Chapter 3: Eligibility

  • 3.1 Determination of Eligibility—Overview
  • 3.1.1 Overview
  • 3.1.2 The Role of the VR Counselor
  • 3.1.3 Role of the Applicant/Consumer (including Representatives/Guardians)
  • 3.1.4 Use of Existing Information
  • 3.2 Eligibility Criteria for VR Services
  • 3.3 Presumptive Eligibility for SSDI and SSI Recipients
  • 3.3.1 Overview
  • 3.3.2 Documentation of Benefits
  • 3.4 Compliance Requirement—60-Day Rule
  • 3.4.1 Exceptions to the 60-Day Rule
  • 3.4.2 Extension of Time
  • 3.4.3 Eligibility Rule
  • 3.4.4 Nondiscrimination in Eligibility Determination
  • 3.4.5 Institutionalized Individuals
  • 3.4.6 Consumers Hospitalized at Time of Referral
  • 3.5 Eligibility for Active VR Services – Criterion I
  • 3.5.1 Statement of Criterion I
  • 3.5.2 Definition of a Visual Impairment
  • 3.5.3 Deafblind Consumers
  • 3.6 Eligibility for Active VR Services – Criterion II
  • 3.6.1 Statement of Criterion II
  • 3.6.2 Definition of Substantial Impediment to Employment
  • 3.6.3 Other Factors Relating to Substantial Impediment to Employment
  • 3.6.4 Remediable Conditions
  • 3.6.5 Employment Outcome
  • 3.7 Eligibility for Active VR Services – Criterion III
  • 3.7.1 Statement of Criterion III
  • 3.7.2 Definition of "Requires" VR Services
  • 3.8 Eligibility for Active Services—Criterion IV
  • 3.8.1 Statement of Criterion IV
  • 3.8.2 Presumed Capable of Employment
  • 3.9 Eligibility for Active VR Services—Other Considerations
  • 3.9.1 Residency Requirement
  • 3.9.2 Legal Status and Employment Eligibility Verification
  • 3.9.3 Authorization to Work
  • 3.10 Eligibility for Extended Evaluation/Trial Work Experience
  • 3.10.1 Purpose
  • 3.10.2 VR Eligibility Criteria
  • 3.10.3 Clear and Convincing Evidence
  • 3.10.4 Trial Work Experience
  • 3.10.5 Case Movement
  • 3.10.6 Monitoring Requirements
  • 3.10.7 Services in Extended Evaluation/Trial Work Experience
  • 3.11 Eligibility Statement(DARS5101)
  • 3.12 Ineligibility for VR Services
  • 3.12.1 Overview
  • 3.12.2 Ineligibility Documentation at Application
  • 3.12.3 Reasons for Ineligibility from Application
  • 3.13 DBS/DRS Agreement for Serving Consumers
  • 3.13.1 Consumers Served by DBS
  • 3.13.2 Substantial Secondary Disability
  • 3.13.3 Referring Cases Between DBS and DRS
  • 3.13.4 Exchange of Information Between VR Agencies

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3.1.4 Use of Existing Information

When possible, counselors should use existing information to determine eligibility. Information available from other programs and providers, particularly information used by education and Social Security may be helpful. Information provided by the individual and the family should also be obtained and used. The existing information does not have to be current in terms of date, but must reflect the current functioning or condition of the individual. An example might be an eye exam that is 2 years old, but shows that the individual has been totally blind since birth.

Note: InTWorksReHabWorks,if a consumer's case has been closed two or more times unsuccessfully in Outcome Unsuccessful before or after Plan Initiated, the field director must review the case before the counselor determines eligibility.

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3.3.1 Overview

An applicant showing documentation of receiving SSI or SSDISSI (Title XVI) or SSDI (Title II) based on being blind must be presumed eligible for vocational rehabilitation services, provided the applicant meets all VR eligibility criteria.intends to

  • become employed,
  • retain employment, or
  • regain employment.

In some cases, because of the severity of the applicant’s disability, a counselor cannot presume eligibility. In those cases, the counselor must provide an extended evaluation and /trial work experiencea trial work or extended evaluation in accordance with Criterion IV.

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3.3.2 Documentation of Benefits

The counselor must work with the applicant to verify eligibility when the individual

  • cannot provide evidence, such as an award letter, of receiving SSI or SSDI benefits; and
  • is not sure the benefits are for blindness.

The counselor can obtain eligibility verification by

  • asking the applicant to bring documentation of SSI or SSDI benefits eligibility to the initial intake appointment; or
  • having the applicant request and provide to the counselor a Benefits Planning Query (PBQY) from the Social Security Administration by calling 1-800-772-1213. The BPQY is a snapshot of the individual’s benefits and work history and is mailed to the applicant within a few days.; or

having the applicant sign two SSA 3288, Consent for Release of Information forms and requesting the BPQY directly. The first form is needed to make Social Security records available, and the second form is needed to authorize the release of Internal Revenue Service earnings records. Both are sent to the local SSA office.

For an active consumer who is receiving SSI or SSDI benefits and whom the counselor is unable to locate, the counselor may request a current address from the SSA/VR Coordinator in the Central Office by email or phone at (512) 377-0668. The counselor must provide

Social Security number,

name,

last address listed, and

birth date.

When the counselor enters information into the TWorks ReHabWorksMonthly fFinancial Informationscreenpageshowing the applicant receives SSI or SSDI benefits, the counselor must also enter a case note documenting the

  • presumption of eligibility, or
  • reason the counselor cannot presume eligibility.

A person who receives either SSDI or SSI due tobecause of disability is also considered anindividual person with a significant disability.

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3.4.2 Extension of Time

(Revised 11/11, 08/12)

Document that the consumer has agreed to an extension of time to determine eligibility by

  • selecting the “Extension of Time” link in ReHabWorks and entering the specific number of additional days the applicant has agreed to (ReHabWorks creates a new action to determine eligibility by the extended date); and
  • entering a comment on the “Extension of Time” page explaining that the applicant has agreed to an extension of a specific time period.

If the consumer is not available, document in a case note why the consumer is not available and efforts made to obtain written authorization for an extension of time.

Note: The visual acuity to be used is the best corrected distance acuity. Best correction is the best visual acuity obtained with a simple refraction (glasses or contact lenses), not with a low vision aid, e.g., telescopic aid. The visual acuity is to be measured by the distance Snellen chart or converted to the distance Snellen equivalent in writing by an ophthalmologist or optometrist.

To document that the applicant has agreed, either verbally or in writing, to a specific extension of time to determine eligibility, the counselor can

select the “Extended Time” link in TWorks and enter the specific number of additional days the applicant has agreed to (TWorks creates a new action to determine eligibility by the extended date.); or

enter a case note labeled “Extension of Time” that explains that the applicant has agreed to a specific extension of time

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3.6.4 Remediable Conditions

In determining eligibility for VR services, remediable conditions may be considered disabling. These conditions:

  • are chronic, and
  • require physical restoration services, and
  • result in no substantial visual impairment to employment after physical restoration services have been provided (see the definition of a visual impairment).

Consumers with remediable conditions must be informed in their IPEs that if a remediable condition improves to the point that the consumer no longer has a visual impairment to employment, DBS can provide only counseling and guidance, information and referral, and placement services. Example: Cataracts.

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3.11 Eligibility Statement(DARS5101)

In TWorksReHabWorks if the counselor believes that the individual meets the eligibility requirements for VR services, the counselor will read and electronically sign the following:

I certify that this individual has a visual disability; that the visual disability results in a substantial impediment to employment for the individual; and that the individual requires vocational rehabilitation services to prepare for, secure, retain, or regain employment.

This individual is presumed to be capable of achieving an employment outcome from the provision of vocational rehabilitation services.

In addition, the counselor documents the functional limitations that result from the visual impairment by checking the box for the appropriate categories.

While it is available, the counselor does not need to print the Eligibility Statement unless the consumer requests a copy or the documentation is needed by some other agency.

Note: An individual who documents receiving either SSI or SSDI due to vision loss is presumed to meet all eligibility criteria, provided the consumer intends to be employed.

3.12 Ineligibility for VR Services

3.12.1 Overview

An individual who applies to this agency for VR services may not be eligible.

3.12.2 Ineligibility Documentation at Application

If an individual is determined ineligible after an individual has signed an application for VR services, the counselor must offer the consumer the opportunity for a full consultation. The counselor must also provide the consumer with a written reason for ineligibility. The counselor completes a Letter of Ineligibility(DARS2405) (DARS5102), which is produced in TWorksReHabWorks,and sends it to the consumer unless:

  • the case is closed before an application has been signed,
  • the consumer has died, or
  • the counselor is unable to locate the consumer.

If the consumer has died or is unable to locate, the counselor should document this information in a case note.

3.12.3 Reasons for Ineligibility from Application

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For information on closure of a case after eligibility has been determined select:

Outcome, Not Rehabilitated or

Outcome, Rehabilitated

  • Successful Closure,
  • Unsuccessful Closure before Plan Initiated, or
  • Unsuccessful Closure after Plan Initiated.