What is a Supplemental Job Displacement Voucher in California?

Form Focus

In California, injured workers may be eligible to submit a supplemental job displacement non-transferrable $6,000 voucher for education-related retraining or skill enhancement. It can be used for education, counseling or training services.

The form, DWC-AD Form 10133.32, is available on Simply Research.

How Does it Work?

A worker can take the voucher to a California public school or to a state-certified provider on the Eligible
Training Provider List, at http://etpl.edd.ca.gov and the school will be directly reimbursed upon receipt of
a documented invoice by the claims examiner. The worker can also present the voucher to a counselor, which can be selected from the list on the Division of Workers' Compensation's ("DWC") website at: http://www. dir.ca.gov/dwc/SJDB/VRTWC_list.xlsx.

Eligible Expenses

This voucher may be applied to any of the following expenses at the choice of the injured employee:

(1) Education-related retraining or skill enhancement, or both, at a California public school or with
a provider that is certified and on the Eligible Training Provider List, including payment of tuition,
fees, books, and other expenses required by the school for retraining or skill enhancement.

(2) Occupational licensing or professional certification fees, related examination fees, and
examination preparation course fees.

(3) The services of licensed placement agencies, vocational or return-to-work counseling, and
résumé preparation, all up to a combined limit of $600.

(4) Tools required by a training or educational program in which the employee is enrolled.

(5) Computer equipment including, monitors, software, networking devices, keyboards, mouse,
printers, and tablet computers of up to $1,000 submitted with appropriate documentation. The employer may give the employee the option to obtain computer equipment directly from the employer. The employee shall not be entitled to reimbursement for games or any entertainment media.

(6) Up to $500 as a miscellaneous expense reimbursement or advance, payable upon request without need for itemized documentation or accounting. The employee is not entitled to any other voucher payment for transportation, travel expenses, telephone or internet access, clothing or uniforms, or incidental expenses.

Return-to-Work Supplement

Because an injured worker receives the voucher and is unable to return to usual employment, the worker may be eligible for a Return-to-Work Supplement. The worker must apply within one year from the date the Voucher was served. The worker should make a copy of the voucher that she will need to apply for the Return-to-Work Supplement. Details about the Return-to-Work supplement program are available from the Department of Industrial Relations on its website, www.dir.ca.gov, or by calling 510-286-0787.

If a worker pays for eligible expenses, she may be reimbursed for these expenses upon submission of
documented receipts to the claims administrator for reimbursement. Reimbursement payments must be
made by the claims administrator within 45 calendar days upon receipt of voucher, receipts, and
documentation.

If a worker decides to voluntarily withdraw from a program, she may not be entitled to a full refund of the
voucher. If there is a dispute regarding the voucher, the employee or claims administrator may file Form DWC-AD 10133.55 "Request for Dispute Resolution before the Administrative Director" with the
Administrative Director, Division of Workers' Compensation, P.O. Box 420603, San Francisco, CA
94142-0603.

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