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What Is Vocational Rehabilitation?

Injured workers may need to consult with different types of therapists. It can be confusing to understand which therapist does what. Generally, physical therapists provide exercises and treatments to help your body recover from your injuries. Occupational therapists help injury victims learn to do everyday tasks and to work with assistive devices. Vocational therapists are supposed to work to help an injured worker return to work.

Yet there is really a huge difference between those therapists and the role of a Vocational Rehabilitation Counselor in a workers compensation case. The big difference  between the role of physical therapists and occupational therapists vs. Vocational Rehabilitation Specialists is that unlike the PT and OT folks, the vocational rehabilitation counselor (VRC) is hired directly by the workers compensation insurance company. Your doctor will not typically refer you to a vocational rehabilitation counselor. 

The reason for the hire is unfortunately really not to help you, but to ultimately reduce the value of your claim. As will be further described below, the Vocational Rehabilitation Counselor is one of what I call the “Unholy Trinity” of Defense Professionals who will usually work against you in your case. Those are 1. The insurance adjuster, 2. The Nurse Case Manager and 3. The Vocational Rehabilitation Counselor. Their primary goal is to cut off or eliminate your weekly check. The Insurance adjuster can be thought of as the “puppet master,” pulling the strings of the Nurse Case Manager to try to get you released back to your old job at Full Duty, ready or not. If that fails, the adjuster may then try another tact, which will be to try and at least reduce their weekly obligation by finding you another job within your restrictions through the Vocational Rehabilitation Counselor.  

The bottom line is that employers and insurance companies want to minimize their “exposure,” i.e. ongoing weekly payments to you. Assuming your injuries prevent you from returning to your pre-injury job, the best way to do this is to find you another job that you are able to perform within your physical restrictions. 

What does a vocational rehabilitation professional do for injured workers? 

In a perfect world, according to Vocational Training HQ some of the services that a vocational rehab professional would provide would include:

  • Assessing your current work and health situation
  • Helping understand your goals
  • Giving health advice to help the worker return to their job
  • Finding ways to help you return to work by reducing the impact of your medical condition on your job
  • Coordinating with other people such as career counselors to help you return to work
  • Career counseling
  • Analyzing your current job options
  • Continually assessing your ability to return to work
  • Helping you prepare the best resume’
  • Getting you into classes so that you can acquire more skills and return to the job market

Workers often are asked to participate in vocational rehabilitation if they are involved in an Awarded or accepted claim. This typically does not occur until the injured worker has reached maximum medical improvement (MMI). Your doctor then may conclude that you can return to light-duty work/work with restrictions. If your pre-injury job cannot accommodate those restrictions, then the insurance carrier will often set you up with vocational rehabilitation.  Common workplace restrictions include being able to rest after standing on your feet – after a specific period of time such as 5-minute breaks every hour. Another common workplace restriction is doing work that does not require that you lift or carry objects that weigh more than 20 pounds.

Vocational rehab therapists review these workplace restrictions to see how you can do your job within these workplace limitations. They may consult with various employers to see what adjustments can be made to your work.

A vocational rehabilitation professional will tell you that they will work to help you find new employment. Unfortunately, the reality is that the experience is usually not a pleasant one and further, that the VRC, having been hired directly by the workers’ compensation insurance company, is really not there to primarily help you. They are involved in your case to help the insurance company and they tend to work very closely with the adjuster. Their actions vary, but they are typically engaged in a two-pronged effort: 

  1. To find you a job to reduce or eliminate the obligation of the insurance carrier to keep paying you a weekly check. Some are quite aggressive and will require you to follow up on numerous job leads per week that are provided to you. These are not usually jobs that you have any interest in. After the initial meeting, typically held in your attorney’s office, the VRC will usually meet with you each and every week at a location near your home, often at a public library. Depending on your degree of availability via computer and your level of tech-savviness, they may meet with you via Zoom. 


  1. To trip you up and so you can be deemed non-cooperative with the vocational rehabilitation plan. This will allow the insurance carrier to file a motion to terminate your weekly check. In Virginia, that motion will result in you getting cut off immediately. They may do this by switching meetings on you, or you may simply forget about some of your meetings. If you are sufficiently non-compliant, you will be cut off of benefits immediately and it is not very easy to get them back, at all. 

What skills and certifications should a vocational rehabilitation counselor have?

Vocational rehabilitation counselors usually have a master’s degree in vocational rehabilitation or some comparable field such as “counseling psychology.” In Virginia, they must be “certified” in accordance with regulations at 18 VAC 115-40-10, et. seq. and in North Carolina they actually must be an approved VR Professional through the NC Industrial Commission in accordance with N.C.G.S. 97-32.2

For the most part, an injured or ill worker works directly with the vocational rehab counselor. If you have an attorney, he or she will typically attend the initial meeting, and at your subsequent meetings, you meet alone with the counselor, although the VRC should be including your attorney in all correspondence and formal communication with you. 

Vocational Training HQ recommends that when you speak with your vocational rehab counselor that you should:

  • “Always be honest about your condition, abilities, restrictions, and desires so they can help you as much as possible.
  • Respect their decisions in regards to your next steps towards employment since they know what they are doing.
  • Communicate frequently with them about any problems or concerns you are having so small problems can be solved while they’re still small.”

It’s important that you and your rehab counselor get along as much as possible. Being rude or walking out on meeting is a sure way to get cut off of benefits and ruin the value of your case. It is simply a fact that some counselors engage in conduct that is inappropriate, such as failing to pre-screen job leads or requiring you to apply for jobs you are completely unqualified for. Others will actually go out of their way to aggravate you, hoping to get you to walk out of the meeting. Don’t fall for it. If you do, you have handed the workers’ compensation insurance company a victory. 

Fortunately, there are guidelines that the VRC’s are required to follow. In Virginia, the VRC Guidelines discuss the duties of each party to the relationship and what is appropriate and inappropriate. If the VRC continually violates these standards, then your workers compensation lawyer will file an appropriate motion to eject the VRC from the case and bring in another vocational rehabilitation professional. In North Carolina, they must follow the Rules for Vocational Rehabilitation Services. 

A few FAQs about Vocational Rehabilitation

What Should I Bring to My First Meeting with a Vocational Rehabilitation Counselor?

If you have an attorney, you should bring nothing. Your attorney and either the defense attorney and/or adjuster for the insurance company should already be in possession of most, if not all of your relevant medical records at this point. This is because in a workers’ compensation case, you essentially give up your right to privacy to the insurance company paying for your treatment as well as those who work for them. They therefore are entitled to all of your medical records and should have already obtained them. If your attorney feels the VRC needs to see something he or she does not have, your lawyer will provide a copy to them at the initial meeting. The most important thing for the VRC to see pertains to your current work restrictions. This is typically found at this point in connection with the records of your Functional Capacity Exam.  This can be absolutely key to making sure the VRC does not exceed his or her boundaries. 

For instance, in a recent case, we had a client with a very severe injury to his left leg and foot. In one small corner of the FCE, it was mentioned that he should not operate any controls with his left foot, including a clutch. The client had a manual transmission vehicle. This meant he was really unable to drive and this ended up having a huge effect on the VRC’s ability to find the client other employment. Therefore, the clients’ weekly checks continued. 

What do you need to do to be in compliance with the vocational rehab requirements?

When you work with a vocational rehabilitation counselor, you will need to do everything you can to  follow his or her instructions.  This means you need to keep any appointments including your weekly meetings, and follow up on all the job leads you are given. If you obtain interviews for any of the jobs, you should be on time and not attempt to “sabotage” the interview by dressing or acting inappropriately. If class attendance is required, you’ll need to attend and keep up with the class instruction. 

What will your counselor do for an injured worker?

At the initial meeting, the counselor will thoroughly review with you your work and educational history  to determine what types of transferrable skills you possess. That history, together with familiarity of your physical work restrictions, will help him or her identify the types of jobs that meet your skills and work experience. 

After the initial meeting, the vocational rehabilitation counselor will typically devise an overall plan for you based on your previous work experience and physical limitations. Sometimes, because of your lack of experience in anything that does not involve intense physical labor, combined with physical restrictions that severely limit you, the only immediate thing that can be done is to get you into some type of training such as computer classes. In other situations, the VR may be able to find you send you leads of jobs that do not require a great deal of training, or where you can essentially train on the job. And in still other situations, the VRC may determine that you are simply not a candidate for vocational rehabilitation.  

What is the employer’s role in vocational rehabilitation?

Your employer’s insurance company will  pay for the cost of the services and you should continue to receive your weekly checks at 2/3rds of your average weekly wage– provided you continue to follow the instructions of the VRC. As noted previously, the insurance company will seek to terminate benefits if you are not cooperating with the VRC.  When and if new work is found by the VRC, if it is at the same or greater pay rate as your pre-injury wage, you will no longer receive your workers compensation checks. 

If the new job’s  pay rate is less than your pre-injury pay rate, then you will still be entitled to two-thirds of the difference between the new job and your pre-injury average weekly wage. This is called temporary partial disability. (TPD). For instance, let’s assume you were earning $1000.00 per week on average, pre-injury. That would mean your normal temporary total disability (TTD) compensation rate would be 2/3rds of that, or $666.67. 

If the VRC finds you a new job paying $400.00, then the difference between the new job and the pre-injury work is $600.00. Two-thirds of that is $400.00. Therefore, even after you get the new job, you are still going to be entitled to ongoing payments of $400.00 per weeks, in addition to your pay in the new job. 

Your attorney’s job is to make sure the vocational rehabilitation professional is acting in accordance with the rules. 

Our skilled North Carolina and Virginia worker’s compensation attorneys have helped thousands of injured and ill workers obtain just recoveries. We fight to get you all the benefits you deserve including payment for your medical bills and your rightful share or your lost income. To discuss all aspects of your work injury claim, call lawyer Joe Miller, Esq., at 888-667-8295. or complete my online contact form.

Injured or ill workers in North Carolina and Virginia can also use our New Electronic Case Review. The link is a convenient way of telling us about your case without having to pick up the phone. You can input the information at any hour night or day, and someone should be back to you by the next business day. 

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