C.A.R.E. Unit - Frequently Asked Questions
What type of injuries might qualify for vocational rehabilitation?
The employer may retain a rehabilitation practitioner or provider if it is determined by the treating physician that the employee sustained an injury of sufficient severity that interferes with occupational functioning that involves:
- Severe mangling, crushing, amputation or nerve impairment of a major extremity;
- A traumatic injury to the spinal cord that has caused or may cause paralysis or severe restriction of movement;
- Severe Burns;
- A serious head injury with neurological or neuropsychological involvement; or
- Loss of sight in one or both eyes or loss of hearing in both ears or loss of speech or both.
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How are injured employees identified?
The Director of the Division of Workers′ Compensation reviews medical reports and other documents submitted to the Division to identify injured workers who might benefit from vocational rehabilitation.
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How long does the plan cover?
- The initial period of the plan cannot exceed 26 weeks.
- Only the employer may extend the plan for an additional 26 weeks.
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What does it cost?
The maximum cost for implementing the vocational testing, vocational rehabilitation plan, tuition or retraining shall not exceed five thousand ($5,000) dollars. Medical treatment, medical evaluation and the provider’s fees are excluded.
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Will temporary total disability (TTD) or temporary partial disability (TPD) benefits continue to be paid?
Yes, benefit payments will continue to be paid throughout the rehabilitative process.
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Can an employee refuse vocational rehabilitation?
Yes, however, if the employee refuses services and the vocational rehabilitation has been deemed necessary; the employer shall reduce all disability payments including temporary partial disability benefits, by 50% for each week of refusal.
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How is the jurisdiction or venue of a case determined?
Unless the parties otherwise agree, the hearings are held in the county, or in a city not part of a county where the accident occurred, or in any county, or city that is adjacent. If the accident occurred outside of the state of Missouri, the hearing is held in the county or city where the contract of employment was entered or where the employee′s employment is primarily situated.
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How do I use the auto-calculate Form Commencement and Termination of Compensation?
Download both the form and instruction page which is in the format of an Excel spreadsheet. The instruction page provides detailed information for filing out the Notice of Commencement/Termination of Compensation (WC-2) Excel Spreadsheet
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Do I need to file a First Report of Injury on an Incident only case?
Section 287.380 (1), RSMo states: "Every employer or his insurer in this state...shall within 30 days after knowledge of the injury, file with the division...a full and complete report of every injury or death to any employee for which the employer would be liable to furnish medical aid, other than immediate first aid which does not result in further medical treatment or lost time from work..."
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What forms does the Division accept electronically?
The First Report of Injury and changes or corrections to the First Report of Injury.
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How do we file First Reports of Injury electronically?
Insurance companies or third party administrators must sign a Trading Partner Agreement with the Division of Workers′ Compensation to file electronically. The Trading Partner Agreement will provide detailed instructions for electronic submissions. The Trading Partner will initially send test data to the division. Once the Division is satisfied that the Trading Partner can submit the data in the correct format with all mandatory information provided the Division will notify the Trading Partner that they can start sending production data. For more information click here.
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Why would an electronic First Report of Injury be returned to the sender?
Mandatory information may not have been provided. In addition, there may be other technical errors that result in the First Report of Injury being returned to the sender. The sender is required to resubmit the First Report of Injury after corrections are made. The EDI File Matrix defines the reasons a report may be returned to the sender for correction.
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What are the benefits of filing reports electronically to the Division?
EDI is a cost effective way to report the injury plus it is received and acknowledged by the Division within one or two business days. This method assists the employer-insurer with meeting the reporting timelines outlined by statute. The information is reported in a consistent, accurate and standardize format established by the International Association of Accident Boards and Commissions (IAIABC).
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