Request for Plan Development Extension (State Fund)

Document Information
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Title
Description For state fund use only. Use this form to request a "good cause" extension to the 90-day requirement during vocational plan development. Examples of good cause include, but are not limited to: - A death in the worker's immediate family. For purposes of determining good cause, immediate family is defined as spouse, domestic partner, child, sibling, parent or grandparent. - Delays caused by documented changes in the worker’s medical ability to participate in plan development. - Information received by the vocational rehabilitation provider that impacts plan development and was not available when assessment services were provided. - Documented delay in receipt of requested information from a medical provider relevant to developing the vocational plan. - The impact of previously identified barriers to employment and/or retraining.
Detail
Form number F280-025-000
Availability
Online only. See document above to download.
Keywords
Languages English
Valid dates All dates valid
Contact information

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