California Labor Codes 139.5 118

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§ Vocational rehabilitation unit

(a) The administrative director shall establish a vocational rehabilitation unit, which shall include appropriate professional staff, and which shall have the following duties: (1) To foster, review, and approve vocational rehabilitation plans developed by a qualified rehabilitation representative of the employer, insurer, state agency, or employee. Plans agreed to by the employer and employee do not require approval by the vocational rehabilitation unit unless the employee is unrepresented. (2) To develop rules and regulations, to be promulgated by the administrative director, providing for a procedure in which an employee may waive the services of a qualified rehabilitation representative where the employee has been enrolled and made substantial progress toward completion of a degree or certificate from a community college, California State University, or the University of California and desires a plan to complete the degree or certificate. These rules and regulations shall provide that any such waiver as well as any plan developed without the assistance of a qualified rehabilitation representative must be approved by the rehabilitation unit. (3) To develop rules and regulations, to be promulgated by the administrative director, which would expedite and facilitate the identification, notification and referral of industrially injured employees to vocational rehabilitation services. (4) To coordinate and enforce the implementation of vocational rehabilitation plans. (5) To develop a fee schedule, to be promulgated by the administrative director, governing reasonable fees for vocational rehabilitation services provided on and after January 1, 1991. The initial fee schedule promulgated under this paragraph shall be designed to reduce the cost of vocational rehabilitation services by 10 percent from the level of fees paid during 1989. On or before July 1, 1994, the administrative director shall establish the maximum aggregate permissible fees that may be charged for counseling. Those fees shall not exceed four thousand five hundred dollars ($4,500) and shall be included within the sixteen thousand dollar ($16,000) cap. The fee schedule shall establish maximum aggregate permissible fees for evaluation, plan development, and job placement services. (6) To develop standards, to be promulgated by the administrative director, for governing the timeliness and the quality of vocational rehabilitation services.

(b) The salaries of the personnel of the vocational rehabilitation unit shall be fixed by the Department of Personnel Administration.

(c) When an employee is determined to be medically eligible and chooses to participate in a vocational rehabilitation program, he or she shall continue to receive temporary disability indemnity payments only until his or her medical condition becomes permanent and stationary and, thereafter, may receive a maintenance allowance. Rehabilitation maintenance allowance payments shall begin after the employee's medical condition becomes permanent and stationary, upon a request for vocational rehabilitation services. Thereafter, the maintenance allowance shall be paid for a period not to exceed 52 weeks in the aggregate, except where the overall cap on vocational rehabilitation services can be exceeded under this section or Section 4642 or subdivision (d) or (e) of Section 4644. The employee also shall receive additional living expenses necessitated by the vocational rehabilitation services, together with all reasonable and necessary vocational training, at the expense of the employer, but in no event shall the expenses, counseling fees, training, maintenance allowance, and costs associated with, or arising out of, vocational rehabilitation services incurred after the employee's request for vocational rehabilitation services, except temporary disability payments, exceed sixteen thousand dollars ($16,000). The administrative director shall adopt regulations to ensure that the continued receipt of vocational rehabilitation maintenance allowance benefits is dependent upon the injured worker's regular and consistent attendance at, and participation in, his or her vocational rehabilitation program.

(d) The amount of the maintenance allowance due under subdivision (c) shall be two-thirds of the employee's average weekly earnings at the date of injury payable as follows: (1) The amount the employee would have received as continuing temporary disability indemnity, but not more than two hundred forty-six dollars ($246) a week for injuries occurring on or after January 1, 1990. (2) At the employee's option, an additional amount from permanent disability indemnity due or payable, sufficient to provide the employee with a maintenance allowance equal to two-thirds of the employee's average weekly earnings at the date of injury subject to the limits specified in subdivision (a) of Section 4453 and the requirements of Section 4661.5. In no event shall temporary disability indemnity and maintenance allowance be payable�concurrently.�If the employer disputes the treating physician's determination of�medical eligibility, the employee shall continue to receive that�portion of the maintenance allowance payable under paragraph (1)�pending final determination of the dispute. If the employee disputes�the treating physician's determination of medical eligibility and�prevails, the employee shall be entitled to that portion of the�maintenance allowance payable under paragraph (1) retroactive to the�date of the employee's request for vocational rehabilitation�services. These payments shall not be counted against the maximum�expenditures for vocational rehabilitation services provided by this�section.��

(e) No provision of this section nor of any rule, regulation, or�vocational rehabilitation plan developed or promulgated under this�section nor any benefit provided pursuant to this section shall apply�to an injured employee whose injury occurred prior to January 1,�1975. Nothing in this section shall affect any plan, benefit, or�program authorized by this section as added by Chapter 1513 of the�Statutes of 1965 or as amended by Chapter 83 of the Statutes of 1972.

(f) The time within which an employee may request vocational�rehabilitation services is set forth in Sections 5405.5, 5410, and� 5803.�

(g) An offer of a job within state service to a state employee in�State bargaining unit 1, 4, 15, 18, or 20 at the same or similar�salary and the same or similar geographic location is a prima facie�offer of vocational rehabilitation under this statute.��(h) It shall be unlawful for a qualified rehabilitation�representative or rehabilitation counselor to refer any employee to�any work evaluation facility or to any education or training program�if the qualified rehabilitation representative or rehabilitation�counselor, or a spouse, employer, coemployee, or any party with whom�he or she has entered into contract, express or implied, has any�proprietary interest in or contractual relationship with the work�evaluation facility or education or training program. It shall also�be unlawful for any insurer to refer any injured worker to any�rehabilitation provider or facility if the insurer has a proprietary�interest in the rehabilitation provider or facility or for any�insurer to charge against any claim for the expenses of employees of�the insurer to provide vocational rehabilitation services unless�those expenses are disclosed to the insured and agreed to in advance.��

(i) Any charges by an insurer for the activities of an employee�who supervises outside vocational rehabilitation services shall not�exceed the vocational rehabilitation fee schedule, and shall not be�counted against the overall cap for vocational rehabilitation or the�limit on counselor's fees provided for in this section. These�charges shall be attributed as expenses by the insurer and not losses�for purposes of insurance rating pursuant to Article 2 (commencing�with Section 11730) of Chapter 3 of Division 2 of the Insurance Code.��

(j) Any costs of an employer of supervising vocational�rehabilitation services shall not be counted against the overall cap�for vocational rehabilitation or the limit on counselor's fees�provided for in this section.