Authorization Request For Vocational Rehabilitation Plan {BWC-3013}

BWC-3013 - AUTHORIZATION REQUEST FOR VOCATIONAL REHABILITATION PLAN. This form is used in Ohio workers' compensation claims to request authorization for a vocational rehabilitation plan. It is submitted by a vocational rehabilitation case manager to a managed care organization (MCO) for approval. The purpose is to outline the services and associated costs needed to assist an injured worker in returning to work, either in their previous role, a modified role, or a new job, depending on their capabilities post-injury. The form includes details about the injured worker, the job goal, the type of plan, specific services to be provided (e.g., service providers, frequency, duration, and estimated costs), and totals for the plan's scope and budget. It also records the signatures and dates of the case manager and MCO representative to confirm whether the request is approved or denied. RH-45. www.FormsWorkflow.com