Referral leads to resolution
A work transition plan was placed on hold while Mr. D received treatment for a non-compensable medical condition. The case manager told Mr. D his benefits would be reduced if he could not resume the work transition plan by the required date. Two days later the case manager told his representative that the work transition plan was closed and the 72-month lock-in would be completed. A specialist had just assessed Mr. D, and he was cleared to resume the work transition plan in two weeks. The case manager, however, said the decision to close the plan and lock in his benefits at a reduced rate was final.
The representative contacted the Commission, who suggested he call the manager. After speaking to the representative, the manager agreed to reconsider the decision. The case manager adjusted Mr. D’s benefits until he was able to resume the work transition plan and deferred the 72-month lock-in.