreteness is critical. We are talking reality.”
“I’m not there to help the person get over what ever injury happened to them.”
“It is not family counseling.”
“I try to give them choices and get people to be responsible for making them.”
“I don’t have time to cajole, convince or comfort them into something.”
Treat the injured working with respect.
“This is all about handling the claim, and helping the person through the system.”
Remember to limit self-disclosure.
“It’s about them.”
Body language in the initial interview is very telling.
Whole family is okay, but after that no
Provide information
Generally set aside 1 ½ hour for this
“I may be the first person to really listen to them.”
“I put the control in their hands and help them get into the process.”
Look at potential plan barriers
Even if applicant is not yet medically eligible etc., can interrupt and look at options i.e. getting GED, learning English etc.
Crisis in Chinese has two parts, Danger + Opportunity
Economic danger is real
Need to focus on opportunity now available with rehab.
“I want to hear what they can do.”
“We start problem solving.”
In CA, $6.75 an hour – minimum wage is considered gainful employment.
Applicant is protected medically, but not salary wise.
Applicant’s only get one plan.
There is no confidentially privilege with the counselor.
Go over work history comprehensively.
Need to be aware of potential cultural issues.
Applicants have to explain large gaps in work history.
RU-120 – claims gets the original, not to employer.
