This chapter explains how to gather the information that is necessary to develop a case and to support the eligibility determination.
Any potential DARS consumer can contact or enter any DARS office and begin the process of applying for vocational rehabilitation (VR) services, regardless of the potential consumer's disability or place of residence. A consumer should need to make no more than one visit or contact to start the VR process. This intake protocol is referred to as "No Wrong Door."
A DARS staff member at the office takes the information needed from the consumer; and coordinates with other DARS divisions, programs, or offices, as needed, to serve the potential consumer. This initial contact is referred to as the First Contact Date or as Initial Contact without Case Assignment.
Service levels are divided into phases in the VR process to facilitate caseload management and to document which rehabilitation services have been provided to each consumer.
This process includes:
The word "you" refers to the counselor or the rehabilitation assistant (RA), as appropriate. The terms "applicant" and "consumer" refer to any customer of the VR program at any point from pre-application to closure.
This section includes a flowchart and procedural outline for the VR process. By following the chart and procedural outline, the vocational rehabilitation counselor (VRC) can identify appropriate service statuses for consumers and the documents required for each status.
Note: Some terms such as "Outcome," "Closure," "Rehabilitated," and "Successful," are used interchangeably throughout this manual and ReHabWorks.
To review the flow chart, go to Vocational Rehabilitation Process Flow Chart.
The following subsections describe the flow for normal progression.
A referral, first contact date, or initial contact without case assignment is a person who meets the following criteria:
This is called the "first contact date" or "initial contact" in ReHabWorks.
Movement into referral can be made when a person comes to the attention of the agency and basic information is obtained.
Movement out of referral is made when:
First contact or initial contact may take place by letter, telephone, email, or in person. Each division office provides the direct number of the corresponding DARS office to the consumer during the initial contact and then transfers the call or email to the appropriate office to provide the consumer with information about requested DARS services. If the consumer visits a field office in person, the office provides the direct number of the corresponding DARS office to the consumer during the initial contact and then calls the office to set up a call or appointment for the consumer.
The initial contact is a critical point in the vocational rehabilitation process. It is a time for the consumer not only to exchange information with DBS staff but also to form an impression about the staff's sincerity, concern, and professionalism. A successful exchange of information means that both counselor and consumer fully understand what is being discussed. It is the counselor's responsibility to communicate with the consumer in a way that best accommodates disabilities the consumer has.
During this contact with the consumer, develop an understanding of the consumer's needs, and identify and explain the purpose of the DBS program that seems most suited to meet those needs.
All persons referred to DBS must be given the opportunity to apply for DBS services and meet with a counselor, regardless of whether or not the information obtained during the initial contact or application for services appears to support the individual's eligibility for DBS services. Only a counselor can make the decision regarding whether or not the individual is eligible for DBS services or should be referred to another DARS division or program or to an external agency or organization.
If you determine that DBS is not the appropriate resource for the consumer (for example, when the consumer is requesting housing assistance and is not requesting or in need of disability-related services), refer the consumer to the appropriate agency or organization.
If you cannot meet with the person for an application or profile at the time of the initial contact, schedule an appointment for the earliest possible date. Counselors are responsible for completing the profile within 30 days of the initial contact.
If the individual cannot be seen for an application/profile at the time of the initial contact, schedule an appointment at the earliest possible date. Counselors are responsible for completing the profile within 30 days of the initial contact.
Ask for the applicant's Social Security number (SSN), but do not deny services solely because he or she refuses to provide a Social Security card or SSN. Section 7(a) of the Privacy Act of 1974 prohibits "any federal, state or local government agency" from denying any "right, benefit, or privilege provided by law" on the basis of a person refusing to disclose his or her Social Security number.
If the consumer refuses to provide an SSN:
For additional information, refer to:
When a person has been referred to DBS and has not applied for VR services by signing an application, no documentation is required other than the information placed in ReHabWorks in the initial contact. An additional case note can be developed if there is information that will be helpful later.
*An application for services must be completed within 30 calendar days of initial contact. If the application cannot be completed within 30 calendar days, the case file documentation must reflect a good-faith effort to meet this time standard.*
*Based on 34 CFR Section 361.41(a)
When scheduling the appointment, *determine the consumer's:
*Based on 34 CFR Section 361.37(a)
For DARS policy and procedures about how to access language services, see Business Procedures Manual, Chapter 35: Language Services.
When appropriate, use DARS5001, Application Appointment Letter (available only in ReHabWorks), to schedule the appointment for completing the profile.
If the person is coming to your office, ask him or her to bring appropriate records (names, addresses, and dates of medical treatment, employment history, school, DD214-Certificate of Release or Discharge from Active Duty, and training records) to the appointment.
An applicant is a person for whom the following basic information has been obtained:
Before the application for VR Services is signed, the counselor offers to read "Vocational Rehabilitation Appeal Procedures - Can We Talk?" to the consumer. If the consumer declines having it read, the counselor explains the contents. Every consumer then receives a copy of "Can We Talk?" in the consumer's preferred medium (large print in English and Spanish or braille). The "Can We Talk?" booklet is available from the TWC Internet, Appeal a Vocational Rehabilitation Decision page. You may convert the text-only format of "Can We Talk?" into braille and emboss the text at the local office. If consumer is not able to access information in any of the media listed above, notify the field director. The field director will contact the Central Office and request a special translation.
Obtain signatures (either handwritten or electronic) from:
The following forms, in addition to the application, are signed to permit the exchange of information needed during the rehabilitation process:
File the signed forms according to Chapter 40: Case Management.
The consumer or his or her representative signs the DARS5052, Application Statement for Vocational Rehabilitation (only in ReHabWorks), electronically. The consumer's signature:
In some circumstances, however, other signatures might be required. These signatures might be the:
*A new consumer PIN without a parent or guardian PIN is required once the consumer turns 18. The exception is when the parent or guardian has received an extension through a court.
Ensure that all information in the profile is accurate. The profile, application, or case management in ReHabWorks consists of the following fields:
You can edit the agency involvement field only during the initial contact with case assignment and application phases. Once the case moves into eligibility status, ReHabWorks does not allow you to edit the agency involvement field.
Be sure that the information you enter is accurate. Many state and federal reports are compiled from the information in ReHabWorks, and their accuracy relies on the accuracy of DARS' data.
Note: Some data fields are correlated. For example, if, under the employment status field, you select "Employment without Supports in Integrated Setting," you must then complete the Employment page and also enter the applicant's monthly wages on the Monthly Financial Information page.
If information is missing, leave the corresponding fields blank and get the information as soon as possible.
When the DARS5051, Application for Services is complete in ReHabWorks, the applicant signs the DARS5052, Application Statement for Vocational Rehabilitation, electronically using his or her PIN.
To prevent the appearance of impropriety, the applicant or consumer must:
Note: If the applicant or consumer is unable to enter his or her PIN, you may enter it, but a witness and an accompanying case note are required.
Note: If the applicant asks, you may give him or her a printed copy of the completed Application for Services Statement.
If a person is hospitalized at the time of referral and the application for vocational rehabilitation (VR) services has been signed, you may purchase medical records to determine eligibility, but you may not purchase medical services.
Upon hospital release of an eligible consumer, services may be provided in accordance with other criteria specified in the VR manual.
It is important to provide a timely and efficient response to referrals of consumers from medical or community resources for emergency physical restoration services. It also is important to consider your response carefully in order to:
Movement out of the Application phase occurs once you have determined that the applicant should be certified as:
Note: Movement out of the Application phase may proceed only to the Outcome Not Accepted phase or the Eligibility and Plan Development phase. If you are unable to determine whether a consumer will benefit from VR services because of the severity of the consumer's disability, place the consumer in Pre-eligibility Trial Work by completing an Individualized Plan for Employment (IPE) for Extended Evaluation in ReHabWorks. The IPE for Extended Evaluation in RHW serves as the consumer's Pre-eligibility Trial Work Plan.
During Pre-eligibility Trial Work, work with the consumer to explore the consumer's abilities, capabilities, and capacity to perform in realistic work situations until you obtain enough information to decide whether the consumer is eligible for VR services.
Pre-eligibility Trial Work is offered only when a consumer's disability is expected to meet the criteria of "significant."
To place a case in the application phase, use the following procedure:
To provide adequate review of preliminary assessments and to plan for comprehensive diagnostics, counselors must allow time to make good eligibility decisions, before they initiated individualized plan for employment services. Counselors must determine eligibility based on all diagnostics and not make premature decisions in response to emergency physical restoration referrals from community resources.
You must determine an applicant eligible for the vocational rehabilitation program by the 60th day after the date that the application is signed, unless you:
Based on 34 CFR Section 361.41(b)(1)
DARS may make exceptions to the 60-day rule only if the applicant agrees and:
Pre-eligibility Trial Work is offered to consumers during the Application phase. Trial work experiences must be provided in competitive integrated employment settings to the maximum extent possible, consistent with the informed choice and rehabilitation needs of the consumer. Pre-eligibility Trial Work is used to gather information and determine whether an applicant with a significant disability can benefit from services and is capable of finding employment and staying employed. Pre-eligibility Trial Work must include more than one trial work experience.
Pre-eligibility Trial Work demonstrates the consumer's abilities, capabilities, interests, and capacity to perform in work situations, each of which must be assessed periodically during the Pre-eligibility Trial Work, including when the consumer receives appropriate support services and training.
(Authority: Sections 7(2) and 12(c) of the Rehabilitation Act of 1973, as amended; 29 U.S.C. 705(2) and 709(c))
When to Move Into Pre-eligibility Trial Work
An applicant is placed in Pre-eligibility Trial Work when:
DARS must provide the person with more than one trial work experience, such as supported employment. Trial work experiences must be provided in competitive integrated employment settings to the maximum extent possible, consistent with the consumer's informed choice and rehabilitation needs.
Pre-eligibility Trial Work
To place a consumer in trial work, take the following steps:
When to Move Out of Pre-eligibility Trial Work
Move a consumer out of Pre-eligibility Trial Work, if after the first trial work experience:
Note: A case that is in Pre-eligibility Trial Work can progress only to the Outcome Not Accepted phase or the Acceptance phase.
For information about Closure before Application or Closure after Application, refer to 38.1.1 Reasons for Case Closure.
A consumer placed in plan development status is one who is eligible for VR services and who may require diagnostics beyond those necessary to determine eligibility and to plan the VR program. Comprehensive diagnostics are often required to formulate an IPE.
The purpose of plan development is to conduct a comprehensive case study in order to determine the employment outcome and the nature and scope of services.
Counselors must determine eligibility and then develop the IPE based on a comprehensive assessment to determine the unique strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice, including the need for supported employment, of the eligible individual.
This comprehensive assessment must be documented in the case notes prior to development of the IPE.
Note: Counselor decisions must be based on vocational rehabilitation needs and not in response to emergency physical restoration referrals from community resources.
An individual is placed in plan development upon certification of eligibility for VR services.
A consumer is moved out of plan development when the IPE has been formulated and written.
A consumer in active services is one who is receiving:
In addition, a consumer who is ready for employment is in active services.
A consumer is moved into active services once the individualized plan for employment (IPE) has been written, agreed to by the consumer, and services have begun.
A consumer is moved from active services when the services listed above are completed and the consumer is moved into employment status or the case is being closed with the outcome of "not rehabilitated."
The counselor takes the following steps to place a consumer in Active Services:
For information about the Employment Phase, refer to 38.2 Criteria for Closing Cases as Rehabilitated.
For information about Successful Closure, refer to 38.2.1 Basic Criteria.
For information about Unsuccessful Closure after Plan Initiated, refer to 38.3.1 Basic Criteria.
For information about Unsuccessful Closure before Plan Initiated, refer to 38.3 Criteria for Closing Cases as "Unsuccessful".
For information about Post-Closure services, refer to Chapter 39: Post-Closure Services.
For information about Post-Closure Completed, refer to Chapter 39: Post-Closure Services.
All assessments are gathered to help applicants/consumers better understand their skills, abilities, and interests and to assist the counselor in making decisions in partnership with the consumer regarding the consumer's eligibility and ability to go to work ultimately.
A preliminary assessment is started after the application and profile process is complete. A preliminary assessment gathers information that establishes whether the applicant is eligible for vocational rehabilitation services.
An eye exam can be used to establish a visual impairment, but whenever possible, use one of the following methods to establish a permanent visual loss or impairment:
All of the methods used above must be verified and documented with a case note that clarifies how the visual disability was determined.
Throughout the preliminary assessment, the counselor must summarize the process and rationale related to an eligibility decision. This may require one or more case notes. For more information, see Chapter 40: Case Notes, 40.1.4 Preliminary Assessment.
This section provides information regarding three types of medical diagnostic studies used by the VR counselor, which are
Medical diagnostic studies may be provided as a part of
Medical studies purchased by the division should include
Counselors, at a minimum, must include a review of the applicant's visual condition when determining eligibility. Existing information must be used when the nature of the data is consistent with the person's reported disability. Factors relevant to whether existing data are adequate and appropriate are the
Other records may include information from
The visual acuity to be used is the best-corrected distance acuity. Best correction is the best acuity obtained with a simple refraction lens (glasses or contact lenses), not the acuity obtained with a low-vision aid such as a telescopic aid.
Visual acuity is measured by the Snellen chart or converted to the Snellen equivalent by an ophthalmologist or optometrist in writing.
Visual field must be reported in degrees (not percentages) by an ophthalmologist or optometrist in writing. The visual field must not be measured by a confrontation test.
An optometrist or ophthalmologist may indicate, based upon diagnostic interpretations, that other conditions (such as complete hemianopia) be considered as blindness.
Visual impairment is
Visual efficiency is a measure determined by an ophthalmologist or optometrist that combines visual acuity and visual field. In some cases, functional visual efficiency is a measure of how well a person uses his or her vision. A lack of visual efficiency can interfere with a person's ability to perceive and identify objects in the environment.
If a counselor observes a lack of visual efficiency or a consumer reports limited functional visual performance that is not reflected in the available diagnostic information, the counselor should request a review by the State Optometric or State Medical Consultant. For more information on how to request a review, see the MAPS Guidelines, Chapter 2: State Consultants, 2.1.1 Individual Case Reviews.
Confusion sometimes develops about the work performed by an optician.
An optician does not:
When providing a list of several physicians or specialists to an applicant/consumer, the counselor considers:
Note: An individual's ability to hear is especially important when a person is blind. If there appears to be a problem with the individual's ability to hear, then a hearing assessment should be considered.
The Medical Recommendations (DARS2005) substantiate the review of medical documents as interpreted by the local medical consultant. These determinations can be made by the local medical consultant, if one is available:
It is the responsibility of the counselor to see that the local medical consultant or other physician completes the Medical Recommendations (DARS2005) if appropriate.
Diagnostic studies are not always medical. When used in conjunction with other diagnostic studies, non-medical diagnostic studies provide sufficient evaluation of an individual's strengths and limitations to
Examples of other types of diagnostic studies include:
Non-medical diagnostic studies may be provided as a part of
A vocational evaluation provides much useful data, such as:
See the Vocational Evaluation section of the VR manual for additional information.
Through reviewing employment records, the counselor and consumer can determine the:
which have been the individual's pattern of work activity.
The counselor will consider the consumer's
The counselor may document in case notes any conclusions drawn from discussion with the consumer, review of records, and diagnostic studies in the case record.
The counselor addresses the individual's perception of
The purpose of consumer participation in service costs is to
This section describes how to determine the portion of VR service costs, if any, to be paid by the consumer.
"Economic Resources" include
Each is defined later in this section.
Counselors must consider these guidelines:
Comparable services and benefits will be considered as long as such services are adequate in terms of
Income criteria are not applied to the following:
If at the time of providing any VR service it has been determined that the individual currently receives either SSI or SSDI, then the consumer is not required to participate in the cost of VR services. If this determination is made by asking the consumer if they are receiving SSI or SSDI, then documentation of benefits such as a letter of allowance from Social Security must be supplied.
Note: Individuals who receive either SSI or SSDI cash benefits are expected to use those funds for their normal living expenses, but not for payment of VR services.
Consumer participation in service costs is to be addressed throughout the case by:
Changes in economic need are documented and/or updated in financial screen of the ReHabWorks Profile.
Applicants and consumers have the right to not disclose their monthly income or liquid assets. When a consumer declines to provide this information, it will be assumed the consumer has resources in excess of the agency's economic resource table and the "Refused to Disclose Financial Information" box in ReHabWorks should be marked as "Yes."
ReHabWorks automatically computes whether a consumer is required to participate in the cost of services. But if ReHabWorks is not available, you can apply the Basic Living Requirements (BLR) (economic resources) table, which is posted on the DBS VR intranet page under Quick Links, to determine the consumer's participation in cost of services. If the consumer has economic resources in excess of the allowable net monthly income or liquid assets, then the consumer is required to pay the excess for the cost of VR services.
The BLR table is derived from federal Health and Human Services Poverty Guidelines and is updated each year to reflect annual adjustments in those guidelines.
The family of the referral or consumer is considered to be
A minor is an individual who:
A dependent is an individual who:
The Basic Living Requirements Table is based on net monthly income. Net monthly income is total monthly income minus allowable adjustments. Below is the method for determining total monthly income and net monthly income:
The following financial resources are considered in calculating the total monthly income:
The total of these resources is the total monthly income.
Note: When an individual receives payment more frequently than once a month, net monthly income is determined as follows:
Payment weekly: multiply by 4.3
Payment bimonthly: divide by two, then multiply by 4.3
Calculate the adjustments to total monthly income.
Because it is not the policy of DBS to impose a financial hardship upon a consumer, the following adjustments are made to the total monthly income:
Subtract these adjustments from the total monthly income. The resulting net monthly income is compared to the economic resources table.
Liquid assets are:
Note: A certificate of deposit is considered a liquid asset unless it is in a retirement account recognized by the Internal Revenue Service, for example, IRA, Keogh.
The purchase of occupational tools and equipment cannot always be anticipated before a consumer is employed. If special equipment needs are discovered after the newly employed consumer starts to work and without the equipment the consumer's job would be verifiably in jeopardy, consumer participation in the cost of purchase will be based on the level of participation immediately preceding employment.
All cases in which a consumer disagrees with a counselor's decision on determination of financial participation should be referred through supervisory channels to the Executive Director for a final determination.
If feasible, a consumer who participates in the cost of goods and/or services will directly pay the service provider. If not feasible, the counselor can arrange for the consumer to refund DBS by check or money order. For procedures, see Business Procedures Manual, Chapter 23: Accounting, 23.1 Cash Receipts.
The consumer may pay "in kind" for services listed on the IPE; for example, he or she may pay the additional cost of transportation to receive services or pay for uniforms, textbooks, etc.
In order for DBS to purchase equipment for services at the DBS contracted rate, the counselor is not allowed to receive payment from a consumer who is above the maximum income level on the BLR table. See 2.3.7 Basic Living Requirements for more information on the BLR table.