Thursday, October 27, 2016

Vocational Rehabilitation Questions

Less than a year ago the national conversation on Worker's Compensation began. Serious questions were asked about the future of this system. I am pleased that those conversations have extended, and multiple organizations are attempting to focus attention on the future of this integral part of American employment. Hats are being removed, and interests set-aside, as a fresh look is taken. 

At the first gathering in Dallas, last spring, there was a significant discussion of vocational rehabilitation. There was a perception expressed that vocational rehabilitation has been unsuccessful, and questions about that were raised. It is perhaps fair to ask whether vocational rehabilitation has a viable place in Worker's Compensation today? It is also perhaps important for the perceptions about it to be considered. Is vocational rehabilitation successful?

When I think of vocational rehabilitation, I recall taking the bench in Pensacola many years ago. After several months on the bench, I was visited by a rehabilitation counselor employed by the state of Florida (I will call her "Sally" for the sake of this discussion, though I do not recall her name). She was cordial and gracious, but it was clear something was on her mind.

Sally eventually asked why I was not referring clients (injured workers) to her office. She explained that her agency was responsible for training and education of injured workers. She said that her performance was evaluated annually, and one of the important measures of her success was the volume of injured workers that she interviewed and evaluated. She explained that my predecessor had made it a practice to refer all injured workers who were settling their worker's compensation cases to her agency for an evaluation of their potential for training and education. This, she explained, allowed reassurance to the judge that the particular injured worker's settlement was in fact reasonable. 

She handed me several reports that she had prepared over a period of years. Each related to an injured worker who had sought approval of a unrepresented Worker's Compensation settlement in that District. In the course of our conversation, we were interrupted by an office visitor with whom Sally was acquainted.  She politely chatted with the visitor momentarily. In this moment, I quickly perused the training and education agency reports she had handed to me. Each provided a detailed background of an injured worker, a discussion of the Pensacola Florida employment outlook, an overview of educational opportunities in the community, and a brief conclusion. Each of the reports provided concluded that training and education would not be appropriate for that particular injured worker.

The visitor departed, and Sally and I resumed our conversation. I asked how often the her agency concluded that an injured worker was in need of training and education. She had no estimate. I questioned why each of the example reports I had been handed concluded that training and education would be inappropriate. She briefly reviewed the reports, and said the most likely reason was that each person lacked a high school diploma. She explained that her agency success was also measured, in part, upon the outcome of training and education efforts. In other words, her agency wanted to train injured workers, but wanted them to be successful in obtaining employment following that training. Most would agree that this is logical, and an admirable goal.

But, I asked, what is the correlation between a high school diploma and future employment? She knowingly nodded her head and explain to me that completion of schooling, such as a high school diploma, demonstrate an ability to focus on a goal, to complete a process, and is an accepted predictor of future success in further education. Thus, someone who can finish high school has a greater probability of being able to finish another educational pursuit, such as junior college or college. That also made some sense. 

At this stage in the conversation, Sally volunteered that her agency actually preferred individuals who possessed a Associates degree or further college experience. She explained that while high school diploma indicated a probability of success, a college degree indicated an even greater probability of success, both for further training and for job placement. In fact, she assured me, the more education somebody has at the outset of the training and education program, the greater chance for successful reintegration into the workforce.

So I asked whether that meant that her agency would be most likely to except for training and education the people who already have the greatest volume of education? She assured me that that was in fact the case. I did not thereafter make a habit of referrals to that training and education agency. I got the distinct impression that the purpose of those evaluations was far more focused upon this state employee (Sally) appearing busy, than upon the goal of returning injured workers to employment.

Within a year, I received a call from the Deputy Chief Judge in Tallahassee. He had received a call from Sally's supervisor. He had been encouraged to call and tell me to renew the practice of referring injured workers for evaluation. We discuss the subject for several minutes, and we each agreed that such referrals were neither necessary nor appropriate. He related to me that the supervisor's call had been focused upon the volume of referrals from my predecessor to which that agency had become accustomed.

Since that time I have had the opportunity to relate those conversations various times. After describing this situation in a seminar, I was approached by a rehabilitation provider. She explained that the representations regarding education completion, as a predictor of future academic success was absolutely valid, and had been demonstrated in various studies. But, she assured me, the level of education one possesses is also very often a valid predictor of the probability of returning to gainful employment following an injury, irrespective of whether additional training and education is delivered following an injury. She said that this is a result of several factors.

First, she argued that as education increases, physical demands of employment tend to decrease. Thus she explained that finding a position within the vocational capabilities of a college graduate, with physical restrictions, was much easier than locating such jobs for those with less education and those same restrictions.

She concluded that the state agency rehabilitation nurse had adopted a policy of accepting for training and education only those individuals who frankly did not need further training and education. She contended that the appropriate audience for training and education is in fact those who lack education, and who would benefit from obtaining skills that might facilitate less strenuous activity and therefore employment following a work place injury.

In short, she bluntly concluded that the training and education program as I described was nonsensical and destined to be ineffective. Ineffective in that it successfully demonstrated statistical measures, which likely would've been achieved without the training. This rehabilitation provider culled the statistically best candidates with the most education and provided them training, and successfully placed them (or they placed themselves) back into the workforce. Sure, that was "effective" in satisfying statistical measures, but that the program delivered no services to a sizable population of the very individuals who might well have benefited, despite the fact that probabilities were were against them. 

I am no vocational expert, but I frankly found both of these interactions, with Sally years ago and the rehab provider who confronted me at the presentation, intriguing. What is the point of training and education services? I would suggest that it is for increasing skills and knowledge. Increasing skills that are marketable in the community, so that someone can find work that is productive and rewarding. And, if the injured (or "recovering") person is open to self-improvement, and the professionals are careful in selecting training that is appropriate, and if there is a demand for people that possess such skills, wouldn't that increase the odds of returning someone to gainful employment?

As America attempts to redefine what worker's compensation is, and perhaps re-focuses on the ultimate goal of reemploying those who suffer injury, can there be a valid conversation about when training and education is indicated, what the reasonable measures of success might be, and how professionals can be engaged to positively affect the vocational outlook of injured workers, and return them to gainful employment?

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