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Managing Vocational Rehabilitation
(Part 2 of 2)

Selecting The Right VR Service Provider

A good VR program can be beneficial to both employers and employees, but not all VR is the same — and not all insurers have the same attitude toward VR. To maximize VR, an employer needs to be connected to both the right insurer and the right VR service provider.

Insurer Attitude

Although all employers run the risk of having an employee disabled and in need of VR, some employments are more prone to serious injury than others. All employers, but particularly employers in high-risk industries, should determine their insurer’s attitude toward VR.

• Will VR be part of the panoply of cost-containment tools employed — regardless of the letter of the law?
• Or will the employer be told that VR is not a part of the picture?

The insurer’s position toward VR should be discussed before it’s needed for an injured employee, not after. VR does not have to be state-mandated to be a part of an employer’s workers compensation program. Some insurers are firmly committed to VR, seeing its benefits for employer and employee alike. Unfortunately, others may offer VR only in those states where it is mandated. Employers should determine whether the insurer would include the cost of VR in the claim when appropriate — even in states where VR is not mandatory.

Service Providers

Some VR companies are wholly owned subsidiaries of an insurer; some are not. When an insurer refers a claimant to its own subsidiary, there is some guarantee of cooperation and collaboration between the two. When the insurer is dealing with an independent company, this may not be the case. On the other hand, an independent VR company is not necessarily a bad idea. It depends more on how effective its services are. There are several areas that warrant close scrutiny.

Success Rates

As with any profession, some VR companies are better than others. It is important to check the success rates, but when doing so, employers should also look “beneath the hood” to determine what the VR company considers success. Getting someone back to work, only to have that individual quit six months later and try to reopen the workers compensation claim, is hardly successful. The goal should be long-term employment in a job of which the individual is capable and in which the individual will be satisfied.

Cost of Service

If an employer is in a position to select its own service provider, the employer should entertain bids from at least three companies. Employers should not make the choice, however, on rates alone. There may be “cut-rate operations” that promise lower hourly rates, but such economies can easily disappear if the company then bills for more hours than are actually necessary. Instead of looking at hourly rates, employers should ask for each VR firm’s average cost per claimant.

Experience

Employers should look for VR companies that have been around for awhile, have a stable work force, and set standards of accountability for their staffs. The VR company should also maintain thorough records, in case the VR firm ever needs to testify at a hearing on the employer’s behalf.

Employers should meet with the VR counselors, not just with the marketing person. A good VR counselor is a coach, mentor, cheerleader, and more. A good VR counselor can overcome the initial reluctance of an individual — “psyche” that individual up for success. But a good VR counselor must also be a realist, knowing that ambition is not necessarily aptitude. A good VR counselor must combine realism with optimism, encouraging the success of disabled employees and knowing how to deal with any failures. The focus should be on helping people find a place in the work force.

Final Thoughts

Times changes; politics change; economies change. And such changes often affect workers compensation benefits.

Legislative Shifts

VR is a child of the legislatures. States variously enact VR as part of their workers compensation systems — and then “un-enact” it. As the tug-of-war between employer and employee interests waxes and wanes, as first labor and then management get the upper hand, VR as a workers compensation entitlement runs the gamut from virtually unlimited, to no more than one year of training, to not included.

The current economy appears to be in a state of flux. A recession could precipitate changes in VR entitlements, at least in some states. But private-sector VR has proved itself time and again, returning disabled employees to gainful employment for which they are suited and, thus, getting them off of workers compensation and keeping them off of welfare. Employers should keep in mind that VR can be successful, even in a contracting economy.

Wage-at-Injury or Employability

The current focus of private-sector VR has been and is to return the disabled employees to wage-at-injury. But thoughts about that process are evolving, partly in response to concerns about the economy. VR people are beginning to think not so much in terms of wage-at-injury, but of employability. If, for example, someone is retrained as a computer programmer, but computer programmers are being laid off by the dozens and there are no jobs to be found, that does not invalidate the retrained individual’s training. It means, simply, that the individual cannot find a job. It is a question, now, not of disability, but of unemployment.

Of course, an injured and disabled worker who can’t find a job would likely prefer workers compensation benefits to unemployment compensation. The former is tax-free; the latter, taxable. Nonetheless, there may come a point at which the retrained and employable (but not employed) individual no longer collects workers compensation.

Read Managing Vocational Rehabilitation (Part 1)

ABOUT THE AUTHOR

The Journal of Workers Compensation is a quarterly review of risk management and cost containment strategies published by Standard Publishing in Boston, Massachusetts. For more information, please visit our web site, www.standardpublishingcorp.com, or contact the editor at 800-682-5759, extension 222, or subscription services at extension 228.

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October 2001