| Voc Improvement Background |  | |
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L&I is working to improve its vocational rehabilitation services by eliminating delays, reducing costs and improving outcomes for injured workers.
On this page:
- Action plan for improving services.
- Other L&I projects that will impact vocational rehabilitation services.
Answers to questions about this initiative
What does the vocational rehabilitation program do?
The program's core mission is preventing long-term disability by returning people to work as quickly and safely as possible, and ensuring that vocational services result in positive and usable outcomes for workers.
The program purchases services from vocational counselors who help L&I claim managers decide whether injured workers can return to work with their employer and, if not, whether they are able to work.
Voc counselors also help eligible workers develop rehabilitation plans aimed at returning them to the workforce. Currently, L&I makes about 2,000 referrals a month and spends $42.5 million annually on vocational services.
- What are the problems with voc?
General perceptions about vocational services are that they are complicated, unfair and/or inefficient. On a high-level basis, the problems have been identified as these:
- A misunderstanding of the purpose of vocational services.
- Unnecessary delays in obtaining needed services.
- Vocational referrals that do not result in a usable outcome.
- What is the impact of those problems?
When vocational referrals are unsuccessful, they result in:
- Increased costs.
- Likelihood of another referral.
- Delayed claim resolution.
- Frustration for all parties.
- How did the improvement initiative begin?
Many people want "voc" improved, including Gov. Christine Gregoire, L&I, vocational-services providers, workers and employers. In response, a Vocational Rehabilitation Improvement Initiative is underway in cooperation with business and labor to eliminate delays, reduce costs and improve outcomes for injured workers.
- How is this initiative different from previous efforts to fix the voc system?
Perhaps what's different in the current Vocational Rehabilitation Improvement Initiative is the recognition that many of the problems come from internal issues at L&I. The agency is concentrating much of its energies in analyzing internal processes and systems that may be a problem, and looking for short- and long-term solutions.
- What are the goals of the Vocational Rehabilitation Improvement Initiative?
Based on information collected from L&I staff and external customers, these are the goals:
- Develop and share a clear message and set of expectations around vocational services.
- Provide timely, appropriate services to quickly and safely return workers to work.
- Reduce delays in obtaining vocational services.
- Provide eligible workers with effective plan-development assistance that results in an approved plan.
- Ensure approved plans are completed successfully.
- Improve the vocational purchasing process.
Action plan for improving services
Below are the strategies that L&I's workgroups decided on. The workgroups were made up of L&I staff, including representatives from the executive team, claims administration, vocational units, claims training, information systems and regional staff.
| Claim manager education and accountability | |
|---|---|
| Implement a new management reporting system that will give L&I a better understanding of the timeliness and effectiveness of our referrals. | Implemented May 2006. |
| Identify areas for improvement in how claim managers use vocational rehabilitation services based on objective data on performance. | Implemented July 2006. |
| Train claim managers to make timely, appropriate vocational referrals. | Completed September 2006. |
| Redesign training curriculum for claim managers to highlight vocational and adjudication issues and use a vocational services consultant to train them. | Completed August 2006. |
| Take timely action on claims that exit Early Return to Work or Centers for Occupational Health and Education processes without the injured worker returning to work. | November 1, 2007. |
| Vocational provider education and accountability | |
|---|---|
| Reduce delays by giving vocational rehabilitation counselors access to current claim information through the on-line Claim and Account Center. | Implemented May 2006. |
| Limit vocational rehabilitation counselors to three contiguous service locations in which they may receive State Fund Vocational Referrals. A reapplication process in which providers will identify service locations will begin March 1, 2007. | Implemented March 2007. |
| Display open referral numbers by vocational rehabilitation counselors on claim manager's computers. | Implemented September 2006. |
| Ask the assigned vocational rehabilitation counselor to identify all vocational rehabilitation counselors and interns who provide services on each progress report. | Implemented September 2006. |
| Early Return-to-Work Program | |
|---|---|
| Establish consistent performance expectations statewide. | Implemented July 2006. |
| Provide better information on claims by implementing new standards for documentation. | Implemented July 2006. |
| Legislated change | |
|---|---|
| Review data and evidence pertaining to our Return-to-Work Program and vocational rehabilitation services. | Ongoing. |
| Voc Improvement Project (VIP) implements the provisions of the 2007 legislation. | January 1, 2008. |
Other L&I projects that will impact vocational rehabilitation services
L&I developed the new Activity Prescription form (F242‑385‑000) that health care providers will use to communicate the worker's status and activity levels in two projects.
Contact Karen Jost at josk235@LNI.wa.gov, 360‑902‑6803 (Orthopedic & Neurological Surgeons) for more information about this form.
| Other L&I projects | |
|---|---|
| Streamline three forms (Estimate of Physical Capacities, Time Loss Notification and Supplemental Medical Report) into a new Activity Prescription form. | June 2006. |
| Test the form with doctors enrolled in L&I's Centers of Occupational Health and Education and the Orthopedic & Surgeon Quality Pilot and improve the form as needed. | July - November 2006. |
| Encourage the consistent reporting of work readiness by making the Activity Prescription form available to all physicians who treat injured workers. | Effective November 1, 2007. |
| L&I is working closely with stakeholders to Develop a New Performance Assessment System. A new system will be phased in and will replace the CACO formula (Cost Adjusted Complexity Outcome). | Ongoing |
