Division of Worker’s Compensation
RULE NOS.: RULE TITLES:
69L-22.006 Screening Process
69L-22.008 Reemployment Services and Programs
69L-22.009 Employee Responsibilities
69L-22.011 List of Forms
PURPOSE AND EFFECT: The proposed rules are amended
to clarify the process injured employees must follow when
seeking to obtain Department-sponsored reemployment
services. The proposed rules provide injured employees with
information and guidance regarding available reemployment
services and the terms, conditions, and responsibilities
associated with receiving such services. Additionally, the
proposed rulemaking incorporates two new forms and revises
two existing forms.
SUMMARY: The proposed rules clarify the process through
which injured employees access reemployment services.
SUMMARY OF STATEMENT OF ESTIMATED
REGULATORY COSTS AND LEGISLATIVE
RATIFICATION: The Agency has determined that this will
not have an adverse impact on small business or likely
increase directly or indirectly regulatory costs in excess of
$200,000 in the aggregate within one year after the
implementation of the rule. A SERC has not been prepared by
the Agency.
The Agency has determined that the proposed rule is not
expected to require legislative ratification based on the
statement of estimated regulatory costs or if no SERC is
required, the information expressly relied upon and described
herein: The Department conducted an economic analysis of
the potential impact of the proposed rule and determined that
there will be no resulting adverse economic impact or
regulatory increases that would require legislative ratification.
Any person who wishes to provide information regarding a
statement of estimated regulatory costs, or provide a proposal
for a lower cost regulatory alternative must do so in writing
within 21 days of this notice.
RULEMAKING AUTHORITY: 440.491(6), 440.591 FS.
LAW IMPLEMENTED: 440.491 FS.
IF REQUESTED WITHIN 21 DAYS OF THE DATE OF
THIS NOTICE, A HEARING WILL BE HELD AT THE
DATE, TIME AND PLACE SHOWN BELOW (IF NOT
REQUESTED, THIS HEARING WILL NOT BE HELD):
DATE AND TIME: Monday, March 28, 2016, 9:00 a.m. ‒
11:00 a.m.
PLACE: Room 102, Hartman Building, 2012 Capital Circle
Southeast, Tallahassee, Florida
Pursuant to the provisions of the Americans with Disabilities
Act, any person requiring special accommodations to
participate in this workshop/meeting is asked to advise the
agency at least 5 days before the workshop/meeting by
contacting: Stephen Yon, telephone: (850)413-1786, email:
Stephen.Yon@myfloridacfo.com. If you are hearing or speech
impaired, please contact the agency using the Florida Relay
Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice).
THE PERSON TO BE CONTACTED REGARDING THE
PROPOSED RULE IS: Stephen Yon, Chief, Bureau of
Employee Assistance and Ombudsman Office, Division of
Workers’ Compensation, Department of Financial Services,
address: 200 East Gaines Street, Tallahassee, Florida 32399-
4225, telephone: (850)413-1786, email:
Stephen.Yon@myfloridacfo.com
THE FULL TEXT OF THE PROPOSED RULE IS:
69L-22.006 Screening Process.
(1) A request for screening must be is made using a Form
DFS-F3-DWC-23, Request for Screening. Before the
Department will consider a request complete and initiate a
screening, the injured employee must: sign the Form DFS-F3-
DWC-23.
(a) Complete, sign and submit Form DFS-F3-DWC-23,
Request for Screening;
(b) Complete, sign and submit Form DFS-F3-DWC-27,
Reemployment Services Questionnaire;
(c) Provide documentation to establish identity and
employment eligibility. Such documentation shall be
consistent with the acceptable documents for verifying identity
and employment eligibility as required by the U.S.
Department of Homeland Security, U.S. Citizenship and
Immigration Services’ Form I-9, Employment Eligibility
Verification (Rev. 03/08/13 N), which is incorporated by
reference herein and available at
http://www.uscis.gov/files/form/i-9.pdf.
(d) Provide the most current DFS-F5-DWC-25, Florida
Workers’ Compensation Uniform Medical Treatment/Status
Report Form, from all authorized treating physicians.
(2) An injured employee may submit an electronic
Requestrequest for Screeningscreening and Reemployment
Services Questionnaire screening through the Injured
Employee Web Portal located on the internet at
https://wcres.fldfs.com/resportal/ieweb/ielogin.aspx. An
electronically submitted Requestrequest for
Screeningscreening and Reemployment Services
Questionnaire shall be considered electronically signed by the
injured employee.
(3) through (8) No change.
(9) The Department shall not provide a vocational
evaluation or any reemployment services when Form DFS-F3-
DWC-23, Request for Screening, which is signed by the
injured employee, and all documents specified in 69L-
22.006(1), F.A.C., are is received by the Department more
than one (1) year from the date of last payment of indemnity
benefits or the furnishing of remedial treatment, care, or
attendance from the employer or carrier.
(10) through (11) No change.
Rulemaking Authority 440.491(6), 440.591 FS. Law Implemented
440.491 FS. History–New 7-1-96, Amended 6-26-01, Formerly 38F-
55.009, Amended 5-5-04, 5-7-09, Formerly 6A-22.006, Amended 3-
31-14, ________.
69L-22.008 Reemployment Services and Programs.
(1) through (3) No change.
(4) The Department will approve entry into a
recommended training and education program at the next
available start date.
(5) The Department will not approve training and
education programs at a community college when the injured
employee must complete more than two (2) remedial courses.
(6) The Department will not approve training and
education programs at a career center when the injured
employee must remediate more than two (2) grade levels to
meet the exit requirements of the program.
(7) The Department will approve an individual course or
multiple courses when it is demonstrated that the skills to be
gained are necessary for the injured employee to secure
suitable gainful employment.
(8)(4) The Department will shall approve training and
education programs which exceed 52 weeks only when there
is no program shorter than 52 weeks which would enable the
injured employee to return to suitable gainful employment, the
injured employee provides a plan for living expenses during
the period in excess of 52 weeks, and the injured employee
has no formal marketable vocational training and education.
(9)(5) If the Department determines a training and
education program is necessary to return an injured employee
to suitable gainful employment, the Department shall have the
exclusive right to approve training and education programs
and facilities at which to sponsor the injured employee.
(a) through (d) No change.
(10)(6) The Department will shall not approve the transfer
its approval of reemployment services unless the Department
determines that the substantially same services are available in
the location to which theyservices would be transferred.
(11)(7) The Department will shall not approve
reemployment services if the vocational evaluation does not
recommend reemployment services.
Rulemaking Authority 440.491(6), 440.591 FS. Law Implemented
440.491 FS. History–New 7-1-96, Amended 2-9-00, 6-26-01,
Formerly 38F-55.011, Amended 3-1-05, 5-7-09, Formerly 6A-
22.008, Amended 3-31-14,_________.
69L-22.009 Employee Responsibilities.
(1) Upon approval of training and education by the
Department, the injured employee and Department staff shall
sign and date:
(a)(2) Form A Department and student agreement for
sponsorship of training and education form DFS-F3-DWC-24,
Department and Student Agreement for Sponsorship of
Training and Education, which is adopted incorporated by
reference in Rule 69L-22.011, F.A.C.; and,
(b)(3) An Individualized Written Reemployment Plan.
(2) Upon approval of reemployment services, including
job-seeking assistance, by the Department, the injured
employee and Department staff must sign and date Form DFS-F3-DWC-26, Department and Injured Employee Agreement
for the Provision of Contracted Placement Services, which is
adopted in Rule 69L-22.011, F.A.C.
Rulemaking Authority 440.491(6), 440.591 FS. Law Implemented
440.491 FS. History–New 7-1-96, Amended 6-26-01, Formerly 38F-
55.012, Amended 3-1-05, 5-7-09, Formerly 6A-22.009, Amended 3-
31-14, _________.
69L-22.011 List of Forms.
(1) The following forms are to be used with this rule
chapter and are hereby incorporated by reference:
(a) Form DFS-F3-DWC-23 (Revised: 12/2015), Request
for Screening;
(b) Form DFS-F3-DWC-24 (Revised: 12/2015),
Department and Student Agreement for Sponsorship of
Training and Education;
(c) Form DFS-F3-DWC-26 (Effective: 12/2015),
Department and Injured Employee Agreement for the
Provision of Contracted Placement Services.
(d) Form DFS-F3-DWC-27 (Effective: 12/2015),
Reemployment Services Questionnaire;
(2) No change.
Rulemaking Authority 440.491(6), 440.591 FS. Law Implemented
440.491 FS. History–New 7-1-96, Amended 6-26-01, Formerly 38F-
55.014, Amended 5-5-04, 5-7-09, Formerly 6A-22.011, Amended 3-
31-14, _________.
NAME OF PERSON ORIGINATING PROPOSED RULE:
Stephen Yon, Chief, Bureau of Employee Assistance and
Ombudsman Office, Division of Workers’ Compensation,
Department of Financial Services
NAME OF AGENCY HEAD WHO APPROVED THE
PROPOSED RULE: Jeff Atwater, Chief Financial Officer,
Department of Financial Services
DATE PROPOSED RULE APPROVED BY AGENCY
HEAD: February 29, 2016
DATE NOTICE OF PROPOSED RULE DEVELOPMENT
PUBLISHED IN FAR: January 7, 2016.
