Management Follow-Up Services
Kroninger, Chief of Medical Operations
and procedure #VR-03-01
purpose of this policy is to ensure the requirements for providing follow-up
vocational rehabilitation services are clearly detailed.
policy applies to the:
disability management coordinators (DMC);
care organization (MCO) staff involved in the coordination and management of
the vocational rehabilitation program; and
rehabilitation case managers (VRCM) assigned by the MCO.
“Vocational Rehabilitation Definitions” in Chapter 4 of the MCO Policy
A. It is the policy of BWC
to provide follow-up services to an IW that has returned to work as the result
of participating in a comprehensive vocational rehabilitation plan.
B. BWC will only reimburse
for follow-up services when the IW returns to work as a result of the
vocational rehabilitation plan, whether or not the plan was completed.
C. It is the policy of BWC
that follow-up services may be provided, as needed, when the return to work
occurs during pre-plan or during an assessment plan, or following a job
A. The VRCM shall provide
follow-up services in a comprehensive plan for as long as needed, but for not
less than 30 calendar days after an IW returns to work. Follow-up services may
be provided concurrent with other services (e.g., on the job training, gradual
return to work).
B. If the VRCM determines
that post-return-to-work services are needed beyond 30 calendar days after the
IW returns to work:
1. The VRCM shall include
a justification in the narrative section of the Vocational Rehabilitation
Progress Report (RH-46); and
2. The time shall be submitted
on the Authorization Request for Vocational Rehabilitation Plan (RH-45).
C. If the VRCM determines
that follow-up services are appropriate following a return to work, during
assessment plan or a job retention plan, the VRCM shall amend the assessment or
job retention plan and provide justification.
D. The VRCM shall instruct
the IW who is returning to work to immediately contact the VRCM concerning any
problems that might affect maintaining employment. The VRCM shall take prompt
action to resolve such issues.
E. If employment is not maintained
during the follow-up period, the VRCM and the MCO shall staff the case to
determine plan direction.
F. The DMC shall ensure
the IW is aware of provisions for living maintenance wage loss if the IW
appears eligible. (See the Living Maintenance Wage Loss policy).
G. For information
regarding outcome payments refer to the Provider Billing and