Claims Adjudication Tune-Up (CAT-U)
November 2025 Edition
Welcome to Self-Insurance’s (SI) Claims Adjudication Tune-Up (CAT-U) newsletter. This is where the Washington State Department of Labor & Industries (L&I) shares best practices and information, as well as highlights opportunities for improvement. The focus of this month’s edition of CAT-U is when to consider a formal vocational referral.
Legal Corner
Washington Administrative Code WAC 296-19A-010(2) Definitions. What are vocational rehabilitation services?
(2) What are vocational rehabilitation services? Vocational rehabilitation services are those provided by a vocational rehabilitation provider and include, but are not limited to, the following:
(a) Gathering industrially injured or ill workers' work and/or education histories and physical capacities information;
(b) Assessing industrially injured or ill workers' employability;
(c) Developing, documenting, and writing vocational rehabilitation plans;
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(m) Providing the Option 2 vocational services listed in WAC 296-19A-631.
WAC 296-19A-040 What vocational rehabilitation services require authorization? (1) All vocational rehabilitation services must be preauthorized…
Take away: While the priority is to address the worker’s ability to return to the job if injury, it may not always be feasible. If resolving a worker’s permanent employability requires more than a medically approved job offer, the services laid out in WAC 296-19A-010 will be necessary and a Vocational Rehabilitation Counselor must provide them.
WAC 296-19A-050 What are vocational recovery services?
(1) Vocational recovery services are intended to ensure appropriate support is provided to an industrially injured or ill worker so that they return to work, continue to work, or are enabled to become employable at gainful employment consistent with the priorities listed in RCW 51.32.095 (3)(a) through (g) with the highest priority given to returning a worker to employment:
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(4) To ensure appropriate assistance has been provided or offered to the worker so that they return to work, continue to work, or are enabled to become employable as outlined in subsections (2) and (3) of this section the vocational provider must document their efforts to provide the services outlined in subsection (3)(a)(i) through (viii) and (b)(i) through (ix) of this section, including offers of employment and the worker's response(s), prior to requesting a referral for an ability to work assessment as described in WAC 296-19A-065.
Take away: Early intervention can be crucial to a worker meeting their return-to-work goal(s). Vocational counselors can assist here, as well, even if formal vocational services are not needed.
Trainer Trivia
Last month’s question, “What is the fear of Halloween called?”
Answer: “Samhainophobia”, Samhain or Sauin is a Gaelic festival on Nov. 1, marking the end of the harvest season and beginning of winter or the “darker half” of the year. Celebrations begin Oct. 31.
November Question: Leaves on trees survive storms, hot weather, and incessant rain. So why do they all fall off in autumn?
More reading/resources:
Reminders/tips from the SI teams:
Remember, if a worker is working permanent light duty and losing more than five percent of their earning power on the date of injury, they are eligible for Loss of Earning Power benefits payments through claim closure, effective July 1, 2025. The Claim Closure Form has been updated to reflect this change.
The Self-Insurance Vocational Reporting Form is required unless the worker returns to or is found able to work at the job of injury.
Remember to:
- Complete the Self Insurance Vocational Reporting Form (SIVRF) in its entirety including up-to-date contact information.
- Attach the vocational closing report to the SIVRF.
- Ensure the correct vocational outcome code is selected.
- Sign and date the SIVRF.
For more information, email: SITrainerQuestions@Lni.wa.gov
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