Vocational Rehabilitation
Publications & Forms
Publications
- Vocational Rehabilitation Services (PDF: 0.25 KB)
- Vocational Rehabilitation Services (Spanish) (PDF: 0.25 KB)
- Rules 36 - 45 (PDF: 0.25 KB)
Forms
The forms below may be completed electronically, then printed and mailed to the Nebraska Workers' Compensation Court, Vocational Rehabilitation Section, P.O. Box 98908, Lincoln NE 68509-8908. If additional space is required to complete a form, please attach the necessary information on a separate sheet(s) of paper. You may send questions or comments about these forms to the E-Mail Help Desk.
- Form VR-37E: Case Closure Report (PDF: 0.5 KB)
- Form VR-39: Application for Certification (PDF: 0.5 KB)
- Form VR-39A: Application for Renewal of Certification (PDF: 0.25 KB)
- Form VR-42: VR Counselor Designation (PDF: 0.5 KB)
- Form VR-42B: VR Counselor Appointment Request (PDF: 0.5 KB). Note: Send one copy each to the Nebraska Workers' Compensation Court, Employer/Insurer/Insurer Attorney, and Employee/Employee Attorney.
- Form VR-42C: Agreement for the Selection of a VR Counselor (PDF: 0.25 KB)
- Form VR-42C: Agreement for the Selection of a VR Counselor (Spanish) (PDF: 0.25 KB)
- Form VR-43: Request for Change of VR Counselor (PDF: 0.25 KB). Note: Send one copy each to the Nebraska Workers' Compensation Court, Employer/Insurer/Insurer Attorney, Employee/Employee Attorney, and Current Vocational Rehabilitation Counselor.
- Form VR-44: VR Plan (PDF: 0.25 KB)
- Form VR-44S: Supplemental Billing Request (PDF: 0.25 KB)
- Form VR-44SI: Student Information and Instructions (PDF: 0.25 KB)
- Form VR-44JPI: Job Placement Information and Instructions (PDF: 0.25 KB)
- Job Search Mileage Reimbursement Request:
- Select this link to report travel on and after 07/01/2008:
Job Search Activity Log—Mileage Reimbursement Request, effective 07/01/2008. (PDF: 0.25 KB) - Select this link to report travel prior to 07/01/2008:
Job Search Activity Log—Mileage Reimbursement Request, effective 01/01/2008. (PDF: 0.25 KB)
- Select this link to report travel on and after 07/01/2008:
- Training Mileage Reimbursement Request:
- Select this link to report travel on and after 07/01/2008:
Training Mileage Reimbursement Request, effective 07/01/2008. (PDF: 0.25 KB) - Select this link to report travel prior to 07/01/2008:
Training Mileage Reimbursement Request, effective 01/01/2008. (PDF: 0.25 KB)
- Select this link to report travel on and after 07/01/2008:
- Monthly Tutor Payment Form (PDF: 0.5 KB)
- Instructor's Monthly Progress Report (PDF: 0.5 KB)
- Program of Study (PDF: 1.0 KB). Note: this is a voluntary form.
- Post-Secondary End of Term Report (PDF: 0.25 KB). Note: this is a voluntary form.