Overview

L&I has funding to assess and modify a job or retraining site. This modification may be accomplished through the use of adjustments and job restructuring, or through tools, equipment or appliances.

If the worker has an employer

Job modification

The modification may allow the worker to return to work or allow the worker to remain at work while recovering.

Example: Molly sustained a back injury assisting a client into bed. The attending physician gave her a 30 pound lifting restriction. A job modification consultation was provided and a patient lift was recommended. Using this funding to purchase the lift, she was able to return to work full time.

If the worker does not have an employer

Pre-job accommodation

The accommodation may allow the worker to participate in a retraining plan or be employable.

Example: John was participating in a retraining plan as a computer operator at a local college. Due to a shoulder injury, he could not carry his required books to class due to a carrying restriction. A consultation was provided and a rolling book bag was recommended. Using this funding to purchase the bag, he no longer had to carry his books and was able to complete his schooling.

Billing

Occupational therapist, physical therapist, or ergonomist specialist

Note: All fees on this page are effective July 1, 2012.

Billing forms

For claims:

• Without an open vocational referral, use the Statement for Retraining Job Modification Services (F245‑030‑000) form.
• With an open vocational referral, use the Statement of Miscellaneous Services (F245‑072‑000) form.

Vocational rehabilitation provider

Billing forms

Use the Statement for Retraining Job Modification Services (F245‑030‑000) form.

Vendors

Billing forms

You can only bill 1 code (0380R or 0385R) on the:

• Statement for Retraining Job Modification Services (F245‑030‑000) form.
  or
• Statement of Miscellaneous Services (F245‑072‑000) form.

Also, attach to the form:

• If billing 0380R, a copy of the Job Modification Assistance Application form*, signed by the claim manager or therapist consultant.
• If billing 0385R, a copy of the Pre-Job Accommodation Assistance Application form*, signed by the claim manager.
  
  * This form is supplied to you by the employer, therapist, or vocational counselor, etc.

Questions/Answers

Questions and answers about job modification and pre-job accommodation.

• What are the primary differences between the two benefits?

  Job Modification	Pre-Job Accommodation
  Encourage employers to modify jobs to retain or hire injured workers.	Make it possible for the worker to perform the essential functions of a job.
  Employer-employee relationship exists. The worker: Is currently employed and receiving a wage by the employer. Has received a written offer of employment with a start date. Has received approval for an on-the-job training plan that includes a written intent to hire (even if there is no specific start date) and the employer pays the worker a wage. May be self-employed and have a business license.	No employer-employee relationship.
  Paid out of the Second Injury Fund.	Paid out of the Accident Fund.

• Who may receive these benefits?

  Job Modification

  Pre-Job Accommodation

  An injured worker who: Has a claim status which is open or in statutory pension status Has temporary or permanent restrictions resulting from the accepted condition (light or modified duty, limited physical capacities). Needs the modification to return to the job of injury or a new job. And 1 of the following applies, the worker: Is or was off work and paid time-loss compensation. Is or was paid full wages (kept on salary [KOS] by the employer). Is or was receiving loss of earning power benefits (LEP).

  An injured worker who: Has a claim that is open or Is in statutory pension status, and Has restrictions imposed by the industrial condition that prevent the worker from: Participating in an approved retraining plan; or Performing the essential functions of a job or return-to-work goal in which the worker is seeking employment consistent with: A completed retraining plan; or The recommendations of an ability to work assessment. Note: If claim is reopened 7 years after it was closed, these benefits are not available unless L&I's director has already approved other benefits from the Accident Fund.

• What are the limits?

  Job Modification

  Pre-Job Accommodation

  State Fund or self-insured employers: $5,000/per job or job site. If combined with pre-job accommodations for the same return-to-work goal, the combined limit is $5,000. Note:This does not include professional consultative services. Only modifications related to the restrictions imposed by the accepted condition are eligible. A job modification may be for more than 1 job or employer, when: The worker has 2 or more distinct jobs or job sites with 1 or more employers; and The job modification is not portable or Work demands are distinctly different at each job or job station. Note: Self-insurers may submit reimbursements for expenses to L&I's Self-Insurance Section.

  State Fund or bankrupt self-insured employers: $5,000/per claim. If combined with job modifications for the same return-to-work goal, the combined limit is $5,000. Note:This does not include professional consultative services. Only accommodations related to the restrictions imposed by the accepted condition are eligible. Self-Insured employers may pay for out-of-pocket expenses for injured workers who no longer work for them. Employers are not reimbursed for pre-job accommodation expenses.

• When are these benefits not available?

  Job Modification

  Pre-Job Accommodation

  Modification benefits are not available in the following situations: The claim is closed, To supplement retraining plan funds, or Make changes other than those needed due to the restrictions of the accepted conditions, or Solely to increase comfort or reduce the chance of injury/re-injury. For personal appliances or items: L&I generally does not purchase personal appliances or items under a claim (see WAC 296-20-100 - WAC 296-20-1102). However, these items may be purchased as a job modification if the item: Enhances the worker's employability; that is, without it the worker may not be able to work, and The employer is not already supplying to his or her employees. Job modifications and pre-job accommodations do not include modification of the home or vehicle, unless: Job modifications - directly related to work activity. Pre-job accommodations - the worker needs the modification solely to perform the essential job functions or to enable retraining.

• How is a consultation initiated?

  Job Modification	Pre-Job Accommodation
  Contact the worker's claim manager.	Contact the worker's claim manager or vocational rehabilitation provider.

• What role does the consultant play?

  Job Modification	Pre-Job Accommodation
  The consultant assesses the work site or retraining location and sends a report with recommendations. The consultant may use our Suggested Format for Consultation Report (18 KB PDF). If equipment needs to be purchased, based on the consultant's report, the consultant: Develops a formal request for a modification or accommodation: Obtains medical documentation, if for: Job modification - verify the claim file contains the worker's restrictions. Pre-job accommodation - obtain the attending physician's certification. Considers the following alternatives prior to purchasing new equipment: Improve existing equipment (e.g., portable back support instead of a new chair). Borrow or rent proposed equipment. Purchase used equipment. Selects equipment and attempts to obtain trial use to ensure it meets the worker's needs. Provides a list of equipment pre-determined as necessary for the modification or accommodation to the vendor. The vendor then develops a bid based on the list. Any item over $2,500 (except for sole source or unique items), requires 2 documented bids. Bids should include the cost of fitting, delivery, tax, warranties, set up and training. Completes the Job Modification Assistance Application (F245−346−000) form or Pre-Job Accommodation Assistance Application (F245−350−000) form. Completes the ownership agreement and obtains necessary signatures. Submits the Assistance Application and required documents to the claim manager. If modification is approved: Sends the vendor(s) a copy of the authorization letter and approved Assistance Application. If needed, helps with implementing the modification and follow-up with a report to the claim manager.
  Get Help Downloading Files (files open in a new window).

• What role does the attending physician play?

  Job Modification	Pre-Job Accommodation
  The attending physician (AP) may request a job site analysis or job modification assistance for a worker. The AP provides information in the claim file regarding restrictions. The restrictions must be related to the accepted industrial condition for which a modification is needed.	The AP certifies that the accommodations are medically necessary due to the restrictions imposed by the accepted industrial condition. They also propose accommodations which will meet the worker's needs.

• What role does the injured worker play?

  Job Modification	Pre-Job Accommodation
  May request equipment. Participates in consultation. Must sign the ownership agreement. Sends copy of business license if self-employed. Returns equipment to L&I if return-to-work or retraining plan fails.

• What role does the employer play?

  Job Modification	Pre-Job Accommodation
  Employers are encouraged to participate which may include: All or part of the cost of the job modification. Materials. Staff time. Production down time. The employer signs the ownership agreement.	State Fund employers are not involved in pre-job accommodations. Self-insured employers may pay for pre-job accommodations for workers who no longer work for them.

• What role does the equipment vendor play?

  Job Modification

  Pre-Job Accommodation

  Have an L&I provider number for State Fund claims. Submits a bid, based on the consultant's pre-determined list. The bid includes: Cost of fitting. Delivery. Tax. Warranties. Set-up. Training. Sets up equipment and provides training to the worker and employer, as needed. May not supply equipment and perform the consultation, unless authorized, in advance, as a sole-source provider by the claim manager.

• Who owns the equipment?

  Job Modification

  Pre-Job Accommodation

  State Fund: L&I owns the equipment until the return-to-work (RTW) activity is successfully completed. Then the equipment will be owned and maintained by the parties designated in the ownership agreement. Unless covered by warranty, the owner is responsible for repair or replacement of the equipment. Self-Insured employer: L&I may reimburse the self-insurer, but still owns the equipment until the worker successfully returns to work.

  L&I owns the equipment until the worker has been released for work or has successfully completed the retraining plan. Then the equipment will be owned and maintained by the worker, as noted in the ownership agreement. Unless covered by warranty, the owner is responsible for repair or replacement of the equipment.

• What happens if the equipment needs to be altered or replaced?

  Job Modification

  Pre-Job Accommodation

  Existing modifications may be altered or replaced only if: The claim is open or in statutory pension status; and There is still some money from the initial modification; and The worker's condition or the job duties that were modified have changed; or The initial modification must be enhanced to meet the worker's restrictions imposed by the accepted industrial condition.

  The adjudicator may consider authorizing alteration or replacement of the equipment only if: The claim is in open or statutory pension status, and Funds remain for the same job goal, and The worker's condition has changed; or The initial accommodation requires enhancement to meet the worker's restrictions imposed by the accepted industrial condition. If more economical, the adjudicator may replace rather than alter or repair the equipment.

• Can L&I pay to move the equipment to a new location?

  Job Modification	Pre-Job Accommodation
  L&I may cover the cost of moving the equipment if: The equipment was purchased as part of the modification or accommodation and The claim is still open and There is money remaining from the $5,000.

• What happens to the equipment when a modification or accommodation fails?

  Job Modification	Pre-Job Accommodation
  If the employer paid for part of the modification or if the equipment is affixed to the work site, the employer may retain the equipment regardless if the worker returned to work successfully. All other equipment from failed modifications should be promptly returned by the worker to the nearest L&I service location.	State Fund or bankrupt self-insured employers: Equipment from failed accommodations should be promptly returned by the worker to the nearest L&I service location.

Resources

Laws and Rules

• WAC 296-19A-010(9)(10) (www.leg.wa.gov)
  Definitions.
• WAC 296-19A-180 (www.leg.wa.gov)
  When may the department authorize job modifications?
• WAC 296-19A-190 (www.leg.wa.gov)
  How much money is available for job modification assistance?
• WAC 296-19A-192 (www.leg.wa.gov)
  How much is available for pre-job accommodations?
• WAC 296-19A-200 (www.leg.wa.gov)
  How does an employer apply for job modification assistance?
• RCW 51.32.095(4) (www.leg.wa.gov)
  Vocational rehabilitation services — Benefits — Priorities — Allowable costs — Performance criteria. (Expires June 30, 2013.)
• RCW 51.32.250 (www.leg.wa.gov)
  Payment of Job modification costs.

Forms and Publications

• Statement for Retraining Job Modification Services (F245‑030‑000).
• Statement of Miscellaneous Services (F245‑072‑000).
• Job Modification Assistance Application (F245‑346‑000).
• Pre-Job Accommodation Assistance Application (F245‑350‑000).
• Frequently Asked Questions about Job Modifications (F245‑057‑000) fact sheet.

• Suggested Format for Job Modification Consultation Report (18 KB PDF).
•  Get Help Downloading Files (files open in a new window).

Web sites

L&I's Vocational Self-Insurance.

L&I's Ergonomics Ideas Bank.

Dept. of Social and Health Services Vocational Rehabilitation (www.dshs.wa.gov).

Job Accommodation Network (www.jan.wvu.edu).