Worker's Compensation

Vocational Rehabilitation Guide - Chronological Sequence of Events

  Who Does What When Why (Law or Rule)
Step 1 Worker's Comp. Division (WCD) Mails the injured worker a questionnaire or pamphlet containing information for self-referral to the Division of Vocational Rehabilitation (DVR). Temporary Total Disability (TTD) is more than 13 weeks and employee has permanent partial disability. sec. 102.42 (9)
Step 2 Insurer Obtains a final medical report.  If the injured worker has not returned to work, notifies the worker about the potential availability of vocational rehabilitation services. End of medical healing period. DWD 80.49 (7)(a)
Step 3 Injured Worker Provides the employer with a written medical report stating the worker's permanent restrictions. As soon as available. DWD 80.49 (8) Intro
Step 4 Employer Provides the injured worker (or the worker's authorized representative):

A. A written offer of suitable employment; or

B. A written statement that the employer does not have suitable employment; or

C. A medical report disputing the permanent work restrictions given by the injured worker's doctor, or medical or vocational documentation that the difference in work restrictions would materially affect the employer's ability to provide suitable employment.

While it is not required under Ch. 102, the employer or insurer may want to bring in a specialist at this point to re-design the job site to facilitate return-to-work within the permanent restrictions.
Within 60 days of receiving a medical report with the worker’s permanent work restrictions from the worker (or the worker’s authorized representative).

DWD 80.49 (8)(a) to (c)
DWD 80.49
(4)(d) and (5)

Step 5 Any Party May request a hearing with the WCD regarding permanent work restrictions.

Note: Any party may also request that the Division informally resolve any dispute that arises regarding work restrictions or any other issue. In  determining if the offer is suitable, the WCD will consider the injured worker's age, education, training, previous work experience, occupation and earnings when injured, travel distance, career goals, and the extent to which the job would restore pre-injury earning capacity and potential.
30 days after the worker receives the employer’s Independent Medical Examiner’s (IME) medical report disputing the treating physician’s permanent work restrictions. (See Step 4C)

Note: The 30-day waiting period is to encourage the employer and the  worker to resolve the problem informally.
DWD 80.49 (8)(c)
Step 6 WCD Resolves the dispute regarding the extent of the worker's permanent work restrictions informally or by a formal hearing. Within 90 days after final hearing and close of record. 102.18
Step 7 Employer Provides the worker or the worker's authorized representative:

A. A written offer of suitable employment as defined in WIs. Admin. Code, section DWD. 80.49 (4) (d) and (5) ; or

B. A written statement that the employer has no suitable employment.

Within 30 days after WCD determines permanent work restrictions. DWD 80.49(4)(d) and (5)
DWD 80.49 (8)(c)

DWD 80.49 (8)(b)
Step 8 Injured Worker Contacts DVR

Note: An injured worker may request a DVR determination at any time.

A failure by the WCD or insured to follow the process in Steps 1 and 2 does not affect the DVR's ability to make a determination of eligibility under Step 9.
   
Step 9 DVR Determines:

(1) If worker is eligible to receive vocational services; and

(2) If the DVR will be able to provide services or must place the worker on a waiting list.

Notifies the injured worker and the Worker's Compensation Division that DVR will not provide vocational services to the worker.
DVR will usually determine eligibility and if it will serve the applicant within 60 days. sec. 102.61(1m)

DWD 80.49 (7)(b)
Step 10 WCD Provides the injured worker with a list of certified private rehabilitation specialists. When notified by the DVR that vocational services will not be provided. sec. 102.61 (1m)(a)
DWD 80.49 (7)(b)
Step 11 Injured Worker Chooses any certified specialist (from the list provided by the WCD in Step 10) and may change specialists with the consent of the insurer.

Note: Partners count as one specialist.

After the employer states it has no suitable employment (see Step 7); or if the employer does not respond and the 60-day response period has elapsed. DWD 80.49 (7)(c)
Step 12 VR Specialist Notifies WCD and the insurer that the worker has selected the specialist.

Note: Notification of Vocational Services form is available by contacting  the WCD or on the WCD website.

Within 7 days. DWD 80.49 (7)(d)
Step 13 VR Specialist Determines if suitable employment is reasonably likely to be available in the general labor market without retraining. After the employer states it has no suitable employment (see Step 7); or if the employer does not respond and the 60-day response period has elapsed. DWD 80.49 (9)(a) and (b)
Step 14 VR Specialist If suitable employment is reasonably likely to be available, attempts to place the employee in the general labor market. At least 90 days prior to developing a retraining program. DWD80.49 (9)(b)
Step 15 Injured Worker Cooperates fully in the specialist's placement efforts and accepts any offer of suitable employment.  Note: If the employee finds or refuses to accept suitable employment, the insurer is not liable for more costs unless the employment ends during the 12 year statute of limitations period in s. 102.17 (4).

Note: If the worker does not  find suitable employment, it is presumed that the worker needs retraining.  But this presumption can be rebutted.   The presumption is rebutted by evidence that:
 
1. The worker will not benefit from retraining; or

2. The worker or specialist did not make a reasonably diligent effort to obtain suitable employment; or

3. The worker or specialist withheld or misrepresented highly material facts.
During the  90 days of the job search in the general labor market. DWD 80.49 (9)(b) and (c)





DWD 80.49 (10)(a)
Step 16 VR Specialist Develops an Individualized Plan for Employment (IPE) for the worker.

Note: There is a rebuttable presumption that a retraining program of 80 weeks or less is reasonable. A retraining program of more than 80 weeks may be reasonable, but there is no presumption. A retraining program of more than 80 weeks may not be authorized if the primary purpose is to improve upon pre-injury earning capacity rather than restore pre-injury earning capacity.

After determining suitable employment is not reasonably likely to be available, or after the 90-day job search. sec. 102.61 (1m)
DWD 80.49 (10)
DWD 80.49 (11) (a)
Step 17 Employer May offer an alternative retraining program that will restore the worker's pre-injury earning capacity in less time than the retraining program developed by the specialist.

Note: A  worker may not refuse a timely, good-faith, written offer of an alternative retraining program without reasonable cause.

If the retraining program developed by the specialist is for more than 80 weeks. DWD 80.49 (10) (d)
Step 18 VR Specialist Notifies worker, employer, insurer and WCD of worker's status. Periodic.

Note: The WCD recommends quarterly reports.

DWD 80.49 (11) (b)
Step 19 VR Specialist Provides any information reasonably related to the specialist's services to the worker undertaken as a result of the injury. Within a reasonable period of time after receiving a written request from the WCD, worker, employer or insurer. DWD 80.49 (11) (c)
Step 20 Insurer Pays TTD benefit while worker is in an accepted retraining program and maintaining satisfactory progress. Beginning the date the retraining course begins. sec 102.43(5)
Step 21 Insurer Pay for the services of the private vocational rehabilitation specialist and reasonable cost of the training program. When request for payment is submitted by specialist or school. DWD 80.49(7)(e)