California Regulations 10126

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§ 10126 Vocational Rehabilitation; Plans and Offers of Modified or Alternate Work


(a) For Injuries occurring prior to 1/1/94, �(1) Within ninety (90) days after determination of the employees vocational feasibility, the claims administrator �shall either: �(a)(a) Submit Vocational Rehabilitation Plan, DWC Form RU-102, agreed to by the parties with appropriate �attachments or; �(b)(b) Advise the Rehabilitation Unit of any dispute by filing a Request For Dispute Resolution, DWC Form �RU-103, to the Rehabilitation Unit, attaching a summary of the informal conference and the results thereof, �including identification of the issues, issues resolved, issues pending, position of the parties and the �rationale/supporting information for the position(s). �(2) A vocational rehabilitation plan that provides for modified or alternative work with the same employer and has� been agreed to by the employer and employee shall not be subject to Rehabilitation Unit approval prior to �implementation. �(3) Where a question arises concerning the duration of alternate plans of equal merit, the unit shall approve the �plan that expedites the employees return to suitable gainful employment.

�(b) For Injuries Occurring On Or After 1/1/94. �(1) Offers to provide alternative or modified employment with the employer which meet the criteria of Labor Code� Section 4644(a)(5), (6), or (7) do not require a written plan nor approval from the Rehabilitation Unit. The offer �shall be made on DWC Form RU-94. The injured employee shall accept or reject a bona fide offer within 30 �calendar days of receipt of the offer. In the event that the offer is not accepted or rejected within 30 days, the offer� is deemed rejected unless the time period for reply is extended by the employer or by the terms and conditions of a� collective bargaining agreement. The claims administrator shall submit a copy of the acceptance or rejection of �the re-employment offer to the Rehabilitation Unit within 30 days of the acceptance or rejection. �(2) Plans developed for unrepresented employees or plan developed without the service of a Qualified �Rehabilitation Representative require the approval of the Rehabilitation Unit. The plan must be submitted, on �DWC Form RU 102, to the Rehabilitation Unit within 15 days of the agreement to the provisions of the plan. �(3) Agreed plans developed by a Qualified Rehabilitation Representative for represented employees do not require�Rehabilitation Unit approval. The claims administrator shall submit a copy of the plan to the rehabilitation Unit �upon submission of the Notice of Termination of Vocational Rehabilitation Services at the time of completion. �(4) Plans which provide the employee with discretionary monies to be used on a non-specific and/or self-directed �basis must be reviewed by the Rehabilitation Unit to determine whether the plan is in conflict with Labor Code� Section 4646. Any plan found to be in conflict with Labor Code Section 4646 shall not terminate an insurers �liability to provide vocational rehabilitation services and any money expended on such a plan shall not be counted� against the maximum expenditure for vocational rehabilitation services. �(5) An employee may be granted a waiver of the services of a Qualified Rehabilitation Representative if the �employee has made substantial progress towards the completion of a certificate or degree program from a �community college, California State University, or the University of California. Substantial progress includes but� is not limited to situations where the employee can demonstrate all of the following: �(a)(a) The employee is, was, or will be enrolled as a full-time student taking 12 units or more; �(b)(b) The employee has completed 35% or more of the units necessary to complete the degree or certificate �program and has attained at least a C grade in those courses necessary to complete the degree or certificate program; �(c)(c) The employee has produced a letter of recommendation from the school in which the employee is enrolled�supporting the employees course of study from one of the following: the Dean of Admissions, the school �department head or the school counselor. Accompanying the letter shall be an outline of the courses to be taken �and the estimated time frames for completion of each course. �(d)(d) The employee has identified the vocational goal to be achieved, the resources and time frames required to �achieve the goal and, if the goal extends beyond the maximum expenditures and time frames allowed, the �alternative resources available to the employee to complete the program. The Rehabilitation Unit will assist the �employee in completing the DWC Form RU 102.

�(c) All plans must contain a description of the level of participation expected of the employee in order to continue� to receive maintenance allowance. If the employee fails to adhere to the agreement, the claims administrator may� petition to withhold the employees maintenance allowance as described in Section 9813.

�(d) Nothing shall preclude the claims administrator or employee from requesting the Rehabilitation Unit to �approve a modification of the plan because of an unforeseen circumstance arising subsequent to the initial plan �agreement.

�(e) Within 15 days after the employee and claims administrator have agreed to the terms and conditions of a �vocational rehabilitation plan, the plan shall be submitted to the Rehabilitation Unit for review and approval �where approval is required. Within thirty (30) days of receipt of a properly submitted, documented and signed plan,� the Rehabilitation Unit shall approve or disapprove the plan. If disapproval is not made within thirty (30) days of� receipt of a properly submitted plan, the plan shall be deemed approved. Notice of approval shall issue only in �instances where the plan has been previously disapproved. Plan commencement shall not be deemed approval.

�(f) Plans that are in conflict with Labor Code Section 139.5(h) or Section 10123.3 of these regulations shall not �terminate the insurers liability to provide vocational rehabilitation services and, for injuries occurring on or after �1/1/94, shall not be counted against the maximum expenditure for vocational rehabilitation services.

�(g) A vocational rehabilitation plan is complete when the claims administrator and employee have fulfilled their �respective obligations specified in the plan or when applicable maximum expenditures for vocational rehabilitation� services have been reached, whichever occurs first.

�(h) For injuries occurring on or after 1/1/94, a rehabilitation plan must be completed within 18 consecutive �months from the date of plan approval, or, if approval is not required, from the date of plan commencement. �Except as provided in Subdivision (i), the job placement period in a plan shall not exceed 60 days.

�(i) For employees injured on or after 1/1/94 who initiate rehabilitation benefits or services pursuant to Section � 10125 on or after 1/1/98, the period of job placement in a rehabilitation plan may be up to 90 days where the plan� exclusively utilizes�transferable skills and experience for direct placement.

�(j) A second vocational rehabilitation plan will not be provided where the claims administrator has fulfilled its �obligations under the plan and the employee has completed, or with reasonable diligence could have completed the �vocational rehabilitation plan, unless the employee can demonstrate a deterioration of his or her disability to the �point where the employee is unable to meet the physical demands of the first plan.

�(k) Private providers of vocational training selected to provide training as part of a vocational rehabilitation plan �shall have either approval from the Bureau for Private Postsecondary and Vocational Education, approval from a �California state agency that has an agreement with the Bureau for the regulation and oversight of �non-degree-granting private postsecondary institutions, accreditation from the Western Association of Schools and� Colleges, or certification from the Federal Aviation Administration.

�(l) Vocational rehabilitation plans for employees who lack English language proficiency may include English �language training when necessary to return the employee to suitable gainful employment.

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