Amendment-Suspension-Closure Of Vocational Rehabilitation Plan {152}

Forms 152 - AMENDMENT, SUSPENSION, OR CLOSURE OF VOCATIONAL REHABILITATION. This form is used by the Department of Industrial Accidents in Massachusetts for requesting amendments, suspensions, or closures of vocational rehabilitation plans. It collects information about the employee, DIA Board number, adjuster, VR provider, VR specialist, vocational goal, and DOT code. The form requires details regarding the reason for amendment or suspension, proposed changes, and additional VR services with estimated costs. It also includes sections for signatures and dates. If closing the plan, it asks for return-to-work details, employer information, VR expenses, reasons for closure, and closure date. The completion and signature are required on the front page. www.FormsWorkflow.com