MWCEA 2023 Program Directory

 The VR counselor should conduct periodic assessments to evaluate progress with the existing VR Plan recommendations/goals and determine whether new recommendations are warranted  Several factors must be explored when moving along the hierarchy or recommending discontinuation of services:  Aptitude  Qualifications  Motivation  History of compliance  Labor market conditions

 Rather than informing an IW they have been “non-compliant,” the specific areas of non-compliance must be communicated and expectations must be re- stated  The IW should be an active participant in their own rehabilitation plan, and understand they are being held accountable for their participation  As an active participant in their own rehabilitation, the IW should be given the opportunity to provide input as to the issues impacting their compliance and what would help them get back on track  If the rehabilitation provider cannot resolve compliance issues with the IW themselves, the claimant’s attorney should be involved

 The VR hierarchy has been explored and continued services are unlikely to lead to employment due to one or more factors  Adhere to the Maryland WCC VR guidelines:  The VR counselor shall not initiate or continue placement services that do not appear reasonably likely to result in placement in suitable gainful employment  The counselor shall report to the parties when efforts to initiate or continue placement activities do not appear reasonable likely to result in placement  A discussion should occur between the VR counselor and the parties prior to concluding services. If there are barriers to employment which are unlikely to change the best course of action is likely to conclude VR services *Tip: The IW should feel they are part of a team who share common goals of 1) physically restoring them to as much function as possible and 2) returning them to suitable gainful employment – if these do not align with the IW’s goals VR should likely be discontinued

VR Dispute  Initial referral for VR was denied  VR was discontinued after IW declined a job offer which may not have been suitable gainful employment and/or the position was misrepresented by the employer

Permanency  VR was discontinued after IW declined a job offer which did represent suitable gainful employment  IW no longer wishes to participate and/or does not want to pursue the recommendations of

the VR counselor  Non-compliance

 Case#1  Pre-injury job: CNA  Compensable body parts: head/headaches, neck, psych [IW was assaulted by a patient]  Barriers to employment:  Pre-existing medical conditions: bilateral carpal tunnel surgeries  Symptoms related to injury: displayed severe psychological and emotional symptoms, easily triggered by being near others  Limited transferable skills to other occupations: prior work experience was in corrections and medical field  Outcome: With her participation in the rehabilitation process, the IW was able to RTW helping people with disabilities find employment, but did not require in-person communication with clients.

 Case#2  Pre-injury job: Drywall Finisher  Compensable body part: right knee requiring 2 surgeries  Barriers to employment:

 Physical capabilities: demonstrated the ability to perform work at the Medium PDL at the time of the FCE, not meeting his pre-injury job requirements which were classified at the Heavy PDL  Limited transferable skills to other occupations: prior work experience was in drywall and he had no other RTW interests with the exception of his pre- injury position  Outcome: The PT provider, E/I, defense counsel, claimant counsel, and vocational counselor agreed to pursue work hardening as the best opportunity for him to get closer to his pre-injury level function and meet his RTW goal. The VR counselor met with the IW and staff at the WHP facility to support the IW’s goals. IW was discharged from the WHP at the Heavy PDL, and RTW with a different employer in the same job earning more than his pre- injury position.