4.06: Notice to Insurer of Suitability
OEVR shall notify the insurer in writing of its determination of suitability and whether vocational rehabilitation has been found to be necessary and feasible for an injured employee. Within ten working days of receipt of such notification, the insurer shall provide to OEVR all pertinent medical records on the injured employee if not previously submitted. If the insurer fails to produce the requested medical information and the treating physician is unable to provide a current medical report, OEVR shall order an impartial medical examination, the reasonable cost of which shall be reimbursed by the insurer. Otherwise, OEVR will determine suitability based on the information submitted.
When the injured employee, on the date of such determination, has not been referred to an approved provider, OEVR will request in writing that the insurer provide vocational rehabilitation services to the injured employee through an approved provider as outlined in 452 CMR 4.03 within 30 days of the receipt of the request.
If the insurer fails to assign an approved provider after they have received a second request from OEVR to do so, OEVR will assign an approved provider who will initiate services and, if appropriate, develop an IWRP. The cost of such services and program shall be assumed by the Workers' Compensation Trust Fund under M.G.L. c. 152, § 65(2)(d) and the insurance company will be assessed pursuant to M.G.L. c. 152, § 30H upon the attainment of a successful rehabilitation as defined in 452 CMR 4.02.