(a) In the event of a catastrophic injury, the employer shall
furnish the employee entitled to benefits under this chapter with
reasonable and necessary rehabilitation services. The employer
either shall appoint a registered rehabilitation supplier or give
reasons why rehabilitation is not necessary within 48 hours of the
employer's acceptance of the injury as compensable or notification
of a final determination of compensability, whichever occurs later.
If it is determined that rehabilitation is required under this Code
section, the employer shall have a period of 15 days from the date
of notification of that determination within which to select a
rehabilitation supplier. If the employer fails to select a
rehabilitation supplier within such time period, a rehabilitation
supplier will be appointed by the board to provide services at the
expense of the employer. The rehabilitation supplier appointed to a
catastrophic injury case shall have the expertise which, in the
judgment of the board, is necessary to provide rehabilitation
services in such case. (b) A change in the designated rehabilitation supplier shall be made
only with approval of the board. Any party to the case may request
the board for a change in rehabilitation supplier. The request
shall be in a form and manner prescribed by rule of the board and
copies of the request shall be served on all parties and each
involved rehabilitation supplier. Written objections to the request
for a change in rehabilitation supplier may be filed with the board
during the 15 day period following the date shown on the certificate
of service and the board shall resolve such objections. (c) The refusal of the employee without reasonable cause to accept rehabilitation shall entitle the board in its discretion to suspend or reduce the compensation otherwise payable to such employee unless, in the opinion of the board, the circumstances justify the refusal, as determined in the manner provided under Code Section 34-9-100. The board may require recommendations from a panel of specialists in determining whether or not suspension or reduction of compensation is justified. (d) Fees of rehabilitation suppliers and the reasonableness and
necessity of their services shall be subject to the approval of the
State Board of Workers' Compensation. All rehabilitation suppliers
shall file with the board all forms required by the board. No
rehabilitation supplier shall bill an employee for authorized
rehabilitation services. The board may require recommendations from
a panel of appropriate peers of the rehabilitation supplier in
determining whether the fees submitted and necessity of services
rendered were reasonable. The recommendations of the panel of
appropriate peers shall be evidence of the reasonableness of fees
and necessity of service which the board may consider. (e) Failure of the employee's attorney to cooperate with the rehabilitation supplier may result in the suspension or reduction of the fees provided in Code Section 34-9-108 if, in the judgment of the board, the failure to cooperate hindered the restoration of the employee to suitable employment. (f) Any rehabilitation supplier shall hold one of the following
certifications or licenses:
(1) Certified Rehabilitation Counselor (CRC); (2) Certified Disability Management Specialist (CDMS); (3) Certified Rehabilitation Registered Nurse (CRRN); (4) Work Adjustment and Vocational Evaluation Specialist (WAVES);
or (5) Licensed Professional Counselor (LPC) and shall be registered with the State Board of Workers' Compensation. The board shall have the authority to refuse to register an applicant as a rehabilitation supplier, to remove a rehabilitation supplier from a case, to require corrective actions of a rehabilitation supplier, to assess penalties as provided under Code Section 34-9-18 against a rehabilitation supplier, or to suspend or revoke the board registration of a rehabilitation supplier for failure to comply with this chapter or the rules and regulations of the board or the standards of ethics of the applicable licensing or certifying body. Revocation of registration shall be determined in a hearing before an administrative law judge and an adverse decision may be appealed as provided under Code Sections 34-9-103 and 34-9-105. The board may establish by rule based upon recognized qualifications, educational standards, and competency in the field of rehabilitation suppliers, as determined and set out by the board, those persons who will be authorized to provide rehabilitation services to injured employees under this chapter. (g) "Catastrophic injury" means any injury which is one of the
following: (1) Spinal cord injury involving severe paralysis of an arm, a
leg, or the trunk; (2) Amputation of an arm, a hand, a foot, or a leg involving the
effective loss of use of that appendage; (3) Severe brain or closed head injury as evidenced by: (A) Severe sensory or motor disturbances; (B) Severe communication disturbances; (C) Severe complex integrated disturbances of cerebral function; (D) Severe disturbances of consciousness; (E) Severe episodic neurological disorders; or (F) Other conditions at least as severe in nature as any
condition provided in subparagraphs (A) through (E) of this
paragraph; (4) Second or third degree burns over 25 percent of the body as a
whole or third degree burns to 5 percent or more of the face or
hands; (5) Total or industrial blindness; or
(6) Any other injury of a nature and severity that prevents the
employee from being able to perform his or her prior work and any
work available in substantial numbers within the national economy
for which such employee is otherwise qualified. A decision
granting or denying disability income benefits under Title II or
supplemental security income benefits under Title XVI of the
Social Security Act shall be admissible in evidence and the board
shall give the evidence the consideration and deference due under
the circumstances regarding the issue of whether the injury is a
catastrophic injury. The rehabilitation supplier appointed to a catastrophic injury case
shall have the expertise which, in the judgment of the board, is
necessary to provide rehabilitation services in such case. (h) In the event of an injury that is not catastrophic, the parties
may elect that the employer will provide a rehabilitation supplier
on a voluntary basis for so long as the parties agree in writing.
The rehabilitation supplier utilized by the parties must hold one of
the certifications or licenses specified in subsection (f) of this
Code section and be registered with the State Board of Workers'
Compensation or have the expertise which, in the judgment of the
board, is necessary to provide rehabilitation services in the case. |