Private Vocational Rehabilitation Services Quarterly Report {WKC-10369}

WKC-10369 - PRIVATE VOCATIONAL REHABILITATION SERVICES QUARTERLY REPORT. This form is used by the Wisconsin Department of Workforce Development, Worker’s Compensation Division, to track the progress of worker’s compensation claimants who are receiving vocational rehabilitation services. This report should be completed for each WC claimant receiving return to work services from the certified specialist and submitted to the WC Rehabilitation Unit by the 5th day of the months April, July, October and January of each year. The form provides updates on the claimant’s current status, including whether services were denied, whether the claimant is engaged in a job search, undergoing retraining, employed with the same or a different employer, or no longer eligible for services. It also captures important details such as post-injury wages, occupations, reasons for case closure, and the outcomes of vocational services. Additionally, the form requires closure information, including the duration and costs of job search or retraining phases, hourly service rates, and whether costs exceeded the allowable cap under state regulations. By completing this form, vocational specialists help ensure compliance with Chapter 102 of the Wisconsin Statutes and provide the Department with information to monitor and administer vocational rehabilitation services in worker’s compensation cases. www.FormsWorkflow.com