Should Rehabilitation Be Mandatory in Workers' Compensation Programs?

Abstract

When workers' compensation and public vocational rehabilitation programs began in the first decades of this century they were closely allied but now have drifted apart. In an effort to bring the benefits of rehabilitation to work-injured persons, some state workers' compensation programs, beginning with California in 1975, mandated the referral of workers to rehabilitation, but not necessarily to the public program. It has proven most difficult to mandate those services. Decisions about when to intervene, how to intervene, and what services ought to be provided—decisions once left to the parties—must be specified in detail if the services are compulsory. In recent years there has been a retreat from the mandatory provisions. Some states have repealed the provisions outright; others have provided different financing devices. The controversy about mandatory rehabilitation illustrates how little we know about the basic mechanics and economics of the process, or at least how little we know which is convincing to state legislatures. Some modest proposals are made for increasing our knowledge in these areas.