SHB 2073 -
By Representative Conway
ADOPTED 03/08/2007
Strike everything after the enacting clause and insert the following:
"Sec. 1 RCW 51.32.095 and 1999 c 110 s 1 are each amended to read
as follows:
(1) One of the primary purposes of this title is to enable the
injured worker to become employable at gainful employment. To this
end, the department or self-insurers shall utilize the services of
individuals and organizations, public or private, whose experience,
training, and interests in vocational rehabilitation and retraining
qualify them to lend expert assistance to the supervisor of industrial
insurance in such programs of vocational rehabilitation as may be
reasonable to make the worker employable consistent with his or her
physical and mental status. Where, after evaluation and recommendation
by such individuals or organizations and prior to final evaluation of
the worker's permanent disability and in the sole opinion of the
supervisor or supervisor's designee, whether or not medical treatment
has been concluded, vocational rehabilitation is both necessary and
likely to enable the injured worker to become employable at gainful
employment, the supervisor or supervisor's designee may, in his or her
sole discretion, pay or, if the employer is a self-insurer, direct the
self-insurer to pay the cost as provided in subsection (3) of this
section or section 2 of this act, as appropriate. An injured worker
may not participate in vocational rehabilitation under this section or
section 2 of this act if such participation would result in a payment
of benefits as described in RCW 51.32.240(5), and any benefits so paid
shall be recovered according to the terms of that section.
(2) When in the sole discretion of the supervisor or the
supervisor's designee vocational rehabilitation is both necessary and
likely to make the worker employable at gainful employment, then the
following order of priorities shall be used:
(a) Return to the previous job with the same employer;
(b) Modification of the previous job with the same employer
including transitional return to work;
(c) A new job with the same employer in keeping with any
limitations or restrictions;
(d) Modification of a new job with the same employer including
transitional return to work;
(e) Modification of the previous job with a new employer;
(f) A new job with a new employer or self-employment based upon
transferable skills;
(g) Modification of a new job with a new employer;
(h) A new job with a new employer or self-employment involving on-the-job training;
(i) Short-term retraining and job placement.
(3)(a) ((Except as provided in (b) of this subsection)) For
vocational plans approved prior to July 1, 1999, costs for vocational
rehabilitation benefits allowed by the supervisor or supervisor's
designee under subsection (1) of this section may include the cost of
books, tuition, fees, supplies, equipment, transportation, child or
dependent care, and other necessary expenses for any such worker in an
amount not to exceed three thousand dollars in any fifty-two week
period except as authorized by RCW 51.60.060, and the cost of
continuing the temporary total disability compensation under RCW
51.32.090 while the worker is actively and successfully undergoing a
formal program of vocational rehabilitation.
(b) ((Beginning with vocational rehabilitation plans approved on or
after)) When the department has approved a vocational plan for a worker
between July 1, 1999, through December 31, 2007, costs for vocational
rehabilitation benefits allowed by the supervisor or supervisor's
designee under subsection (1) of this section may include the cost of
books, tuition, fees, supplies, equipment, child or dependent care, and
other necessary expenses for any such worker in an amount not to exceed
four thousand dollars in any fifty-two week period except as authorized
by RCW 51.60.060, and the cost of transportation and continuing the
temporary total disability compensation under RCW 51.32.090 while the
worker is actively and successfully undergoing a formal program of
vocational rehabilitation.
(c) The expenses allowed under (a) or (b) of this subsection may
include training fees for on-the-job training and the cost of
furnishing tools and other equipment necessary for self-employment or
reemployment. However, compensation or payment of retraining with job
placement expenses under (a) or (b) of this subsection may not be
authorized for a period of more than fifty-two weeks, except that such
period may, in the sole discretion of the supervisor after his or her
review, be extended for an additional fifty-two weeks or portion
thereof by written order of the supervisor.
(d) In cases where the worker is required to reside away from his
or her customary residence, the reasonable cost of board and lodging
shall also be paid.
(e) Costs paid under this subsection shall be chargeable to the
employer's cost experience or shall be paid by the self-insurer as the
case may be.
(4) In addition to the vocational rehabilitation expenditures
provided for under subsection (3) of this section and section 2 of this
act, an additional five thousand dollars may, upon authorization of the
supervisor or the supervisor's designee, be expended for: (a)
Accommodations for an injured worker that are medically necessary for
the worker to participate in an approved retraining plan; and (b)
accommodations necessary to perform the essential functions of an
occupation in which an injured worker is seeking employment, consistent
with the retraining plan or the recommendations of a vocational
evaluation. The injured worker's attending physician must verify the
necessity of the modifications or accommodations. The total
expenditures authorized in this subsection and the expenditures
authorized under RCW 51.32.250 shall not exceed five thousand dollars.
(5) When the department has approved a vocational plan for a worker
prior to January 1, 2008, regardless of whether the worker has begun
participating in the approved plan, costs for vocational rehabilitation
benefits allowed by the supervisor or supervisor's designee under
subsection (1) of this section are limited to those provided under
subsections (3) and (4) of this section.
For vocational plans approved for a worker between January 1, 2008,
through June 30, 2013, total vocational costs allowed by the supervisor
or supervisor's designee under subsection (1) of this section shall be
limited to those provided under the pilot program established in
section 2 of this act, and vocational rehabilitation services shall
conform to the requirements in section 2 of this act.
(6) The department shall establish criteria to monitor the quality
and effectiveness of rehabilitation services provided by the
individuals and organizations used under subsection (1) of this section
and under section 2 of this act. The state fund shall make referrals
for vocational rehabilitation services based on these performance
criteria.
(((6))) (7) The department shall engage in, where feasible and
cost-effective, a cooperative program with the state employment
security department to provide job placement services under this
section and section 2 of this act.
(((7))) (8) The benefits in this section and section 2 of this act
shall be provided for the injured workers of self-insured employers.
Self-insurers shall report both benefits provided and benefits denied
under this section and section 2 of this act in the manner prescribed
by the department by rule adopted under chapter 34.05 RCW. The
director may, in his or her sole discretion and upon his or her own
initiative or at any time that a dispute arises under this section or
section 2 of this act, promptly make such inquiries as circumstances
require and take such other action as he or she considers will properly
determine the matter and protect the rights of the parties.
(((8))) (9) Except as otherwise provided in this section or section
2 of this act, the benefits provided for in this section and section 2
of this act are available to any otherwise eligible worker regardless
of the date of industrial injury. However, claims shall not be
reopened solely for vocational rehabilitation purposes.
NEW SECTION. Sec. 2 A new section is added to chapter 51.32 RCW
to read as follows:
(1)(a) The legislature intends to create improved vocational
outcomes for Washington state injured workers and employers through
legislative and regulatory change under a pilot program for the period
of January 1, 2008, through June 30, 2013. This pilot vocational
system is intended to allow opportunities for eligible workers to
participate in meaningful retraining in high demand occupations,
improve successful return to work and achieve positive outcomes for
workers, reduce the incidence of repeat vocational services, increase
accountability and responsibility, and improve cost predictability. To
facilitate the study and evaluation of the results of the proposed
changes, the department shall establish the temporary funding of
certain state fund vocational costs through the medical aid account to
ensure the appropriate assessments to employers for the costs of their
claims for vocational services in accordance with section 3 of this
act.
(b) An independent review and study of the effects of the pilot
program shall be conducted to determine whether it has achieved the
appropriate outcomes at reasonable cost to the system. The review
shall include, at a minimum, a report on the department's performance
with regard to the provision of vocational services, the skills
acquired by workers who receive retraining services, the types of
training programs approved, whether the workers are employed, at what
jobs and wages after completion of the training program and at various
times subsequent to their claim closure, the number and demographics of
workers who choose the option provided in subsection (4)(b) of this
section, and their employment and earnings status at various times
subsequent to claim closure. The department may adopt rules, in
collaboration with the subcommittee created under (c)(iii) of this
subsection, to further define the scope and elements of the required
study. Reports of the independent researcher are due on December 1,
2010, December 1, 2011, and December 1, 2012.
(c) In implementing the pilot program, the department shall:
(i) Establish a vocational initiative project that includes
participation by the department as a partner with WorkSource, the
established state system that administers the federal workforce
investment act of 1998. As a partner, the department shall place
vocational professional full-time employees at pilot WorkSource
locations; refer some workers for vocational services to these
vocational professionals; and work with employers in work source pilot
areas to market the benefits of on-the-job training programs and with
community colleges to reserve slots in high demand programs. These on-the-job training programs and community college slots may be considered
by both department and private sector vocational professionals for
vocational plan development. The department will also assist
stakeholders in developing additional vocational training programs in
various industries, including but not limited to agriculture and
construction. These programs will expand the choices available to
injured workers in developing their vocational training plans with the
assistance of vocational professionals.
(ii) Develop and maintain a register of state fund and self-insured workers who have been retrained or have selected any of the
vocational options described in this section for at least the duration
of the pilot program.
(iii) Create a vocational rehabilitation subcommittee made up of
members appointed by the director for at least the duration of the
pilot program. This subcommittee shall provide the business and labor
partnership needed to maintain focus on the intent of the pilot
program, as described in this section, and provide consistency and
transparency to the development of rules and policies. The
subcommittee shall report to the director at least annually and
recommend to the director and the legislature any additional statutory
changes needed, which may include extension of the pilot period. The
subcommittee shall provide input and oversight with the department
concerning the study required under (b) of this subsection. The
subcommittee shall provide recommendations for additional changes or
incentives for injured workers to return to work with their employer of
injury.
(iv) The department shall develop an annual report concerning
Washington's workers' compensation vocational rehabilitation system to
the legislature and to the subcommittee by December 1, 2009, and
annually thereafter with the final report due by December 1, 2012. The
annual report shall include the number of workers who have participated
in more than one vocational training plan beginning with plans approved
on January 1, 2008, and in which industries those workers were
employed. The final report shall include the department's assessment
and recommendations for further legislative action, in collaboration
with the subcommittee.
(2)(a) For the purposes of this section, the day the worker
commences vocational plan development means the date the department or
self-insurer notifies the worker of his or her eligibility for plan
development services.
(b) When vocational rehabilitation is both necessary and likely to
make the worker employable at gainful employment, he or she shall be
provided with services necessary to develop a vocational plan that, if
completed, would render the worker employable. The vocational
professional assigned to the claim shall, at the initial meeting with
the worker, fully inform the worker of the return-to-work priorities
set forth in RCW 51.32.095(2) and of his or her rights and
responsibilities under the workers' compensation vocational system.
The department shall provide tools to the vocational professional for
communicating this and other information required by RCW 51.32.095 and
this section to the worker.
(c) On the date the worker commences vocational plan development,
the department shall also inform the employer in writing of the
employer's right to make a valid return-to-work offer during the first
fifteen days following the commencement of vocational plan development.
To be valid, the offer must be for bona fide employment with the
employer of injury, consistent with the worker's documented physical
and mental restrictions as provided by the worker's health care
provider. When the employer makes a valid return-to-work offer, the
vocational plan development services and temporary total disability
compensation shall be terminated effective the starting date for the
job without regard to whether the worker accepts the return-to-work
offer. Following the fifteen-day period, the employer may still
provide, and the worker may accept, any valid return-to-work offer.
The worker's acceptance of such an offer shall result in the
termination of vocational plan development or implementation services
and temporary total disability compensation effective the day the
employment begins.
(3)(a) All vocational plans must contain an accountability
agreement signed by the worker detailing expectations regarding
progress, attendance, and other factors influencing successful
participation in the plan. Failure to abide by the agreed expectations
shall result in suspension of vocational benefits pursuant to RCW
51.32.110.
(b) Any formal education included as part of the vocational plan
must be for an accredited or licensed program or other program approved
by the department. The department shall develop rules that provide
criteria for the approval of nonaccredited or unlicensed programs.
(c) The vocational plan for an individual worker must be completed
and submitted to the department within ninety days of the day the
worker commences vocational plan development. The department may
extend the ninety days for good cause. Criteria for good cause shall
be provided in rule. The frequency and reasons for good cause
extensions shall be reported to the subcommittee created under
subsection (1)(c)(iii) of this section.
(d) Costs for the vocational plan may include books, tuition, fees,
supplies, equipment, child or dependent care, training fees for on-the-job training, the cost of furnishing tools and other equipment
necessary for self-employment or reemployment, and other necessary
expenses in an amount not to exceed twelve thousand dollars. This
amount shall be adjusted effective July 1 of each year for vocational
plans or retraining benefits available under subsection (4)(b) of this
section approved on or after this date but before June 30 of the next
year based on the average percentage change in tuition for the next
fall quarter for all Washington state community colleges.
(e) The duration of the vocational plan shall not exceed two years
from the date the plan is implemented. The worker shall receive
temporary total disability compensation under RCW 51.32.090 and the
cost of transportation while he or she is actively and successfully
participating in a vocational plan.
(f) If the worker is required to reside away from his or her
customary residence, the reasonable cost of board and lodging shall
also be paid.
(4) Vocational plan development services shall be completed within
ninety days of commencing. During vocational plan development the
worker shall, with the assistance of a vocational professional,
participate in vocational counseling and occupational exploration to
include, but not be limited to, identifying possible job goals,
training needs, resources, and expenses, consistent with the worker's
physical and mental status. A vocational rehabilitation plan shall be
developed by the worker and the vocational professional and submitted
to the department or self-insurer. Following this submission, the
worker shall elect one of the following options:
(a) Option 1: The department or self-insurer implements and the
worker participates in the vocational plan developed by the vocational
professional and approved by the worker and the department or
self-insurer. For state fund claims, the department must review and
approve the vocational plan before implementation may begin. If the
department takes no action within fifteen days, the plan is deemed
approved. The worker may, within fifteen days of approval of the plan
by the department, elect option 2.
(i) Following successful completion of the vocational plan, any
subsequent assessment of whether vocational rehabilitation is both
necessary and likely to enable the injured worker to become employable
at gainful employment under RCW 51.32.095(1) shall include
consideration of transferable skills obtained in the vocational plan.
(ii) If a vocational plan is successfully completed on a claim
which is thereafter reopened as provided in RCW 51.32.160, the cost and
duration available for any subsequent vocational plan is limited to
that in subsection (3)(d) and (e) of this section, less that previously
expended.
(b) Option 2: The worker declines further vocational services
under the claim and receives an amount equal to six months of temporary
total disability compensation under RCW 51.32.090. The award is
payable in biweekly payments in accordance with the schedule of
temporary total disability payments, until such award is paid in full.
These payments shall not include interest on the unpaid balance.
However, upon application by the worker, and at the discretion of the
department, the compensation may be converted to a lump sum payment.
The vocational costs defined in subsection (3)(d) of this section shall
remain available to the worker, upon application to the department or
self-insurer, for a period of five years. The vocational costs shall,
if expended, be available for programs or courses at any accredited or
licensed institution or program from a list of those approved by the
department for tuition, books, fees, supplies, equipment, and tools,
without department or self-insurer oversight. The department shall
issue an order as provided in RCW 51.52.050 confirming the option 2
election, setting a payment schedule, and terminating temporary total
disability benefits. The department shall thereafter close the claim.
(i) If within five years from the date the option 2 order becomes
final, the worker is subsequently injured or suffers an occupational
disease or reopens the claim as provided in RCW 51.32.160, and
vocational rehabilitation is found both necessary and likely to enable
the injured worker to become employable at gainful employment under RCW
51.32.095(1), the duration of any vocational plan under subsection
(3)(e) of this section shall not exceed eighteen months.
(ii) If the available vocational costs are utilized by the worker,
any subsequent assessment of whether vocational rehabilitation is both
necessary and likely to enable the injured worker to become employable
at gainful employment under RCW 51.32.095(1) shall include
consideration of the transferable skills obtained.
(iii) If the available vocational costs are utilized by the worker
and the claim is thereafter reopened as provided in RCW 51.32.160, the
cost available for any vocational plan is limited to that in subsection
(3)(d) of this section less that previously expended.
(iv) Option 2 may only be elected once per worker.
(c) The director, in his or her sole discretion, may provide the
worker vocational assistance not to exceed that in subsection (3) of
this section, without regard to the worker's prior option selection or
benefits expended, where vocational assistance would prevent permanent
total disability under RCW 51.32.060.
(5)(a) As used in this section, "vocational plan interruption"
means an occurrence which disrupts the plan to the extent the
employability goal is no longer attainable. "Vocational plan
interruption" does not include institutionally scheduled breaks in
educational programs, occasional absence due to illness, or
modifications to the plan which will allow it to be completed within
the cost and time provisions of subsection (3)(d) and (e) of this
section.
(b) When a vocational plan interruption is beyond the control of
the worker, the department or self-insurer shall recommence plan
development. If necessary to complete vocational services, the cost
and duration of the plan may include credit for that expended prior to
the interruption. A vocational plan interruption is considered outside
the control of the worker when it is due to the closure of the
accredited institution, when it is due to a death in the worker's
immediate family, or when documented changes in the worker's accepted
medical conditions prevent further participation in the vocational
plan.
(c) When a vocational plan interruption is the result of the
worker's actions, the worker's entitlement to benefits shall be
suspended in accordance with RCW 51.32.110. If plan development or
implementation is recommenced, the cost and duration of the plan shall
not include credit for that expended prior to the interruption. A
vocational plan interruption is considered a result of the worker's
actions when it is due to the failure to meet attendance expectations
set by the training or educational institution, failure to achieve
passing grades or acceptable performance review, unaccepted or
postinjury conditions that prevent further participation in the
vocational plan, or the worker's failure to abide by the accountability
agreement per subsection (3)(a) of this section.
NEW SECTION. Sec. 3 A new section is added to chapter 51.32 RCW
to read as follows:
(1) Costs paid for vocational services and plans shall be
chargeable to the employer's cost experience or shall be paid by the
self-insurer, as the case may be. For state fund vocational plans
implemented on or after January 1, 2008, the costs may be paid from the
medical aid fund at the sole discretion of the director under the
following circumstances:
(a) The worker previously participated in a vocational plan or
selected a worker option as described in section 2(4) of this act;
(b) The worker's prior vocational plan or selected option was based
on an approved plan or option on or after January 1, 2008;
(c) For state fund employers, the date of injury or disease
manifestation of the subsequent claim is within the period of time used
to calculate their experience factor;
(d) The subsequent claim is for an injury or occupational disease
that resulted from employment and work-related activities beyond the
worker's documented restrictions.
(2) The vocational plan costs payable from the medical aid fund
shall include the costs of temporary total disability benefits, except
those payable from the supplemental pension fund, from the date the
vocational plan is implemented to the date the worker completes the
plan or ceases participation. The vocational costs paid from the
medical aid fund shall not be charged to the state fund employer's cost
experience.
(3) For the duration of the vocational pilot program, all expenses
to the medical aid fund resulting from the director's discretionary
decisions as provided in subsection (1) of this section shall be
separately documented as a medical aid fund expenditure and reported to
the vocational rehabilitation subcommittee and the legislature
annually. This report shall include the number of claims for which
relief to the state fund employer was provided and the average cost per
claim. A report to the vocational rehabilitation subcommittee and the
legislature shall also be made annually including the number of claims
and average cost per claim reported by self-insured employers for
claims meeting the requirements in subsection (1)(a), (b), and (d) of
this section.
NEW SECTION. Sec. 4 The department of labor and industries shall
adopt rules necessary to implement this act.
NEW SECTION. Sec. 5 This act takes effect January 1, 2008.
NEW SECTION. Sec. 6 This act expires June 30, 2013."
Correct the title.
EFFECT: Requires the Department of Labor and Industries to assist stakeholders in developing vocational training programs in various industries, including but not limited to agriculture and construction. Prohibits a worker who has obtained workers' compensation benefits through willful misrepresentation from receiving vocational rehabilitation benefits. Removes the provisions that allowed self- insured employers to request reimbursement from the medical aid fund for the cost of vocational services in certain circumstances. Removes provisions that authorized the vocational rehabilitation subcommittee to make recommendations about assessments to self-insured employers.