Texas Department of Insurance

How CARF Accredited Work Conditioning and Work Hardening Programs work with Preauthorization and Concurrent Review

Occupational rehabilitation facilities with current accreditation by the Commission on Accreditation of Rehabilitation Facilities (CARF) are eligible for exemption from preauthorization and concurrent review requirements for work conditioning and work hardening if the following two (2) conditions are met:

1. The service is within the recommendations of the Texas Division of Workers’ Compensation (DWC) adopted treatment guidelines, ODG – Treatment in Workers’ Comp, for the specific diagnosis,
   
   and
   
2. The CARF accredited facility is on the DWC current exemption list.  (see INSTRUCTIONS FOR REQUESTING OR RENEWING EXEMPTION to be added to  the current exemption list).

Work conditioning is a general occupational rehabilitation program, or its current equivalent as defined by CARF. Work hardening is a comprehensive occupational rehabilitation program, or its current equivalent as defined by CARF.  Both work conditioning and work hardening program exemptions must be requested and granted by DWC in order for a facility to appear on the current exemption list. To maintain DWC exemption status with no time break, facilities must renew before their exemption status expires.   

Resources

•    Current Exemptions (Word, PDF) 9/1/09
•    Previous Exemptions (Word, PDF) 9/1/09
• CARF Website - Commission on Accreditation of Rehabilitation Facilities (CARF)
• Q&As - Work Conditioning & Work Hardening, ODG and Preauthorization Process  01/08  

   Instructions for Requesting or Renewing Exemption

Each CARF accredited facility that wishes to request exemption from preauthorization and concurrent review requirements for work conditioning or work hardening must submit the required written documentation to DWC. To maintain DWC exemption status with no time break, facilities must renew before their exemption status expires.  Exemption requests are dependent on the date the DWC grants the request.  Renewals are intended to maintain the continuity of exemption status and are dependent on the ongoing DWC notification by the facility of the CARF accreditation process. 

If DWC exemption status expires without a request to renew, the DWC website will reflect a break in the facility’s exemption status. In order to limit the break in exemption, the facility should immediately request a new DWC exemption.

To request an exemption, or to renew exemption status when the CARF accreditation period is expiring, the facility must submit the following required written documentation:

1. A copy of a dated CARF letter to each facility that describes the accreditations granted and the dates of the accreditation period
2. A written request stating which work conditioning and/or work hardening program(s), and at which facilities, the exemption is requested.
3. The name of each facility, including the physical and billing address, phone and fax numbers.
4. A contact name and phone number for the facility requesting the exemption.

DWC will accept the required written documentation by regular mail or fax.

Texas Department of Insurance
Division of Workers Compensation
Health Care Policy, MS-7
7551 Metro Center Drive, Suite 100
Austin, TX 78744
Fax:  512-804-5001

For further information regarding initial or continued exemption, please contact 512-804-5002 or 512-804-4706 or e-mail MedBen@tdi.state.tx.us.

For more information contact: