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Vocational Rehabilitation in Illinois Workers' Compensation Cases

Vocational Rehabilitation in Illinois Workers' Compensation CasesThe Illinois workers' compensation laws have, as a primary goal, not just compensating injured employees, but also helping to get them back to work and to being productive. To that end, Illinois law provides for vocational rehabilitation as part of its system in certain situations.

When does vocational rehabilitation come into play?

Vocational rehabilitation is not a part of every work-related injury and workers' compensation case. Initially, the employee receives medical care to treat the injury or illness, in an attempt to return to the original state of health before the accident occurred.

After that treatment, when the employee has reached maximum improvement where the condition is essentially as good as it is going to get, if limitations still exist preventing him or her from returning to the original job, it may be a case for vocational rehabilitation. Generally, the worker may be entitled to these rehabilitative services, where the result of the work-related injury causes reduction in job abilities that cannot be accommodated by the employer. It is important, in order to be a candidate for vocational rehabilitation, though, that there is evidence that the rehabilitation services will have a positive impact on the employee's earning capacity.

In Illinois, the courts have set out factors to be looked at to determine whether vocational rehabilitation is warranted in a specific situation.

There are three factors which support the necessity of rehabilitation: (1) the injury has caused a reduction in earning capacity and the evidence shows that rehabilitation will have a positive impact; (2) job security is diminished because of the injury; and (3) it is likely that the rehabilitation will enable the employee to successfully get hired after completion.

There are likewise factors which mitigate against the necessity for vocational rehabilitation: (1) such a treatment has been unsuccessful in the past for this employee; (2) a prior rehabilitation program has enabled him to resume employment; (3) some characteristic of the employee such as age, training, skills set, and the type of occupation worked at prior to the injury, makes him or her not “trainable”; and (4) the employee's skills without the rehabilitation are sufficient to allow him or her to get hired.

It is also relevant to factor in: a cost-benefit analysis for the program; the number of years the employee is likely to be able to work; the employee's ability and motivation to go through the rehabilitation; and the prospects for further improvement in employment by other means such as medical rehabilitation.

What is involved?

When it is determined that vocational rehabilitation is warranted, the insurance will pay for training and maintenance costs associated with helping the employee look for and find work within the post-injury restrictions that exist. There is no specific timetable for completion of the rehabilitation program, but it is assumed that it will be completed as expeditiously as possible.

Some of the services provided in the rehabilitation program include:

  • analysis of current vocational, physical, emotional, intellectual skills to determine options and earning capacity;
  • preparation for job searches, including resume writing and skills targeting;
  • guidance and supervision related to the job search;
  • skills retraining to develop alternate and additional skills sets, which could include a referral to receive specified education for a degree or to learn a new trade.

Both parties have obligations to fulfill in this process. The employee must comply and cooperate with the rehabilitation plan, including attending appointments with the counselor, completing assignments and follow-up tests, and applying for jobs as required. It is important that the employee documents in detail each of the actions he or she takes along the way. The insurance company must continue to provide benefits as long as the employee is cooperating, however a failure to cooperate by the employee could result in a termination of benefits.

In addition to the rehabilitative services, the employee may be entitled to maintenance benefits while participating in the rehabilitation, before a job placement is achieved. These benefits are similar in nature to the temporary total disability benefits (TDD).

What if there is a disagreement?

If the insurance company will not provide vocational rehabilitation benefits when warranted, or there is a dispute related to the program, either party can petition the court to help resolve the issue. If the insurance company is denying the benefit completely, the employee can go on his own to a vocational counselor and receive the services, while petitioning the court for payment. It is critical in this scenario, to document each step, including applying for and being rejected from employment.

An expedited process is available for resolving disputes with the Illinois Workers' Compensation Commission, when vocational rehabilitation or maintenance benefits, among others, are denied.

Does this sound confusing? It can be. If you have any questions or would like a referral to a lawyer in Illinois who is experienced with work injury claims involving vocational rehabilitation, please contact us at any time.