Resources for Carriers, TPAs and Disability Insurers

Claims professionals at workers' compensation carriers, third-party administrators and disability insurers refer to KWVRS for two kinds of work: vocational opinions that answer a question on a claim, and placement that works to return a claimant to employment. The opinions are written by credentialed rehabilitation counselors for the adjuster, the nurse case manager or the claims counsel who asked the question, and each states its method, its sources and the records it relied on, so that the file holds a reasoned basis for the decision the claim turns on.

A labor market survey identifies employers who hire for the occupations a claimant can perform within the documented restrictions and records the openings, the wage offered where the employer states one and the hiring requirements. A transferable skills analysis maps the skills from the claimant's work history to occupations that fit the restrictions, using the occupational classifications and the worker traits each occupation requires. A vocational evaluation combines the record review, an interview and, where the question calls for it, testing into an opinion on whether the claimant can work, in which occupations and at what wage. An earning capacity analysis prices that opinion against the wages the labor market pays for those occupations.

Each of these is a report, delivered to the referral source on the schedule agreed at referral, and each is written to be relied on in the claim: by the adjuster who decides a benefit, by the hearing officer or the court if the claim is contested, and by counsel on either side. The referral source sets the question, supplies the records and receives the report. KWVRS does not change the method for the party that asked.

Return-to-work placement is a service to the claimant rather than an opinion about the claimant. When the pre-injury job is gone or no longer fits the restrictions, a certified rehabilitation counselor builds a vocational profile, sets target occupations inside the restrictions, prepares the resume and the applications, rehearses interviews, contacts employers who hire for those occupations and records every contact, application, interview and offer in a dated log. The job placement page describes the service in full, with its process, timeline and cost pages.

The referral sets the scope. A carrier can refer a full placement engagement, job-seeking skills training on its own, a labor market survey with live leads, or the documentation of a search the claimant is already conducting. It also sets the hours authorized and the interval at which status reports are due. Each status report covers the period since the last: employer contacts, applications and interviews, the claimant's participation, any change in the restrictions the referral source has passed on, and what the next period targets. A closure report collects the whole search log when the file closes, whether on a hire or on the referral source's instruction.

The counselor reports to the adjuster or the nurse case manager named in the referral and takes direction from that person on scope and hours. Placement is billed hourly or against the hours the referral source authorizes, with a written estimate and the rate schedule provided before work begins; a change to the scope or the hours is confirmed in writing before the work continues.

A referral starts on the contact form. Choose "Job Placement Referral" under Case Type, name the claim and the referring organization, and describe the scope being authorized. KWVRS confirms receipt, runs the conflict check described below and replies with the written estimate and the rate schedule.

Send with the referral, or as soon after as the file allows: the documented restrictions from the treating provider, with the date and the provider; the claimant's work history, with job titles, employers and dates, and any education or training record on file; the authorized hours and the period they cover; and the reporting interval the claims file requires. Contact details for the claimant and for the adjuster or nurse case manager who will direct the file complete the referral. Vocational opinions, labor market surveys and transferable skills analyses are referred the same way, with the question to be answered stated in the message.

KWVRS provides job placement in person in New Jersey and Virginia and remotely elsewhere. In-person engagements cover the intake meeting and the job-seeking skills sessions; remote engagements cover the same steps by telephone and video, with employer contact by telephone and email. In both, the search targets employers in the claimant's own labor market. Vocational opinions and surveys are prepared for claims in any state, from the records and the labor market data for that state.

KWVRS provides both forensic vocational opinions and placement, by the same kind of counselor, and keeps them apart within any one matter. The rule is that KWVRS does not provide placement services to a person for whom KWVRS is, or is expected to be, the retained forensic expert in the same matter, and it does not accept a forensic engagement for a person it is placing in that matter. A counselor who placed a claimant does not later testify about that claimant's capacity in the same claim, and an expert who evaluated a claimant does not then place the claimant for the same claim.

The check is made at referral. Every placement referral is checked against the firm's open forensic matters before it is accepted. A match is flagged for review before any work begins, and the default is to decline or to refer the placement to another provider. A claims professional who wants both services for the same claimant in the same claim is told which one KWVRS will provide, so that the file is never served by a counselor in two roles.