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Eligibility - Worker's Compensation

Categorized In: Case Services - Referral to Eligibility

Approved Date: October 02, 2018

Owner: Angela Fujan

Nebraska VR Rehabilitation and Service Specialists are not certified by the Workers' Compensation Court to act as a Workers’ Compensation court-certified counselor for an injured worker.

Nebraska VR does not provide vocational assessments or evaluations requested by attorneys, insurance companies, or private rehabilitation counselors for the purpose of seeking benefits through the Workers' Compensation Court for an injured worker.

Nebraska VR is able to provide and purchase services to an individual being served under a Workers' Compensation Court approved rehabilitation plan as long as

  • (1) Nebraska Workers’ Compensation Court never funds that service,
  • (2) the injured worker meets the eligibility criteria for the Nebraska VR program, and
  • (3) develops an Individualized Plan for Employment.

It is permissible for Nebraska VR staff to provide job placement services to WC clients when these services are requested by an individual’s Court-Certified Rehab Counselor.

  • Determine the official status of their Workers Compensation case.
    • Worker’s Compensation case is closed/settled – proceed as typical VR referral.
    • WC case not settled – determine the following:
    • Maximum Medical Improvement (permanent impairment & released to work)
    • If so, has a Court Certified Rehabilitation Specialist been assigned?
    • If so, discuss direction of WC Case and what additional services VR can provide
  • Conduct Employment Discussion
    • Determine request for services is consistent with NE VR Policy
    • Add all involved parties to VR Release form.
  • Determine eligibility and placement in a priority group
  • Develop IPE
    • Information to justify the job goal and plan can be obtained from the court-certified and the individual
    • IPE job goal must match the WC Plan job goal, but not duplicate services.
      • Disagreement about job goal should be addressed with the court-certified rehab counselor by the VR specialist and office director
      • If not resolved, contact the VR Director of Counseling
  1. Determine the status of the Worker Compensation (WC) case. Contact one of the Rehabilitation Specialists at the Workers' Compensation Court (402-471-6468). This is public information and a release is not required, but best practice is to ask the applicant's permission and call the individual in your office.
    • If the WC case is settled/closed - proceed as a regular VR referral.
    • If the WC case is not settled - determine if the applicant has reached Maximum Medical Improvement (MMI)?
      • If the individual has NOT reached MMI - Do not proceed with the VR Application. It is difficult to determine VR Eligibility until MMI has been met, as there is a question of permanent impairment. Explain this to the applicant and encourage him or her to recontact Nebraska VR after reaching MMI.
      • If the individual has reached MMI it is recommended the individual and the VR Specialist or Office Director contact the Court Certified Rehabilitation Specialist (if one has been assigned) while the client is in the VR office to understand the direction of the WC case and what additional services NE VR can provide. If a decision is made to open a NE VR case the Court Certified Rehabilitation Specialist should be added to the information release for future communication. If the client has a Worker Compensation Lawyer his/her name should also be added to the release.
    • An individual being referred to NE VR can be referred for one of two reasons:
      • Placement Services - A referral for placement services from a Court-Certified Rehab Counselor must be made to the Office Director who will assign the case to an Employment Specialist. The referral is made because the Certified Rehab Counselor have access to all available services for the WC client, except placement services.This case will still need to follow VR Eligibility and VR Process.
      • Case Coordination - A referral for case coordination or a self-referral does not need to go to the Office Director first. Case coordination services provides for VR services that are not provided by the Certified Rehab Counselor, insurance company, etc. VR does not supplant services that should be provided by other agencies or individuals.
  2. Conduct employment discussion. Determine if the request for services is consistent with Nebraska VR Policy and Workers' Compensation rules.
  3. Determine eligibility and placement in a priority group.
    • Information required for eligibility can be obtained from the Court-Certified Rehab Counselor, Worker's Compensation Court, lawyer, medical professional and/or from the individual.
    • If there is disagreement about the job readiness of the individual the VR Specialist and Office Director should discuss the issues with the Court-Certified Rehab Counselor. If resolution is not reached, contact the VR Program Director of Counseling.
  4. Develop IPE
    • The VR Plan must be consistent with the WC Plan.
    • Information needed to justify the IPE can be obtained from the Court-Certified Rehab Counselor and from the individual. The individual may have participated in vocational and/or Loss of Earnings Assessments.
    • For a referral for placement services, the individual and VR Specialist must agree to the job goal on the approved Workers' Comp Plan.
    • For a referral for case coordination, the IPE must include the job goal on the approved Workers' Compensation Plan and only the services that are not funded by Workers' Compensation.
    • If there is disagreement about the appropriateness of the job goal, the VR specialist and Office Director should discuss the issues with the Court-Certified Rehab Counselor. If resolution is not reached, contact the VR Director of Counseling.

Workers’ Compensation Court in Nebraska is designed to provide certain benefits to employees who sustain work-related injuries or occupational diseases. Most private employers in Nebraska are covered under the Nebraska Workers' Compensation Act and are required to carry a workers' compensation insurance policy.

Workers who experience a work-related injury are entitled to benefits that include:

  • Medical Benefits – all reasonable medical and hospital services, appliances, prescribed drugs, prosthetic devices and other supplies that are necessary as the result of the work-related injury.
  • Wage Loss Benefits –Payments may be paid to the injured worker and may continue until the individual returns to work. There are two classifications of benefits, total and partial. Total benefits may be further classified into temporary total or permanent total. Partial benefits are further classified into temporary partial, permanent partial loss of a member, or permanent partial to the body as a whole. Individuals receive different amounts of compensation depending upon the classification and the wages they were earning.
  • Death Benefits – If the injury results in death the spouse and dependent children are paid death benefits plus there is a burial benefit.
  • Vocational Rehabilitation Benefits – When, as a result of an injury, the employee is unable to return to suitable employment for which they had previous training or work experience the employee is entitled to Workers’ Compensation vocational rehabilitation services. The injured worker and the employer/insurer must try to agree to a court-certified vocational rehabilitation counselor. If they cannot agree the Workers’ Compensation Court will appoint a counselor. Note: Nebraska VR Specialists are not certified by the court.
  • Worker's Compensation is a return to work first program. The Worker's Compensation Rehabilitation Counselor is required to determine the following steps when submitting a plan.
    • Can the individual return to the same employer in the same position?
    • Can the individual return to the same employer in a different position?
    • Can the individual return to a different employer in the same position he/she was injured in?
    • Can the individual return to a different employer in a different position?
    • If none of the above, does the individual need to go to school to make the same wage they were injured at? WC is unable to consider training until all of the above questions have been addressed.
  • The Court-Certified Counselor evaluates the individual, develops a rehabilitation plan, and submits the plan to the Workers' Compensation Court. In preparing this plan the court-certified counselor must determine whether the individual could return to their previous job, a different job with their previous employer, or a comparable job in the community. Often the WC plan developed includes only job placement with mileage reimbursement while looking for employment. If the individual is unable to return to previous employment, a different job with the employer or work in a comparable job, a re-training plan may be submitted. The insurer pays for the costs of assessment and plan development.
  • Written plans must be approved by the Workers’ Compensation Court and the insurance company. The Workers’ Compensation Court employs three rehabilitation specialists to approve and oversee plans. The individual will receive wage loss benefits and the court will pay for costs associated with the plan through the Workers’ Compensation Trust Fund. The Trust Fund was established by assessing a fee to all workers’ compensation insurers and self-insured employers covered under the Workers’ Compensation law.
  • Services typically paid for by the trust fund include required tuition, fees, books, supplies, mileage, tools, equipment and uniforms.
  • Services not funded by the trust fund include assistive technology, computers, interview clothing, childcare, car repairs, medications, glasses, and independent living training.
  • Court-Certified Vocational Rehabilitation Counselors are paid for the amount of time they spend providing services. They do not receive payment for job placement services unless they actually spend time providing, arranging or monitoring that service.
  • Injured workers can request information about workers’ compensation vocational rehabilitation benefits by contacting the Workers’ Compensation Court at (402) 471-6468 or 1-800-599-5155. The mailing address is PO Box 98908, Lincoln, NE 68509-8908. Information can also be accessed on the court’s website www.nol.org/workcomp.

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