As in effect on June 1, 2008
A. The definitions under Title 34A, Chapter 8 apply to this rule.
B. In addition to the foregoing definitions, all definitions in Rule R612-1 apply to this section.
This rule is enacted under the authority of Section 34A-8-111.
This rule is enacted to outline the procedural guidelines for the reemployment program.
Status Report - Form 206. When it appears that an injured worker is or shall be a disabled worker, or when the period of the injured worker's temporary total disability compensation period exceeds 90 days, whichever comes first, the employer or its workers' compensation insurance carrier shall, within 30 days thereafter file with the division and serve on the injured worker a Status Report. The report shall contain claimant demographics, insurance coverage details, and address the need for vocational assistance. The report shall also contain information regarding employer and employee expectations of return-to-work. In the event an injured worker returns to employment, or is deemed to have transferable skills but doesn't have a job to return to, the insurance carrier shall monitor the injured worker for sixty (60) days prior to closure to ensure transition into employment. If the injured worker is unsuccessful in a return to work effort, the issue of need for vocational assistance will then be addressed. A final 206 shall be submitted at the end of the monitoring period indicating whether the injured worker was successful or unsuccessful in a return to work effort.
An initial assessment shall be completed for injured workers who are unable to return to work in the same or similar occupation because of functional limitations, and for workers who have been unsuccessful in their return to work effort. The initial assessment shall be completed by a qualified rehabilitation provider and shall include the employee's work history, functional limitations, transferable skills analysis detailing a list of transferable skills and recommendations for viable job opportunities. The assessment shall be filed with the Reemployment Office within 120 days of the date of injury. For injured workers that have been unsuccessful in their return to work effort, the initial assessment shall be filed within 30 days after the determination.
a. In the event an insurance carrier postpones an injured worker's status due to medical reasons, the insurance carrier shall submit a summary statement outlining the diagnosis and medical treatment plan, along with the Status Report (Form 206), documenting the need for postponement to the Reemployment Program. An updated summary of the medical status shall be provided by the insurance carrier every 90 days of postponement, or at the time the injured worker's status changes.
b. The potential for rehabilitation shall be addressed during the period of postponement, and the insurance carrier/rehabilitation provider shall identify possible work related activities and/or training options the injured worker might engage in to encourage return to work at the end of medical treatment, i.e., attaining their G.E.D., attending English as a second language (E.S.L.) classes, on-the-job training with an employer, or other work related activities. These work related activities or training options may be suggested to the injured worker, as an alternative to light duty during postponement, in the event light duty work is not available.
The Request for Administrative Review (Form 207) shall be made available to the injured worker upon request. This form is completed when the employee wishes to contest the information/decision made by the carrier or employer on the Status Report (206) or initial assessment. In the event it is determined through Administrative Review that the employee has a valid dispute, the division may initiate a voluntary alternative dispute resolution conference between all parties involved, i.e., carrier, rehabilitation agency, medical personnel, employer, and employee.
A Rehabilitation Progress Report (Form 208A) shall be requested from the Utah State Office of Rehabilitation at each stage of the reemployment process (eligibility determination, reemployment plan development/implementation and case closure) or at any interruption of the process. An Individualized Written Rehabilitation Program (USOR 5 IWRP) shall also be requested when a plan is developed. All other private rehabilitation providers shall submit a Form 206 for any plan progress, postponement, or interruption in the plan.
A Reemployment Plan (Form 209) shall be provided for injured workers who are identified on the initial assessment as needing reemployment assistance, due to an industrial accident or illness which creates a significant barrier preventing a return to the work force. Significant barriers include, but are not limited to: 1) impairment(s) resulting from the industrial accident(s) or illness which prevent the employee from performing the essential functions of the work activity for which the employee has been qualified until the time of the industrial accident; 2) lack of transferable skills; 3) education/training; and 4) age. The plan shall not be provided for those injured workers who have previously been screened out through Form 206. The report should contain a return-to-work plan outlining employee demographics, functional limitations, type of plan, specific job target or employment category, specific tasks, time frames for completion and costs. Parties responsible for carrying out each task shall be identified (i.e., employee, employer, qualified rehabilitation provider, and insurance carrier). The plan shall be completed by a qualified rehabilitation provider (as defined by Section 34A-8-109) and filed within 30 days of the Initial Assessment.
Upon completion of the Reemployment Plan, a Reemployment Plan Closure Report (Form 210) shall be submitted to the division. The closure report shall detail costs in dollar amounts. The report shall also contain all the details on the return to work status of the employee.
reemployment workers' compensation guidelines
June 15, 1995
September 30, 2004
34A-1-104; 34A-8-109
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