West Virginia Code
Article 4. Disability and Death Benefits
§23-4-9. Physical and Vocational Rehabilitation

(a) The Legislature hereby finds that it is a goal of the workers' compensation program to assist employees to return to suitable gainful employment after an injury. In order to encourage workers to return to employment and to encourage and assist employers in providing suitable employment to injured employees, it is a priority of the commission, successor to the commission, other private carrier or self-insured employer, whichever is applicable, to achieve early identification of individuals likely to need rehabilitation services and to assess the rehabilitation needs of these injured employees. It is the goal of rehabilitation to return injured employees to employment which is comparable in work and pay to that which the individual performed prior to the injury. If a return to comparable work is not possible, the goal of rehabilitation is to return the individual to alternative suitable employment, using all possible alternatives of job modification, restructuring, reassignment and training, so that the individual will return to productivity with his or her employer or, if necessary, with another employer. The Legislature further finds that it is the shared responsibility of the employer, the employee, the physician and the commission to cooperate in the development of a rehabilitation process designed to promote reemployment for the injured employee.
(b) In cases where an employee has sustained a permanent disability, or has sustained an injury likely to result in temporary disability as determined by the commission, successor to the commission, other private carrier or self-insured employer, whichever is applicable, the commission, successor to the commission, other private carrier or self-insured employer, whichever is applicable, shall at the earliest possible time determine whether the employee would be assisted in returning to remunerative employment with the provision of rehabilitation services and if it is determined that the employee can be physically and vocationally rehabilitated and returned to remunerative employment by the provision of rehabilitation services including, but not limited to, vocational or on-the-job training, counseling, assistance in obtaining appropriate temporary or permanent work site, work duties or work hours modification, by the provision of crutches, artificial limbs or other approved mechanical appliances, or medicines, medical, surgical, dental or hospital treatment or other services which the commission, successor to the commission, other private carrier or self-insured employer, whichever is applicable, in its sole discretion determines will directly assist the employee's return to employment, the commission, successor to the commission, other private carrier or self-insured employer, whichever is applicable, shall immediately develop a rehabilitation plan for the employee and, after due notice to the employer, expend an amount necessary for that purpose: Provided, That the expenditure for vocational rehabilitation shall not exceed $20,000 for any one injured employee: Provided, however, That no payment shall be made for such vocational rehabilitation purposes as provided in this section unless authorized by the commission, successor to the commission, other private carrier or self-insured employer, whichever is applicable, prior to the rendering of the physical or vocational rehabilitation, except that payments shall be made for reasonable medical expenses without prior authorization if sufficient evidence exists which would relate the treatment to the injury and the attending physician or physicians have requested authorization prior to the rendering of the treatment: Provided further, That payment for physical rehabilitation, including the purchase of prosthetic devices and other equipment and training in use of the devices and equipment, are considered expenses within the meaning of section three of this article and are subject to the provisions of sections three, three-b and three-c of this article. The provision of any rehabilitation services may be pursuant to a rehabilitation plan to be developed and monitored by a rehabilitation professional for each injured employee or by such other provider as determined by the commission, successor to the commission, other private carrier or self-insured employer, whichever is applicable. Notwithstanding any other provision of this section to the contrary, the commission may determine under rules promulgated by the board of managers that a rehabilitation plan or any component thereof is not appropriate for an injured employee.
(c) In every case in which the commission, successor to the commission, other private carrier or self-insured employer, whichever is applicable, orders physical or vocational rehabilitation of a claimant as provided in this section, the claimant shall, during the time he or she is receiving any vocational rehabilitation or rehabilitative treatment that renders him or her totally disabled during the period of rehabilitation, be compensated on a temporary total disability basis for that period.
(d) In every case in which the claimant returns to gainful employment as part of a rehabilitation plan, and the employee's average weekly wage earnings are less than the average weekly wage earnings earned by the injured employee at the time of the injury, he or she shall receive temporary partial rehabilitation benefits calculated as follows: The temporary partial rehabilitation benefit shall be seventy percent of the difference between the average weekly wage earnings earned at the time of the injury and the average weekly wage earnings earned at the new employment, both to be calculated as provided in sections six, six-d and fourteen of this article as the calculation is performed for temporary total disability benefits, subject to the following limitations: In no event are the benefits subject to the minimum benefit amounts required by the provisions of subdivision (b), section six of this article, nor may the benefits exceed the temporary total disability benefits to which the injured employee would be entitled pursuant to sections six, six-d and fourteen of this article during any period of temporary total disability resulting from the injury in the claim: Provided, That no temporary total disability benefits shall be paid for any period for which temporary partial rehabilitation benefits are paid: Provided, however, That the aggregate award of temporary total rehabilitation or temporary partial rehabilitation benefits for a single injury for which an award of temporary total rehabilitation or temporary partial rehabilitation benefits is made on or after the effective date of the amendment and reenactment of this section in the year two thousand three shall be for a period not exceeding fifty-two weeks unless the payment of temporary total rehabilitation disability benefits is in conjunction with an approved vocational rehabilitation plan for retraining, in which event the payment period of temporary total rehabilitation disability benefits may be extended for a period not to exceed a total of one hundred four weeks. The amount of temporary partial rehabilitation benefits payable under this subsection shall be reviewed every ninety days to determine whether the injured employee's average weekly wage in the new employment has changed and, if the change has occurred, the amount of benefits payable under this subsection shall be adjusted prospectively. Temporary partial rehabilitation benefits shall only be payable when the injured employee is receiving vocational rehabilitation services in accordance with a rehabilitation plan developed under this section and no payment of temporary partial rehabilitation benefits shall be made after the claimant has received the vocational training provided under the rehabilitation plan.
(e) The executive director, in consultation with the board of managers, shall propose for promulgation rules for the purpose of developing a comprehensive rehabilitation program which will assist injured workers to return to suitable gainful employment after an injury in a manner consistent with the provisions and findings of this section. The rules shall provide definitions for rehabilitation facilities and rehabilitation services pursuant to this section. Notwithstanding any other provision of this chapter to the contrary, and in addition to the provisions of section three of this article authorizing employers to participate in a managed health care plan, including a managed health care plan that provides physical and vocational rehabilitation services, an employer may contract directly with one or more providers of vocational rehabilitation services to be the employer's preferred provider of vocational rehabilitation services for its employees who receive injuries compensable under the provisions of this chapter and the rules promulgated under this section may require those employees to use the preferred providers.

Structure West Virginia Code

West Virginia Code

Chapter 23. Workers' Compensation

Article 4. Disability and Death Benefits

§23-4-1. To Whom Compensation Fund Disbursed; Occupational Pneumoconiosis and Other Occupational Diseases Included in Injury and Personal Injury ; Definition of Occupational Pneumoconiosis and Other Occupational Diseases; Rebuttable Presumption for C...

§23-4-1a. Report of Injuries by Employee

§23-4-1b. Report of Injuries by Employers

§23-4-1c.§23-4-1c. Payment of Temporary Total Disability Benefits Directly to Claimant; Payment of Medical Benefits; Payments of Benefits During Protest; Right of Commission, Successor to the Commission, Private Carriers and Self-Insured Employers to...

§23-4-1d. Method and Time of Payments for Permanent Disability

§23-4-1e. Temporary Total Disability Benefits Not to Be Paid for Periods of Correctional Center or Jail Confinement; Denial of Workers' Compensation Benefits for Injuries or Disease Incurred While Confined

§23-4-1f. Certain Psychiatric Injuries and Diseases Not Compensable; Definitions; Legislative Findings; Terms; Report Required

§23-4-1g. Weighing of Evidence

§23-4-2. Disbursement Where Injury Is Self-Inflicted or Intentionally Caused by Employer; Legislative Declarations and Findings; &Quot;deliberate Intention" Defined

§23-4-3. Schedule of Maximum Disbursements for Medical, Surgical, Dental and Hospital Treatment; Legislative Approval; Guidelines; Preferred Provider Agreements; Charges in Excess of Scheduled Amounts Not to Be Made; Required Disclosure of Financial...

§23-4-3b. Creation of Health Care Advisory Panel

§23-4-3c. Suspension or Termination of Providers of Health Care

§23-4-4. Funeral Expenses; Wrongfully Seeking Payment; Criminal Penalties

§23-4-5. Benefits for First Three Days After Injury

§23-4-6. Classification of and Criteria for Disability Benefits

§23-4-6a. Benefits and Mode of Payment to Employees and Dependents for Occupational Pneumoconiosis; Further Adjustment of Claim for Occupational Pneumoconiosis

§23-4-6b. Occupational Hearing Loss Claims

§23-4-6c. Benefits Payable to Certain Sheltered Workshop Employees; Limitations

§23-4-6d. Benefits Payable to Part-Time Employees

§23-4-7. Release of Medical Information to Employer; Legislative Findings; Effect of Application for Benefits; Duty of Employer

§23-4-7a. Monitoring of Injury Claims; Legislative Findings; Review of Medical Evidence; Recommendation of Authorized Treating Physician; Independent Medical Evaluations; Temporary Total Disability Benefits and the Termination Thereof; Mandatory Acti...

§23-4-7b. Trial Return to Work; Insurance Commissioner to Develop Rules

§23-4-8. Physical Examination of Claimant

§23-4-8a. Occupational Pneumoconiosis Board; Composition; Term of Office; Duties; Quorum; Remuneration

§23-4-8b. Occupational Pneumoconiosis Board; Procedure; Autopsy

§23-4-8c. Occupational Pneumoconiosis Board; Reports and Distribution Thereof; Presumption; Findings Required of Board; Objection to Findings; Procedure Thereon; Limitations on Refilings; Consolidation of Claims

§23-4-8d. Occupational Pneumoconiosis Claims Never Closed for Medical Benefits With Exception of Settled Claims

§23-4-9. Physical and Vocational Rehabilitation

§23-4-9b. Preexisting Impairments Not Considered in Fixing Amount of Compensation

§23-4-10. Classification of Death Benefits; "dependent" Defined

§23-4-11. To Whom Death Benefits Paid

§23-4-12. Application of Benefits

§23-4-13. Effect of Abandonment of Spouse

§23-4-14. Computation of Benefits

§23-4-15. Application for Benefits

§23-4-15a. Nonresident Alien Beneficiaries

§23-4-15b. Determination of Nonmedical Questions; Claims for Occupational Pneumoconiosis; Hearing

§23-4-16. Jurisdiction Over Case Continuous; Modification of Finding or Order; Time Limitation on Awards; Reimbursement of Claimant for Expenses; Reopening Cases Involving Permanent Total Disability; Promulgation of Rules

§23-4-16a. Interest on Benefits

§23-4-17. Commutation of Periodical Benefits

§23-4-18. Mode of Paying Benefits Generally; Exemptions of Compensation From Legal Process

§23-4-20. Postmortem Examinations

§23-4-21. Severability

§23-4-22. Permanent Disability Evaluations; Limitations; Notice

§23-4-23. Permanent Total Disability Benefits; Reduction of Disability Benefits; Reduction of Benefits; Application of Section; Severability

§23-4-24. Permanent Total Disability Awards; Retirement Age; Limitations on Eligibility and the Introduction of Evidence; Effects of Other Types of Awards; Procedures; Requests for Awards; Jurisdiction

§23-4-25. Permanent Total Disability Benefits; Reduction of Disability Benefits for Wages Earned by Claimant