04 NCAC 10C .0103          DEFINITIONS

As used in this Subchapter:

(1)           "Rehabilitation professional" means a medical case manager, a coordinator of medical rehabilitation services, or a vocational rehabilitation professional providing vocational rehabilitation services, including state, private, or carrier based, whether on site, telephonic, or in or out of state. Physical therapists, occupational therapists, speech therapists, and other direct care providers are not rehabilitation professionals under the Rules in this Subchapter.

(2)           "Medical rehabilitation" means the planning and coordination of health care services by a medical case manager or coordinator, with the goal of assisting an injured worker to be restored as nearly as possible to the worker's pre-injury level of physical function.  Medical case management includes:

(a)           case assessment;

(b)           development, implementation and coordination of a care plan with health care providers, the worker, and his or her family;

(c)           evaluation of treatment results;

(d)           planning for community re-entry and return to work; and

(e)           referral for further vocational rehabilitation services.

(3)           "Vocational rehabilitation" means the delivery and coordination of services under an individualized written plan, with the goal of assisting the injured worker to return to suitable employment or participate in education or retraining, as defined by Item (5) of this Rule or applicable statute.

(4)           "Return to work" means placement of the injured worker into suitable employment, as defined by Item (5) of this Rule or applicable statute.

(5)           For claims arising before June 24, 2011, "suitable employment" means employment in the labor market or self-employment that is reasonably attainable and that offers an opportunity to restore the worker as soon as possible and as nearly as practicable to pre-injury wage, while giving due consideration to the worker's qualifications (age, education, work experience, physical and mental capacities), impairment, vocational interests, and aptitudes.  No one factor shall be considered solely in determining suitable employment.  For claims arising on or after June 24, 2011, the statutory definition of "suitable employment," G.S. 97-2(22), applies.

(6)           "Conditional rehabilitation professional" means a rehabilitation professional who has not met the requirements for qualified rehabilitation professionals under of Rule .0105(d) of this Subchapter and who desires to provide services as a rehabilitation professional in cases subject to the rules in this Subchapter.

 

History Note:        Authority G.S. 97-2(22); 97-25.4; 97-25.5; 97-32.2; 97-80;

Eff. January 1, 1996;

Recodified from 04 NCAC 10C .0101 Eff. April 17, 2000;

Amended Eff. November 1, 2014; June 1, 2000.