NAC616C.601. Suspension or termination of vocational rehabilitation benefits: Grounds; report by private carrier; notice; appeal.  


Latest version.
  •      1. An injured employee who:

         (a) Rejects a suitable program of vocational rehabilitation which is offered to him or her;

         (b) Rejects employment which is within the limitations prescribed by a treating physician or chiropractor; or

         (c) Refuses to cooperate with the insurer in the development of a program of vocational rehabilitation or a search for a job,

    Ê is subject to a suspension or termination of his or her vocational rehabilitation benefits.

         2. An injured employee who has agreed to participate in a suitable program of vocational rehabilitation but who:

         (a) Fails to report for scheduled activities, a search for a job, training or employment;

         (b) Reports but refuses to cooperate with the insurer;

         (c) Reports but is impaired by alcohol or drugs not prescribed by a physician;

         (d) Has an unexcused absence of 3 or more consecutive days; or

         (e) Has unexcused absences that prevent him or her from:

              (1) Completing the training in the period specified in the agreement for the program; or

              (2) Developing skills for employment,

    Ê is subject to a suspension or termination of his or her vocational rehabilitation benefits.

         3. An insurer may terminate vocational rehabilitation benefits if the injured employee has misrepresented or concealed a matter which was material to the evaluation of his or her eligibility or the provision of vocational rehabilitation services.

         4. If the insurer is a private carrier, it shall report to the employer each injured employee who rejects or fails to participate in a program of vocational rehabilitation. The report must contain a brief description of the facts and a statement of the determination of the private carrier to suspend or terminate benefits at a specified future date.

         5. Vocational rehabilitation benefits terminate on the date specified in the report of the private carrier.

         6. An insurer shall give the injured employee a written notice that his or her vocational rehabilitation benefits have been suspended or terminated and a statement of the reason for the suspension or termination.

         7. An injured employee whose vocational rehabilitation benefits have been suspended or terminated is entitled to a hearing on the suspension or termination and may appeal from any decision of a hearing officer on that matter.

     [Industrial Comm’n, No. 14.070, eff. 7-1-73; A 3-26-82; renumbered as 6.070, 6-30-82]—(NAC A by Div. of Industrial Insurance Regulation, 10-26-83; A by Div. of Industrial Relations, 1-20-94; R098-98, 12-18-98; R098-98, 12-18-98, eff. 7-1-99)