VOUCHER 411

ANSWERS TO FREQUENTLY ASKED QUESTIONS ABOUT SUPPLEMENTAL JOB DISPLACEMENT BENEFITS (SJDB)

The FAQs below apply to claims filed on or before Jan. 1, 2013. Updated information based upon the implementation of SB 863 and its changes to California’s workers’ compensation system will be available soon.

VOUCHER 411

ANSWERS TO FREQUENTLY ASKED QUESTIONS ABOUT SUPPLEMENTAL JOB DISPLACEMENT BENEFITS (SJDB)

The FAQs below apply to claims filed on or before Jan. 1, 2013. Updated information based upon the implementation of SB 863 and its changes to California’s workers’ compensation system will be available soon.

TOPICS COVERED IN THIS FAQ INCLUDE:

  • Voucher criteria and eligibility requirements
  • How the voucher works and determining amounts
  • When an employee can expect to receive the voucher and when payments are due
  • Time frames for using the voucher
  • Training facilities and the Bureau for Private Postsecondary Education
  • Vocational return to work counselors and how they are involved in the voucher process
  • Out of state use of the voucher
  • Where I should go if my claims administrator and I disagree on the voucher
  • Options for students faced with school closure

About voucher criteria and eligibility requirements:

Q: What is the SJDB voucher and what is covered?

A: Employees injured between Jan. 1, 2004 and Dec. 31, 2012, who are permanently unable to do their usual job, and whose employer does not offer other work, may qualify for the SJDB. The benefit comes in the form of a non-transferable voucher that can be used to pay for educational retraining or skill enhancement, or both, at state-approved or state-accredited schools. The voucher covers school tuition, fees, books and expenses required by the school for training. No more than 10 percent of the value of the voucher can be used for vocational & return to work counseling. The amount of the voucher varies from $4,000 to $10,000, depending on the permanent disability level.

Employees injured on or after Jan. 1, 2013, who are permanently unable to do their usual job, and whose employer does not offer other work, may also qualify for the SJDB voucher. The voucher amount is $6000 for all permanent disability ratings and can be used for training at a California public school or any other provider listed on the state’s eligible training provider list. It can also be used to pay licensing or certification and testing fees, to purchase tools required by a training course, to purchase computer equipment of up to $1,000 and to reimburse up to $500 in miscellaneous expenses. Up to 10 percent, or $600 may be used to pay for the services of a licensed placement agency or vocational counselor. No more than 10 percent of the value of the voucher can be used for vocational & return to work counseling.

Q: When is the voucher available?

A: For injuries occurring between Jan. 1, 2004 and Dec. 31, 2012, the voucher is offered to an injured worker when his or her PD level has been determined, either by way of an agreement between the worker and the employer or insurance company or by way of an award by a workers’ compensation judge. For injuries on or after Jan. 1, 2013, the voucher is due 60 days after a treating doctor, agreed medical evaluator (AME), or qualified medical evaluator (QME) declares the injured worker permanent and stationary, and issues a report outlining the worker’s work capacities, if the employer does not offer the worker a job. The job must pay no less than 85 percent of the worker’s earnings at the time of the injury, and must be expected to last at least 12 months.

Q: What if my employer offers a modified or alternative job and I don’t accept it — can I still receive the voucher?

A: No. For injuries occurring between Jan. 1, 2004 and Dec. 31, 2012, if the employer sends a notice of offer of modified or alternative work within 30 days of your last temporary disability (TD) payment and the offer meets certain requirements, and you don’t accept the job, you’re not eligible for the voucher. The offer of modified or alternative work must meet the following conditions:

  • You have the ability to perform the essential functions of the job
  • The job is a regular position lasting at least 12 months
  • The job offers wages and compensation that are at least 85 percent of those paid to you at the time of your injury
  • The job is located within reasonable commuting distance of your residence at the time of injury.

For injuries on or after Jan. 1, 2013, if the employer makes an offer of regular, modified, or alternative work within 60 days after receipt by the claims administrator of the Physician’s Return-to-Work & Voucher Report and the offer meets certain requirements and you don’t accept the job, you’re not eligible for the voucher. The offer of modified or alternative work must meet the following conditions:

  • You have the ability to perform the essential functions of the job
  • The job is a regular position lasting at least 12 months
  • The job offers wages and compensation that are at least 85 percent of those paid to you at the time of your injury
  • The job is located within reasonable commuting distance of your residence at the time of injury.

 



About how the voucher works and determining amounts:

Q: How does the voucher work?

A: For injuries occurring between Jan. 1, 2004 and Dec. 31, 2012, you will receive the voucher. When you receive the voucher, the claims administrator should have completed lines 1 – 8. You are then responsible for completing lines 9 – 19. Lines 9 – 12 must be completed when using a vocational return to work counselor (VRTWC). A list of counselors is available to you on the DWC Web site. If you do not select a counselor, you do not need to complete lines 9 – 12. The training provider you select should assist you in completing lines 13 – 19 on the voucher. You can contact the Bureau for Private Postsecondary Education (BPPVE) at www.bppe.ca.gov to get a list of accredited training providers in your area. When you have completed the voucher, you must sign and date it before sending it back to the claims administrator. You must also attach any receipts or invoices for direct payment to you, the training provider, and/or the VRTWC. You can expect the payment to be made within 45 calendar days from the date the claims administrator receives the voucher.

For injuries on or after Jan 1, 2013, you will receive the voucher. on. When you receive the voucher, the claims administrator should have completed the information on the first page. If you will be using the services of a vocational return-to-work counselor, and/or training provider or school, complete the second page and mail it along with a copy of the first page to the claims administrator. If you would like to request an advance and/or reimbursement on miscellaneous expenses up to $500, complete the third page and return it to the claims administrator. If you would like to request reimbursement for computer equipment, tuition, fees, books, and/or tools, return page four to the claims administrator along with receipts and documentation. You can expect the payment to be made within 45 calendar days from the date the claims administrator receives the voucher.

Q: What is the amount of the voucher and how is the amount determined?

A: For injuries occurring between Jan. 1, 2004 and Dec. 31, 2012, the amount of the voucher depends on the amount of your disability award:

Up to $4,000 voucher for permanent partial disability of less than 15 percent
Up to $6,000 voucher for permanent partial disability between 15 and 25 percent
Up to $8,000 voucher for permanent partial disability between 26 and 49 percent
Up to $10,000 voucher for permanent partial disability between 50 and 99 percent
For injuries occurring on or after Jan 1, 2013, the amount of the voucher is $6000.

 


About when an employee can expect to receive the voucher and when payments are due:

Q: When will I receive the supplemental job displacement benefit voucher?

A: For injuries occurring between Jan. 1, 2004 and Dec. 31, 2012, if you are eligible for the voucher and you haven’t settled your eligibility (as part of an overall settlement in your case) you will receive the voucher from the claims administrator within 25 calendar days from the date your disability award is issued by the workers’ compensation judge at the local Workers’ Compensation Appeals Board district office. For injuries occurring on or after Jan. 1, 2013, the voucher is due 60 days after a treating doctor, AME or QME declares the injured worker permanent and stationary, and issues a report outlining the worker’s work capacities, if the employer does not offer the worker a job.

Q: When can I expect to receive the payments specified in the voucher?

A: The claims administrator must issue reimbursement payments to you or direct payments to the VRTWC and training provider within 45 calendar days from receipt of the completed voucher, receipts and documentation.

 


About time frames for using the voucher:

Q. Does a voucher expire?

A. The voucher does not expire if issued prior to Jan. 1, 2013. If issued on or after Jan. 1, 2013, the voucher will expire within two years of being issued or five years from the date of injury, whichever comes later.

 


About education and training facilities:

Q: For injuries occurring between Jan. 1, 2004 and Dec. 31, 2012, where can I find information on approved private providers of education-related retraining or skill enhancement schools?

A: Mailing address:

Bureau for Private Postsecondary Education
P.O. Box 980818
West Sacramento, CA 95798-0818

Physical address:

Bureau for Private Postsecondary Education
1625 North Market Blvd., Suite S-202
Sacramento, CA 95834
Phone: (916) 574-7720 Toll Free: (888) 370-7589
Web site: www.bppe.ca.gov
E-mail: [email protected]

Q. For injuries occurring on or after Jan. 1, 2013, where can I find information about state-certified providers?

A: The State of California’s Eligible Training Provider List can be viewed at http://etpl.edd.ca.gov.

  


About the vocational return to work counselor (VRTWC) and how he or she is involved in the voucher process:

Q: Am I required to select a vocational return to work counselor (VRTWC) and how do I find one?

A: You are not required to use a VRTWC. However, you might want to use an expert who can help you choose a training program that’s in step with your abilities and medical restrictions. VRTWCs are paid to help injured workers figure out a vocational goal and a return to work plan.

The Division of Workers’ Compensation (DWC) maintains a VRTWC list.

Q: How is the VRTWC paid and what is the most he or she can receive?

A: The claims administrator pays the VRTWC the amount specified in the voucher. In no event shall the amount paid to a VRTWC be more than 10 percent of the total value of the voucher.

 


About out of state use of the voucher:

Q: Can I use the voucher out of state?

A: Yes for injuries occurring between Jan. 1, 2004 and Dec. 31, 2012. You can use the voucher to pay an out of state private provider of education-related retraining or skill enhancement. The provider must be approved by the governing state agency similarly to the way California providers are approved.

For injuries occurring on or after Jan. 1, 2013, education-related retraining or skill enhancement must be with a California public school or with a provider that is certified and on the state’s Eligible Training Provider List.

 


About where I should go if my claims administrator and I disagree on the voucher:

Q: What if I disagree with the claims administrator about the SJDB voucher?

A: You can file a Request for Dispute Resolution form with the DWC. The form will be reviewed by the DWC and a decision will be issued. Send the “Request for Dispute Resolution” form to:

State of California
Department of Industrial Relations
Division of Workers’ Compensation
Supplemental Job Displacement Benefits (SJDB)
Attn: Administrative Director
P.O. Box 420603
San Francisco, CA 94142

 


About options for the students faced with school closure:

Q: What happens if I paid tuition prior to enrolling and the school files for bankruptcy and/or closes?

A: The best option for students faced with a school closure is to retain credits earned, continue their course of studies and obtain their certificate or degree. For most students, this involves a transfer to another school.

If continuing studies is not possible, students may consider other options, including requesting a refund of tuition, discharge of their student loans, or other compensation. However, selecting discharges or refunds will likely result in the loss of credits already earned according to the Bureau for Private Postsecondary Education. There may also be legal remedies. For more information, including a loan discharge application, go to http://studentaid.ed.gov/.

 


 

December 2012