90- 351 C.M.R. ch. 6, § 4

Current through 2024-44, October 30, 2024

Section 351-6-4 - Proposed Employment Rehabilitation Plan

1. Upon receipt of a proposed plan, the Executive Director or the Executive Director's designee shall forward the plan to all interested parties.

2. No later than 10 business days after receipt of the plan:

A. The Executive Director or the Executive Director's designee, or an interested party may request clarification of the plan.

i. Requests for clarification must include specific, written questions to the provider, with copies provided to the Executive Director or the Executive Director's designee, and interested parties; and

ii. The provider shall respond to the request in writing and amend the report as needed, or request a conference, with copies provided to the Executive Director or the Executive Director's designee, and interested parties, no later than 10 business days after receipt of the request for clarification.

B. The employer/insurer must notify the Board if the employer/insurer intends to voluntarily pay for the plan. If clarification has been requested, the employer/insurer must notify the Board if it intends to voluntarily pay for the plan no later than 10 days after receipt of clarification; and

C. The employer/insurer may file a written objection to the plan. If clarification has been requested, the employer/insurer may object to the plan no later than 10 days after receipt of the clarification.

3. If a timely objection is received, the matter will be forwarded to a Hearing Officer or ALJ for review.

A. The Hearing Officer or ALJ shall require all interested parties to submit written evidence and arguments pursuant to a schedule established by the Hearing Officer or ALJ. At the discretion of the Hearing Officer or ALJ, a testimonial hearing may be scheduled for the parties to present relevant testimony; and

B. The Hearing Officer or ALJ's decision will be limited to whether the proposed plan is likely to return the injured employee to suitable employment at a reasonable cost.

C. The Hearing Officer or ALJ's decision is final and not subject to any appeal unless the request to implement the plan is denied.

4. If a timely objection is not received, the Executive Director or the Executive Director's designee:

A. Shall order implementation of the proposed plan if the employer/insurer has agreed to voluntarily pay for the plan; or

B. May, after review of the plan, order implementation of the proposed plan, with costs to be paid from the Employment Rehabilitation Fund, if the employer/insurer has not agreed to voluntarily pay for the plan.

90- 351 C.M.R. ch. 6, § 4