DATE: May 4, 1999
TO: All Interested Parties
FROM: Douglas K. Langham, Administrator
This memorandum is a revised copy of previous guidelines issued on October 23,1989. Please note the new language that has been added to the guidelines on evaluations.
On numerous occasions mediators have expressed strong concerns that at the time of the VR hearing, they have failed to see evidence of either a comprehensive rehabilitation evaluation or rehabilitation plan. In order to address the problem, guidelines were developed for both the evaluation and plan and were provided to the mediators. The guidelines are used by the VR hearing officers to assist them in evaluating the appropriateness of the rehabilitation program.
Copies of the protocol for both the rehabilitation evaluation and rehabilitation plan are attached. The guidelines set forth a general outline of the relevant areas which should be addressed by the rehabilitation practitioner when developing the evaluation and plan. We request that you carefully review the protocol with all professional staff who provide direct rehabilitation services to injured workers. If, at the time of a VR hearing, the hearing officer determines that an appropriate evaluation or plan has not previously been developed, that need will become an immediate priority. We also request that you review each active rehabilitation case file to ensure that these service delivery areas have been appropriately addressed.
Please note that time frames are expected for completion of needed services. For example, direct job placement services which continue beyond 60-90 days without success are highly questionable. We would normally expect at that point that a re-evaluation of the plan would occur to determine the need for other services such as possible re-training.
If you have any questions regarding the guidelines, feel free to contact this office.
The first step in the rehabilitation process is the evaluation or assessment. Depending upon the presenting needs of each individual, the services may include many different items. However, there are factors that should be addressed in every instance. This evaluation/assessment should always include a direct, face-to-face interview with the injured employee to verify his or her current medical status, prior work history, etc.
There are two basic areas included in the evaluation. The first is the initial assessment. This is simply a "fact-finding" task designed to gather as much information on the client as possible so that the VR specialist has an understanding of the client's present situation. The second is the vocational evaluation, where all of the information regarding the client's skills, aptitudes, interests, and physical abilities are analyzed to determine the need for and feasibility of rehabilitation services. It is the rationale used to decide upon the direction of continuing services.
• Initial Assessment
An initial assessment should include the following:
- medical factors related to the rehabilitation program
- vocational history including job duties, transferrable skills, worker traits, wages earned, and reasons for leaving
- educational history, both formal and informal
- client's interests and aptitudes
- specialist's observations and impressions
- next steps to be taken and specific recommendations
Upon completion of the initial assessment, the rehabilitation specialist should gather adequate, up-to-date medical records, recommend additional medical exams as needed, schedule appropriate vocational/psychometric testing, and arrange for more in-depth work evaluations if indicated. Examples of these include on-the-job evaluations, situational assessments, or work adjustment.
• Vocational Evaluation
The vocation evaluation is a comprehensive process utilizing all of the information needed to formulate a rehabilitation plan. The feasibility and rationale for continuing a rehabilitation program is provided specific to that individual's needs. A complete and thorough evaluation will minimize the opportunity for a client being involved in a program that is not compatible with the client's skills, interests, and capabilities.
Other factors to be included when considering the need for and feasibility of rehabilitation may be:
- medical stability
- client's adjustment to the disability
- testing results
- transportation needs
- available family support
Basically, the evaluation is the objective documentation that is necessary prior to developing a rehabilitation plan, whether it involves a return to work with the same employer, another employer, re-training, or self-employment.
If the vocational evaluation determines that continuing services are both needed and feasible, the next step is to develop a rehabilitation plan.
The purpose for writing a rehabilitation plan is to outline, in detail, the steps necessary for an injured worker to return to work. Each plan should be specifically tailored to the individual and be written so that the responsibilities of each of the parties to the plan are clearly identified. while it is recognized that rehabilitation plans will vary depending upon the presenting circumstances, there are basic factors which should be addressed in every plan.
• Specific factors which must be included in each plan:
- What is the specific job goal?
- Why was this job goal decided upon?
- What services are necessary to reach the job goal?
- Who will provide the various services?
- Are the responsibilities of all parties clearly stated?
- What are the criteria for plan completion, suspension, or termination?
- How much does each service cost, and who will pay for it?
- What is the estimated time needed to complete the plan?
- Have the injured worker and counselor signed the plan? If not, Why not?
• Factors which should be considered when developing a rehabilitation plan include:
- What on-going medical treatment is needed?
- Can the injured worker perform the duties of this job?
- Does the vocational testing support such a goal?
- Does the client have adequate job seeking skills?
- Is training required? What type? Where? How long? Who pays?
- Has a labor market survey been completed to assure job availability in the chosen field of employment?
- Has a detailed job analysis been obtained, and been approved by the attending physician?
- What are the anticipated wages?
- Are transportation and other related expenses being covered?
- What are the indicators that progress is being made?
- How much support can be expected from the family?
- What problems can be anticipated?