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OHIO BWC VOC REHAB ELIGIBILITY Eligible for Voc Rehab in Ohio
Vocational Rehabilitation Eligibility Criteria
1. To be eligible for rehabilitation services, the injured worker must meet the following criteria:
a. a referred claim allowed by a BWC or Industrial Commission order with 8 or more days off work due a work related injury); or, b. a claim certified by a state university or state agency; or c. a claim certified by a self-insuring employer
and,
2. The injured worker must have a significant impediment to employment or the maintenance of employment as a direct result of the allowed conditions in the referred claim.
and,
3. The injured worker must also have at least one of the following present in the referred claim:
(a) The injured worker is receiving or has been awarded temporary total, non-working wage loss, or permanent total compensation for a period of time that must include the date of referral (the first date the BWC or MCO receives a request for rehab services from anyone which is verified by a date stamp or note in the claim file). For purposes of this section, payments made in lieu of temporary total compensation (e.g. salary continuation) shall be treated the same as temporary total compensation;
or,
(b) The injured worker was granted a scheduled loss award (PP) under division (B) of section 4123.57 of the Revised Code;
or,
(c) The injured worker received, or was awarded, a permanent partial award (%PP) under division (A) of section 4123.57 of the Revised Code and has documented job restrictions as a result of that award documented by the physician of record and dated not more than one hundred eighty days prior to the date of referral;
or,
(d) The injured worker was determined to have reached maximum medical improvement in the claim (with eight or more days of lost time due to a work related injury) by an order of the bureau or the industrial commission, or the injured worker's physician of record has documented in writing that the injured worker has reached maximum medical improvement in the claim, but and the injured worker is not currently receiving compensation and continues to have has job restrictions in the claim as documented by the physician of record and dated not more than one hundred eighty days prior to the date of referral;
or,
(e) The injured worker is currently receiving Job Retention services to maintain employment or satisfies the criteria set forth in paragraph F. 5 (a) of this chapter on the date of referral;
or,
(f) The injured worker sustained a catastrophic injury claim and a vocational goal can be established;
or,
(g) The injured worker was receiving living maintenance wage loss not more than ninety days prior to the date of referral, has continuing job restrictions documented by the physician of record as a result of the allowed conditions in the claim, and has lost his or her job through no fault of his or her own.
4. An injured worker employed by a state agency or state university is eligible for vocational rehabilitation services when the employer has accepted or certified the claim. and the employee and employer agree upon a program of rehabilitation services.
5. An injured worker is eligible for vocational rehabilitation services in a Job Retention Status when currently working and experiencing a significant current work related problem as a direct result of the allowed conditions of the claim,
and,
a. The injured worker has received temporary total compensation or salary continuation from an allowed claim (8 or more days off work due to work related injury)
and,
b. The physician of record must provide a written statement, in office notes or correspondence, indicating that the injured worker has work limitations related to the allowed conditions in the claim that negatively impact the injured worker‟s ability to maintain the injured worker‟s employment
and,
c. The injured worker‟s employer describes the specific job task problem(s) the injured worker is experiencing to the MCO and the MCO documents these problems in the claim. The MCO shall include a statement describing why the injured worker needs job retention services to maintain employment.
6. Non-eligibility for vocational rehabilitation services. The injured worker is not eligible for vocational rehabilitation services and such services shall be terminated:
a. After the effective date of a lump sum settlement; or
b. If the claim is subsequently disallowed on appeal by an order of the industrial commission, its district or staff hearing officers, or by an order of the court.
7. Diagnostic evaluations. Prior to rehabilitation plan implementation by the MCO, diagnostic evaluations may be used in determining feasibility for vocational rehabilitation services. Payment for such examination(s) and the vocational rehabilitation case management occurring during this period may be charged to the surplus fund.
• The injured worker must not be working on the date of referral, with the exception of referral for job retention services.
IVS provides vocational services throughout the State of Ohio, which includes, but is not limited to Cleveland, Lorain, Painesville, Ashtabula, Akron, Canton, Youngstown, Mansfield, Lima, Columbus, Dayton, Zanesville, Hamilton and Cincinnati.