RETURN TO WORK SERVICES - Workers' Compensation Board

RETURN TO WORK SERVICES
SCHEDULE "C"
Vocational Rehabilitation Services
The maximum value the Services provided pursuant to this Schedule over the period
July 1, 2013 to June 30, 2017 is $. Each party shall notify the other when the sum of
the amount paid and payable under this Schedule is $. The WCB may amend the
maximum value of this Schedule at any time, however, the Contractor shall not provide
any Service which would require the WCB to pay more than the aggregate sum of $
without such amendment.
Vocational Rehabilitation Services shall be provided only at the Contractor’s current
address(es): ____, or at the Worker’s work site or home address, and at no other
location or facility without the prior written consent of the Health Care Consultant.
I. SERVICE OVERVIEW
1. Vocational Rehabilitation Services (VRS) are designed to address the return to
work needs of the Worker to facilitate suitable, accessible, sustainable
employment that maximizes the Worker’s earnings and supports claim closure.
Vocational Rehabilitation Services may be delivered as part of:
a) an integrated RTW program; or
b) as a stand-alone Service depending on the circumstances of each case.
II.
SERVICE OBJECTIVES
1. The objectives of VRS are to:
a) optimize the Worker’s safe, appropriate, sustainable re-employment;
b) maximize employability;
c) minimize earnings loss; and
d) promote the Worker’s responsibility and self-management in the reemployment
process.

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III.
SERVICE PRINCIPLES
1. VRS shall be delivered in a structured, goal oriented fashion, and individualized
to take into account the Worker’s functional abilities, education level, work
experience, transferable skills, and interests.
2. If modified duties with the pre-accident employer have been ruled out by the
assessment process and work restrictions are anticipated, the Contractor is
authorized to provide integrated VRS as part of a RTW program. The level of
VRS shall be based on the anticipated work restrictions. The Contractor shall
ensure that all interventions match the entitlement level as per the Claim Owner’s
direction.
3. The Contractor shall actively obtain and maintain up-to-date knowledge
regarding employment opportunities and labor market trends that pertain to
Alberta and specifically the Contractor’s local labor market. Labor market
knowledge shall include: labor market trends, employer needs, job requirements,
specific vocational training requirements, general education requirements,
wages, employment environments, and availability of transportation.
4. The Contractor shall strive to obtain the Worker’s active participation throughout
the provision of VRS. The Contractor shall facilitate the Worker’s understanding
and motivation by providing information and resources in a manner appropriate
for the Worker’s individual needs, learning pace, and level of education.
5. The Contractor shall maintain a VRS resource area for Workers that shall
include, but is not limited to, the following:
a) computer access for online work and research;
b) faxing, copying, word processing, and printing services;
c) local and long distance telephone access for exploring job leads;
d) job board (updated on a weekly basis);
e) resume templates and examples;
f) resource materials for job leads and research (hand outs, videos, etc.); and
g) access to vocational staff for coaching.
6. The Contractor shall ensure that the Worker has access to the resource area on
a daily basis for the duration of VRS.
7. The Contractor shall communicate with and involve the Worker and Claim Owner
in all aspects of the VRS process. The Contractor shall involve other
stakeholders (family members, etc.), as appropriate.

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8. The Contractor shall demonstrate in their reporting that the Worker is making
measurable progress toward their employment goals.
9. The Contractor shall maximize Worker and Claim Owner satisfaction with the
VRS process.
10. The Contractor shall encourage the Worker to partake in actual job search
activities during the planning phase including interviews with employers in the
local labor market for the purpose of transferring newly acquired job search skills
and aptitudes into practical situations.
IV.
ADMISSION CRITERIA
1. The Contractor shall ensure that all of the following criteria are met prior to
commencing Vocational Services:
a) The Worker’s informed consent has been obtained via the Agreement to
Participate form (HC-326).
b) The Worker does not have a compensable or non-compensable issue that
prohibits safe participation in Vocational Services.
c) The Worker’s participation in Vocational Services will not place other Workers
or the Contractor’s staff at risk.
d) There is no evidence of illicit substance abuse or criminal behavior by the
Worker that will interfere with Vocational Services.
2. The Contractor shall inform the Claim Owner immediately if any of the above
admission criteria are not met.
3. Only the Health Care Consultant may waive applicability of any of the above
admission criteria.
V. ADMISSION PROCESS
1. For stand-alone V RS, upon receipt of the Referral form (FM733B) from the
Claim Owner, the Contractor shall contact the Worker to schedule the first
intervention.
a) The Contractor shall orientate the Worker to the VRS process during the
booking conversation including:
i. provision of an outline of what the Worker should expect during VRS
delivery (e.g., expected outcomes, etc.);
ii. directions to the facility;

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iii. suggestions as to what kind of employment information to bring (e.g.,
current resume, work history, etc.);
iv. components and duration of the interventions; and
v. any other appropriate information.
b) The Contractor shall answer any questions the Worker may have about the
VRS process.
c) The Contractor shall facilitate any reasonable requirements that the Worker
may have in order to attend VRS (e.g., accommodation, work schedules,
interpretation arrangements) with the Claim Owner. Where such
arrangements involve added costs, the Contractor shall advise the Claim
Owner of any such requirements and seek approval prior to providing same.
2. For integrated VRS, the Contractor shall determine the need for VRS within the
first 5 working days of a RTW program admission. If VRS are required, the
Contractor shall start VRS within the first 5 working days of an RTW program
admission.
VI.
ATTENDANCE MANAGEMENT
1. The Contractor shall minimize the occurrence of Worker absences during VRS
by applying a comprehensive attendance management system as outlined in the
Attendance Management Contract Guide (HC-502) including:
a) orientating the Worker to the benefits of VRS;
b) facilitating the removal of attendance barriers in conjunction with the Claim
Owner; and
c) notifying the Claim Owner of any Worker absences.
VII.
SERVICE PHASES AND INTERVENTIONS
The Vocational Services Pathways were developed to serve as a guide to triage
Workers into VRS. Refer to Vocational Services Pathways (HC-439) for a schematic
diagram for triaging Workers into Vocational Rehabilitation Service streams.
Planning Phase
1. Planning Phase Objective
a) The objective of the planning phase is to develop a specific RTW plan that will
result in suitable, accessible, sustainable employability that maximizes the
Worker’s earnings and supports claim closure.
2. Planning Phase Admission Criteria

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a) The Contractor shall ensure that the general admission criteria continue to be
met as outlined in Section IV Admission Criteria, and that the following criteria
are met prior to commencing the planning phase:
i. The Worker agrees to actively participate in planning phase interventions.
ii. The Worker has restrictions that are anticipated or confirmed.
iii. A Return to Work Skills Profile (RWSP) has been completed in order to
assess the Worker’s transferable skills and abilities.
3. Planning Phase Duration
a) The Contractor shall make best efforts to complete the appropriate
components of the planning phase (Career Counseling, Job Search Skills
Development, and Resume) within twenty four (24) working days from the
start of the planning phase. If the planning phase is expected to take longer
than twenty four (24) working days, the Contractor shall alert the Claim Owner
as soon as possible and obtain agreement from the Claim Owner about the
expected duration of the planning phase.
b) The Contractor shall make best efforts to complete the Career Counseling
component and submit the Planning Phase report (C880) within 18 working
days from the date of referral for VRS. The referral date is defined as per the
VRS Discharge Data – Contract Reference Guide HC-322 for integrated and
stand-alone VRS.
4. Planning Phase Components
a) The Contractor shall ensure that VRS are individually tailored to meet the
needs of each Worker and may include any or all of the following
interventions in the planning phase.
i. Career Counseling
• The purpose of Career Counseling is to provide Workers with one-onone
assistance to identify a minimum of two (2) suitable and accessible
walk-in job options that:
- maximize the worker’s earning capacity;
- are accessible in the Worker’s local job market;
- are within the Worker’s identified functional abilities;
- are suitable for the Worker’s work experience, transferable skills,
and interests;
- maximize utilization of the Worker’s existing skills and knowledge;
and
- are agreed to by the Claim Owner at the planning phase case
conference(s).

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• On the day that the Contractor and the Worker start Career
Counseling, the Contractor shall send an e-mail to the Claim Owner to
inform them of the date that the Service started. This is necessary so
that the Claim Owner can plan their tasks in the Career Counseling
process.
• The two (2) job options must be presented to the Claim Owner in a
case conference at 12 to 14 working days after the start of the Career
Counseling service. The case conference may involve the Provider
and the Claim Owner only, or the worker also. A discussion about
suitability, accessibility, and maximizing earning capacity is essential at
this stage. To facilitate the discussion, the Provider must send the
information about the job options and supporting Labour Market
Analysis (LMA) or Employability Profile (EP) information to the Claim
Owner at least 48 hours prior to the case conference. Agreement with
the Claim Owner on these job options must be established before
proceeding further.
• The Contractor must present the best possible job options that they
can identify. The goal is always to identify job options that pay 100%
or more of the worker’s pre-accident earnings. If the identified job
options don’t allow the worker to earn at least 75% of their pre-accident
earnings, then the provider must state the reasons why they cannot
identify walk-in job options with salaries at least 75% of the preaccident
earnings (ie. Worker’s transferable skills, restrictions,
education, geographic location, etc.). These reasons shall be
documented and explained in the Planning Phase Report (C880).
• The Contractor shall utilize LMA information from the WCB LMA
database or EP information from the WCB Employability Profile
Database (EPD) to support the two (2) job options. If LMA information
is required and is not on the WCB LMA database to fit a particular job
option, the Contractor shall request the appropriate LMA research to
ensure there is LMA support for the two (2) job options.
• The Provider shall compare the worker’s pre accident earnings with the
post accident earnings of the job options and calculate the percentage
of recovery of pre-accident earnings (Wage Quality) for the salaries of
the two (2) job options and document it in the Planning Phase Report
(C880).
• In the Planning Phase Report (C880), the contractor shall document all
the job options that were considered during the career counseling
process and also document the reason why these options were not
chosen as job options.
• If the Claim Owner does not agree that the two (2) job options are
suitable, accessible or maximize the worker’s earning capacity, the

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Contractor must identify two (2) other job options and present them to
the Claim Owner in a second case conference. When the Contractor
obtains agreement from the Claim Owner on the two (2) job options
then further interventions can proceed.
• If neither of the identified job options have a salary of at least 75% of
pre-accident earnings, then the Provider, Claim Owner and Worker
must consider other job options that will increase the worker’s post
accident earnings. Even if the walk-in job options are at least 75% of
pre-accident earnings, other options may be considered if they will
increase the worker’s post accident earnings to 100%.
• Other options such as Employer provided training, certification training,
short term course work or long term academic retraining may be
considered. However, judgment must be used to determine if the
worker is a good candidate for academic retraining. An Academic
Assessment may be used to help determine this, but consideration
should first be given to the worker’s past educational history and
academic success. When considering other options such as short or
long term academic options, the Claim Owner and the Provider may
decide to first conduct a case conference without the worker.
• If the Contractor identifies that an academic retraining plan is
appropriate to address the WCB’s Economic Loss Payment (ELP)
liability, the Contractor shall present this plan with the job option that
results from the plan, to the Claim Owner for consideration. If the
Claim Owner agrees to consider an academic retraining plan, the
Career Counseling will focus on the resulting occupation of the
academic retraining. LMA or EP information for this occupation shall
be provided to show that the expected salary after the retraining will
significantly reduce or eliminate the WCB’s ELP liability.
ii. Job Search Skills Development (JSSD)
• The purpose of the JSSD is to assist the Worker in the:
- organization, development, and implementation of a focused job
search action plan; and
- development and/or re-establishment of attitudes, personal
characteristics, interpersonal skills, self-marketing skills, work
behaviors, and general employment knowledge in order to facilitate
effective job search strategies and a positive employment outcome.
• The primary objectives of the JSSD are to:
- motivate the Worker to participate in actual job search activities;

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- develop and/or enhance the Worker’s potential for job placement
through increased job search and maintenance skills and improved
outlook;
- provide the Worker with an interactive learning environment in
which the necessary attitudes, personal characteristics,
interpersonal skills, self-marketing skills, work behaviors, and
general employment knowledge necessary for conducting an active
job search can be acquired; and
- ensure the Worker has the skills and knowledge required to
successfully participate in actual job search activities; and develop
and/or enhance the Worker’s job sustainability skills.
• The JSSD shall, at a minimum, include the following training modules:
a) Productive job search strategies:
o networking skills (in person or via the telephone);
o accessing non-advertised jobs; and
o goal setting and motivation.
b) Researching potential employers:
o organizing a job search; and
o using technology and other resources.
c) Marketing the job searcher and his/her skills:
o resumes, cover letters, application forms;
o dressing for success; and
o interviews and follow-ups.
d) Maintaining a job:
o
o
o
o
conflict resolution;
managing multiple priorities;
personal hygiene; and
building a strong work ethic.
iii. Resume
• The contractor shall submit a copy of the Worker’s resume to the WCB
when it is completed.
• The purpose of the Resume is to generate potential employer(s)
interest in interviewing the Worker.

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• The primary objectives of the Resume are to:
- provide a documented summary of the Worker’s education and
occupational qualifications, experiences, skills, and
accomplishments;
- provide the Worker with a self-marketing tool to be utilized with
potential employers;
- generate potential employer(s) interest in arranging a meeting with
the Worker to acquire more information and/or provide an
employment offer; and
- ensure the Worker’s resume is completed in an acceptable and
effective format.
• The Resume shall, whenever appropriate, identify the Worker’s:
- job search goal;
- contact information such as name, address, and telephone number;
- education and career development activities such as training
programs, apprenticeships, licenses, and certificates;
- work experience including identification of key duties and
responsibilities (may include part-time and temporary positions);
- skills;
- awards, certificates, etc;
- volunteer and community related activities; and
- references or the indication that references are available on
request.
• The Contractor shall ensure that the Worker’s resume does not
contain:
- typing, spelling or grammatical errors;
- any false or inaccurate information (to the best of the Contractor’s
knowledge); and
- any inappropriate personal information such as age, gender, marital
status, etc.

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Implementation Phase
1. Implementation Phase Objective
a) The objective of the implementation phase is to obtain employment that is, in
the WCB’s opinion, suitable, accessible, sustainable and maximizes the
Worker’s earning capacity and supports claim closure.
b) Suitable means the employment:
i. is consistent with the Worker’s abilities (mental and/or physical);
ii. can accommodate the Worker’s restrictions (mental and/or physical); and
iii. utilizes the Worker’s transferable skills and education.
c) Accessible means the employment:
i. is reasonably accessible within the Worker’s locale or may be with
appropriate relocation;
ii. considers if the Worker lives in a major urban centre or a rural area; and
iii. considers if the Worker has a history of traveling to work.
d) Sustainable means the employment is consistent with the Worker’s abilities
and restrictions (mental and/or physical) so that the Worker can safely work in
that position indefinitely.
e) Maximizes earning capacity means the employment:
i. represents the maximum amount of earnings possible given the Worker’s
capabilities;
ii. reflects the rate and hours of the Worker prior to the accident; and
iii. has the potential for wage increases.
f) Claim closure means the employment provides an opportunity for the Worker
to be re-established in gainful employment.
2. Implementation Phase Admission Criteria
a) The Contractor shall ensure that the general admission criteria as outlined in
Section IV Admission Criteria continue to be met, and that the following
criteria are met prior to commencing the implementation phase:
b) The Worker agrees to actively participate in a job.
c) The Worker has achieved diagnostic and medical closure.

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d) The Worker is functionally able to participate in an active job search.
e) The Claim Owner has approved the job options that shall be utilized during
the job search.
f) The Worker has signed off on the resume (if provided in the planning phase).
3. Implementation Phase Duration
a) Implementation phase interventions shall be made available for up to five (5)
days per week.
b) Implementation phase interventions shall be made available for a maximum
of twelve (12) consecutive calendar weeks as per Claim Owner authorization.
c) The Contractor shall confirm the length of eligible Supported Job Search
duration at the initiation of the implementation phase.
d) The Contractor shall make best efforts to achieve implementation phase
deliverables as soon as possible in the authorized duration timeframe.
4. Implementation Phase Component
a) Supported Job Search (SJS)
i. The purpose of SJS is to provide intensive and individualized assistance
during a Worker’s job search activities in order to maximize the Worker’s
opportunity to secure appropriate employment.
ii. The SJS shall, at a minimum, consist of the Contractor:
• reviewing the availability and appropriateness of local job market
employment opportunities with the Worker at least on a weekly basis;
• developing potential employment placements through direct and
indirect promotional opportunities with employers located within the
Worker’s local job market (including training on the job opportunities);
• identifying and developing job opportunities for the Worker through
comprehensive and direct employer contacts;
• developing, maintaining, and utilizing an established bank of employer
contacts in order to facilitate the Worker with an employment outcome;
• conducting debriefing interviews with the Worker and/or prospective
employers;

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• providing one-on-one vocational coaching, instruction, and guidance to
the Worker as required;
• assisting the Worker with resume revisions;
• assisting the Worker with cover letter development and/or revisions;
• marketing the Worker directly to prospective employers;
• providing the Worker with networking opportunities with other job
searchers at the Contractor’s site;
• recognizing and reinforcing positive behaviors and/or actions
demonstrated by the Worker;
• motivating the Worker and ensuring the Worker’s active participation in
the job search;
• focusing on the job options that were developed in the planning phase;
• conducting cold calls to employers;
• researching the local labor market for potential and/or actual job leads
(i.e. hidden and unhidden job markets);
• information interviews with employers in the local labor market; and
• networking with employers, Workers, and other resources.
iii. The Contractor shall have the Worker complete an Employer Contact
report (C472) on a weekly basis during the implementation phase. The
Contractor shall:
• review the Employer Contact report (C472) with the Worker on a
weekly basis to ensure the job search activities are focused on
appropriate and previously identified job recommendations (e.g., within
the Worker’s physical restrictions);
• ensure Employer Contact reports (C472) are submitted to the WCB on
a weekly basis.
iv. The Contractor shall, as appropriate, provide potential employers with
information on the WCB’s Training on the Job (TOJ) Program**.
v. The Contractor shall contact the Claim Owner immediately if a potential
employer expresses interest in or availability of TOJ opportunities for the
Worker.

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vi. The Contractor may, at the Claim Owner’s request, discuss with the
potential employer the training requirements and length of the TOJ
Program based on the Worker’s required amount of training.
vii. The Contractor shall not negotiate the WCB subsidy schedule with the
Worker and/or TOJ employer. If the need for negotiation of a subsidy
schedule is identified, the Contractor shall immediately contact the Claim
Owner and advise the Claim Owner of the negotiation need.
** Training on the Job Program is a WCB sponsored program to provide Workers, who are not able to return to pre-accident
employment due to compensable work restrictions, with skill development and work experience.
viii. The Contractor shall convene an implementation phase mid point case
conference prior to the Worker’s discharge date. The Contractor shall
review the phase deliverables with the Worker (in person) and Claim
Owner via teleconference.
Supplementary Assessments
1. The following interventions may be provided with Claim Owner authorization
as supplementary assessments to obtain additional information to support
interventions that are appropriate for the Worker.
a) Academic Assessments
• The purpose of the Academic Assessment is to evaluate a Worker’s
suitability for and probability of successful completion of training and/or
educational upgrading based on the Worker’s intellect, aptitudes, and
interests.
• The primary objectives of the Academic Assessment are to:
- provide a range (e.g., average, high average) and/or percentile
ranking of the Worker’s intelligence (IQ testing);
- provide a wide range screening measurement for achievement
based on reading recognition, spelling and arithmetic; and
- provide a quantitative measure of the Worker’s general aptitudes to
perform various job functions.
• The Academic Assessment shall, at a minimum, involve completion of:
- Wechsler Adult Intelligence Scale IV (WAIS-IV); and
- Wide Range Achievement Test IV (WRAT-IV).
• The Contractor shall ensure that validated and published test protocols
are adhered to for each test (i.e. WAIS-IV, WRAT-IV).

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• The Contractor shall ensure that the WAIS-IV is completed under the
supervision of a licensed Psychologist in Alberta and that the
Psychologist has provided written interpretation and approval of the
results.
• The Contractor shall be responsible for the following Academic
Assessment cycle times:
- The Academic Assessment shall be conducted within two (2)
working days of the confirmed referral; and
- An Academic Assessment report (C761) shall be submitted to the
WCB within five (5) working days of the completion of the
assessment.
• The Academic Assessment report (C761) shall be completed in
accordance with the Academic Assessment Report Contract
Reference Guide (HC-335).
b) Specialized Assessment/Service
• The Contractor may perform a specialized assessment/intervention with
prior written approval from the Health Care Consultant.
VIII.
DISCHARGE CRITERIA
1. If one or more of the following criteria are met, the Worker shall be discharged
from the Service:
a) The Worker has achieved an appropriate RTW placement.
b) The Worker has reached the maximum Vocational Services length of stay.
c) The Worker voluntarily withdraws or is removed from the Services by the
Claim Owner.
IX.
REPORTING
1. Service reports/forms include:
a) Referral form (FM733) – for stand alone Vocational Services
b) Vocational Services memo (C963) – for customized reporting
c) Planning Phase report (C880)
d) Implementation Phase Initial Case Conference (C959)

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e) Implementation Phase Progress report (C881)
f) Implementation Phase Discharge report (C888)
g) Employer Contact report (C472)
h) Academic Assessment (C761)
2. All reports shall be typed and follow the standardized format as outlined in the
contract reference guides.
3. The Contractor shall prepare and forward a draft Planning Phase Report (C880)
and include it in their invitation for a case conference with the Claim Owner to
discuss the job options. The draft C880 shall contain at minimum the completed
section of the C880 called “Return to Work Plan – Summary of Job Options”.
4. The Contractor shall prepare and forward a finalized Planning Phase report
(C880) to the WCB within two (2) working days of the final planning phase case
conference and after the Claim Owner has agreed to the proposed job options.
A copy of the report shall also be faxed or mailed to the Worker. The report shall
be completed as per the format and guidelines outlined in the Planning Phase
report Contract Reference Guide (HC-336).
5. The Contractor shall prepare and forward an Implementation Phase Initial Case
Conference (C959) to the WCB during the first week of the implementation
phase. A copy of the report shall also be faxed or mailed to the Worker. The
report shall be completed as per the format and guidelines outlined in the
Implementation Phase Initial Case Conference Contract Reference Guide (HC-
409).
6. The Contractor shall prepare and forward an Implementation Phase Progress
report (C881) to the WCB at the mid point (6 weeks) of the implementation
phase. A copy of the report shall also be faxed or mailed to the Worker. The
report shall be completed as per the format and guidelines outlined in
Implementation Phase Progress Contract Reference Guide (HC-660). If the
Worker is discharged prior to the mid point of the implementation phase, the
Progress report (C881) is not required. In this case, only the Implementation
Phase Initial Case Conference (C959) and Implementation Phase Discharge
report (C888) are required.
7. The Contractor shall prepare and forward an Implementation Phase Discharge
report (C888) to the WCB within two (2) working days of the Worker’s discharge.
A copy of the report shall also be faxed or mailed to the Worker. The report shall
be completed as per the format and guidelines outlined in the Implementation
Phase Discharge Contract Reference Guide (HC-337)

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8. Reports shall be faxed to the Claim Owner as follows:
• Within Edmonton to: 780-427-5863
• Outside Edmonton to: 1-800-661-1993
9. The WCB may monitor the content and quality of the Service reports on a
continuous basis. The Contractor shall be required to participate in report quality
assurance activities during the term of the Contract as and when directed by the
WCB.
X. STAFFING
All VRS interventions shall be conducted by a vocational counsellor with the
following qualifications:
• Post secondary education in the social sciences or a related field and training
in career counselling, job development, and placement. Experience and
equivalencies are acceptable.

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XI.
SERVICE DELIVERABLES
1. The Contractor shall use reasonable efforts to meet the following cycle times:
a) Confirmed referral date to Service initiation – three (3) working days.
b) Academic Assessment confirmed referral date to Academic Assessment
admission – two (2) working days.
c) Academic Assessment completion date to Academic Assessment report
distribution – five (5) working days.
2. The Contractor shall use reasonable efforts to meet the following service
expectations on a consistent basis:
a) Generation of reports and distribution to involved stakeholders (i.e. Claim
Owner and Worker) – 100% of cases.
b) Involvement of the Claim Owner in planning and implementation phase case
conferences – Target = 100% of cases.
c) Involvement of the Worker in planning and implementation phase case
conferences – Target = 75% of cases.
3. The Contractor shall use its best efforts to meet the following outcome
expectations on a consistent basis:
a) Service evaluation data shall be submitted in the agreed format within the
expected timeframe as per the Discharge Data Collection Reference Guide
(HC-322).
b) Implementation phase placement rate – Target = 70%
c) Percent of placements with post accident wage of equal to or greater than
75% of the pre-accident wage – Target = 76.5%
d) Placement sustainability rate – Target = 75%
e) Worker satisfaction rate – Target = 80%
f) Worker satisfaction survey response rate – Target = 70%

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XII.
SERVICE EVALUATION
1. Service evaluation data shall be collected for Service discharges using the
Vocational Services Data Collection Sheet (Form HC-315). This data shall be
submitted to Health Care Services (HCS) on a monthly basis [within fifteen (15)
days of month end].
2. Worker Satisfaction Surveys shall be administered to Workers at the completion of
the planning phase (HC-316) and at mid point of the implementation phase (HC-
317).
3. It is the responsibility of the Contractor to ensure that the Worker Satisfaction
Survey (HC-316 and HC-317) distribution process is followed to ensure Worker
confidentiality as outlined in the Worker Satisfaction Survey Reference Guide (HC-
503). Return envelopes for the Worker Satisfaction Surveys will be provided by
Health Care Services.
4. Evaluation data shall be submitted via an electronic file to Health Care Services c/o
Evaluation Unit.
a) Electronic file data shall be submitted in SPSS (sav) format using the file
specifications provided by Health Care Services.
b) All data shall be specified via categories and definitions outlined in the
Discharge Data Collection Reference Guide (Form HC-322).
c) The unique identifier in each file sent to HCS shall be the Worker’s claim
number. Satisfaction surveys do not require the claim number, however, the
discharge date and phase type is required.
d) It is the Contractor’s responsibility to ensure that all evaluation data submitted to
HCS is timely, complete and accurate. Random file audits will be conducted by
HCS to ensure the accuracy of data submission.
5. HCS may edit the content of data collection forms in order to meet changing service
evaluation needs. Any changes shall be made with Contractor input.
6. Monthly scorecards shall be provided by HCS to the Contractor outlining outcomes
for all Services.
7. The evaluation unit of Health Care Services may monitor Service processes and
outcomes on a continuous basis. If outcomes fall below acceptable benchmark
standards, the Contractor will be required to participate in quality improvement
initiatives including service evaluation, action planning and follow-up.

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XIII.
PAYMENT AND SCHEDULE OF FEES
1. Services shall be invoiced utilizing the Vocational Services Invoice (C749).
2. HCS may conduct random audits of Worker discharges and related Service rates
to monitor the accuracy of Contractor billing. Should any discrepancy in what
rate has been billed versus actual Worker length of stay be discovered, the WCB
may terminate this Agreement forthwith without limiting other remedies that may
be available at law.
3. The WCB shall pay the rates below for cases in which the Worker was
discharged from a Vocational Services:
Service
Fee
Return to Work Planning $620.00
Job Search Skills Development $360.00
Resume $210.00
Supported Job Search $905.00
Academic Assessment - WAIS IV and WRAT IV $480.00
4. The WCB shall pay No Show/Cancellation Fees as follows:
Service
Cancellations
(< 24 hours notice)
No Show
Academic Assessment 90% of total $432.00 100% of total $480.00
5. No show/cancellation fees shall only be paid if the Contractor has made
reasonable efforts to utilize the associated staff in another billable fashion and is
unable to do so.
6. The WCB shall pay the following incentives in cases where planning or
implementation phase Services assisted the Worker in securing employment
(placement).
Incentive
Fee
Placement Wage is 100% or more than DOA earnings $1,000.00
Placement Wage is 90% to 99% of DOA earnings $850.00
Placement Wage is 80% to 89% of DOA earnings $750.00
Placement Wage is 75% to 79% of DOA earnings $500.00
Placement Sustainability for 60 days $700.00
a) The Contractor shall be eligible to receive a Placement Wage Incentive
payment provided that:
i. there is evidence that the Contractor assisted with the employment
placement during Vocational Services; and

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ii. the Worker started employment within two (2) weeks of being discharged
from the planning or implementation phase.
b) If the Worker’s annual pre-accident earnings were greater than the applicable
maximum insurable earnings on the date of accident, the maximum insurable
earnings shall be deemed to be the Worker’s Pre-accident Earnings to
determine if a Placement Wage Incentive is payable.
c) The Contractor shall be eligible to receive a Placement Sustainability
Incentive payment provided that:
i. there is evidence that the Contractor assisted with the employment
placement during Vocational Services; and
ii. the Worker started employment within two (2) weeks of being discharged
from the planning or implementation phase; and
iii. the Worker was not entitled to receive any of the following rate based
benefits from the WCB during a period of sixty (60) calendar days after the
date the Worker returned to work in their placement position:
• TD-01 (Temporary Total Disability Benefits
• VR-01 (Interim Program Allowance Benefits)
• VR-02 (Retraining Allowance)
• VR-04 (Re-Employment Assistance Benefits)
7. The Health Care Services evaluation unit will generate placement wage and
placement sustainability incentive payments [Incentive Invoice (C1022)] on behalf
of the Contractor on a monthly basis.
8. Health Care Services may conduct random audits of the cycle time incentives to
monitor the accuracy of Contractor evaluation data submissions.
9. Any work not expressly contemplated by this Agreement shall require advance
authorization by the Health Care Consultant. If so authorized, all reporting,
payment and evaluation requirements of this Agreement shall apply.
10. The WCB may deny payment of any invoice where the Contractor has failed to
obtain proper approval of Services. Where the WCB denies payment because the
required approval process was not followed by the Contractor, the Contractor shall
not bill the Worker for the same.

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11. Provided that the required Services were provided and a complete invoice is
submitted for the Services provided to Workers, the WCB shall pay the Contractor
the invoiced amount within thirty (30) calendar days of receipt of such invoice.
Failure to submit evaluation data may result in withholding of payment.
12. The WCB will not pay late charges on any outstanding balances.
13. The WCB shall reimburse the Contractor for associated mileage and meal costs for
Services provided outside of the city limits at the same rate and upon the same
terms as the WCB reimburses its own employees which rates are currently as
follows:
Mileage
Breakfast
Lunch
Dinner
$ 0.49/kilometre
$ 9.00 – leaves before 7:00 a.m. and arrives after 8:30 a.m.
$13.00 – leaves before 11:30 a.m. and arrives after 1:00 p.m.
$22.00 – leaves before 5:30 p.m. and arrives after 7:00 p.m.
14. The WCB shall pay the Professional’s travelling time outside of the city limits at a
rate of $78.00 per hour.
15. The Contractor shall utilize the Invoice Contract Reference Guide (Form HC-500)
to guide the billing process.