Original Notice.

     Preproposal statement of inquiry was filed as WSR 02-01-136.

     Title of Rule: Chapter 296-19A WAC, Vocational rehabilitation.

     Purpose: Proposed chapter 296-19A WAC will make amendments and revisions to the existing chapter 296-19A WAC to clarify language and make technical and original changes. The proposed chapter will be the basis for vocational rehabilitation for industrial insurance.

     The new section WAC 296-19A-025 moves language from the existing WAC 296-19A-020 to define criteria the department considers when determining whether vocational rehabilitation services will be offered to industrially injured or ill workers.

     New section WAC 296-19A-065 establishes ability to work assessment (AWA) services criteria.

     New section WAC 296-19A-125 clarifies the purpose of forensic services.

     New section WAC 296-19A-135 sets forth the department's reporting requirements for forensic services.

     New section WAC 296-19A-137 establishes the department's requirements for a stand alone job analysis referral type.

     New section WAC 296-19A-191 establishes prejob accommodations available for injured workers.

     New section WAC 296-19A-192 establishes funding available for prejob accommodations.

     New section WAC 296-19A-193 establishes service requirements for prejob accommodations.

     New section WAC 296-19A-245 moves provider protest appeal rights from WAC 296-19A-240.

     Statutory Authority for Adoption: RCW 51.04.020, 51.04.030, 51.32.095, 51.36.100, 51.36.110.

     Statute Being Implemented: RCW 51.32.095, 51.36.100, 51.36.110.

     Summary: The proposed revisions to existing chapter 296-19A WAC will:

•     Spell out additional detail on provider qualifications, billing processes and L&I auditing.

•     Explain more clearly the department's expectations of what services will be provided for each type of vocational referral, what reports to the department contain and when they will be submitted.

•     Address how providers are to be held accountable for the services they deliver (corrective actions and performance measurement).

     Reasons Supporting Proposal: In 1998-99, the Department of Labor and Industries (L&I) conducted a study of its vocational purchasing practices. Based on the recommendation of the department's project consultant, William H. Mercer, Inc., L&I concluded that its purchasing method of contracting with private sector vocational providers should be discontinued and the requirements of the contract should be placed in WAC. In addition, the Joint Legislative Audit and Review Committee conducted a performance audit of the department's workers' compensation activities. JLARC (21A) recommended that the department to "move toward higher standards of private vocational rehabilitation providers." In addition, other program improvements recommended both by JLARC and Mercer warranted significant changes to the vocational rehabilitation chapter 296-18A WAC. The department conducted a rule making and subsequently adopted chapter 296-19A WAC. A petition to repeal/amend chapter 296-19A WAC was filed with the Joint Administrative Rules Review Committee (JARRC). JARRC reviewed the petition and determined that the department has not provided an opportunity for meaningful input by department employees. JARRC recommended that the department review the chapter of rules and reopen the rules for further comment. Based on this recommendation, the department initiated a rule making by filing a CR-101. The department sought input from the public and its employees during the CR-101 phase. The input received was reviewed and considered during the preparation of the proposed amendments to chapter 296-19A WAC.

     Name of Agency Personnel Responsible for Drafting: Roy Plaeger-Brockway, Tumwater, Washington, (360) 902-5052; Implementation and Enforcement: Linda Murphy, Program Manager, Tumwater, Washington, (360) 902-6699 or Jody Moran, Program Manager, Tumwater, Washington, (360) 902-4300.

     Name of Proponent: Department of Labor and Industries, governmental.

     Rule is not necessitated by federal law, federal or state court decision.

     Explanation of Rule, its Purpose, and Anticipated Effects: The proposed revisions to existing chapter 296-19A WAC will:

•     Spell out additional detail on provider qualifications, billing processes and L&I auditing.

•     Explain more clearly the department's expectations of what services will be provided for each type of vocational referral, what reports to the department must contain and when they must be submitted.

•     Address how providers are to be held accountable for the services they deliver (corrective actions and performance measurement).

     The anticipated effects of the proposed revisions to existing chapter 296-19A WAC will include:

•     More efficient service delivery through more detailed billing requirements.

•     More highly qualified vocational providers delivering better quality service to injured workers.

•     More consistent application of the rules through better, more consistent definitions and easier to understand language.

•     Increased level of provider accountability for services rendered.

     Proposal Changes the Following Existing Rules: The current proposal will make revisions to chapter 296-19A WAC on vocational rehabilitation. The proposed revisions will make several changes to existing rule:

•     It organizes the rules more clearly, places the rules in clear rule-writing format and defines terms used in the rules more clearly and consistently.

•     Defines more clearly specific types of vocational rehabilitation services.

•     Makes technical changes and corrections to chapter 296-19A WAC.

•     Clarifies where providers can find their protest and appeal rights.

     A small business economic impact statement has been prepared under chapter 19.85 RCW.

     Legal Background for Rule Amendments: Each of the amendments to the existing WAC represents an effort to make the rules work better in order to attain the objectives and directives in the law. The Industrial Insurance Act (act) is to be liberally construed for the purposes of reducing to a minimum the suffering and economic loss caused by work related injuries and illnesses. RCW 51.04.010. To this end, one of the most important goals of the act is to enable injured workers to become employable at gainful employment. RCW 51.32.095(1). The department may provide vocational rehabilitation services to industrially injured workers where, in the department's sole discretion, vocational rehabilitation services are both necessary and likely to enable the injured worker to become employable at gainful employment. RCW 51.32.095(1). The department is directed to utilize the services of individuals and organizations whose experience, training, and interests in vocational rehabilitation and retraining qualify them to lend expert assistance in the provision of vocational rehabilitation services. RCW 51.32.095(1). In addition, the department is required to establish criteria to monitor the quality and effectiveness of rehabilitation services provided by vocational rehabilitation providers. RCW 51.32.095(5). Likewise, the department is required by law to supervise the provision of prompt, efficient and quality vocational services rendered to injured workers by qualified vocational providers. RCW 51.04.020, 51.04.030(1), 51.36.100, and 51.36.110. A "provider" is defined as "any person, firm, corporation, partnership, association, agency, institution, or other legal entity providing any kind of services related to the treatment of an industrially injured worker." RCW 51.08.095.

     Recognizing the strong public interest in ensuring that injured workers receive quality vocational services, the legislature enacted sweeping legislation in 1986 that gave the department broad authority to regulate and inspect vocational services under the act.

     The legislature finds and declares it to be in the public interest of the residents of the state of Washington that a proper regulatory and inspection program be instituted in connection with the provision of medical, chiropractic, dental, vocational and other health services to industrially injured workers pursuant to Title 51 RCW. In order to effectively accomplish such purpose and to assure that the industrially injured worker receives such services as are paid for by the state of Washington, the acceptance by the industrially injured worker of such services, and the request by a provider of services for reimbursement for providing such services, shall authorize the Department of Labor and Industries or the director's authorized representative to inspect and audit all records in connection with the provision of such services.

     RCW 51.36.100. The legislature specifically authorized the department to "conduct audits and investigations of providers of medical, chiropractic, dental, vocational, and other health services" furnished to injured workers. RCW 51.36.110(1). These audit provisions allow for post-payment evaluation of vocational services rendered to injured workers to ensure they conform with the act and rules adopted by the department. See Department of Labor & Indus. v. Kantor, 94 Wn. App. 764, 778, 973 P.2d 30 (1999). In addition, the department may "approve or deny applications to participate as a provider of services" to injured workers, as well as "terminate or suspend eligibility to participate as a provider of services" to injured workers based on the findings of an audit. RCW 51.36.110 (2), (3). In fulfilling the department's statutory responsibility to injured workers, the director is permitted to enact rules governing the provision of vocational services. RCW 51.04.030(1), 51.32.095.

     Overview of rule impacts:

     Small Business Economic Impact Analysis: The Regulatory Fairness Act, chapter 19.85 RCW, requires that the economic impact of proposed regulations on small businesses be examined relative to their impact on large businesses. The act outlines the requirements for a small business economic impact statement (SBEIS).² The agency must prepare an SBEIS when a proposed rule, or proposed rule amendments, have the potential of placing a more than minor economic impact on business.

     The proposed rule would have an impact on Job Training or Vocational Rehabilitation Services (SIC #8331). The minor impact threshold for this sector is sixty-six dollars (2002 dollars) per business.³ The SIC also has other activities such as job training and counseling for people who have not been injured. Only one hundred eight-nine out of the three hundred sixty-six companies provide vocational rehabilitation to workers insured through the department or self-insured providers. The SIC covers eight thousand seventy-three employees, where this rule affects only one thousand eight Vocational Rehabilitation Counselors (VRCs) or 12.5% of the SIC's employment.⁴ This analysis therefore only covers the one hundred eighty-nine companies actually affected by the rule.

Affected Businesses in the SIC 8331
	Number	Total Employment	Average Employment of VRCs
Small Businesses	170	379	2.2
Large Businesses	19	629	33.1

Table 1.

     The rule amendments affect providers of vocational rehabilitation services directly. The amendments also create indirect impacts to individuals receiving services and to those businesses, which self-insure.

     The largest beneficial impacts of the rule come from these amendments:

•     Proposed language change to WAC 296-19A-210 (1)(b) and (2)(b). The department is proposing that the deadline by which vocational rehabilitation providers must satisfy the educational and certification requirements be extended from December 1, 2006, to December 1, 2010.

     The largest cost impacts of the rule come from these amendments:

•     Proposed language change in WAC 296-19A-210(3). The proposed amendment provides that vocational providers must have five years experience in order to render forensic services as opposed to the prior three year requirement.

•     Proposed language addition in WAC 296-19A-210(4). This reduces confusion and places the interpretive policy requirement in WAC. The proposal clarifies that the VRC is directly responsible for the intern's work product.

•     Proposed addition of WAC 296-19A-137. The department is proposing the addition of a distinct referral type for a stand-alone job analysis. This will only affect the department providers and not self-insurers.

•     Proposed language addition in WAC 296-19A-400(2). This reduces confusion and places the interpretive policy requirement in WAC. The rules will require that paper copies of all records be maintained for audit purposes.

•     Proposed language change of WAC 296-19A-210 (4)(e). Previously there has been no limitation on length of internships in this chapter. The proposed rule limits an intern to work as an intern for up to sixty months full-time or part-time equivalent experience.

     Many proposed amendments will have small impacts which reduce costs to businesses and which are cost minimization features of the rule. The following cost reducing impacts were not calculated:

•     Proposed deletion of WAC 296-19A-030 (2)(b) and (c). The proposed revision establishes that the department will no longer be required to send reports to employers that do not request them. This will save employers who do not wish to receive these reports the time it takes to look at them before discarding them.

•     Proposed language addition in WAC 296-19A-060(2). The proposed amendment acknowledges that not all of the documentation requested in this section is always obtainable. The proposed change recognizes that this information is not always available and allows providers to document the absence of the information in the closing report.

•     Proposed language change in WAC 296-19A-100 (2)(h)(ii). This proposed amendment reduces confusion created by the word "form." The "form" mentioned is actually a statement requiring the signature of the provider and the injured worker. This change clarifies the intention of the process and the document available from the department.

•     Proposed language addition in WAC 296-19A-170(6). This proposed amendment would increase flexibility for providers and decreases costs. "Etc." is vague and ambiguous. The proposed language specifies the information required. Some providers believe that the DOT code is becoming outdated. However, no suitable replacement has yet been developed. The proposed language will allow providers to use the DOT code but also use other sources such as those used by the Bureau of Labor Statistics, as they become available. The proposed change will allow for advances in technology.

•     Proposed language change in WAC 296-19A-170(7). This proposed amendment would increase flexibility for providers. This information is only needed for occupational exposure claims. This addition allows providers to use their professional judgment.

•     Proposed language addition in WAC 296-19A-200(1). This proposed amendment would add flexibility to service provision. Some providers were confused regarding the applicability of this section to providers. The proposal clarifies that the provider's responsibility is to provide assistance to the employer when applying for job modification assistance.

•     Proposed language change in WAC 296-19A-240. The number of days to send in materials for a desk audit is being extended from ten days to thirty days. This gives people more time to prepare their materials.

     The following proposed amendments may impose costs for the handling of a case but the cost will be billed to the department so that no cost is actually imposed. The following cost shift items were not calculated:

•     Proposed addition of WAC 296-19A-100 (3)(c). This proposal generates greater flexibility on a case. The addition of the proposed language enables the department to determine whether further services are appropriate without making an additional referral. Providers will bill the department for the time.

•     Proposed language change in WAC 296-19A-110(1). The proposed language increases provider accountability by clarifying providers' responsibility to assist the injured worker in starting and progressing in the plan. Most providers do this already and the work is billed to the department.

     Other proposed amendments have no impact for purposes of the small business economic impact statement. These were reviewed and are listed in Appendix 1, chapter 296-19A WAC - summary of proposed WAC changes.

     Finally, the department decided not to include some suggested items in the proposed rule due to the burden they would place on providers.⁵ The department received the suggestions below during the prenotice inquiry (CR-101) phase from vocational providers and other stakeholders. The decision not to include these features reduces the potential cost that would have been imposed by the suggested amendment and makes the rule less burdensome. The department's rationale for not including the suggestion follows the idea.

     (1) Require current vocational providers to obtain a master's degree in any area with five graduate courses in rehabilitation or CRC. Require a master's degree in rehabilitation or a CRC for new hires to be able to render services to the department's injured workers.

     The department chose not to incorporate this suggestion into the proposed rules for the following reasons:

•     This requirement is unnecessarily burdensome to the vocational provider. The department is confident that the current requirements are sufficient to provide the vocational provider with the expertise to render quality services to Washington industrially injured or ill workers.

•     The department has identified, in CDMS, the minimum education, experience and knowledge requirements that providers must satisfy to be qualified to provide quality vocational rehabilitation services. While requiring all providers to obtain a CRC or ABVE would address the department's need to ensure quality vocational services, the CDMS credential is nationally recognized for practicing vocational counseling in a workers' compensation setting.

•     CDMS was developed out of a need to recognize rehabilitation counselors practicing in workers' compensation settings and other areas of disability management. The CDMS requirements are similar to the CRC requirements. Both require similar core knowledge, mentoring by a credentialed counselor, counseling experience, passing an exam, agreeing to a code of ethics, and maintaining continued professional education.

•     One of the options only addresses educational requirements, which is only one component of credentialing. The vocational rehabilitation profession through the credentialing bodies has established minimum requirements for more than education. They have also established an exam to measure core knowledge, requirements for training from a credentialed professional, continuing education expectations, and an ethical code of conduct.

     (2) The current audit notice allows providers to recreate records. Change the audit notice to forty-eight hours.

     The department chose not to incorporate this suggestion into the proposed rules for the following reasons:

•     The department believed that forty-eight hours was insufficient time to prepare materials and files for auditing and that this was unnecessarily burdensome to vocational providers.

•     The current audit notice of ten days is consistent with the notice set forth in the Medical Aid Rules and Fee Schedule for nonvocational providers.

•     The department believes that there should not be a concern in regard to the providers recreating records.

     (3) The term "timely fashion" is not defined in WAC 296-19A-030(1). Increase specificity by giving a timeframe (i.e. fifteen working days).

     The department chose not to incorporate this suggestion into the proposed rules for the following reasons:

•     The department believed that this would be unnecessarily burdensome to medical providers.

•     Enforcing timelines for medical providers would be burdensome to the department's claim staff.

     Analysis of Costs and Benefits to Small and Large Businesses: The rule amendments increase costs for providers. The ten year net present value of cost increases for the average business is $25,000 for small businesses and $485,000 for large businesses. On a per employee basis this comes to a net present value of cost per employee of $11,500 for small business and $14,600 for large business. The cost impact is not disproportionate.

     Data: The analysis uses data from two surveys.

     1. Credential Status of Vocational Service Providers, 2002 survey - A survey by the Gilmore Group in 2000 found that 29% of Washington state's providers had obtained a national credential. As of March 2002, the number had risen to 46%. The department sent a survey to remaining uncredentialed 54% (N=484) of providers inquiring on their current credential status. The response rate was 57%. Participants were asked the following:

     •     Are you currently working on a national credential, planning to obtain one some time in the future, not planning on obtaining a credential, or undecided?

     •     What credential do you plan to obtain and when do you anticipate obtaining it or when do you plan on starting the process?

     The results illustrated that of the remaining 64% of vocational providers that were uncredentialed, 31% were currently working toward a credential, twenty-six were planning to obtain a credential, 24% had no plans to obtain a credential and nineteen were undecided. 57% of respondents indicated that they would be obtaining a credential.

     2. Small business economic impact statement, 2002 survey - This survey covered 100% of the nineteen largest vocational rehabilitation providers and random sampled the small business providers. The survey sample was further stratified into three sets based on sampling of vocational rehabilitation counselors (VRCs): VRCs, VRCs who are qualified to do forensic referrals, and VRCs who provide supervision of interns. Thus, the stratification has six subsets, first the two large and small business subsets and second the three VRC subsets within the large and small subsets. The two hundred sixty-five individuals called were selected based on random sampling within the subsets.⁶ Gilmore Research conducted the survey in late September and early October 2002. They obtained two hundred one responses for a response rate of 76%. The numbers presented from this survey are weighted averages based on the proportion of the small and large businesses that fall into each of the VRC subsets.

Impact Breakdown for the Proposed Amendments
	Small Business		Large Business
Cost Reduction
Credential
Reduced Rehire Costs	$	139	$	2,066
Reduced Income Transfer Losses	$	3,048	$	49,532
Total	$	3,187	$	51,597
Present Value of 10 Years Income from New Referral Code	$	4,238	$	114,724
Present Value of New Referral	$	4,238	$	114,724
Cost Increases
Loss of Interns at the End of 60 Months (Present Value)		-		-
Supervision of Interns (annual)	$	3,801	$	63,509
Forensic
Income Loss to Companies (annual)	$	28.48	$	208.04
New Referral
Average Cost without Income Offset (first year)	$	1,751	$	1,639
Average Cost with Income Offset (first year)*	$	1,496	$	(5,284)
Maintaining Paper Copies
Current and Record Conversion - Year 1	$	920	$	59,289
Current Records - Following Years	$	348	$	18,857
Net Cumulative Impact
Average Net Impact Per Business
- Year 1	$	(6,245)	$	(117,723)
- Year 2	$	(4,177)	$	(82,575)
Average Present Value	$	(25,612)	$	(484,898)
Average Number of Employees	$	2.2	$	33.1
Net Cost Present Value per Employee	$	(11,488)	$	(14,647)
*a cost for small business but a net for large business.

Impact Breakdown for the Proposed Amendments
	Small Business		Large Business
Cost Reduction
Credential
Reduced Rehire Costs	$	139	$	2,066
Reduced Income Transfer Losses	$	3,048	$	49,532
Total	$	3,187	$	51,597
Present Value of 10 Years Income from New Referral Code	$	4,238	$	114,724
Present Value of New Referral	$	4,238	$	114,724
Cost Increases
Loss of Interns at the End of 60 Months (Present Value)
Supervision of Interns (annual)	$	3,801	$	63,509
Forensic
Income Loss to Companies (annual)	$	7.81	$	51.94
New Referral
Average Cost without Income Offset (first year)	$	1,751	$	1,639
Average Cost with Income Offset (first year)*	$	1,496	$	(5,284)
Maintaining Paper Copies
Current and Record Conversion - Year 1	$	920	$	59,289
Current Records - Following Years	$	348	$	18,857
Net Cumulative Impact
Average Net Impact Per Business
- Year 1	$	(6,224)	$	(117,567)
- Year 2	$	(4,157)	$	(82,419)
Average Present Value	$	(25,377)	$	(483,172)
Average Number of Employees	$	2.2	$	33.1
Net Cost Present Value per Employee	$	(11,383)	$	(14,595)
*a cost for small business but a net for large business.

Table 2.

     Breakdown by Cost Components:

     Keeping Paper Copies of All Records - Record Keeping Costs: The department currently requires providers to maintain paper copies of current referrals and records of the last five years of referrals. The proposed amendment moves this current interpretive policy requirement into WAC.

     Most firms already comply with the amendment. Survey data shows that only 13% of small businesses and 18% of large businesses keep part of the current referral files in electronic form. Only 5% of small businesses and 9% of large businesses keep part of their archived records in electronic form. In the first year businesses will have to convert both current and archived records. Survey data indicates that it will cost small businesses an average of $900 to shift to paper copies of all materials. The estimated cost to large businesses is $59,000. In subsequent years the expected cost per small business is $300 and for large business is $19,000.⁷

     While the information that the department has obtained indicates the results discussed above, the department has additional information that indicates that this may not be an accurate representation of the population sampled. However, because the department was unable to confirm this information, this will be an area the department investigates for the cost-benefit analysis.

Cost of Keeping Paper Copy of Records
	Small		Large
Total Cases Allocated per year ADJUSTED - 2002 so far x 4/3		5057		15303
Number of firms		170		19
Percent of firms keeping current files electronically		13.0%		17.6%
Percent of firms keeping records electronically		4.8%		9.2%
Weighted average cost per current file	$	11.71	$	23.41
Weighted average cost per record file	$	3.85	$	10.04
Average cost of records per firm	$	920.36	$	59,288.99
Cost of Current Files	$	348.24	$	18,857.30
Cost of Records	$	572.12	$	40,431.69
Annual cost of making all further records paper	$	114.42	$	8,086.34
*Weighed average costs have a serious small numbers problem, especially for large firms keeping current files electronically. Here only 6 VRCs are reporting very high costs, where others in the same firm are reporting full compliance. By comparison 18 VRCs from small firms are reporting in cost of converting records group and further there is less likelihood that the VRCs are reporting from the same firm as others reporting full compliance. That number has a higher likelihood of validity.

Table 3.

     New Stand Alone Job Analysis Referrals - Initial year costs of reporting and record-keeping, equipment, professional services and longer-term revenue increase: The proposed new referral type may impose new reporting and record-keeping costs. The intention of the new referral type is to generate faster resolution of a claim if either the injured worker or the business where the injury took place finds an opening and if all parties are amenable.

     The survey data indicates an estimated cost of upgrading the reporting and record-keeping systems for small business is approximately $1,700 and for large business is approximately

$1,600.⁸ These costs include labor and professional services necessary to upgrade the computer systems used for billing.

New Stand Alone Job Analysis
	Small Business		Large Business
Average Cost of Professional Services	$	1,916	$	1,348
% Using Professional Services	$	0	$	0
Cost	$	759	$	554
Average Hours of In-House Professional Services	$	17	$	25
Average Wage	$	47	$	25
Average Cost	$	803	$	616
Average Hours of In-House Clerical Services	$	13	$	21
Average Wage	$	14	$	23
Average Cost	$	190	$	469
Average Cost per Business	$	1,751	$	1,639
New Referrals Estimated first year shares of new referrals	$	43,469	$	131,531
Average income from new referrals	$	256	$	6,923
Total Cost	$	297,732	$	31,141
Net Cost Year 1	$	254,263	$	(100,390)
Per business basis	$	1,496	$	(5,284)
Estimated shares of subsequent annual new referrals	$	86,938	$	263,062
Present value of subsequent 9 years of referrals	$	676,912	$	2,048,226
Net Present Value Per Business for first 10 years	$	4,238	$	114,724

Table 4.

     The number of new referrals is generally lower in the first year and increases as needed.⁹ The department estimates that there may be at least five hundred stand alone job analysis referrals the first year and perhaps as many as 1,000 per year thereafter.¹⁰ The department expects that the new rate will be a flat rate of $250 to $450, however, the estimated rate of $350 is being used in this analysis. Thus, it is possible that at least $175,000 the first year in new referrals will be made. The amount may double in the next year. There is no special eligibility requirement for the stand alone job analysis referrals. Therefore, all providers will be eligible to receive the referrals.

     Based on the ratio for current assignments small businesses can expect $43,000 to $87,000 per year in new income and large businesses can expect $131,000 to $263,000 per year in new income. In the first year this would allocate $250 or $7,000 to small and large businesses respectively. In this first year for the individual small businesses, this means an expected net loss of $1,500 in the first year but a net increase in income for the remaining years. However, in the first year for large businesses this means an expected net gain of $5,000 and a net increase in income for subsequent years.¹¹ The present value for the next nine years of subsequent referrals is $4,000 and $114,000 for an average small or large business respectively.¹²

     While the information that the department has obtained indicates the results discussed above, the department has additional information that indicates that this may not be an accurate representation of the population sampled. However, because the department was unable to confirm this information, this will be an area the department investigates for the cost-benefit analysis.

     Increasing the experience required for forensic referrals - Foregone Revenue: Small businesses are expected to lose on average $28 and large businesses are expected to lose on average $208 per year. These low numbers are due to the low frequency of the referral, the relatively small number of hours per referral and the relatively small hourly rate difference.

     The rule amendment will require that unless a VRC is currently eligible to receive forensic referrals, the forensic referral go to a VRC with five years of experience rather than three years experience. Approximately 4.9% of the eligible VRCs working for small businesses and 4.4% of the eligible VRCs working for large businesses have the three years experience but do not have the five years of experience. This ratio is extrapolated to the ongoing population of VRCs.

     For companies employing VRCs that will be unable to receive forensic referrals, this means that they will only be able to bill the VRCs time for five other categories of referral at a lower rate. A forensic referral is billed at $91.50 per hour, where the other referrals would be billed at $75.70 per hour. This is a billable rate shift of $15.80 per hour.

     These referrals are rare, constituting less than 0.3% of all referrals. Thus most eligible VRCs and businesses do not receive them. Further, not all the VRCs in a business, which is eligible to receive a forensic referral, are eligible to receive one. This year small businesses will receive approximately twenty-nine such referrals and large businesses receive approximately forty-three such referrals.¹³ This means that an eligible small business will receive on average only .4 referrals per year and a large business would receive on average 2.5 referrals per year.

     The number of hours worked on these referrals is low relative to total hours worked. Small businesses spend on average twenty-three hours on forensic referral. Large businesses spend on average twenty-nine hours on such a referral. Thus the income shift for a single referral lost to a business is $365 for small businesses and $466 for large businesses. However, the probability that a given firm will actually experience such a loss because they have a VRC who was not placed on the referral list and that that VRC would have received a referral is only 2.1% for small business and 11% for large business.

Forensic Vocational Rehabilitation Counselor
	Small Business		Large Business
Number of new VRCs that may do Forensics		18.2		11.5
Number of Businesses with at least 1 eligible FRC		67		17
VRCs per Business		1.5		3.8
% of VRCs Eligible per Business		68%		11%
Annual Referral Total		29		43
Probability of a VRC receiving a referral		0.29		0.66
Probability of a business receiving a referral		0.44		2.51
% Current FRCs without 5 years experience		4.9%		4.4%
Estimated Number of FRCs without 5 years experience		18		11
Probability that a company employs an FRC without 5 years experience		27.1%		67.5%
Probability that the removed FRC would have received a forensic referral		7.8%		44.6%
Hourly rate of pay
VRC	$	75.70	$	75.70
Forensic VRC	$	91.50	$	91.50
Hourly income shift	$	15.80	$	15.80
Average Hours Billed	$	23.15	$	29.50
Estimated Average Income Shift per Referral	$	365.77	$	466.03
Estimated Average Income Shift/Company	$	28.48	$	208.04
Number of VRCs doing Forensics		84		53
Number of Businesses with at least 1 eligible FRC		67		17
VRCs per Business		1.3		3.1
% of VRCs Eligible per Business		56%		9%
Annual Referral Total		29		43
Probability of a VRC receiving a referral		0.35		0.81
Probability of a business receiving a referral		0.44		2.51
% Current FRCs without 5 years experience		4.9%		4.4%
Estimated Number of FRCs without 5 years experience		4		2
Probability that a company employs an FRC without 5 years experience		6.1%		13.8%
Probability that the removed FRC would have received a forensic referral		2.1%		11.1%
Hourly rate of pay
VRC	$	75.70	$	75.70
Forensic VRC	$	91.50	$	91.50
Hourly income shift	$	15.80	$	15.80
Average Hours Billed	$	23.15	$	29.50
Estimated Average Income Shift per Referral	$	365.77	$	46.03
Estimated Average Income Shift/Company	$	7.81	$	51.94

Table 5.

     Requiring Review of 100% of Intern Work - Labor costs and nonbillable expenditures: The proposed rule will require that a VRC review 100% of the work done on their referrals. The department estimates that this will cost the average small business $5,000 and the average large business $30,000 per year. However, this part of the analysis is characterized by anomalies in reporting and high variance.

     Currently only 20% of VRCs working for small businesses report that they review 100% of the work done by interns on their referrals. 39% of VRCs working for large businesses report that they review 100% of their intern's work. However, the average reported share of the work reviewed is 74% for small businesses and 78% for large businesses.

     VRCs at small businesses report needing an additional 3.8 hours per intern per week to review 100% of the work. VRCs at large businesses report needing an additional 4.1 hours per intern per week to review 100% of the work.¹⁴ This data was subject to high variance and those VRCs in large businesses who report reviewing 100% of the work actually report lower hours than those who do not review 100% of the intern's work. Thus, these values should be regarded with some skepticism.

     Some businesses, 30% of the small and 34% of the large businesses, report nonreimbursable costs associated with reviewing the intern's work. This data was subject to the same high variance and uncertainty as the hours data. Again the VRCs at large businesses who reported reviewing 100% of the intern's work gave lower associated cost estimates ($45 average) than those who reported reviewing less than 100% of the work ($60 average). This would imply that the rule would reduce the nonreimbursable costs. However, the department does not believe this is the case. Indeed the costs are more likely to be positive. In order to be conservative the "savings" is not subtracted from the remaining total cost.

     Setting a 60 Month Limit for Interns - No cost expected: The department currently allows interns three years to become certified. This policy is being moved into WAC but the deadline is being extended to five years.

Cost of Reviewing 100% of Intern Work
	Small Business		Large Business
% of VRCs with interns		46%		76%
Average number of interns per VRC with interns		1.69		2.18
Average number of VRCs		2.23		33.11
Percent of VRCs with interns reviewing 100% of intern work		20%		39%
Average percent of work reviewed		74%		78%
Average interns per business		0.41		3.09
Average number of hours of review per intern
Reported Added Hours per Intern		3.79		4.09
VRCs reviewing 100% report these hours for review		4.18		1.86
VRCs reviewing less than 100% report these hours for review		3.17		2.80
Change in Hours from shift to 100%		1.01		(0.94)
Change in Hours from shift to 100% - based on Regression estimate		1.57		1.03
Additional cost incurred per intern
% incurring cost		30%		34%
VRCs reviewing 100% report these costs for review	$	74.47	$	45.49
VRCs reviewing less than 100% report these costs for review	$	72.30	$	60.48
Estimated change in cost from shift to 100%	$	2.18	$	(14.99)
Value per hour of VRC time	$	75.70	$	75.70
Annual Cost for Businesses not Reviewing 100% of Intern Work	$	6,171.11	$	49,663.08
Hours	$	14.11	$	(822.71)
Added cost incurred	$	6,185.22	$	48,840.37
Average Annual Cost per Average Business		4,950.09		29,766.74
**Large Business Revised Estimate Ignoring Cost Reduction		4,950.09	$	30,268.15
Loss of interns at the end of 60 months
Average number of interns per VRC with interns		1.7		2.2
% of VRCs with interns		46%		76%
Average number of VRCs with Interns per Business		0.46		2.68
Average number of Interns per Business		0.79		5.86
Recently active interns		70.38		58.62
Average time from Intern Application to VRC in months		273		273
Standards Deviation time from Intern Application to VRC in Months		126		126
Probability of an intern remaining after 5 years given the Mean and Standard Deviation		3.59E-36		3.59E-36
Remaining Interns at cut off		2.53E-34		2.10E-34
Net Present Value of Billable hours	$	0	$	0

Table 6.

     It is highly likely that all interns who wish to become VRCs will do so. The average time it takes to move from the internship application to the approved VRC stage is two hundred seventy-three days. The standard deviation is one hundred twenty-six days. Given this the probability that an intern will be unable to become a VRC in the time allowed is very close to zero.¹⁵ Thus the probability that a company will experience any foregone income due to the loss of an intern is also close to zero.

     Analysis of Cost Reductions - Extending the deadline for obtaining a credential from 2006 to 2010 - Reduced labor costs and retained income: Extending the deadline to obtain a credential will give VRCs an additional four years to obtain a credential. Currently the department expects that between 13% and 23% of the VRCs will not be ready by 2006.¹⁶ This means that in 2006 businesses would have to replace up to two hundred thirty-four of their VRCs.¹⁷ By extending the deadline to 2010 the VRCs will have twice the remaining time to obtain the credential. It is hoped that the lower end, 13% loss would occur due to the reduced cost of obtaining the classes each year. This would drop the number of VRCs that businesses would have to replace to one hundred thirty-one and postpone the reduction four years. The small and large businesses would save $24,000 and $39,000 in personnel replacement costs respectively. This would result in a cost savings of $100 for the average small business and of $2,000 for the average large business.

     Some firms that get referrals based on a performance rating (CACO score) might lose referrals if they are assigned to a VRC, who does not obtain a credential by the deadline. The estimated average value of the loss of income for companies is $50,000 for large businesses and $3,000 for small businesses.¹⁸

     This extension offsets some of the forecast costs above. However, it creates no benefit for firms that already employ only credentialed VRCs.

Credential extension 2006 to 2010
Reduced Hiring Costs
		Small Business		Large Business		Total
% VRCs that would not be ready in 2006
High							23%	3
Low							13%	3
N of VRCs			379		629		1008	6
Current providers that would not be ready in 2006			88		146		234
Current providers remaining that would not be ready in 2010			49		82		131	2
Company: Reduced turn over cost per employee
	2006					$	533
	2010					$	474
Total: Reduced Turn Over Cost
	2006	$	46,914	$	77,860	$	124,774
	2010	$	23,265	$	38,611	$	61,876
Net		$	23,649	$	39,249	$	62,899
Reduction in average cost per company		$	139	$	2,066
Reduction in average cost per employee		$	62	$	62
Reduced Retraction of Referrals
Total Referrals - Estimated 2002			5,057		15,303
Average Number of Cases per VRC			19		19
Likely number of cases retracted
	2006		1,672		2,775		4,447
	2010		933		1,549		2,482
Average Revenue per Referral		$	1,384	$	1,514
	2006	$	2,055,804	$	3,733,790	$	5,789,594	1
	2010	$	1,019,473	$	1,851,586	$	2,871,058	1
Net Revenue due to Avoided Retracted Referrals		$	1,036,331	$	1,882,205	$	2,918,536
Assume that referrals are half done			50%		50%
Average net Revenue due to Reduced Retractions		$	3,048	$	49,532
1. Discounted value
2. Assumes undecided VRCs would be able to obtain a credential given the annual cost reduction and the increased time.
3. Credential Status of Vocational Service Providers, 2002 survey
6. Vocational Rehabilitation Data Base

Table 7.

     Analysis of Disproportionate Impact: The proposed amendments will not have a disproportionate impact on most affected companies. The analysis is based on the net present value of the costs for a ten year period. The average cost per small business employee is $11,500, which is less than the average cost per employee for large business of $14,600. Cost minimization is not required. However, the lack of a disproportionate impact is due to extensive cost minimization provided by the department. These are listed in pages 3 through 6.

     Involvement of Small Businesses in the Rule-Making Process: Since December of 2001, the department has worked to ensure business has not only been informed but also involved in the rule-making process. All businesses have been and will be treated equally in this process. However, this statement specifically addresses the department's involvement of small businesses. In addition, over 90% of vocational firms meet the statutory definition of a small business, therefore, any mention of "business" is inclusive of small businesses. As a result, the following paragraphs are focused around the department's involvement with small businesses in the rule-making process.

     Throughout the rule-making process the department has maintained a website notifying the public of progress and future developments in the rule making. Additionally, when the website has been updated the department has sent mass mailings to vocational providers and other interested parties notifying them of developments. The department has also updated the Vocational Technical Stakeholder Group (VTSG) at the group's bimonthly meetings. At the conclusion of these meetings, the department offers an opportunity for public comment through a public forum. At this time, interested parties, including small businesses, are able to comment and ask questions about issues related to vocational practices. To date, the VTSG has met in January, March, May, July and September and is planning to meet in November. The minutes from these meetings are published on the department's website.

     Further, the department conducted focus groups with the Washington State International Association of Rehabilitation Professionals (IARP) Management Group and VTSG in January and March of 2002 respectively. These focus groups were used to provide business an opportunity to provide commentary on the current chapter 296-19A WAC. In addition, all of Washington state vocational providers registered with the department were sent a survey in March of 2002 requesting commentary on the current chapter 296-19A WAC. Another survey was sent to vocational providers requesting information regarding the status of the credentialing process in March of 2002. In September of 2002, the department contracted with the Gilmore Research Group to conduct a phone survey to gather information for the SBEIS.

     The proposed amendments to chapter 296-19A WAC will be implemented via the publication of a provider bulletin at the end of 2003. Additionally, the department will mail copies of the final rules to the providers and all interested persons. The provider bulletin will be mailed to providers and all interested parties no later than December 2003. The final adopted rules will be mailed to affected providers and interested parties no later than April 2003. The department will publish final rules and supporting information on the department's Internet and Intranet homepage. In addition, the department will communicate final rules and supporting information to members of the Vocational Technical Stakeholder Group (VTSG). Further, the department will provide training to its staff and will develop several training seminars to be offered to the vocational community. Finally, the department will have available a provider toll free hotline to the provider community for assistance with questions regarding the final rules.

Appendix 1

Appendix 2

SUMMARY OUTPUT
Regression Statistics
Multiple R	0.739
R Square	0.546
Adjusted R Square	0.510
Standard Error	4.289
Observations	98.000
ANOVA
	df	SS	MS	F	Significance F
Regression	7.000	1987.937	283.991	15.437	0.000
Residual	90.000	1655.736	18.397
Total	97.000	3643.673
	Coefficients	Standard Error	t Stat	P-value	Lower 95%	Upper 95%	Lower 95.0%	Upper
Intercept	-9.344	1.939	-4.820	0.000	-13.196	-5.493	-13.196
pop	-1.427	0.943	-1.513	0.134	-3.301	0.447	-3.301
N intern	1.578	0.272	5.806	0.000	1.038	2.118	1.038
CAT2	-0.750	1.069	-0.701	0.485	-2.873	1.374	-2.873
CAT3	0.165	0.346	0.476	0.635	-0.523	0.852	-0.523
hrs/intern@100% est	0.757	0.101	7.484	0.000	0.556	0.959	0.556
$ for review	0.015	0.008	1.794	0.076	-0.002	0.031	-0.002
% reviewed	10.281	1.495	6.875	0.000	7.310	13.252	7.310
				Based on Regression
				6.04	4.29
				8.70	6.54
				1.69	2.18
				3.57	1.97
				5.14	3.00
				1.57	1.03	Added Hours per intern needed

¹ Washington Administrative Code.

² For the purposes of an SBEIS the term small business is defined as a business entity that has the purpose of making a profit and has fifty or fewer employees. However, the law also requires that the department analyze the relative cost for the 10% largest businesses by comparison with small businesses. This analysis uses the largest nineteen providers and compares the impact to a sample drawn from the remaining one hundred seventy providers.

³ The minimum value was set at $50 in 1993 at the 25th percentile of .1% of profits for all businesses and has been indexed to year 2002 dollars.

⁴ Based on 4 digit data from the Washington State Department of Employment Security, John Wines.

⁵ There were many other suggestions. The ones listed here had high potential costs and burden. These were some of the primary reasons for not including them in the rule.

⁶ Several VRCs were sampled more than once because some VRCs worked at more than one firm and many VRCs fit into more than one subset. This may have contributed to some refusals to participate. Further, some firms had more than one VRC who was called. Gilmore reported that the receptionist sometimes refused to put the second or third call through.

⁷ The large business cost estimates have a small numbers problem and are very sensitive to assumptions about the range center-points taken from the survey data. Further, the VRCs reporting high costs are often in the same class of firm, and the same firm number as VRCs reporting full compliance.

⁸ (A) 40% of small business and 41% of large businesses expect to use professional assistance to update their systems. Their costs may be higher than for other companies. The data for large businesses regarding professional service costs was edited to eliminate an outlier that was three standard deviations above the mean. Another outlier 2.6 standard deviations above the mean was eliminated, $50,000, because the value is eight times the next highest value reported by the class of respondent and the respondent characterized the value as only fairly accurate. (B) Wage data for this analysis was difficult to use. Some people reported annual salaries as monthly (e.g. 15,000) and some reported hourly as monthly (e.g. 8). Some monthly salaries were clearly part time in that at full time the wage would have been below the minimum wage. After reallocating some data, wages over $300 per hour were not allowed if the person indicated they were guessing and wages under minimum wage were not allowed.

⁹ Estimation based on experience with the new forensic referrals.

¹⁰ Jamie Scibelli. Early estimates are subject to change.

¹¹ Note the net does not include the cost of doing the work on the stand alone job analysis referral.

¹² Present value based on gross income and a 3% discount rate.

¹³ Based on extrapolation from 2002 data.

¹⁴ There are probably differences in interpretation between VRCs as to the meaning of 100% review. Among VRCs, who report reviewing 100% of the intern's work, the VRCs that work for small business report spending more hours (4.18) per intern per week on review than VRCs working for large businesses (1.86). Further the VRCs who work for large business, who do not review 100% of the work indicate that they spend more hours (2.8) in review. This unexpected result persists for reporting of costs associated with review. VRCs working for large companies who report reviewing 100% of an intern's work have lower costs per intern for review ($45 per week) than VRCs who report reviewing less than 100% ($61). All correlations of other intern related explanatory variables are weak. Further, the percentages and costs change depending on how missing data is handled. However, regression analysis on the reporting of actual hours, without the inclusion of the VRC's estimates of the number of hours of increase tend to support an increased level they report needing. See Appendix 2.

¹⁵ NORMDIST calculates the probability at 3.6 E-36. This calculation, which is giving the result in scientific notation, is the probability that an event (not finishing) will occur, given the known mean and standard deviation. The scientific notation indicates that the value is 3.6 divided by 10 to the 36th power or approximately zero.

¹⁶ The difference between these values is the number of VRCs who are undecided. In a four year period it is likely that a full time VRC would be unable to obtain the credential because of annual costs, distances, small children, caring for the elderly, or some other family or professional necessity. Doubling the remaining time frame may remove many temporary encumbrances and would mean that the VRC would have the annual costs including time and money reduced by 1/3.

¹⁷ Credential Status of Vocational Service Providers, 2002 survey.

¹⁸ Values are based on the assumption that the system will retract referrals from noncredentialed VRCs regardless of whether they are firm referral. This could be changed but the system as it is currently designed would automatically do this. Discount rate is 3%.

     A copy of the statement may be obtained by writing to Carmen Moore, Rules Coordinator, phone (360) 902-4206, fax (360) 902-4202.

     RCW 34.05.328 applies to this rule adoption. The proposed revisions to chapter 296-19A WAC constitute significant legislative rules of the Department of Labor and Industries.

     Hearing Location: Yakima Double Tree, Naches Room, 1507 North First Street, Yakima, WA 98901, on January 2, 2003, at 11:30 a.m. - 1:30 p.m.; at the Vancouver Red Lion, West River Rooms 1 & 2, 100 Columbia Street, Vancouver, WA 98660, on January 3, 2003, at 11:00 a.m. - 1:00 p.m.; at the Everett Howard Johnson, Shaw/Lopez Room, 3105 Pine Street, Everett, WA 98201, on January 7, 2003, at 8:00 a.m. - 10:00 a.m.; at the Sea-Tac Double Tree, Room Cascade 11, 18740 Pacific Highway South, Seattle, WA 98188, on January 7, 2003, at 3:00 p.m. - 5:00 p.m.; at the Spokane WestCoast RidPath, Legend B Room, 515 West Sprague Avenue, Spokane, WA 99201, on January 8, 2003, at 11:00 a.m. - 1:00 p.m.; and at the Tumwater L&I Service Location, Auditorium, 7273 Linderson Way, Tumwater, WA 98501, on January 10, 2003, at 11:00 a.m. - 1:00 p.m.

     Assistance for Persons with Disabilities: Contact Jamie Scibelli by December 20, 2002, TDD (360) 902-5797, or (360) 902-4791.

     Submit Written Comments to: Jamie Scibelli, Research Analyst, Department of Labor and Industries, P.O. Box 44322, Tumwater, WA 98501, e-mail Scij235@lni.wa.gov, fax (360) 902-4249, by January 10, 2003, by 5:00 p.m.

     Date of Intended Adoption: March 18, 2003.

October 22, 2002

Gary Moore

Director

OTS-5967.2

AMENDATORY SECTION(Amending WSR 00-18-078, filed 9/1/00, effective 6/1/01)

WAC 296-19A-010   Definitions.   (1) What does it mean to say an injured worker is employable?

     (a) "Employable" means having the skills and training that are commonly and currently necessary in the labor market to be capable of performing and obtaining gainful employment on a reasonably continuous basis when considering the worker's:

     (i) Age, education, and experience;

     (ii) Preexisting physical and mental limitations; and

     (iii) Physical and mental limitations caused, at least in part, by the worker's industrial injury or occupational disease.

     (b) Physical and/or mental conditions that arose after the industrial injury/occupational disease that were not caused or aggravated by the industrial injury/occupational disease are not considered in determining whether the worker is employable under the Industrial Insurance Act.

     (c) If there are no physical or mental ((limitations)) restrictions caused by the worker's industrial injury/occupational disease, the worker must be found employable under the Industrial Insurance Act.

     (2) What are vocational rehabilitation services? Vocational rehabilitation services are those provided by a vocational rehabilitation provider and include, but are not limited to, the following:

     (a) Gathering industrially injured or ill workers' work and/or education histories and physical capacities information;

     (b) Assessing industrially injured or ill workers' employability;

     (c) Developing, documenting, and writing vocational rehabilitation plans;

     (d) Monitoring injured workers' progress during training;

     (e) Writing progress reports;

     (f) Analyzing and documenting the transferable skills of the injured worker and writing transferable skills analyses;

     (g) Performing occupational research;

     (h) Conducting labor market surveys and writing labor market survey reports;

     (i) Conducting and writing job analyses;

     (j) Communicating with industrially injured or ill workers, employers, physicians and others;

     (k) Developing job modifications and work site modifications, as well as prejob accommodations, and writing reports for this work; and

     (l) All work done to obtain any job with any employer for injured workers referred for vocational rehabilitation services.

     (3) What is a vocational rehabilitation provider (provider)? A provider is any person, firm, partnership, corporation, or other legal entity that provides vocational rehabilitation services to industrially injured or ill workers, pursuant to RCW 51.32.095. A provider must meet the qualifications listed in WAC 296-19A-210.

     (4) What is an injured worker's labor market? Generally, the worker's relevant labor market is the geographic area where the worker was last gainfully employed. The labor market must be within a reasonable commuting distance and be consistent with the industrially injured or ill worker's physical and mental capacities. The exceptions to this rule are listed in the table below:

When a worker:	Then the department:
•     Relocates to a labor market other than at the time of injury and •     Returns to work and •     Suffers an aggravation of the work-related condition.	Uses the labor market where the industrially injured or ill worker worked at the time of the aggravation. This applies whether the department closed and reopened the claim or whether the claim remained open during the period of aggravation.
•     Relocates after the industrial injury/illness or aggravation and •     Now lives in a labor market with more employment opportunities than where the industrially injured or ill worker worked at the time of injury.	Uses the industrially injured or ill worker's current labor market. For example, an industrially injured or ill worker was injured in Forks but after the injury, moves to Tacoma. Provider would use Tacoma as the industrially injured or ill worker's labor market.
•     Relocates to a labor market other than at the time of injury or onset of illness and •     The ((industrial injury or occupational disease was a proximate cause of the)) move was proximately caused by the medical condition arising from the occupational injury or disease.	Uses the injured or ill worker's current labor market. For example, an industrially injured or ill worker moves to a drier climate due to an accepted asthma condition. Provider would use the labor market in the drier climate.

     (5) What is a labor market survey (LMS)? It is a survey of employers in an industrially injured or ill worker's labor market to obtain specific information (such as physical demands and qualifications) related to job possibilities.

     (6) What is a job analysis (JA)? It is the gathering, evaluating, and recording of accurate, objective data about the characteristics of a particular job.

     (7) What is a transferable skill? Transferable skills are any combination of learned or demonstrated behavior, education, training, work traits, and work-related skills that can be readily applied by the worker. They are skills that are interchangeable among different jobs and workplaces. Nonwork-related talents or skills that are both demonstrated and applicable may also be considered.

     (8) What is a transferable skills analysis? It is a systematic study of the transferable skill or skills a worker has demonstrated to see if that skill set makes him/her employable.

     (9) What are job modifications? Job modifications are adjustments or alterations made to the way a job is performed to accommodate the restrictions imposed by an industrial injury or occupational disease. The purpose of job modification benefits is to encourage employers to modify jobs to retain or hire injured workers. Job modifications are used when an employer-employee relationship exists, and they may include worksite adjustment; job restructuring; and/or tools, equipment or appliances.

     (10) What are prejob accommodations? Prejob accommodations are adjustments or alterations made to the way a job is performed to accommodate the restrictions imposed by an industrial injury or occupational disease. The purpose of prejob accommodation benefits is to make it possible for the worker to perform the essential functions of a job. Accommodations are used when an industrially injured or ill worker is engaged in a vocational rehabilitation plan or in a job search, and they may include tools, equipment or appliances.

[Statutory Authority: RCW 51.04.020, 51.04.030, 51.32.095, 51.36.100, 51.36.110. 00-18-078, § 296-19A-010, filed 9/1/00, effective 6/1/01.]

     (3) The likelihood that the worker will be employable after the vocational rehabilitation services are completed.))

[Statutory Authority: RCW 51.04.020, 51.04.030, 51.32.095, 51.36.100, 51.36.110. 00-18-078, § 296-19A-020, filed 9/1/00, effective 6/1/01.]

     (1) Whether the worker took advantage of and utilized vocational rehabilitation services offered in this or other claims;

     (2) The worker's ability and willingness to participate in and benefit from vocational rehabilitation services; and

     (3) The likelihood that the worker will be employable after the vocational rehabilitation services are completed.

[]

     (1) The attending physician shall maintain open communication with the industrially injured or ill worker's assigned vocational rehabilitation counselor and the referral source. The attending physician shall respond to any requests for information in a timely fashion and will do all that is possible to expedite the vocational rehabilitation process, including making an estimate of the worker's physical or mental capacities that affect the worker's employability.

     (2) The claims unit within the department shall((:

     (a))) notify the employer of the referral to a vocational rehabilitation provider((;

     (b) Send the employer a copy of the closing report; and

     (c) Give written notice to an injured worker if a complaint of noncooperation has been made)).

     (3) The employer shall assist the vocational rehabilitation counselor in any way necessary to collect data regarding the former gainful employment of the injured worker. Further, the employer will assist the vocational rehabilitation counselor and attending physician to determine whether or not a modified job could be made available for employment of the injured worker.

     (4) The injured worker shall cooperate with all reasonable requests from all responsible individuals in determining disability, developing and implementing the rehabilitation process. Should the injured worker fail to be cooperative, the sanctions as set out in RCW 51.32.110 shall be applied.

     (5) In assisting the injured worker to become employable at gainful employment, the provider is to follow the priorities as set out in RCW 51.32.095 and the requirements as set out in this chapter.

[Statutory Authority: RCW 51.04.020, 51.04.030, 51.32.095, 51.36.100, 51.36.110. 00-18-078, § 296-19A-030, filed 9/1/00, effective 6/1/01.]

[Statutory Authority: RCW 51.04.020, 51.04.030, 51.32.095, 51.36.100, 51.36.110. 00-18-078, § 296-19A-040, filed 9/1/00, effective 6/1/01.]

     (a) Summarized results of all contacts the provider had with the industrially injured or ill worker, employer of injury or current employer, and medical provider(s);

     (b) Summary of all actions taken including progress on previously recommended actions;

     (c) Identification and analysis of any barriers preventing completion of the referral; and

     (d) Description of the specific actions the provider intends to take to overcome barriers and the expected time frame to complete those actions.

     (2) Closing reports. The provider must always submit an early intervention closing report at the conclusion of services. In the report the provider must include or address:

     (a) A brief description of the industrially injured or ill worker's work history((:));

     (b) Summary of the industrially injured or ill worker's education, training, licenses, and certificates;

     (c) A medically reviewed job analysis for the job of injury and any other return to work options;

     (d) Description of the worker's medical status and physical capacities;

     (e) ((The date the worker returned to work and the monthly salary or wage, or document attempts to obtain this information;

     (f) Indication of which return to work priority relates to the situation;

     (g) Documentation that no return to work options exist with the employer of injury or current employer, if applicable;

     (h) Any other supporting documentation.)) Indication of which return to work priority relates to the situation;

     (f) Any other supporting documentation;

     (g) The date the worker returned to work and the monthly salary or wage, or document attempts to obtain this information, if applicable;

     (h) Documentation that no return to work options exist with the employer of injury or current employer, if applicable.

     (3) The provider must notify the department orally and in writing within two working days after learning of an unsuccessful return to work by the injured worker.

     (4) The provider must notify the department orally and in writing within two working days after learning of a return to work by the injured worker.

[Statutory Authority: RCW 51.04.020, 51.04.030, 51.32.095, 51.36.100, 51.36.110. 00-18-078, § 296-19A-060, filed 9/1/00, effective 6/1/01.]

     (1) Performing job analyses;

     (2) Conducting labor market surveys;

     (3) Assessing transferable skills;

     (4) Obtaining work restrictions;

     (5) Evaluating the injured worker's ability to work at the job of injury or any other job;

     (6) Coordinating with medical providers to obtain physical capacities and restriction information and a release to participate in vocational rehabilitation plan development services;

     (7) With authorization from the department, vocational testing may be used to evaluate the industrially injured or ill worker's ability to benefit from vocational rehabilitation services.

[]

     (a) Age, education and experience;

     (b) Transferable skills;

     (c) Preexisting physical and mental conditions and the effect of those conditions on the worker's employability;

     (d) Physical and mental conditions proximately caused by the worker's industrial injury or occupational disease and the effect of those conditions on the worker's employability;

     (e) Wage at the time of injury;

     (f) Work pattern;

     (g) Significant barriers to employment;

     (h) Labor market; and

     (i) Complete work history, in addition to information about education level, courses or transcripts, licenses, certifications or registrations that the worker may have obtained in the past.

     (2) The AWA must also include one of the following recommendations:

     (a) Able to work: The injured worker is employable at gainful employment. The report must include:

     (i) Whether the worker is employable with the employer of injury or current employer, or if not, ((the)) a list of job ((possibility(ies))) possibilities for which the worker is qualified;

     (ii) A medically approved job analysis. When this is not obtainable or physical capacities information ((when a JA is not possible)) regarding the worker's ability to perform the job may be used; and

     (iii) Labor market information supporting the provider's recommendation. Labor market information is not necessary when ((not returning to the employer of injury or current employer)) the injured worker is medically released to work for their job of injury at their previous work pattern;

     (b) Further services appropriate: Vocational rehabilitation services are necessary and likely to enable the injured worker to become employable at gainful employment. The report must include:

     (i) An analysis demonstrating ((why the worker is unlikely to return to work without vocational rehabilitation services)) how vocational rehabilitation plan development services are necessary and likely to enable the injured worker to become employable at gainful employment;

     (ii) The specific return to work possibilities investigated and the reasons why they were ruled out including labor market information when necessary; or

     (c) Further services not appropriate: The injured worker is not likely to benefit from vocational services. The report must include:

     (i) An analysis explaining why vocational rehabilitation services are not appropriate;

     (ii) ((Any)) Identifying barriers that will ((interfere with the worker's return to work or)) make it unlikely the worker will benefit from vocational rehabilitation services, consistent with the requirements in WAC 296-19A-010(1);

     (iii) ((If appropriate)) Medical, labor market, and/or other information, as necessary, supporting the provider's recommendations.

     (d) Return to work: The injured worker has returned to work. The report must specify and/or document attempts to obtain the following information:

     (i) A description of the job the worker returned to;

     (ii) The name of the employer;

     (iii) The date that the worker returned to work;

     (iv) The worker's monthly wages.

     (3) ((The provider must notify the department in writing within two working days if the worker is medically released to work without restrictions.)) The provider must immediately inform the department orally if the worker is medically released without restrictions or has returned to work and must follow the oral notification with written notification within two working days. The provider must attach documentation showing the worker was medically released to work without restrictions. Except for completing the closing report, the provider should not perform any other work on the AWA without the prior authorization of the referral source.

     (((4) The provider must notify the department orally and in writing within two working days if the worker has returned to work. This report must specify and/or document attempts to obtain the following information:

     (a) A description of the job the worker returned to;

     (b) The name of the employer;

     (c) The date that the worker returned to work;

     (d) The worker's monthly wages.))

[Statutory Authority: RCW 51.04.020, 51.04.030, 51.32.095, 51.36.100, 51.36.110. 00-18-078, § 296-19A-070, filed 9/1/00, effective 6/1/01.]

     (1) Vocational counseling and occupational exploration;

     (2) Identifying job goal, training needs, resources, and expenses;

     (3) Vocational rehabilitation plan development services are authorized for the vocational rehabilitation provider to produce a recommended vocational rehabilitation plan for an industrially injured or ill worker.

     (4) Coordinating with medical providers to obtain physical capacities and restrictions information and a release to participate in a vocational rehabilitation plan; and

     (((4))) (5) Vocational testing.

[Statutory Authority: RCW 51.04.020, 51.04.030, 51.32.095, 51.36.100, 51.36.110. 00-18-078, § 296-19A-090, filed 9/1/00, effective 6/1/01.]

     (a) Description of the return to work goals explored, accepted or ruled out;

     (b) Review of the return to work priorities being addressed;

     (c) Summary of all actions taken, including progress on previously recommended actions;

     (d) Identification and analysis of any barriers preventing completion of the referral; and

     (e) Description of the specific actions the provider intends to take to overcome barriers and the expected time frame to complete those actions.

     (2) Vocational rehabilitation plan. The provider must address the return to work priorities listed in RCW 51.32.095(2) in the plan and explain why each preceding priority would not help the industrially injured or ill worker return to work. The vocational plan must also include the following information:

     (a) An assessment of the industrially injured or ill worker's skills and abilities considering the industrially injured or ill worker's physical capacities and mental status, aptitudes and transferable skills gained through prior work experience, education, training and avocation;

     (b) The services necessary to enable the industrially injured or ill worker to become employable in the labor market;

     (c) Labor market survey supportive of the industrially injured or ill worker's employability upon plan completion;

     (d) Documentation of the time and costs required for completion of the plan;

     (e) A direct comparison of the industrially injured or ill worker's skills, both existing and those to be acquired through the plan, with potential types of employment to demonstrate a likelihood of plan success;

     (f) A medically approved job analysis for the proposed retraining job goal;

     (g) Any other information that may significantly affect the plan; and

     (h) An agreement signed by the provider and industrially injured or ill worker that:

     (i) Acknowledges that the provider and the industrially injured or ill worker have reviewed, understand and agree to the vocational rehabilitation plan; and

     (ii) Sets forth the provider's and industrially injured or ill worker's responsibilities for the successful implementation and completion of the vocational rehabilitation plan.

     The provider must use a ((form)) statement approved by, or substantially similar to a ((form)) statement used by, the department in order to document this agreement.

     (3) Closing report. If the provider has to stop plan development before ((reaching a vocational goal)) a rehabilitation plan is submitted and/or approved, submit a plan development closing report. The report must include:

     (a) A list of the reasons the provider cannot proceed with vocational rehabilitation plan development activities; ((and))

     (b) Supporting documentation, such as: Goals researched, job analyses developed, and/or labor market research conducted; and

     (c) Address whether or not further vocational rehabilitation services may be necessary and likely to enable the injured worker to become employable.

[Statutory Authority: RCW 51.04.020, 51.04.030, 51.32.095, 51.36.100, 51.36.110. 00-18-078, § 296-19A-100, filed 9/1/00, effective 6/1/01.]

     (1) Maintain sufficient contact with the industrially injured or ill worker, trainer and medical providers to make sure the worker ((is)) successfully ((progressing)) enters and progresses in the vocational rehabilitation plan;

     (2) Confirm that the industrially injured or ill worker has received all necessary equipment and supplies;

     (3) Contact the industrially injured or ill worker and trainer at least every thirty days to identify potential problems;

     (4) Notify the department if the plan needs to be interrupted;

     (5) Notify the department when the industrially injured or ill worker completes the plan;

     (6) Monitor the industrially injured or ill worker's progress and resolve any problems that might arise or address by submitting supporting documentation regarding why it cannot be brought to resolution;

     (7) Assisting in placement services prior to the completion of the vocational rehabilitation plan.

     (8) Document the industrially injured or ill worker's acquisition of skills; and

     (((8))) (9) Notify the department if the plan needs to be terminated.

     (10) Obtain preferred worker status for worker, if appropriate.

[Statutory Authority: RCW 51.04.020, 51.04.030, 51.32.095, 51.36.100, 51.36.110. 00-18-078, § 296-19A-110, filed 9/1/00, effective 6/1/01.]

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     Vocational recommendations must follow department guidelines and have supporting documentation attached.)) (1) A forensic evaluation constitutes an analysis of prior vocational services and the medical conditions of an injured worker, including pre and post injury, to determine whether any further vocational services are necessary and likely to enable the injured worker to become employable at gainful employment. Services that may be conducted in order to make a recommendation to the department may include, but are not limited to:

     (a) Reviewing medical and vocational records;

     (b) Obtaining, clarifying, and/or evaluating an industrially injured or ill worker's:

     (i) Work and/or education history;

     (ii) Skills, knowledge and aptitudes;

     (iii) Physical capacities information related to the injury or other medical conditions;

     (c) Identifying barriers to employment and possibilities for resolving the barriers;

     (d) Identifying potential training needs and resources;

     (e) Performing recommended services as needed to make a recommendation. These services may include conducting and writing job analyses, conducting labor market surveys, performing transferable skills analysis and performing occupational research.

     (2) Recommendations must address the return to work priorities in RCW 51.32.095(2) and be documented by providing evidence of previous services and/or services performed under this referral.

     (3) Development of a vocational rehabilitation plan is specifically precluded during a forensic evaluation.

     (4) Any vocational provider that has provided any vocational rehabilitation services to the industrially injured or ill worker may not receive a referral for a forensic evaluation of that industrially injured or ill worker. Any vocational provider who begins a forensic evaluation cannot receive further vocational referrals for that worker.

[Statutory Authority: RCW 51.04.020, 51.04.030, 51.32.095, 51.36.100, 51.36.110. 00-18-078, § 296-19A-130, filed 9/1/00, effective 6/1/01.]

     (1) Progress reports. Each progress report must include:

     (a) A detailed explanation why the forensic referral was not completed as of the date of the report;

     (b) A summary of all activities taken in the past thirty days, including progress on previously recommended actions;

     (c) Identification and analysis of any barriers preventing completion of the referral; and

     (d) A description of the specific actions the provider intends to take to overcome barriers and the expected time frame to complete those actions.

     (2) Final report. The final report must include recommendations and a recommended outcome. The report must comprehensively evaluate the vocational and medical aspects of the claim so that the adjudicator can make an appropriate vocational decision. The vocational provider must designate an outcome in the closing report when the forensic evaluation is complete. The recommendations may include, but are not limited to:

     (a) Able to work: The injured worker is employable at gainful employment. The report must include:

     (i) Whether the worker is employable with the employer of injury or current employer, or if not, a list of job possibilities for which the worker is qualified;

     (ii) A medically approved job analysis. When this is not obtainable, medically approved physical capacities information supporting the worker's ability to perform the job may be used; and

     (iii) Labor market information supporting the provider's recommendation. Labor market information is not necessary when the injured worker is medically released to work for their job of injury at their previous work pattern.

     (b) Further services appropriate: Vocational rehabilitation services are necessary and likely to enable the injured worker to become employable at gainful employment. The report must include:

     (i) An analysis demonstrating how vocational rehabilitation plan development services are necessary and likely to enable the injured worker to become employable at gainful employment.

     (ii) The specific return to work possibilities investigated and the reasons why they were ruled out, including labor market information when necessary.

     (c) Further services not appropriate: The injured worker is not likely to benefit from vocational services. The report must include:

     (i) An analysis explaining why vocational services are not appropriate;

     (ii) Identifying barriers that will make it unlikely the worker will benefit from vocational services, consistent with the requirements in WAC 296-19A-010(1);

     (iii) Medical, labor market, and/or other information, as necessary, supporting the provider's recommendations.

     (d) Return to work: The injured worker has returned to work. The report must specify and/or document attempts to obtain the following information:

     (i) A description of the job the worker returned to;

     (ii) The name of the employer;

     (iii) The date that the worker returned to work;

     (iv) The worker's monthly wages.

     (e) Further clarification of medical issues is needed. The vocational rehabilitation provider will identify issues impacting the vocational rehabilitation process and requiring clarification.

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     (3) The labor market survey report must include, or document attempts to obtain:)) that is submitted to the department as documentation in support of a vocational recommendation. This information must be presented in the form of a summary report and accompanied by the results of the individual employer contacts:

     (a) The specific job title surveyed and its DOT code. If the DOT code is not an accurate reflection/description of the job, then list the specific job surveyed, the occupational code and the source from which the occupational code was obtained;

     (b) The name of the surveyor;

     (c) A summary of all contacts and the dates of contact;

     (d) A summary of whether or not the industrially injured or ill worker has the physical and mental/cognitive capacities to perform the job, based upon information from the attending physician or from a preponderance of medical information;

     (e) A summary of whether the labor market matches the industrially injured or ill worker's work pattern;

     (f) A summary of whether the labor market is considered positive or negative, as follows:

     (i) If the labor market survey is conducted during an ability to work assessment, a labor market is considered positive if it shows that there are sufficient job opportunities in the worker's relevant labor market to enable the injured worker to become employable.

     (ii) If the labor market is conducted during a plan development, a labor market is considered positive if it shows that jobs suitable for the injured worker for the proposed job goal exist in sufficient numbers to reasonably conclude that the worker will be employable at plan completion.

     (g) Additional information may be presented in the summary, but only as a supplement to the labor market survey. Additional information may include, but is not limited to, published statistical data regarding occupations and projected job openings.

     (2) The following information must be obtained from the individual employer contacts and submitted to the department with the summary report. If the information is not available, the VRC should document attempts made to obtain the information and why it was not available.

     (a) The specific job title surveyed;

     (b) All specific employer contacts, including their firm names, phone numbers, contact name and job title;

     (c) Physical and mental/cognitive demands of the job in relation to the industrially injured or ill worker's physical and mental/cognitive capacities;

     (d) Minimum hiring requirements and the skills and training commonly and currently necessary to be gainfully employed in the job;

     (e) Work patterns;

     (f) Number of positions per job title;

     (g) Wage;

     (h) Date of last hire;

     (i) Number of current openings; and

     (j) ((A summary of the labor market survey results and whether the survey is)) An indication of whether each contact was considered positive or negative. The provider must include specific documentation to support why a contact was positive or negative for the recommended occupation or proposed vocational goal.

[Statutory Authority: RCW 51.04.020, 51.04.030, 51.32.095, 51.36.100, 51.36.110. 00-18-078, § 296-19A-140, filed 9/1/00, effective 6/1/01.]

     (1) Include identifying information on each page. This information includes the worker's name and claim number, and ((job title and DOT number)) the specific job title surveyed and its DOT code. If the DOT code is not an accurate reflection/description of the job, then list the specific job surveyed, the occupational code and the source from which the occupational code was obtained;

     (2) Note the name of the vocational rehabilitation provider who completed the job analysis, where the provider completed the job analysis and the date of the job analysis. If the analysis is ((done on-site)) based on site specific information, include the employer name and employer contact person(s) name(s) with phone number(s);

     (3) Describe the essential functions and all other tasks required to perform the job. Essential job functions are the basic, necessary, and integral parts of a job performed by a worker;

     (4) List the tools and equipment required to do the job;

     (5) Evaluate and describe the ((competencies)) skills required to perform the job;

     (6) Evaluate and describe the physical demands and their frequency required to perform the job((. This must include demands for sitting, standing, lifting, etc)), utilizing the physical demands listing consistent with the DOT. If the DOT does not represent an accurate reflection/description of the job, then list the specific job surveyed, the physical demands and the source from which the physical demands listing was obtained. The vocational rehabilitation provider should pay special attention to any job duties and physical demands that may be affected by the industrially injured or ill worker's condition;

     (7) Describe, if pertinent, any environmental hazards encountered on the job;

     (8) Describe possible modifications to the job for employer job offers or job modifications;

     (9) A section for medical approval, signature, and comments; and

     (10) The signature of the vocational rehabilitation provider presenting the job analysis for review and date signed.

[Statutory Authority: RCW 51.04.020, 51.04.030, 51.32.095, 51.36.100, 51.36.110. 00-18-078, § 296-19A-170, filed 9/1/00, effective 6/1/01.]

[Statutory Authority: RCW 51.04.020, 51.04.030, 51.32.095, 51.36.100, 51.36.110. 00-18-078, § 296-19A-180, filed 9/1/00, effective 6/1/01.]

[Statutory Authority: RCW 51.04.020, 51.04.030, 51.32.095, 51.36.100, 51.36.110. 00-18-078, § 296-19A-190, filed 9/1/00, effective 6/1/01.]

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     (1) The prejob accommodation is medically necessary to enable the industrially injured or ill worker to participate in an approved retraining program; or

     (2) The prejob accommodation is necessary to enable the industrially injured or ill worker to perform the essential functions of a job or a return to work goal in which the injured worker is seeking employment consistent with:

     (a) A completed retraining plan; or

     (b) The recommendations of an ability to work assessment. The injured worker's attending physician must certify that the prejob accommodation is medically necessary due to restrictions imposed by the accepted industrial injury or condition and that the proposed prejob accommodation will meet the injured worker's needs.

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     (2) The job modification assistance application shall include, but not be limited to:

     (a) A document supporting the need for job modification;

     (b) A description of the job modification; and

     (c) An itemized account of each expense to be incurred in the job modification. Job modification assistance applications shall be submitted on a form prescribed by the department.

     (3) The supervisor or supervisor's designee shall accept, reject or modify the job modification application within thirty days of receipt. Notification of the supervisor's acceptance, rejection, or modification shall be in writing.

[Statutory Authority: RCW 51.04.020, 51.04.030, 51.32.095, 51.36.100, 51.36.110. 00-18-078, § 296-19A-200, filed 9/1/00, effective 6/1/01.]

     (1) Vocational rehabilitation counselor (VRC).

     (a) VRCs not registered with the department and applying for a provider number with the department effective on or after December 1, 2000, must meet the following minimum qualifications:

Education Masters Degree	Experience 1 year full-time industrial insurance experience	Certification and CRC or CDMS or ABVE
OR
Bachelors Degree	2 years full-time industrial insurance experience	and CRC or CDMS

CRC = Certified Rehabilitation Counselor

CDMS = Certified Disability Management Specialist

ABVE = American Board of Vocational Experts

     (b) VRCs registered with the department prior to December 1, 2000, will be required to ((apply for a provider number and will be given six years from December 1, 2000, to meet the above requirements)) meet the qualification criteria in (a) of this subsection no later than November 30, 2010.

     (2) VRC supervisor.

     (a) In order to supervise interns providing vocational rehabilitation services to industrially injured or ill workers beginning on or after December 1, 2000, the VRC((/))supervisor must provide proof of five years full-time experience working with Washington state injured workers. The VRC supervisor must meet all of the qualification requirements in subsection (1) of this section.

     (b) Supervisors registered with the department prior to December 1, 2000, will be required to ((apply for a provider number and will be given six years from December 1, 2000, to meet all VRC/supervisor requirements)) meet the qualification criteria in (a) of this subsection no later than November 30, 2010.

     (c) The VRC supervisor is responsible for ensuring that all work performed by an intern for the department or self-insurer conforms with Title 51 RCW, department rules and department policies.

     (3) Forensic services -- In order to provide forensic services to the department ((on claims other than those for which the VRC provided the vocational rehabilitation services)), a VRC must provide proof of ((three)) five years full-time experience working with Washington state industrially injured or ill workers, and must possess a CRC or ABVE certification.

     (4) Intern.

     (a) Interns not registered with the department and applying for a provider number with the department on or after December 1, 2000, must meet the following minimum qualifications:

Degree	Internship Length
Masters Degree in field acceptable to CRC or CDMS or ABVE	Equal to required experience to obtain CRC or CDMS or ABVE certification including at least 1 year working with industrially injured or ill workers.
OR
Bachelors Degree in field acceptable by CDMS	Equal to required experience to obtain CDMS certification including at least 2 years working with industrially injured or ill workers.

     (b) Interns not registered with the department and applying for a provider number with the department on or after December 1, 2000, must obtain one of the required VRC certifications within one year of completing their required internship. Interns will remain in internship status during this time frame.

     (c) Interns registered with the department prior to December 1, 2000, will be required to apply for a provider number with the department and may work as an intern until the end of their current internship. Upon completion of the internship the intern may submit an application to the department as a VRC. These providers must obtain one of the required VRC certifications by November 30, 2006.

     (d) All interns are required to conform to Title 51 RCW, department rules, and department policies. All interns granted a provider number by the department must be supervised by a VRC supervisor.

     (((5))) (e) No person shall serve as an intern under these rules for more than sixty months of full-time experience, or its equivalent, working with industrially injured or ill workers. The intern must notify the department when there is a change in the status of an internship.

     (5) Interns may not receive referrals directly from the department or self-insured employers. Interns may perform aspects of vocational rehabilitation services under the supervision of a VRC supervisor. The VRC assigned to the referral must review and attest to all work performed by an intern on that referral.

     (6) Providers who receive or are assigned referrals must comply with all electronic security requirements in place for accessing department files.

     (7) Providers registered with the department prior to December 1, 2000, who do not meet the above qualification requirements within the six-year period will no longer be eligible to provide vocational rehabilitation services to industrially injured or ill workers and the department will terminate their provider number(s).

     (((6))) (8) Business requirements.

     (a) Providers must comply with all federal and state laws, regulations and other requirements with regard to business operations. In order to be eligible to receive referrals from the department, providers must satisfy the requirements set forth in this subsection in every service location in which they wish to operate.

     (b) Providers must be covered by general liability insurance, automobile liability insurance, errors and omission insurance, malpractice insurance, and industrial insurance if required by Title 51 RCW.

     (c) Providers must have services and facilities that provide injured workers a private and professionally suitable location in which to discuss vocational rehabilitation services issues. In order to be eligible to receive referrals from the department, providers must satisfy the requirements set forth in this subsection in every service location in which they wish to operate.

     (d) Providers must have telephone-answering capability during regular business hours, Monday through Friday. In order to be eligible to receive referrals from the department, providers must satisfy the requirements set forth in this subsection in every service location in which they wish to operate.

     (e) In order to receive referrals made by the department, providers must maintain or have access to equipment that can utilize the department's remote access system for transmitting vocational referrals.

     (((7))) (9) The department may assign a provider number to a vocational rehabilitation firm, partnership, corporation or other legal entity so long as substantial control over the daily management of the vocational rehabilitation firm, partnership, corporation or other legal entity is performed by a VRC that satisfies the qualifications set forth in this rule.

[Statutory Authority: RCW 51.04.020, 51.04.030, 51.32.095, 51.36.100, 51.36.110. 00-18-078, § 296-19A-210, filed 9/1/00, effective 12/1/00.]

     (((a))) (1) Conduct audits of a provider, either for cause or at random;

     (((b))) (2) Conduct audits at a provider's place of business using copies and originals of all files and records maintained by the provider;

     (((c))) (3) Conduct audits away from a provider's place of business, using copies of all files and records supplied by the provider;

     (((d))) (4) Require a provider to submit legible copies of all files and records requested for audit;

     (((e))) (5) When the department requires the provider to submit copies of records and files to the department, the provider shall submit the requested material within thirty calendar days of the request;

     (6) Inspect and audit all of the provider's vocational rehabilitation files and records relating to services delivered under Title 51 RCW;

     (((f))) (7) Inspect and audit a provider's documentation supporting charges billed for vocational rehabilitation services delivered.

     (((2) For information regarding the formal appeals process refer to chapter 51.52 RCW.))

[Statutory Authority: RCW 51.04.020, 51.04.030, 51.32.095, 51.36.100, 51.36.110. 00-18-078, § 296-19A-240, filed 9/1/00, effective 6/1/01.]

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     (1) Submission and implementation of a written corrective action by the provider showing how the provider will come into compliance;

     (2) Recoupment of payments, plus interest, made to the provider;

     (3) Requirement that the provider satisfactorily complete remedial education courses and/or other educational or training programs;

     (4) Suspension or termination of ((the)) a provider's provider number and ability to receive payment for vocational rehabilitation services rendered to industrially injured or ill workers under the Industrial Insurance Act;

     (5) Rejection of a provider's application to provide vocational rehabilitation services to industrially injured or ill workers under the Industrial Insurance Act;

     (6) Denial or rejection of a request for payment submitted by or on behalf of the provider;

     (7) Placement of the provider on prepayment review status requiring the submission of supporting documents prior to payment;

     (8) Assessment of penalties.

[Statutory Authority: RCW 51.04.020, 51.04.030, 51.32.095, 51.36.100, 51.36.110. 00-18-078, § 296-19A-260, filed 9/1/00, effective 6/1/01.]

     (a) Failure to take reasonable and necessary steps under this chapter to ensure a successful completion of a referral;

     (b) Charging the department for services that do not contribute to the completion of a vocational referral, including, but not limited to:

     (i) Preparation and submission of job analyses during plan development for jobs that are beyond the worker's documented or expected capacities and physical abilities as demonstrated by the medical information in the file at the time the job analysis was performed;

     (ii) Preparation and submission of job analyses or labor market surveys during early intervention or assessment that are not supported by the injured worker's education, work history and/or transferable skills as demonstrated by the information in the file at the time the job analysis and/or labor market survey was performed;

     (iii) Hand delivery of records when other less expensive means of delivery are reasonably appropriate and available;

     (c) Commission of an act involving moral turpitude, dishonesty, or corruption relating to the provision of vocational rehabilitation services whether the act constitutes a crime or not;

     (((b))) (d) Misrepresentation or concealment of a material fact in obtaining a department provider number, or in response to any request for information about service delivery made by the department;

     (((c))) (e) Provision of vocational rehabilitation services without having a department provider number;

     (((d))) (f) Use of persons that do not possess a department provider number to deliver vocational rehabilitation services;

     (((e))) (g) Operation of a vocational firm, partnership, corporation, or other legal entity in violation of the business requirements set forth in RCW, WAC, or written department policy;

     (((f))) (h) Use of false, fraudulent, or misleading advertising;

     (((g))) (i) Commission of any incompetent or negligent action which presents the significant risk of resulting in harm to an industrially injured or ill worker, the referral source, or an employer;

     (((h))) (j) Submission of a false or misleading report or document as part of delivering vocational rehabilitation services;

     (((i))) (k) Failure to supervise a vocational rehabilitation intern in accordance with RCW, WAC, or written department policy;

     (((j))) (l) Failure to comply with any order issued by the department;

     (((k))) (m) Disclosure of confidential information on vocational rehabilitation services to a person who is not entitled to it;

     (((l))) (n) Unauthorized disclosure of confidential claim information, including, but not limited to, private health care information;

     (o) Charges an industrially injured or ill worker or employer a fee for delivering vocational rehabilitation services on a referral from the referral source; and

     (((m))) (p) Bills an industrially injured or ill worker or state fund employer for providing services under the Industrial Insurance Act.

     (2) The department can take corrective action(s) for other violations of RCW, WAC, or written department policy not specifically mentioned above.

[Statutory Authority: RCW 51.04.020, 51.04.030, 51.32.095, 51.36.100, 51.36.110. 00-18-078, § 296-19A-270, filed 9/1/00, effective 6/1/01.]

     (2) Provider community commentary, expert opinion and best practices suggest that there is a correlation between a higher level of vocational rehabilitation services and higher qualifications of vocational rehabilitation providers. Based upon this information, the department concludes that referrals to providers who satisfy these minimum qualification criteria set forth in WAC 296-19A-210 (1)(a) ((and (2)(a))), but who do not have a performance rating with the department, may be appropriate. The department will ensure that these providers are complying with department statutes, rules, and policies and furnishing a high level of service through close and continued monitoring. The department may consider making referrals to vocational rehabilitation providers, on a trial basis, for whom the department does not have performance rating data, under the following circumstances:

     (a) The provider fulfills the qualification requirements set forth in WAC 296-19A-210 (1)(a)((, (2)(a))); and

     (b) The department may consider making referrals sufficient to develop a reliable performance rating.

     (3) If the department elects to refer and monitor a limited number of cases to the provider(s) in order to evaluate a provider's performance and develop performance rating, the department makes no guarantee of future referrals to the provider.

[Statutory Authority: RCW 51.04.020, 51.04.030, 51.32.095, 51.36.100, 51.36.110. 00-18-078, § 296-19A-300, filed 9/1/00, effective 6/1/01.]

     (1) Include the first and last name of the industrially injured or ill worker being served and the worker's claim number at the top of each page;

     (2) Include the first and last name of the vocational rehabilitation provider providing each service documented on each page;

     (3) Be kept in a claimant file corresponding to the reports, medical information, correspondence, and other materials that they provide documentation for;

     (4) Testing and other records with special confidentiality requirements may be kept in separate files;

     (5) Be legible;

     (6) Be in chronological order;

     (7) Record the date each service was provided month month/day day/year year;

     (8) For providers who bill for vocational services, include the amount of time, recorded in tenths of an hour, required to provide each service;

     (9) Describe each service sufficiently to allow the referral source to verify the purpose, level, type, and outcome of each service provided and substantiate the charges billed for them.

[Statutory Authority: RCW 51.04.020, 51.04.030, 51.32.095, 51.36.100, 51.36.110. 00-18-078, § 296-19A-350, filed 9/1/00, effective 6/1/01.]

     (2) A vocational rehabilitation provider who requests payment from the referral source for vocational rehabilitation services must maintain all records necessary for the director's authorized auditors to audit the provision of services. Providers need to keep all records necessary to disclose the specific nature and extent of all services provided for an industrially injured or ill worker, along with the amounts billed to the department, for those services. Paper copies of records must be maintained for audit purposes for a minimum of five years from the date of closure by the provider.

[Statutory Authority: RCW 51.04.020, 51.04.030, 51.32.095, 51.36.100, 51.36.110. 00-18-078, § 296-19A-400, filed 9/1/00, effective 6/1/01.]

     (2) An approved vocational rehabilitation plan may also be disputed.

     (3) An approved plan modification may also be disputed.

     (4) A previously approved vocational rehabilitation plan may not be disputed through a plan modification dispute process.

[Statutory Authority: RCW 51.04.020, 51.04.030, 51.32.095, 51.36.100, 51.36.110. 00-18-078, § 296-19A-440, filed 9/1/00, effective 6/1/01.]

     (3) All remaining sections of chapter 296-19A WAC become effective on June 1, 2001.)) May 1, 2003:

     (a) WAC 296-19A-210;

     (b) WAC 296-19A-137.

     (2) All other amendments to chapter 296-19A WAC become effective January 1, 2004.

     (3) All remaining sections of chapter 296-19A WAC shall remain in full force and effect.

[Statutory Authority: RCW 51.04.020, 51.04.030, 51.32.095, 51.36.100, 51.36.110. 00-18-078, § 296-19A-480, filed 9/1/00, effective 6/1/01.]

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