Department of Labor Revises Form 16 Release and Form 27 Notice to Discontinue Benefits

The Vermont Department of Labor has revised the Form 16 and the Form 27.  The new forms are now available on the Department's website and should be used from this point forward:

http://labor.vermont.gov/forms/#comp

The Department has asked that parties discontinue use of all previous versions of the Form 16 and Form 27. 

New Laws Place Limits on IME, Increase Amounts Paid for Burial and Funeral Expenses; Change Procedures for Discontinuances; and Requires Notice on Communications

The Vermont legislature has passed a bill with sections that will change certain aspects of workers’ compensation claims administration.  Assuming the Governor signs the legislation, the following changes go into effect July 1, 2014.

Below are summaries of four sections of the bill that will impact the handling of claims including: limitations on the employer’s ability to obtain a second opinion; increases to the maximum amounts paid for burial and funeral expenses in death claims; changes to the process for obtaining a discontinuance; and a requirement that contact with injured workers contain a statement regarding the ability to contact the Department of Labor.

Second Opinions:

The Legislature has limited the ability of an employer to have a medical provider conduct a second opinion with regards to a workers’ compensation claim.  Previously any exam performed at the request of the employer must be reasonable as to time and place.  With this legislation employers are limited to scheduling examinations within a two hour driving distance of the residence of the employee.  The Commissioner may permit an examination outside of the two hour driving radius if it is necessary to obtain the services of a provider that specializes in evaluation and treatment specific to the nature and extent of the employee’s injury.  See, 21 VSA §655.

Burial and Funeral Expenses:

The legislation increases the amount paid by employers for burial expenses when a work related injury results in death.  When death results from a work related injury the employer is responsible for paying the actual costs of burial and funeral expenses in an amount not to exceed $10,000 and the actual expenses for out of state transportation of the decedent to the place of burial in an amount not to exceed $5,000.  Previously an employer was to pay $5,500 for burial and funeral expenses and $1,000 for transportation.  Also, every two years the Commissioner is tasked with evaluating the average amount for burial and funeral expenses, and provide a recommendation to the Legislature as to whether an adjustment is warranted. See, 21 VSA §632. 

If a person has suffered a work injury and dies from some other cause while receiving disability or impairment benefits if the person does not have a dependent, then the employer is liable to pay the remaining amount due but no more than the actual burial and funeral expenses not to exceed $10,000.00 and the actual expenses for out-of-state transportation of the decedent to the place of burial not to exceed $5,000.00. See, 21 VSA §639.

Discontinuance of Benefits:

When an employer seeks to discontinue benefits the employer shall continue to give the employee seven days notice from receipt of the discontinuance before terminating the benefit.  However, new language has been added that “if the claimant disputes the discontinuance, the Claimant may file with the Commissioner an objection to the discontinuance and seek an extension of 14 days.  The objection to the discontinuance shall be specific as to the reasons and shall include supporting evidence.  A copy of the objection shall be provided to the employer at the time the request is made to the Commissioner.” The statute continues to provide that the payments are made without prejudice and may be deducted from any amounts due for impairment if the Commissioner approves the discontinuance.  See, 21 VSA §643a.  The statute has a sunset provision repealing it on July 1, 2018 and replacing it with statute that was in effect prior to this amendment. 

There is also a provision that the Commissioner assess the financial and administrative impacts of the provisions and provide the Legislature with a report in 2017 that addresses: whether the statutory provisions expedited the discontinuance process; whether the statutory provisions affected workers’ compensation rates; how many requests were received, acted on, the time required for action; whether there was an order for reinstatement of benefits; and any other matters deemed relevant by the Commissioner.  See, 21 VSA §654c.

Notice Required on Communications with Claimants:

A new provision requires that any communication from the employer or insurance carrier to the claimant that is not required to be on a form must include a statement advising the claimant that he or she should contact the Department of Labor’s Workers’ Compensation Division to determine any right to object or appeal, as provided by law and to seek information from the Department on process and procedures. See, 21 VSA §602.

Vermont Senate Considers Workers' Compensation Bill

The Vermont House has passed H. 645 an act relating to workers’ compensation.  The legislation is now pending in the Vermont Senate where it is being considered in the Senate Finance Committee.

The Bill’s provisions include:

·         An increase the amount payable for funeral expenses from $5,500.00 to $10,000.00;

·         An increase in the amount payable for transportation of the decedent to the place of burial to $5,000.00;

·         An injured worker who disputes a discontinuance may file for an extension of the seven day waiting period extending the liability for payment for an additional seven days;

·         Only relevant evidence is to be filed with a discontinuance;

·         That the Commissioner adopt Rules governing prescription of opiods; and

·         That the Commissioner adopt Rules promoting development and implementation of cost-effective, early return-to- work programs.

The legislation is located at the following link:  http://www.leg.state.vt.us/database/status/summary.cfm?Bill=H%2E0645&Session=2014

Making Settlement Payments Payable to Claimant's Attorneys

Common practice in Vermont has been that a lump sum payment for benefits is made payable to the claimant and sent to the claimant's attorney with Department approval.  It appears that, due to IOLTA (Interest on Lawyer's Trust Accounts) trust account requirements, attorney's representing injured workers have recently requested that drafts be made payable jointly to the injured worker and the attorney. 

The Vermont Workers' Compensation Rules provide that, "a check for a claimant's workers' compensation benefits may not be made payable either solely or jointly to the claimant's attorney unless approved, in writing, by the commissioner." Vermont Workers' Compensation Rules, Rule 10.5  Carriers may consider incorporating language into the settlement documents that allows the settlement draft to be made payable to the injured worker and the injured worker's attorney.  This can be done in addition to the language allowing for the settlement draft to be sent to the injured worker's attorney.


 

Department Revises Vocational Rehabilitation Referral Form

The Vermont Department of Labor has revised the form used to refer injured workers for vocational rehabilitation services.

The new Vocational Rehabilitation Referral Form (VR-1) requires the following new information:
(1)  electronic mail addresses for the claimant, claimant's attorney, the vocational provider and the adjuster/defense attorney; and 
(2)  the name of a contact person at the employer. 

The revisions move the lines to identify the name of the treating physician and the type of injury sustained to the section entitled, "Employee Information."

The Department has noted, that as of now, companies should discontinue use of the prior version of the VR-1.

 

The new form is located at the following link:

http://labor.vermont.gov/LinkClick.aspx?link=VR%2fVRreferral82013fillin.pdf&tabid=170&mid=583

Department of Labor Updates Change of Vocational Provider Form

Today the Vermont Department of Labor has issued an update to the Change of Vocational Provider Form (VR-8).  The Department has asked that previous versions of the Form be discontinued as of this date.  

 

The new form is available at the following link:

http://labor.vermont.gov/FormsPublications/WCFormsandPublications/VRForms/tabid/185/Default.aspx

Department of Labor Creates "Health Care Provider Report" Form

The Vermont Department of Labor has created a new form to assist physicians in providing the employer/carrier with information regarding the treatment of an injured worker.  The form is called the “Health Care Provider Report” and is also known as the HCP1. The form is not required to be filed.  The Department describes this as a tool to assist in obtaining relevant medical information regarding workers’ compensation injuries/illnesses. 

The form is a one page document that provides basic information such as: The employee’s name, address, date of birth and phone number; Information regarding the injury itself, such as, the date of the injury, the body part injured, the date of the examination, the diagnosis and whether the injury was work related; A line is provided for documenting test results, interpretation of the results, what medications are prescribed and what the treatment plan is; and there is a section for a brief comment on return to work.

This form is not required.  It does not change the law that requires that any provider seeking reimbursement for services must provide legible, supporting documentation. Vermont Workers’ Compensation Rules, Rule 40.021(C).  That supporting documentation is described as, “documentation for each service provided which is sufficiently detailed to allow for the review of the medical necessity of the service and the appropriateness of the fee charged.” Vermont Workers’ Compensation Rules, Rule 40.021(E).

The link to the new form is:

http://www.labor.vermont.gov/Portals/0/WC/healthcareprovidersrpt.pdf