Vermont Legislature SmartTranscripts:

[Edye Graning (Vice Chair)]: Good morning. Good This is the House Committee on Commerce and Economic Development. It's still Thursday, March 26. It's 10:00 in the morning, and we are here to talk more about S-one 173. Good morning, Kirk.

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: Good morning. Good morning, members of the committee. I'm Dirk Anderson. I am director of workers' compensation and safety for the Vermont Department of Labor. Bill I'm here to talk about, S-one 173, and we testified on this in the Senate. We are generally in favor of all the contributions of the bill, the testimony, and the inquiry. Is this committee taking testimony in this bill yet?

[Edye Graning (Vice Chair)]: A little bit, but we're hoping you can kind of give us the big picture overview and talk us through how the program works.

[Kirk White (Ranking Member)]: Sure.

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: So big picture, First of all, how much fun do I have? Till

[Edye Graning (Vice Chair)]: 10:45 or eleven.

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: Okay, great. I'm not going to take it all. Let me stop me if you've already gotten this overview, one of the benefits that injured workers are entitled to on the Vermont's Workers' Compensation Act is vocational rehabilitation services. So generally, and you may have heard this from others, I apologize, but workers compensation provides a wide variety of benefits to injured workers. First and foremost, it provides coverage for the costs of medical bills incurred associated with a workplace injury. It also provides wage replacement benefits, also known as indemnity benefits, are provided to a worker if they are forced to miss time from work due to a work related injury. You break your leg at work, you're out for six weeks. After three days of missed work you're 're entitled to temporary public disability benefits kicks in. And you get wage replacement benefits based on your average weekly wage, roughly 66% of your average weekly wage. So it gives an injured worker something to live on, they're out of work, because of the work they get injured. If a worker is permanently injured, there are benefits associated with permanency depending on what percentage of totally permanently disabled you are and that's a rating that get from a medical professional. In some cases, injured workers are injured in such a manner that they cannot return to their previous job. And that's generally what folk rehab is all about. And the way it works under the law currently is if you go out on workers' compensation and a couple of things can happen. First of all, after ninety days, if you're out on temporary total disability benefits for ninety days or longer, that triggers a referral to an initial screening as to whether or not you should be eligible for Voc Rehab services. The idea is if you've been out of work that long without being able to go back to your job, there's a good chance you may never be able to go back to that job. Or you may need some sort of accommodation to go back to that job, you may need some retraining. So there's a mechanism in the law at ninety days if somebody is still out from temporary total disability benefits the system you know creates a little slag and can tell that individual you may be entitled to vocational rehabilitation services. Alternatively, Dave's here to keep being honest if I speak because he's done workers comp in the past. Alternatively, if an injury is such that the injured worker or a medical provider or the insurance adjuster is like wow, you're probably never going to be able to go back to that particular job. They can initiate vocational rehabilitation entitlement assessment prior to that ninety days. So it doesn't always take ninety days to get to that point. But anyway, that's what Voc Rehab is for. Voc Rehab in Vermont, services are provided by the private sector. There are vocational rehabilitation counselors who are certified by the department who provide these services. They bill the insurance companies for those services. And back in, I think it was 2003, so it was around because barely. So I don't know what happened. Bill Mayer. There was a provision added, so it used to be at ninety days or sooner you were sent to a vocational rehabilitation counselor or what is known as an entitlement assessment. And the legislature added a step between the injury and the entitlement assessment. An initial screening. And the idea was, I think, and again I wasn't here hear the back and forth, but the idea was to have a neutral third party do an initial evaluation to see if this person ought to be referred to Boutin Rial. And the idea I think, again, I wasn't here, was if a neutral third party did it, you would eliminate the parent conflict of interest that a voc rehab counselor would have in doing an initial assessment. Obviously a voc rehab counselor needs clients. So again, I'm speculating a little bit here, but I think the idea was we don't want voc rehab counsel to determine whether somebody needs voc rehab or not. They're all going to say, Yes, there should be Voc Rehab. So we're going have this initial screening. And that screening is done by employees with a Department Disability, aging and independent living, higher ability, needs to be Voc Rehab. So after ninety days, there's a referral to Voc Rehab. The department of state government, not the private counselors, would do an initial screening. And at the initial screening, they look at whether the employee has been medically released to work, whether the evidence indicates that the employee will eventually be able to return to his or her job, And finally, whether the employer has suitable work available for the individual. And if two or more of those questions are answered in the negative, the screener is supposed to refer a person for appropriate entitlement assessment. That sounds good on paper. It is my position, the department's position. What this really does is add an element of uncertainty and delay in the individual receiving both rehab services. Because claimants, if they are workers' comp claimants, they are not represented by an attorney. This is all new to them. They don't really know what's going on. Know, they get a letter like you're being referred for an initial screening, they don't know what that is. Somebody has to do the initial screening, they have to reach out, they have to gather information from the claimants, they have to look at medical records, the employment situation, they have to make a decision, they're supposed to do all of this in a fairly short period of time, but that doesn't necessarily happen. And then they may say, if they do say in about half of the cases, we're not going to refill a person with ovaries and that could be for a number of reasons. It could be because the individual is still recovering from a surgery and it's not clear how fully they're going to recover, may be because the individual has a surgery pending that you know they had to schedule for several months out. I don't know if you've tried to see a specialist label for buses. It

[Emily Carris Duncan (Member)]: could take a while, right?

[Edye Graning (Vice Chair)]: You can get it in four months, you're doing great.

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: Yeah, so the screener, you know, using their criteria might be like, Okay, this individual got surgery coming up. We don't know what the outcome is going be. We don't know if they'll be able to go back to their job or not. So we'll wait and see, see how they recover, see how the surgery goes. And the longer this lays out, the less likely, in my opinion, the individual will eventually receive Voc Rehab services because they could settle the whole claim and just walk away from it. They could go and get a new job. The goal of Oak Rehab is to restore someone to a position that makes them as relatively whole as possible. So if you did something that paid a lot of money, but sorry, Brent, but if you had a job that was highly paid but was very physical, And you're injured in such a way that you're on the lease for light duty sedentary work. You're not going be able to do that job. Depending on your level of education and training, it may be very hard to find a secondary job that pays what your former job paid. So the goal of both rehab cancer is to find, to come up with some plan of training, education that gets you back to your former financial situation, earning situation, as closely as possible. It's not always possible, obviously. That's the Voc Rehab Cancer's GI. And I don't know if you've heard from any Voc Rehab from us yet, but you know, they will tell you that the initial screening is just boxed, things found, plaintiff's attorneys will tell you that, and we as a department tend to agree to that. And the key thing to remember when looking at this bill is, and I know there's a study component to it, we talked about that as well, but key thing to remember is that it's no longer an individual that's out of the world, but less likely to return to the So, we've got some pretty good data that shows you know, there's a pretty dramatic curve, right? Like, if you're out of work for twelve weeks or more, you're likely returning to gainful employment starts to go down. So as well meaning as the initial screening is, it really does act as more of an impediment and a delay in receiving Voc Rehab services than it does in ensuring that both rehab services are equitably available to injured workers. And bear in mind that to the extent that the initial screening was created as a keeper or neutral look at the individual and their entitlements. The insurance carrier, if a voc rehab counselor, if an entitlement assessment is made and a voc rehab counselor proposes a plan to return that individual to work, If the insurance adjuster believes that plan is ridiculous or unworkable or overly expensive, they can always object. And then the department, my department, my division, we have specialists and administrative law judges who

[Emily Carris Duncan (Member)]: regulate

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: disputes between carriers and insurers. And we also have an internal position on a voc rehab specialist who looks at every voc rehab plan and approves it, recognizes it, or sends it back with questions if she thinks that it is not feasible or that it's just flawed in some way. Is one person enough people to do that? How much time does that take? I think it is. So roughly I do have some numbers I wrote down on an annual basis. We receive roughly 400 referrals for both rehab, see roughly 200 entitlement assessments. Of those entitlement assessments, we see on the average of 50 voc rehab plans that are approved by the partner. So that means, I mean we have a very good Voc Rehab specialist. She retired in June. Her position posted if anybody's interested. But I think 50 plans annually on average is probably not overwhelming. Since you mentioned it, what is the backup plan if you are filing in store a vacancy in Huntsville? We have one already. Haven't looked at their resume. Oh my god, we've got no applicants. That's something that you would outsource. They say you did, like a contractor that you would, that is Yeah, I think initially I'd do a wider job offer. Posted more aggressively. Which is subsequent forward about ones, we have five specialist twos and we have one VR specialist so if I had to put all the other specialists on and seem to find, you know, book we have when I'm reviewing, I get really cautious about that. That's it. Emily?

[Emily Carris Duncan (Member)]: Jonathan kind of got to it, my question is maybe a little bit more nuanced, which is, with somebody who is so experienced, well, guess, is this the kind of thing that somebody who's been on the job for a long time obviously becomes more efficient at it? Is it the kind of thing that actually would take more than one person to do the same volume?

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: Potentially initially, while the person gets trained up, but we have other experienced steps. Thanks.

[Kirk White (Ranking Member)]: Little curious about the provisions of law, the impact of the provisions law now and how it would change. And the way I understand it, that there's a ninety day period for more If you get to ninety days, you get screened.

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: Currently, if you get to ninety days and nothing else happens, you're referring first initial screen.

[Kirk White (Ranking Member)]: Correct. And I understand you said something to the effect, I think that the carrier can step in and say, geez, let's get this girl kind of thing. Yes. I don't know how many times that happened.

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: It does happen. It's not. Doesn't sound

[Kirk White (Ranking Member)]: like that. Do you have number?

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: Anyway. Probably not the majority. Yeah.

[Kirk White (Ranking Member)]: Okay. All right. My question, though, had to do with what happens before the tyranny kills. And like you said, alluded to the fact that the sooner folks that can really benefit from VR can start baptizing, the better for worker, insurance claims and stuff like that too. So both, and right now it looks like you gotta wait ninety days to be screened. And so now we're eliminated, the bill that came to consent would eliminate the screen, but the structure seems like it's the timing seems like it's still in place.

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: So at ninety days, you would go to an actual entitlement assessment with a book rehab counselor, bypass the initial screening.

[Kirk White (Ranking Member)]: Yeah, and so is that what's meant by, let's see, so that would mean, I'm looking at A2, and you got under the new structure, you have a right to request for VR services in the future. And I wasn't sure what that meant, other than maybe referring to Subdivision 3 that says ninety days. So,

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: your right to request vocational rehabilitation

[Michael Marcotte (Chair)]: service.

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: It is always there. So let's say a person is out on temporary total disability benefits for more than ninety days. They get an initial screening but they don't want to deal with it, they think they're going be fine. The claimant can always opt out, So let's say we're at one hundred and twenty days or one hundred and sixty days and the claimant says, you know what, don't know if things could be getting better. At that point they still have the right to request a rehab and that right exists now. I think the way the bill is drafted, it's just making that a little more obvious.

[Edye Graning (Vice Chair)]: We're looking at the middle section of page three, probably.

[Kirk White (Ranking Member)]: I've got the top page two. The

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: right to request.

[Kirk White (Ranking Member)]: Yeah, so A2 talks about the request, under the Senate changes, to request VR service in the future. And I didn't know what that meant, I was wondering if that was keyed into the ninety day period.

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: He said it's independent, ninety day period. It is. Forgive me. I'm sorry. Yeah. No.

[Edye Graning (Vice Chair)]: Line seven on page three kind of reiterates it.

[Michael Marcotte (Chair)]: Mission. But that's only his. Mhmm.

[Kirk White (Ranking Member)]: Yeah. The vice chair was also pointing out that I took my mind that the ninety day period seems to be important over on page three, know, circulation app. So again, it seems like it's keyed on that ninety day period. Everything happens, it seems like everything happens like that, or most things happen like that. And the issue is that I think some folks have said, geez, the sooner we can get folks back on track, the sooner they're gonna be gainfully employed. I don't know.

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: And again, a skilled workers compensation claims adjuster.

[Michael Marcotte (Chair)]: Right.

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: You know, when they accept a claim and the claimant's receiving temporary disability benefits, know, arguably the insurance carrier has an incentive to get somebody back to work so that they're not paying temporary total disability benefits forever. You know if they assess the claimant's injury education background and say this person's never going to go back to that job, let's get them a voc rehab counselor. That can happen at any time prior to the ninety days and we do get referrals Before the From the carrier before the

[Kirk White (Ranking Member)]: ninety days. Any idea? I think I already asked that number, but I'm not entirely sure. If you can get back to us, it's fine. I think

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: I'd have to get back to you. It's not insignificant. It's a substantial number. It's not the majority, but it's not a small minority. Thank you, Ben. I'll get you there.

[Kirk White (Ranking Member)]: No, thanks a lot.

[Edye Graning (Vice Chair)]: So,

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: it gets to voc rehab, and they do an assessment, and they get a plan. That's reviewed by this person at the department. Yes. What happens if that plan is rejected? If the plan is rejected, rehab counselor has to offer another one. Is that counselor being paid for each of these iterations? The counselor is being paid by the insurance carrier. So private sector voc rehab counselors have relationships with insurance carriers. And there is also a process, you mentioned it, for a claimant who's unsatisfied with the Rehab Counselor. In many cases the Voc Rehab Counselor will be chosen by the insurance carrier. And if the claimant doesn't get along with that person or thinks that they have planned or don't, there's a mechanism, there's a form that allows you to notify the department, I would like you to I don't know who all was under the witness list or who he planned to bring in, but the Senate heard from a vote for you to bring one of them in to describe this process from their perspective.

[Edye Graning (Vice Chair)]: We do have a plan to do that. I just had a couple of questions, and I know there are a few more people who have questions. When we first got this bill, I went down the rabbit hole of what certification a voc rehab counselor needs in Vermont. And it seems like they're mainly mental health certified. And I'm curious, that just my bad internet search or is that truly how it works here in Vermont? So the screeners or the voc rehab counselors themselves? The voc rehab counselors themselves.

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: The voc rehab counselors themselves, in order to be certified by the department, they need either a master's degree in rehabilitation counseling or a master's degree in some other type of counseling with a concentration in voc rehab and I believe a year's work experience. So the initial certification is just looking at a resume and the education of the counselor and do they have this degree.

[Edye Graning (Vice Chair)]: It seems different from other states. Other states seemed that they were less heavy on the mental health and more heavy on the physical rehabilitation. And so that's, I guess, my question. It's a super broad question as we're opening up this topic, and it might not be the roadblock we want to have, but just out of curiosity.

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: Certification. I believe what the statute requires is that the counselor be certified by the department. What the criteria for certification are are in our voc rehab rules. So that could be changed either by legislation or by rule making. I will say this, again, I say this all the time, in so many contexts, this is a very small state,

[Michael Marcotte (Chair)]: we

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: have a very small division without that many staff. You know, we don't have like, our certification and oversight process is, I have to call it fairly minimal, just because one person can't hold one. So, you know, one of the questions the chair asked was do we get complaints about voc rehab counseling being qualified? Occasionally we don't get that many, you know, here anecdotally like this person's so good, but we don't get that many formal complaints. And if we do, we follow-up. It's not like OPR or the professional responsibility. We don't have that level of oversight investigation discipline. And that's a pretty small community of voc rehab counselors in Vermont, as you

[Edye Graning (Vice Chair)]: can imagine. I'm wondering if perhaps the working group may be able to make recommendations as to whether that's the appropriate certification in the state today or not. Yes. I think

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: bills that came from the Senate asked the working group to look at a bunch of stuff.

[Edye Graning (Vice Chair)]: I mean, it's the broad question. It could be covered under the broad question of anything else that could be done to make the process better. And we may wanna be more specific because Sure. Okay. And then, Emily had a question because I lost my other question.

[Emily Carris Duncan (Member)]: Actually, you were kind of getting to it. I'm curious to know how big is the vocational rehab community in Vermont, and what is the training type in Vermont rehab only?

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: How big is the training? I should have a list of certified counselors. That would answer that question. I don't have it in front of me. I'd say Struggles.

[Emily Carris Duncan (Member)]: Does Vermont offer these certifications currently? Do we have training programs for rotational rehab counselors?

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: Department doesn't really have anything. All we do is look at their education and job experience and determining whether they qualify to be considered a starter. As far as job training in general for vocational rehabilitation counselors, that's probably a question for the Workforce Development Division. Could ask Jay about. She'll let me

[Edye Graning (Vice Chair)]: Dave, did you have a question? I couldn't tell if you were trying to catch my eye. Okay. Emily, are you good? Yep. Great. My other question did come back to me. For those initial screeners, is that the insurance company paying for that or who pays for that? You know, that is a good question. I don't know.

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: I meant to ask Diane Delmasch. I don't know how they are paid. I think it's higher ability staff that just gets added into their other duties. I do not believe they have dedicated people that do only screenings. I think it's just something that gets packed into the.

[Edye Graning (Vice Chair)]: That's what it sounded like when

[Emily Carris Duncan (Member)]: So you were talking to

[Edye Graning (Vice Chair)]: it comes out of state government budget

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: in some way. Indirectly. I believe, yeah, I can follow-up.

[Emily Carris Duncan (Member)]: Thank you.

[Edye Graning (Vice Chair)]: Other questions, or did the chair give you more questions that he wanted answered?

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: I think I touched on most of them.

[Edye Graning (Vice Chair)]: I I think we all have the same goal, which is how do we get people back to work as quickly and safely as possible, as cheaply as possible. They have to be safe to go back to work. But we know that people are, when you're back at work, you have more generally, you feel better.

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: You do. There's been a lot of research on this. For a person's health, well-being, mental health, the best thing you can do is get them back to work as soon as possible. I mean obviously you don't want them to go back to doing something they're incapable of doing and they reinjure themselves or they injure themselves harder. So the system is structured to give people the help they need, give them interim financial support, get them back to work as soon as possible and if they can't go back to that job, hope rehab, so that they can go back to some sort of painful importance. The sooner that happens, nobody benefits from sitting around the couch.

[Edye Graning (Vice Chair)]: And you have data on the number of people that successfully go through both rehab and go back to work versus those that of?

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: Of people referred for entitlement, you know, entitlement assessment, think the number that eventually, as far as we're able to track is not we don't have a bridge record type of databases we're working on that that's a whole other story We're working on modernization, just the way the employment insurance division is. But it is probably, I think it's fewer than past.

[Edye Graning (Vice Chair)]: Fewer than have returned to work after completing their rehab plan. Yes. Okay, yeah, if you have more numbers, that would be helpful.

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: Okay, let's see

[Michael Marcotte (Chair)]: what I can do.

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: Yeah. Is that returning to the same job or is that any job? Is, leave that is returning either returning to the same employer, a different employer in the

[Kirk White (Ranking Member)]: same

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: capacity, or some judgments that the voc rehab plan was designed to get that person into. So that does not include the class of people who wind up taking, know, if you will, lesser job. A little bit job just to get back. Morning, Mr. Chair.

[Michael Marcotte (Chair)]: Good morning. How are you?

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: I'm good.

[Edye Graning (Vice Chair)]: Emily, you had a question?

[Emily Carris Duncan (Member)]: Yeah, just a little bit. Sure. So I understand the referral numbers. So you said about half of folks are not referred.

[Edye Graning (Vice Chair)]: Those half of people that are not referred,

[Emily Carris Duncan (Member)]: they might end up getting referred again for the ANA?

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: A fairly significant number of those are not referred after the initial screening will be revisited. Like, let us the screener may say, Let's see how your surgery goes. I'll talk to you again in non fictional notes.

[Emily Carris Duncan (Member)]: Okay, so when that happens, that's not necessarily a denial? Is that a different category? Is that just sort of a, we're going to check-in again and you still have access to the That's correct. Okay, so would you put the number at seventy five percent end up going through the process?

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: I don't know if it's seventy five percent, but it's probably more. It's more than fifty percent.

[Emily Carris Duncan (Member)]: So fifty percent go through the process, and then you're

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: referring the

[Emily Carris Duncan (Member)]: And Okay. Then you're saying fewer than half of returning to work, and not even folks that are exposed to a job that's not necessarily available to a particular one.

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: I want

[Edye Graning (Vice Chair)]: to make

[Michael Marcotte (Chair)]: sure

[Emily Carris Duncan (Member)]: I have it.

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: I have not talked at all about the study or very little about the working group. That was something that the Senate adds to the bill. And I know Mr. Chair, you had some that working bill. Thank you.

[Michael Marcotte (Chair)]: Yes. Thank you. Yeah. I'm not really haven't been thinking much about working right at the moment. I'm sorry, I apologize for I being able to be saw another question. The prescreening, we heard from Viability that things seem to be running smooth, that there's not a backlog, or is there people going through the pre screening?

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: Yeah, I don't think there's a backlog. It is an extra step.

[Michael Marcotte (Chair)]: It's step.

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: A pre step, but it's a pre step that's triggered at ninety days which under the bill that ninety day period will trigger an actual entitlement session. We'll both agree on councilor consent. So

[Michael Marcotte (Chair)]: I guess the question that's probably what working group may look at as well is, is the ninety days the right place or should there be a sliding scale depending on the person? Because not everybody's the same.

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: That's correct. Ninety days have been in the statute for a long time. I don't know where that number came from. I don't know if it's the right number. It was, You know, I think the question you have to ask is like, you don't want to send everybody to VR because a lot of people are just going to go back to work in a couple of weeks and at the same time you don't want people to be out of work forever just living off temporary disability benefits before they get looked at by a meeting or a counselor. So what is the correct number? And that ninety days was put in the statute decades ago, know, and I don't even know where it came from, but that might be something that looks to look at.

[Michael Marcotte (Chair)]: Yeah, I'm just, I mean, I'm just wondering if it makes sense to throw out the pre screening right now without knowing can we improve it? And is there a value to it?

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: That was a valid question. Most of the testimony today has been, you know, the it happens to be in my opinion that the initial screening sort of slows things down and doesn't provide a whole lot of benefit. There are people in the room tell you that it is a good thing. And this was suggested in the Senate it did not get written and killed in the Senate obviously, but there was a suggestion that instead of eliminating the initial screening, just roll it into the study. That's something to look at. That didn't have to be scientific, that is still obviously something committee complete.

[Michael Marcotte (Chair)]: And, you know, mean, the data that we heard from our abilities this morning suggests that the percentage of people being screened that don't go on for full VR services, And so seems like there's a value there that those people otherwise would be going for full ER services. And wouldn't that put a wouldn't that increase the cost of the system?

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: They wouldn't necessarily get full VR services. They would get an entitlement assessment from a VR counselor who may well decide that VR is not appropriate. The counselor may say, I think it is appropriate, here's a plan. That plan has to be submitted to the department for approval. So there are some guardrails there. It's not like getting rid of the initial screening would automatically have everybody onto a VR plane.

[Michael Marcotte (Chair)]: This is something that we dealt with many years ago. I'm saying it was the same issues, and I think there were issues. Because FireAbility is doing it, they're non partisan, they have no skin or anything else. And when you look at VR counselors, have skin because that's their job, that's their business, that's what they do. Once I could understand better what those guardrails and how you how you would look at those initial screenings, then I I think it'd be interesting to understand how how those initial screening, how many there would be compared to how many there are right now, they move on to the PRP. So one way of doing that, and that's to eliminate the screen. So I don't know that I'm there yet, but it may be something that we may ask the team to look at. Because I remember when we had those discussions, we felt that they were there was a value. The did you talk about certifications? I can download the video. So I won't make you go through all of that, I guess.

[Edye Graning (Vice Chair)]: We just talked about making it more explicit in the working group to understand what the appropriate certifications are, because it seems like we might be an outlier to other states. Interesting. That was my research. I don't know how good it was, but.

[Michael Marcotte (Chair)]: Yeah, and I mean, when we looked at the ER Counselors Association, understand it goes through mental health counselors, also certified to do VR counseling as well.

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: I don't think our certification process requires,

[Michael Marcotte (Chair)]: I see that when I looked up the association, there's a national association and I click on Vermont, it talks about mental health councils.

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: They may have that in practice. I don't think our certification regulation makes that a requirement. Again, it looks for a master's degree in rehabilitation counseling or other counseling with an occupational information concentration. I don't, beyond the services they perform for injured workers, through the workers compensation program, I don't know what that greater university counselors looks like, it's made up of.

[Michael Marcotte (Chair)]: So who, is it, do you oversee the counselors? We do. And you have the ability to remove counselors or no? Do

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: on paper? We have not done so in quite a while. The last instance I can recall of somebody almost being taken off the list, if you will, was A portion of this commissioner, so. Dean here.

[Michael Marcotte (Chair)]: Do you you receive complaints? And are you able to do you have staff to be able to create the council complaint?

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: We have one vote rehab counselor, one vote rehab specialist who works with the counselors, who approves their plans or doesn't approve their plans and you can give them feedback.

[Michael Marcotte (Chair)]: We don't

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: have, I testified to this earlier, we don't really have a robust enforcement mechanism. We don't have the equivalent of the Office of Professional Regulation or Professional Conduct or you know, it's a very small division.

[Michael Marcotte (Chair)]: Yeah, you ever receive complaints from employers?

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: Not from employers. We receive complaints from employees who are injured workers who say, I don't think this counselor is really helping me. And there is a mechanism to reassign an injured worker to a different counselor in those cases.

[Michael Marcotte (Chair)]: But when you Is there a way for you to understand if you're getting multiple complaints about a counselor and then what do you do about that?

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: Yeah, we haven't, say we haven't done anything, but we haven't removed or taken anybody off the list in my memory.

[Michael Marcotte (Chair)]: You have no data? Do you have data that

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: Number of complaints? Yeah. I can check.

[Michael Marcotte (Chair)]: You can, you know, do you have data? I don't want names of people or anything, but you have data that shows complaints against counselors and complaints against individual counselors, how many they get. It came up here in testimony from an attorney that helps people that talk about they know the good counselors and they know the bad ones, and they always get people away from the bank if they come to them. But not everybody has an attorney. And so, I think it's It doesn't help the system if we have counselors that are not really helping people, and they probably shouldn't be there.

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: Understood. I can see if I can get all this.

[Michael Marcotte (Chair)]: Other questions? Lost most of the committee.

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: I can't hold the crowd. I

[Michael Marcotte (Chair)]: think what happened is I was in the late one for

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: the party.

[Michael Marcotte (Chair)]: I'm asking questions that they already heard. Third, thank you. Thank you. More comes up, we'll ask you to come back in.

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: Okay, and I'll try and get you answers to

[Michael Marcotte (Chair)]: your questions. Okay, that's great. Thank you.

[Dirk Anderson (Director of Workers’ Compensation & Safety, Vermont Department of Labor)]: Sorry, I wasn't here for previous testimony.

[Michael Marcotte (Chair)]: Okay. We'll continue to look at this and see what we're gonna do. Thank you. Thank you. Committee, we're back on at eleven to talk with AOV on CPE. Daphne, can you go up live

[Edye Graning (Vice Chair)]: and