As of 10/1/2017, this manual has been retired. For current policies, procedures, and standards for the Texas Workforce Commission Vocational Rehabilitation Division, please refer to the following manuals:

In this manual, references to DARS now refer to TWC. The manual includes both links to public content and links to content available only to staff.

Chapter 3: Eligibility

(Revised 07/16)

3.1 Overview

(Revised 06/10, 09/10, 09/11, 05/16)

Determining eligibility is a cornerstone of the vocational rehabilitation process. *Only the counselor may make an eligibility determination. The counselor does so by:

To the maximum extent possible, you must:

*Based on 34 CFR Section 361.5(c)(5)(ii)(E)

Only when existing data is unavailable or insufficient, purchase diagnostics to address basic eligibility questions (see 3.3.4 Determining whether Records Are Current).

*If assistive technology devices and services or worksite assessments are necessary to determine whether a consumer is eligible, they must be:

*Based on 34 CFR Section 361.42(d)

Acute Medical Care

If it is in the best interest of the consumer and DRS, you may provide acute medical care before determining eligibility. Document the rationale and obtain area manager approval before providing services.

Example: A consumer is sent from home to another town for an evaluation. There, the person develops acute appendicitis requiring immediate surgery. You may provide this acute medical care.

The eligibility decision must be:

Updating Disability Classification and Level of Significance

When making an eligibility decision, you might have diagnostics and other records that were not available at the time of application. Before entering the eligibility decision into ReHabWorks, the counselor must:

Required Documentation

The rationale for the eligibility decision must be documented in a case note that is entered into RHW.

Document your decision as to whether the consumer has or does not have a significant disability. You may change the significance designation at any time during the life of the case. See Chapter 19: Technical Information and References, 19.2.1 Selecting a Disability Classification and 19.2.2 Establishing the Significance of the Disability.

3.2 Presumption of Eligibility for Social Security Recipients

(Revised 12/15)

*Recipients of Social Security disability benefits (that is, Supplemental Security Income (SSI) and/or Social Security Disability Insurance (SSDI)) are:

*Based on 34 CFR Section 361.42(a)(3)(i)

When the consumer asserts eligibility for SSI or SSDI but is unable to provide evidence such as an award letter, see Chapter 4: Assessing and Planning, 4.10.4 Verification of Social Security Benefits for further information on obtaining proof of benefits.

*If there is a question about the consumer's ability to achieve an employment outcome due to the severity of their disability, you must demonstrate by clear and convincing evidence that such individual is incapable of benefiting in terms of an outcome due to the severity of the individual's disability.* This must done through Pre-eligibility Trial Work services.

*Based on CFR 361.42

Presumptive Eligibility and Pre-eligibility Trial Work Plan (TWP)

Completing a trial work plan (TWP) and moving the case into Pre-eligibility Trial Work services meets the requirement of making an eligibility decision, even though that decision is that pre-eligibility trial work experiences are necessary.

If the consumer is not available to participate in services, an appointment must be scheduled with the consumer to complete the trial work plan as soon as possible.

For more information on presumptive eligibility, refer to 3.2 Presumption of Eligibility for Social Security Recipients.

For more information, refer to 3.9 Pre-eligibility Trial Work.

3.3 Basic Eligibility Criteria

(Revised 12/15)

*To decide whether a consumer is eligible for vocational rehabilitation (VR) services, you must:

  1. determine that the consumer has a physical or mental impairment (first criterion);
  2. determine that the impairment constitutes or results in a substantial impediment to employment (second criterion);
  3. establish that the consumer requires VR services to prepare for, enter, engage in, or advance in competitive integrated employment consistent with the consumer's strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice (third criterion); and
  4. presume that the consumer can achieve an employment outcome, unless pre-eligibility trial work experiences demonstrate by clear and convincing evidence that the consumer cannot achieve an employment outcome because of the severity of the consumer's disability (fourth criterion).*

*Based on 34 CFR Section 361.42(a)(1)

3.3.1 Determining Eligibility by the 60th Day

*You must determine a consumer's eligibility for the vocational rehabilitation (VR) program on or before the 60th day from the date that the application is signed, unless:

*Based on 34 CFR Section 361.41(b)(1)

3.3.2 Extension of Time for Determining Eligibility

(Revised 04/09, 02/11, 05/11)

*When you cannot determine eligibility by the 60th day after the date the consumer signs the application:

  1. inform the consumer of the exceptional and unforeseen circumstances (beyond DRS control) that are delaying eligibility determination;
  2. obtain agreement from the consumer that the extension of time is necessary;
  3. document the reasons for the extension of time* in a case note in ReHabWorks (RHW); and
  4. complete the extension of time page in RHW (see RHW User's Guide Chapter 11 Extension of Time for instructions).

*Based on 34 CRF Section 361.41(b)(1)(i)

3.3.3 Determining Ineligibility

Determine the consumer to be ineligible for services and refer the consumer to any available programs that may be able to help him or her if, after reviewing all records and considering all diagnostic data, you conclude that the consumer does not:

See 3.11.5 Closing a Case after Determining the Consumer Ineligible.

3.3.4 Determining whether Records Are Current

Evaluate records based on a thorough understanding of

If the records sufficiently and accurately reflect the consumer's current functioning and impediments to employment, you may consider them current.

3.4 First Eligibility Criterion: Presence of an Impairment

The first eligibility criterion is that the consumer must have a physical or mental impairment.

3.4.1 Establishing the Presence of an Impairment

(Revised 04/11)

A "physical or mental impairment" is an injury, disease, or other condition that results in persistent functional limitations.

For observable impairments such as amputation, wheelchair usage, deafness, or deformity, you do not need medical reports to determine their presence. You may not need to determine the nature, extent, and significance of an observable condition until the IPE planning process.

For nonobservable impairments, obtain additional examinations or evaluations if records are unavailable or insufficient. In most cases a functional capacity assessment is not required to determine the presence of an impairment.

You may use the DARS3106, Work Restriction Checklist to gather information about a consumer's physical limitations from a treating physician or evaluating specialist.

See Tips on using the DARS3106, Work Restriction Checklist.

For impairments that the consumer reports are unchanged for several years, use available medical and other reports (even if they are several years old) to determine their presence.

For conditions that appear to be unstable or acute, consult with the local medical consultant (LMC) or Central Office program specialist as needed.

3.4.2 Determining There Is No Impairment

Do not purchase evaluations if

If you determine that the consumer does not have an impairment, then the consumer is

See 3.11.5 Closing a Case after Determining the Consumer Ineligible.

3.5 Second Eligibility Criterion: Substantial Impediment to Employment

The second eligibility criterion is that the physical or mental impairment must constitute or result in a substantial impediment to employment.

3.5.1 Establishing a Substantial Impediment to Employment

(Revised 05/12)

Although a consumer may have an impairment that limits certain functions, there may not be an associated substantial impediment to employment.

A substantial impediment to employment exists when the impairment and resultant functional limitations

For additional information about the consumer's condition and treatment and the condition's possible impact on employment, consult the Medical Disability Guidelines.

If a consumer's physical or mental impairment constitutes or results in a substantial impediment to employment, the consumer has a disability for purposes of the vocational rehabilitation program.

3.5.2 Determining There Is No Impediment to Employment

If you determine that the consumer does not have a substantial impediment to employment, then the consumer is

See 3.11.3 Procedure for Closing a Case before Determining Eligibility.

3.6 Third Eligibility Criterion: Requires VR Services

The third eligibility criterion is that the consumer requires VR services to prepare for, enter, engage in, retain, or advance in competitive integrated employment outcome consistent with the consumer's strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice.

VR services are required when

3.7 Fourth Eligibility Criterion: Presumed Capable of Employment

(Revised 12/15)

The fourth eligibility criterion is that it can be presumed that the consumer can benefit in terms of an employment outcome from vocational rehabilitation (VR) services.

You must presume the consumer capable of achieving an employment outcome, unless clear and convincing evidence obtained during pre-eligibility trial work demonstrates that the consumer cannot attain an employment outcome after receiving VR services because of the severity of the consumer's disability. See 3.9 Pre-eligibility Trial Work.

3.8 Required Assessments and Policies for Selected Conditions

(Revised 09/10)

The following sections include information about obtaining and using assessments and a table of

3.8.1 Assessments

(Revised 09/10)

Obtain required assessments before determining eligibility to establish an impairment that has been diagnosed by a qualified professional.

  1. Review available records and determine if the required assessments or equivalent documentation exist.
  2. If not, purchase the required assessments and/or obtain the required documentation.

Exception: If you can observe a consumer's impairment and can determine that he or she has an impairment-related impediment to employment, the first two eligibility criteria have been satisfied. In these cases, no assessments are required before making your eligibility decision.

3.8.2 Table of Required Assessments and Policy for Selected Conditions

(Revised 10/08, 01/09, 03/09, 09/10, 04/11, 12/15, 06/16)

For all conditions, medical records must be obtained from the appropriate licensed professional and placed in the consumer's case file before determining eligibility. The only exception to this requirement is for consumers with an observable impairment or for consumers with proof of Supplemental Security Income (SSI) or Social Security Disability Income (SSDI).

The Table of Required Assessments and Policy for Selected Conditions includes only content related to eligibility determination. See Chapter 6: Physical Restoration Services, 6.4 Physical Restoration Services or Procedures with Special Requirements for information about services.

Eligibility determinations must comply with the condition-specific assessments and policy in the following table. Review this table before making an eligibility determination.

Condition

Required Assessments

Policy

AIDS/HIV

See Counselor Desk Reference, Chapter 1: AIDS/HIV.

 

DRS does not provide HIV testing because it is available through the Texas Department of State Health Services HIV and STD Program. See also Chapter 6: Physical Restoration Services, 6.1.2 Services Not Authorized.

Asthma

See Counselor Desk Reference, Chapter 24: Respiratory Disease.

Evaluation by physician trained in allergic conditions, or

Exam by physician specializing in lung diseases

(Use DARS3102, Pulmonary Evaluation Report)

 

Back disorders

See Counselor Desk Reference, Chapter 4: Back Disorders.

You must have:

  • treating physician's:
    • radiographic evidence of an abnormality; or
    • medical history of back surgery; or
    • clear diagnosis and prognosis based on physical findings; and
  • medical documentation of functional limitations persisting for at least 90 days before eligibility.
See information about back surgery and steroid injections in Chapter 6: Physical Restoration Services, 6.4.2 Back Surgery and Steroid Injections.

Cancer

See Counselor Desk Reference, Chapter 6: Cancer.

DARS3112, Cancer Disability Medical Report, completed by the:

  • referring physician;
  • clinic; or
  • hospital.

Cancers include all carcinomas and sarcomas of the internal organs (muscles, bones, nerves, brain, or glands) and lymphomas and leukemia. The completed DARS3112 must contain information about the general prospects for the consumer's life expectancy and work capabilities.

If a poor prognosis prevents the case from being accepted, you may decide with the attending physician how the "non-acceptance" will be conveyed to the patient.

Screening procedures for cancer (for example, mammograms or Pap smears) are not considered part of the VR diagnostic procedure.

Cardiac disabilities

See Counselor Desk Reference, Chapter 7: Cardiac Disorders.

Use DARS3103, Cardiac Evaluation Report or a comparable documentation. See informational about cardiac catheterization or angiography in Chapter 6: Physical Restoration Services, 6.4.4 Cardiac Catheterization or Angiography.

Cosmetic disfigurement

 

Missing front teeth are not considered an impairment for the purpose of determining eligibility.

See information about dental treatment, including maxillofacial services, in Chapter 6: Physical Restoration Services, 6.4.8 Dental Treatment.

Deaf

See Counselor Desk Reference, Chapter 15: Hearing Impairments.

See also the Hard of Hearing section of this table, below.

Use DARS3105, Hearing Evaluation Report, Section 1 Consumer Questionnaire.

Chapter 19: Technical Information and References, 19.6.4 Tables of Categories for Disability Coding for applicable diagnostic criteria.

See information about cochlear implant in Chapter 6: Physical Restoration Services, 6.4.6 Cochlear Implant.

Ear diseases and other conditions of the auditory system that result in a hearing loss

See Counselor Desk Reference, Chapter 15: Hearing Impairments.

Current evaluation by an otologist, otolaryngologist, or ENT/EENT specialist. Use DARS3105, Hearing Evaluation Report, Section 2 Otological Examination Report or the equivalent.

Current evaluation by licensed audiologist. Use DARS3105, Hearing Evaluation Report, Section 3 Audiometric Evaluation, or the equivalent.

Documentation of social, educational, and/or psychological hearing loss implications from licensed audiologist or specialist in deafness rehabilitation.

Ear diseases and other conditions of the auditory system may cause substantial impediments to employment if the consumer has a:

  • "ski slope" audiogram;
  • profound unilateral hearing loss;
  • vocational objective requiring a high degree of hearing sensitivity;
  • poor adjustment to hearing loss;
  • multiple disabilities; or
  • other unusual conditions.

Epilepsy (seizure disorders)

See Counselor Desk Reference, Chapter 12: Epilepsy and Seizure Disorders.

Medical records from a neurologist

If the consumer is not currently being treated by a neurologist, obtain this evaluation before determining eligibility unless the consumer is on SSI/ and/or SSDI.

 

Fractures

See Counselor Desk Reference, Chapter 13: Fractures: Malunion or Nonunion.

If the consumer is wearing an external fixation device or an external fixation device has been recommended for the treatment of a fracture, medical records must be reviewed by the medical director before eligibility determination.

Nonunion or malunion fractures require medical records from a physician specializing in orthopedics.

Simple fractures are not considered impairments for the purpose of determining eligibility for vocational rehabilitation (VR) services.

A fracture that has healed abnormally (malunion) or failed to heal (nonunion) may constitute an impairment for eligibility purposes.

Gallbladder disease

See Counselor Desk Reference, Chapter 14: Gallbladder Disease.

  Obtain area manager approval before you determine eligibility.
Gynecological condition  

Screening procedures for cancer (for example, mammograms or Pap smears) are not considered part of the VR diagnostic procedure.

Obtain area manager approval before you determine eligibility.

Hard of Hearing

See Counselor Desk Reference, Chapter 15: Hearing Impairments.

See also the Deaf section of this table, above.

Audiometric evaluation (including audiogram) that documents level and type of hearing loss. Documentation older than six months may be used to determine eligibility.

Use DARS3105, Hearing Evaluation Report, Section 3 Audiometric Evaluation, or the equivalent; and

A completed DARS3105, Hearing Evaluation Report, Section 1 Consumer Questionnaire, or the equivalent.

See Chapter 19: Technical Information and References, 19.6.4 Table of Categories for Disability for selecting primary and, if appropriate, secondary disability categories.

Hernia

See Counselor Desk Reference, Chapter 17: Hernias.

  Obtain area manager approval before you determine eligibility.

Intellectual developmental disorders

See Counselor Desk Reference, Chapter 39: Intellectual Developmental Disorders.

 

A consumer has an impairment in adaptive behavior when he or she cannot successfully accomplish two or more of the following:

  • Communication
  • Self-care
  • Home living
  • Social and interpersonal skills
  • Use of community resources
  • Self-direction
  • Functional academic skills
  • Work
  • Leisure
  • Health and safety

Mental illness-psychotic mood, anxiety, or attention deficit disorders

See the following chapters in the Counselor Desk Reference:

 

Before eligibility is determined, consumers with these disorders must be:

  • currently receiving needed medication or therapeutic treatment; or
  • willing to participate in a recommended treatment plan.

See Chapter 7: Mental Restoration Services for information about mental health restoration service guidelines.

Mental illness-somatoform, dissociative, personality, disruptive, adjustment, cognitive, and other mental disorders

See the following chapters in the Counselor Desk Reference:

 

To be determined eligible, consumers with mental disorders in these categories must be participating, or willing to participate, in a structured program to modify their behavior and approach to employment.

See Chapter 7: Mental Restoration Services for information about mental health restoration service guidelines.

Exception: Consumers with autism spectrum disorder (ASD), which is a developmental disability, are not required to participate in a structured program to modify behavior as a condition of eligibility because they do not have a mental illness.

Obesity

 

Obesity is not considered an impairment for eligibility determination purposes if it does not meet the criteria of severe (morbid) obesity, that is, a body mass index (BMI) of 40 or greater.

Obesity may be an attendant factor that affects other established disabilities.

Pregnancy

 

Pregnancy is not considered an impairment for purposes of eligibility determination, but, the condition does not prevent a consumer with a disability from receiving disability-related vocational rehabilitation services. DRS does not pay for assessments or medical services related to the pregnancy.

Severe (Morbid) Obesity
See Counselor Desk Reference, Chapter 18: Morbid Obesity.
 

For obesity to be considered an impairment for eligibility purposes, the consumer must have:

  • a body mass index (BMI) of 40 or greater; and
  • physical limitations in work capacity measured by a functional capacity assessment (FCA) performed by a physical or occupational therapist or chiropractor.

If the consumer is:

  • employed, an occupational or physical therapist must perform a job analysis to determine the functional requirements of the consumer's job; or
  • unemployed, the consumer must be unable to meet the physical demands of the proposed employment goal.

See Chapter 6: Physical Restoration Services, 6.4.29 Severe (Morbid) Obesity Surgery for specific requirements for determining whether severe obesity results in an impediment to employment.

Substance use disorder

See Counselor Desk Reference, Chapter 44: Substance Abuse.

 

Before you determine eligibility, the consumer must have documented evidence of:

  • currently maintaining sobriety;
  • being sober for at least 30 consecutive days, excluding any incarceration time; and
  • current involvement in a therapeutic program.

Exception: Recipients of Social Security benefits are automatically eligible for services. But before you develop an Individualized Plan for Employment (IPE), the consumer must have documented evidence of:

  • currently maintaining sobriety;
  • being sober for at least 30 consecutive days, excluding any incarceration time; and
  • current involvement in a therapeutic program.

See Chapter 4: Assessing and Planning, 4.4.7 Defining Roles and Responsibilities for guidance about how the consumer's responsibilities are reflected in the IPE.

Exception: A consumer with a coexisting brain injury who is unable to benefit from other types of therapeutic programs may use a DRS-sponsored post-acute brain injury rehabilitation program to establish 30 days of sobriety and involvement in a therapeutic program.

Traumatic brain injury (TBI)

See Counselor Desk Reference, Chapter 5: Brain Injury and Rehabilitation.

Neuropsychological evaluation

When you cannot presume that the consumer is capable of an employment outcome, refer to 3.9 Pre-eligibility Trial Work.

Tuberculosis (TB)

See Counselor Desk Reference, Chapter 28: Tuberculosis.

 

Eligibility for VR services requires that the consumer has recovered sufficiently so that he or she is no longer considered infectious to DRS employees, potential employers, and others.

The consumer must:

  • use effective medications, and cooperate in taking them as prescribed; and
  • show definite improvement as ascertained by the physician in charge.

The treating physician must state in writing that the person is ready for employment or training.

See Chapter 6: Physical Restoration Services, 6.1.6 Comparable Services and Benefits for Restoration Services.

Tumors (masses or growths)

Non-painful lumps are not considered impairments for the purpose of eligibility determination.

Screening procedures for cancer (for example, mammograms or Pap smears) are not considered part of the VR diagnostic procedure.

Visual disorders

DARS2006E, Interagency Eye Examination Report

In compliance with Section 91.021, Human Resources Code, a written agreement with the DARS Division for Blind Services (DBS) states that all DRS consumers who are blind or have primary visual impairments are referred to DBS. Copies of medical records obtained for determining eligibility must accompany the referral.

For the purpose of services through DBS, a visual impairment is defined as:

  • a visual acuity of 20/70 or less in the better eye, with best correction; or
  • a visual field of 30 degrees or less in the better eye; or
  • a combination of both.

When it is clear that the nonvisual impairment is the primary disability, DRS may provide services.

In no instance does DRS extend services to a consumer whose only disability is a visual disorder.

When it is not clear whether the visual or nonvisual impairment is the primary disability, the DRS and DBS counselors must decide whether DRS or DBS should serve as the lead division for the case.

If the counselors cannot decide, they refer the matter to the appropriate DRS area manager. If the area manager cannot decide, he or she refers the matter to the DRS assistant commissioner.

Whenever it is determined that a case assigned to one division should be reassigned to the other division, the case is closed in the proper status in the transferring division, and the entire case file is made available to the receiving division. Use DARS2006E, Interagency Eye Examination Report.

DRS and DBS can work jointly with a consumer with multiple disabilities, regardless of which division the consumer is assigned to.

3.8.3 Diagnostic and Statistical Manual of Mental Disorders (DSM) Tool

Mental health professionals use codes in the Diagnostic and Statistical Manual of Mental Disorders (DSM) to refer to various mental disorders in their reports. The DSM states conditions that can be diagnosed but that, as a primary disability, are not likely to meet the criteria for eligibility for vocational rehabilitation services. Refer to the Diagnostic and Statistical Manual Reference Chart to determine whether a DSM code diagnosis may be considered a primary disability for purposes of determining eligibility for services. For additional guidance, contact the program specialist for behavioral health in the Central Office.

3.8.4 Selecting a Disability Classification

Disabling conditions are classified according to a structure that combines an impairment with a specific cause or source. Using prescribed categories, select the impairment and then the cause or source that best describes the consumer's primary disability that results in a substantial impediment to

Complete the following steps to select the disability code:

  1. select the impairment category that best identifies the disability from the following:
  2. select the impairment subcategory within the table, such as
    • deafness, primary communication visual;
    • respiratory; or
    • cognitive; and
  3. select the specific cause or source of the disabling condition, such as
    • cause unknown,
    • amputation,
    • congenital conditions or birth injury, or
    • digestive.

Using the same sequence of actions, select the secondary impairment that contributes to but is not the primary basis of the impediment to employment in VR or to the rehabilitation goals in comprehensive rehabilitation services and independent living services.

For information about eligibility requirements for specific conditions, see 3.8 Required Assessments and Policies for Selected Conditions.

Tables of Categories for Disability Coding

Use the following tables in selecting primary and secondary disability categories.

Sensory and/or Communicative Impairments

Category and Definition Code

Blindness

An impairment that results in the consumer being legally blind, which is defined as central visual acuity 20/200 or less in the better eye with best correction, or visual fields restriction of 20 degrees or less (both eyes).

01

Other Visual Impairments

Other visual impairments that do not result in legal blindness.

02

Deafness, Primary Communication Visual

A hearing impairment causing dependence primarily upon visual communication (for example, writing, manual communication, gestures) or when combined with blindness, tactile communication (for example, finger spelling)

03

Deafness, Primary Communication Auditory

The consumer uses spoken language primarily for expressive communication and has been identified in the past as being oral deaf or late-deafened adult. This category might include consumers who use cochlear implants. These consumers might depend primarily on visual communication, such as

  • speech-to-text translation;
  • lip reading; and/or
  • English-based sign language.

04

Hearing Loss, Primary Communication Visual

An unaided hearing loss

  • of at least 40 dB (American National Standard Institute (ANSI)), or pure tone average (PTA) in the more useful ear; or
  • between 30 and 39 dB loss (ANSI), or PTA in the more useful ear with either
    • speech discrimination of less than 70 percent, or
    • a statement from a physician skilled in diseases of the ear stating a progressive loss of hearing.

The consumer's primary receptive mode of communication is visual (for example, writing, lip reading, manual communication, gestures). The consumer's primary expressive mode of communication is spoken language (when the consumer voices or speaks).

05

Hearing Loss, Primary Communication Auditory

An unaided hearing loss

  • of at least 40 dB (American National Standard Institute [ANSI]), pure tone average (PTA) in the more useful ear; or
  • between 30 and 39 dB (ANSI), or PTA in the more useful ear with either
    • speech discrimination of less than 70%, or
    • a statement from a physician skilled in diseases of the ear stating a progressive loss of hearing.

The consumer's primary receptive mode of communication is auditory with or without the assistance of amplification (for example, hearing aids). The consumer's primary expressive mode of communication is spoken language (when the consumer voices or speaks).

06

Other Hearing Impairments (for example, tinnitus, Meniere's disease, hyperacusis)

Diseases and conditions of the ear or auditory systems that do not cause a hearing loss of at least 30 dB in the conversational range in both ears but that do cause an impediment to employment.

07

Deaf-Blind

A consumer who is deaf-blind is someone

  • who has
    • a central visual acuity of 20/200 or less in the better eye with corrective lenses,
    • a field defect in which the peripheral diameter of visual field subtends an angular distance no greater than 20 degrees (tunnel vision), or a progressive visual loss having a prognosis leading to one or both of these conditions;
    • a chronic hearing impairment so significant that most speech cannot be understood with optimum amplification (speech discrimination of less than 50 percent), or
    • a progressive hearing loss having a prognosis leading to this condition; and
  • for whom the combination of impairments described in 1 and 2 above cause significant difficulty in attaining an employment outcome; or
  • who, despite the inability to be measured accurately for hearing and vision loss because of cognitive and/or behavioral constraints, can be determined through functional and performance assessment to have significant hearing and visual disabilities that cause extreme difficulty in attaining an employment outcome.

08

Communicative Disorder (expressive or receptive)

A disorder that affects a consumer's ability to communicate or understand communication.

09

Physical Impairments

Category and Definition Code

Mobility Impairment—Orthopedic or Neurological

Mobility that is affected by either an orthopedic or neurological condition.

10

Manipulation or Dexterity Impairment—Orthopedic or Neurological

Orthopedic or neurological conditions that affect manipulation or dexterity.

11

Both Mobility and Manipulation-Dexterity Impairment—Orthopedic or Neurological

Orthopedic or neurological conditions that affect both mobility and manipulation and/or dexterity.

12

Other Orthopedic Impairments (for example, limited range of motion)

Limitations caused by other orthopedic impairment

13

Respiratory Impairments

Impairment resulting in reduced breathing capacity.

14

General Physical Debilitation (for example, fatigue, weakness, pain)

A physical condition that results in a reduced capacity to work.

15

Other Physical Impairments (not listed above)

16

Mental Impairments

Category and Definition Code

Cognitive Impairments

Involves learning, thinking, processing information, and concentration.

17

Psychosocial Impairments

(interpersonal and behavioral impairment, difficulty coping)

A mental condition that affects both psychological and social functioning.

18

Other Mental Impairments (not listed above)

19

3.8.5 Establishing the Level of Significance of the Disability

When you select an impairment category, you must also determine the level of significance of the case. The level of significance of a case may be re-determined throughout the life of the case. However, if a case is designated as "significant" or "most significant," the case may not be re-determined as "not significant" without manager approval. Refer to the ReHabWorks (RHW) Users Guide Chapter 13: Eligibility, 13.1 Level of Significance for more information about selecting and updating the level of significance in RHW.

*A consumer's disability is considered "significant" when

*Based on 34 CFR Section 361.5(b)(31)

As a result of the RSA-911 reporting changes that were issued in August 2013, state agencies were required to create three levels of significance: 1) Not Significant, 2) Significant, and 3) Most Significant.

Use the table below to determine the level of significance of a case.

Scenario SSI/SSDI Limited Functional Capacities
if Threshold = 3
Anticipated need for multiple services over Extended Period Level of Significance
1 No 0 Yes No Significant Disability
2 No 1 or 2 Yes Significant Disability
3 Yes 0, 1, or 2 Yes Significant Disability
4 No 0, 1, or 2 No No Significant Disability
5 Yes 3, 4, 5, 6, or 7 Yes Most Significant Disability
6 No 3, 4, 5, 6, or 7 No No Significant Disability
7 No 3, 4, 5, 6, or 7 Yes Most Significant Disability

This table is also available in RHW User's Guide, 13.1 Level of Significance.

Required Level of Significance—"Significant" or "Most Significant"

The following types of cases must be designated in ReHabWorks as having either a significant disability or a most significant disability for the life of the case:

Required Level of Significance—"Most Significant"

All consumers who require supported employment services must have their case designated in RHW as "most significant" disability for the life of the case. Assign the level of significance at the time of eligibility or at any time thereafter when information is available to support the designation.

Documentation for Level of Significance

Select the correct level of significance in RHW. Refer to RHW Users Guide 13.1 Level of Significance for more information about selecting and updating the level of significance. Document the reason for your decision in a case note. You may document the level of significance as part of the eligibility case note.

Designating the Level of Significance in Cases that Require Pre-Eligibility Trial Work

All consumers who require pre-eligibility trial work must have their case files designated in RHW as either:

3.8.6 Designating the Level of Significance

The level of significance is designated at the time of eligibility on the "Disabilities" page in ReHabWorks (RHW).

To determine the level of significance of the case, the counselor

  1. decides on the significance of the disability according to the criteria for significance as defined above and supports the designation with information from
    • the consumer; and
    • review of records and reports.

    Note: Functional limitations causing substantial impediments to employment do not always result in serious limits in functional capacity. If this is the case, select "not significant" and no further action is required.

  2. determines that the consumer meets all criteria for the selected level of significance and selects the corresponding response in the drop-down menu in RHW;
  3. selects one or more capacities in the Limited Functional Capacities page in RHW if "significant" or "most significant " was selected;
  4. ensures that the case file reflects evidence of the serious limitations in the categories selected;
  5. documents the rationale
  6. indicates, when completing the individualized plan for employment (IPE) with the consumer, the need for an extended time (six months or more) to deliver more substantial services than the assessment for developing the IPE and counseling services;
  7. includes in the IPE any needed interventions for each functional capacity area identified as seriously limited;
  8. changes the designation of Level of Significance of the case if he or she determines that the effect of the disability does not require the extent of services originally planned, or if it is determined that the designation was made in error; and
  9. gets area manager approval if a case is changed to "not significant" if it was previously designated as "significant" or "most significant." Otherwise, the designated level of significance remains throughout the life of the case, even though the consumer's functional capacities may improve over the course of the case.

3.8.7 Table of Functional Capacities and Examples

The following table lists

Capacity Definition and Examples of Limitations
Mobility

As a result of the disability, a consumer's ability to move from place to place and move the body into certain positions is limited, and the consumer requires services or accommodations not typically needed by workers without disabilities.

Examples of seriously limited capacity in mobility that requires intervention include when the consumer needs

  • help to get to and from work, such as
    • special training to learn to get to and from work, or
    • a vehicle modification;
  • modifications, adaptive technology, or accommodations not typically made for other workers in order to move around the workplace; for example, a consumer needs
    • modifications to a workstation or work environment, such as ramps or elevators;
    • a scooter, wheelchair, or other mobility aid; or
    • a service dog.
Self-care

As a result of the disability, a consumer's ability to perform activities related to health and hygiene are limited in a way that requires services or accommodations not typically needed by workers without disabilities.

Examples of seriously limited capacity in self-care that requires intervention include when the consumer

  • needs help to manage self-care activities such as eating, dressing, grooming, or taking medication; or
  • uses assistive or adaptive devices for self-care, such as braces, upper-limb orthotics, or grab bars.

Seriously limited capacity in self-care might occur because of physical, cognitive, or emotional impairments and might apply to all tasks of self-care or only to specific tasks.

Self-direction

As a result of the disability, a consumer's ability to control and regulate his or her personal, social, and work life is limited in a way that requires services or accommodations not typically needed by workers without disabilities.

Examples of seriously limited capacity in self-direction that requires intervention include when the consumer

  • becomes confused or disoriented in performing routine job tasks and needs the help of a job coach or other supports;
  • needs ongoing help or intervention (such as a job coach or constant monitoring and redirection on the job) to begin activities related to task completion, socialization, or behavior management; or
  • requires supervision or assistance with managing money or time, or maintaining a schedule.
Work Skills

As a result of the disability, a consumer's capacity to acquire and maintain needed job skills is limited, and the consumer requires services or accommodations not typically needed by workers without disabilities.

Examples of seriously limited capacity in work skills that requires intervention include when the consumer needs

  • modifications, adaptive technology, or accommodations (such as a note taker, interpreter, or personal assistant to get to and from training or to plan, problem solve, or organize work functions) not typically needed by workers without a disability to acquire necessary work skills or training or to get or keep gainful employment; or
  • specialized supports not typically needed by workers without disabilities to get or keep a job; for example, a job coach or natural supports, job duty modification, or job restructuring.

The lack of work skills alone does not meet the criteria for seriously limited capacity in work skills.

Work Tolerance

As a result of the disability, a consumer's ability to consistently and adequately perform a job based on the physical, emotional, environmental, and psychological demands of the position is limited, and the consumer requires services or accommodations not typically needed by workers without disabilities.

Examples of seriously limited capacity in work tolerance that requires intervention include when the consumer

  • needs modified job duties or assistive devices to perform job duties, or needs altered work schedule or work hours, or needs frequent rest or breaks not typically needed by other workers in the workplace; or
  • lacks the capacity to perform effectively and efficiently job duties that require various levels of psychological demand (such as works poorly under stressful conditions or deadlines) and requires prescribed medication or specialized supports to sustain required levels of work function.
Interpersonal Skills

As a result of the disability, a consumer's ability to establish and maintain appropriate relationships with other people in the workplace is limited, and the consumer requires services or accommodations not typically needed by workers without disabilities.

Examples of seriously limited capacity in interpersonal skills that requires intervention include when the consumer requires

  • specialized services, modifications, or supports to establish appropriate relationships with co-workers, employers, and others in the workplace (for example, history of job loss because of conflicts with employers or co-workers); or
  • medication or specialized services in order to interact with others in a socially appropriate manner; or
  • specialized services or supports to reduce inappropriate behaviors that interfere with getting or keeping a job (for example, the consumer has difficulty relating to co-workers, talks excessively, or behaves inappropriately in the job or training setting).
Communication

As a result of the disability, a consumer's ability to convey and receive information efficiently and effectively is limited, and the consumer requires services or accommodations not typically needed by workers without disabilities.

Examples of seriously limited capacity in communication that requires intervention include the following:

The consumer requires modifications, adaptive technology, or accommodations (not typically required for other people) to effectively and efficiently communicate orally or in writing with people without disabilities (for example, the need for an interpreter for training, use of a TTY or TDD to perform job duties, use of a hearing aid (or aids) to understand speech on the job, or use of specialized communication equipment to produce speech).

3.9 Pre-eligibility Trial Work

(Added 12/15)

3.9.1 Overview of Pre-eligibility Trial Work

(Revised 05/16)

If you are unable to determine whether or not a consumer can benefit from vocational rehabilitation (VR) services because of the severity of his or her disability, the consumer must be provided with Pre-eligibility Trial Work services. This decision should be made before determining that a consumer is eligible for services. While providing Pre-eligibility Trial Work services, you and the consumer will explore the consumer's abilities, capabilities, and capacity to perform in realistic work situations until you have enough information to make a decision about whether the consumer is eligible for VR services.

3.9.2 Pre-eligibility Trial Work Key Terms

Clear and Convincing Evidence*The "clear and convincing evidence" standard of evidence in civil matters is similar to the "beyond a reasonable doubt" standard in criminal matters, but is slightly less rigorous. There must be a high degree of certainty before a person can be found incapable of competitive integrated employment.

Psychological testing alone is not clear and convincing evidence. Clear and convincing evidence might include a description of assessments, including trial work experiences, concluding that the consumer would be unable obtain an employment outcome because of the severity of the disability.

When the consumer (and/or consumer's representative) does not agree, and if the determination is appealed to an impartial hearing, the impartial hearing officer becomes the ultimate authority on clear and convincing evidence.*

*Based on 34 CFR Section 361.42(e)

Pre-eligibility Trial Work Plan (TWP) – Written plan for assessing the consumer's ability to participate in vocational rehabilitation (VR) services and achieve an employment outcome when their ability to do so is otherwise in question due to the severity of their disability. The TWP is used prior to determining eligibility. If trial work is used as an evaluation after eligibility, it must be included in an Individualized Plan for Employment (IPE). TWP is also referred to as an IPE for Extended Evaluation in ReHabWorks (RHW).

Pre-eligibility Trial Work Services – These are the services that can be provided after completion of an application for services when there is a question about the consumer's eligibility due to the severity of their disability. An IPE for Extended Evaluation is completed in RHW to authorize pre-eligibility trial work services. For reporting purposes, the consumer is still in "application status".

Trial Work Experience – Planned activities that support the exploration of the individual's abilities, capabilities, and capacity to perform in work situations; include supported employment, on-the-job training, and other experiences using real work settings.

Work Experience – An experience that allows the consumer to understand work culture, work expectations and soft and hard skills of a vocation in a "real people doing real work" environment that is associated with the consumer's strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice. The experience can be set up as a volunteer opportunity, internship or temporary paid work as long as the experience adheres to all state or federal labor laws.

Work experience can be used as a tool for trial work experience if a pre-eligibility trial work plan has been completed; for more information, see Chapter 8: Training Services, 8.4 Work Experience and the DRS Standards for Providers, Chapter 2: Standards for Work Readiness Services, 2.6 Work Experience.

3.9.3 Pre-eligibility Trial Work Timelines

If pre-eligibility trial work is necessary, develop the Pre-eligibility Trial Work Plan (TWP) as soon as possible, but no later than the 60th day after the application has been signed. For more information on determining eligibility, see 3.3.1 Determining Eligibility by the 60th Day.

If the consumer is receives Supplemental Security Income (SSI) and/or Social Security Disability Insurance (SSI/SSDI), you must make an eligibility decision on the same business day that verification is received. Completing a TWP and moving the case into Pre-eligibility Trial Work services meets the requirement of "making an eligibility decision", even though that "decision" is that pre-eligibility trial work experiences are necessary. If the consumer is not available, an appointment must be scheduled with the consumer to complete the Trial Work Plan as soon as possible. For more information on presumptive eligibility, see 3.2 Presumption of Eligibility for Social Security Recipients.

3.9.4 Pre-eligibility Trial Work Plan (TWP)

Note: ReHabWorks (RHW) uses the individualized plan for employment (IPE) for Extended Evaluation. This will be updated in the future to "Pre-eligibility Trial Work (TWP)" to align with policy revisions.

If pre-eligibility trial work is necessary, develop the Pre-eligibility Trial Work Plan (TWP) as soon as possible, but no later than the 60th day after the application has been signed. For more information on determining eligibility, see 3.3.1 Determining Eligibility by the 60th Day.

Use the IPE for extended evaluation in ReHabWorks to complete the Pre-eligibility Trial Work Plan. If RHW is not available, use DARS5157, Pre-eligibility Trial Work Plan, available in the Forms Catalog.

Follow the procedures in Chapter 2: Initial Contact and Application, 2.4.9 When DRS Staff Members May Enter a PIN on Behalf of a Consumer to enter the information into ReHabWorks as soon as possible.

*If you cannot determine whether the consumer is eligible because of the consumer's questionable ability to benefit from services in terms of an employment outcome because of the severity of his or her disability, develop a Pre-eligibility Trial Work Plan (TWP) with the consumer.*

*Based on 34 CFR Section 361.42(e)(2)(i)

A signed TWP is required before any services, including trial work experiences, can be purchased, provided, or arranged for the consumer.

Support Services - When developing the TWP, *consider the need for interpreter, translator, reader, or personal assistant services; rehabilitation technology, and/or other support services needed to determine eligibility.*

*Based on 34 CFR Section 361.42(d)(1)

Objective - The objective for a TWP is to assess the consumer's ability to benefit from vocational rehabilitation (VR) services when there is a specific concern about the severity of the consumer's disability. The consumer's knowledge, skills, abilities, or other key attributes must be thoroughly assessed through the use of trial work experiences to determine if the consumer is capable of participating in VR services and achieving an employment outcome. However, at any point in time during pre-eligibility trial work services, if there is enough information to make a determination that the consumer is eligible for services, pre-eligibility trial work services can be terminated so that an individualized plan for employment can be developed.

Services - All policies throughout the Rehabilitation Policy Manual (RPM) that are related to purchasing, arranging, or providing specific goods or services for DARS consumers apply to consumers that are receiving Pre-eligibility Trial Work services. If a good or service has special requirements or restrictions for eligible consumers, those same requirements and restrictions apply to consumers receiving services through a pre-eligibility trial work plan.

*Pre-eligibility trial work experiences can include supported employment, on-the-job training, and other experiences using real work settings.

*Based on 34 CFR Section 361.42(e)(2)

Supported Employment as Trial Work Experience

When using Supported Employment for trial work experience, Benchmarks 1a, 1b, 2 and 3 must be purchase at a minimum. If a consumer achieves Supported Employment Benchmark 5, he or she would meet the criteria of eligibility. At any time while the consumer is participating in Supported Employment Services it is determined the consumer is eligible for services an Individual Plan of Employment (IPE) must be implemented to continue supported employment service.

A TWP must include trial work experiences that are of sufficient variety and duration to provide:

Trial Work experiences must be provided in competitive integrated employment settings to the maximum extent possible, consistent with the informed choice and rehab needs of the individual.

Additional Assessments

If existing records do not meet the assessment needs for determining eligibility for services, you should include any additional diagnostics and or assessments that are required as planned services in the TWP. Refer to 3.1 Overview for additional information about requirement for use of existing records to determine eligibility.

Services that Require Regional Approval as part of the Pre-eligibility Trial Work Plan

The following goods or services require regional director review and approval when provided as part of a pre-eligibility trial work plan:

Services that Cannot Be Provided as Part of Pre-eligibility Trial Work Plan

Do not provide the following goods or services as part of the pre-eligibility trial work plan:

Area manager exceptions are not permitted.

Frequency of Contact – It is important to maintain frequent contact with a consumer that is participating in pre-eligibility trial work services to ensure that timely progress is being made towards finalizing an eligibility decision. The frequency of contact is individualized to meet the consumer's needs and is included as part of the TWP.

Comparable Benefits – If comparable benefits are readily available, use these benefits during completion of pre-eligibility trial work services. However, if the use of these benefits would create any delays in determining eligibility, document that the reason that comparable benefits are not being used in a case note in RHW and move forward with coordinating necessary services. Refer to Chapter 4: Assessing and Planning, 4.5 Comparable Services and Benefits for additional information about comparable benefits.

Consumer Participation in Cost of Services – Services identified on a TWP are considered assessments for the determination of eligibility. Consumers are not required to participate in the cost assessments. Do not apply basic living requirements (BLR) to consumers receiving Pre-eligibility Trial Work services. Refer to Chapter 4: Assessing and Planning, 4.6 Consumer Participation in the Cost of Services for additional information about consumer participation in cost of services).

3.9.5 Ending Pre-eligibility Trial Work Services

For reporting purposes, a case remains in "application status" while the consumer is participating in Pre-eligibility Trial Work services. When there is sufficient evidence to make a determination of eligibility or when the case is closed for another reason, including ineligibility, the case will move into the next reportable status.

To move the consumer's case out of application status when they have had a Pre-eligibility Trial Work Plan:

  1. enter the eligibility or ineligibility decision or close the case in ReHabWorks;
  2. document the decision in a case note; and
  3. notify the consumer of the decision.

Refer to 3.11.4 Reasons for Closing a Case without Determining Eligibility and 3.11.6 Reasons and Procedure for Closing a Case Because of Ineligibility for more information.

A consumer cannot receive Pre-eligibility Trial Work services for more than 12 months without area manager review and approval. If there is an individualized need to extend the Trial Work Experience services beyond 12 months, a full case review must be completed by the area manager in TxROCS before approving the extension of pre-eligibility trial work.

3.9.6 Pre-eligibility Trial Work for "Disability Too Severe" Closure

At any point after eligibility has been determined, you must evaluate the consumer in a realistic work setting through the use of pre-eligibility trial work before closing the case with the closure reason "Disability Too Severe." Document the Pre-eligibility Trial Work Plan in a case note and provide a copy to the consumer.

Level of Significance

Pre-eligibility Trial Work can be used only with consumers whose disability is expected to meet the criteria of "significant" or "most significant."

The level of significance must be:

After the level of significance has been determined, the counselor must either:

Twelve-Month Review of Ineligibility Determination Based on Severity of the Disability

*Review within 12 months (and annually thereafter, if requested by the consumer or, if appropriate, by the consumer's representative) any ineligibility determination that is based on a finding that the consumer is incapable of achieving an employment outcome due to the severity of the disability.*

*Based on 34 CFR Section 361.43(e)

3.10 Other Eligibility Considerations

3.10.1 Nondiscrimination

*Determine eligibility for VR services without regard to gender, age, race, religion, color, national origin, type of expected employment outcome, type of disability, source of referral, particular services needed, or anticipated cost of services required by a consumer; however,

*Based on 34 CFR Section 361.42(5)(c)(2)

3.10.2 Residency Requirement

*As there is no requirement for how long a consumer must have lived in Texas before being considered for eligibility, you may consider a consumer for eligibility if, at the time of application, the consumer

*Based on 34 CFR Section 361.42(5)(c)(1)

3.10.3 Illegal Aliens, Immigrant Aliens, and Nonimmigrant Aliens

(Revised 03/09)

Illegal aliens are

Immigrant aliens

Nonimmigrant aliens are

The alien individual must be available to complete the IPE, which includes suitable employment in the United States. When completion cannot be expected, the individual is not eligible for VR services.

Aliens who are part of the Amnesty Program receive a letter stating that they are not eligible for federal financial assistance. DRS programs are not considered federal financial assistance, so services may be provided if the person is otherwise eligible.

3.10.4 Students

(Added 09/11)

A student who is in special education, or who has received special education or Section 504 services, is *not automatically eligible for VR services.*

*Based on 34 CFR Section 361.42

See Chapter 10: Transition Services.

3.11 Closing a Case Ineligible or before Eligibility Determination

3.11.1 Overview

You may close a case before eligibility under either of two circumstances:

3.11.2 Closing a Case without Determining Eligibility

A variety of reasons exist for closing a case before determining eligibility.

*Apply the following general closure procedure in all cases closed before determining eligibility. The counselor

  1. notifies the consumer in writing (if the address is known) of the case closure and of the right of appeal;
  2. ensures that the case file contains the justification for closing the case; and
  3. uses an appropriate reason for closure.*

*Based on 34 CFR Sections 361.43 and 361.57

Reasons and Procedure for Closure

Reason Definition Additional Closure Procedure
Death

No notification is required.

Extended Services Not Available

The consumer could benefit from supported employment services, but no source of extended services is available.

Document that you explored

  • comparable benefits, natural supports, and community services; and
  • the factors that made it impossible to arrange an agreement for extended support.
No Longer Interested in Services

This applies to the consumer who chooses not to participate or continue in his or her VR program at this time. Also use this code to indicate when a consumer's actions (or non-actions) make it impossible to begin or continue a VR program. Examples would include repeated failures to keep appointments for assessment, counseling, or other services.

Make sure that the consumer is aware of the services that are available.

Advise the consumer that he or she may reapply for services in the future, if needed.

Incarcerated in Prison or Jail

The consumer will be unavailable to participate in a VR program for a considerable period of time because they are incarcerated in a prison, jail, or other criminal correction facility.

Advise the consumer or their designated representative that they may reapply for services when they are released from incarceration.

Institutionalized

The consumer has entered an institution other than a prison or jail and will be unavailable to participate in a VR program for an indefinite or considerable period of time (includes hospitals, nursing homes, and treatment centers).

Provide information about community-based services where appropriate.

Other

Services may be denied or ended for other reasons. For example, the consumer has achieved employment without substantial VR services.

Document the reason for closure.

Referred to Another Agency or DARS Program

The services of another agency are more appropriate than a DRS program.

Follow procedures in 3.11.1 Overview/Referral to Other Resources

Transportation Not Feasible

Suitable transportation for accepting or maintaining employment is either not available or not feasible (too costly and/or inaccessible).

Document

  • that you considered transportation alternatives; and
  • the reasons they were not available or feasible.
Unable to Locate or Moved Out of State

Contact with the consumer is lost after documented repeated attempts by telephone and mail over a reasonable period have failed. Also used when the consumer moves out of state and gives little evidence of returning any time soon.

Document your attempts to contact the consumer over a reasonable period.

If the consumer moves to another state and additional VR services are necessary,

  • when possible, provide the consumer with the name and address of the VR agency office nearest the new residence (obtain this information from the appropriate state office of VR services); and
  • upon request, provide the VR agency with copies of appropriate case folder materials.

3.11.3 Reasons for Closing a Case without Determining Eligibility

(Revised 02/11, 07/12, 09/12, 04/14)

After the closure has been processed in ReHabWorks, a closure letter is available to complete, print, and mail to the consumer.

Reason

Definition

Additional Closure Procedure

Death

No notification is required.

Extended Services Not Available

The consumer could benefit from supported employment services, but no source of extended services is available.

Document that you explored

  • comparable benefits, natural supports, community services, etc., and
  • the factors that made it impossible to arrange an agreement for extended support.

No Longer Interested in Services

This applies to the consumer who chooses not to participate or continue in his or her VR program at this time. Also use this code to indicate when a consumer's actions (or non-actions) make it impossible to begin or continue a VR program. Examples would include repeated failures to keep appointments for assessment, counseling, or other services.

Make sure that the consumer is aware of the services that are available.

Advise the consumer that he or she may reapply for services in the future, if needed.

Incarcerated in Prison or Jail The consumer will be unavailable to participate in a VR program for a considerable period of time because they are incarcerated in a prison, jail, or other criminal correction facility. Advise the consumer or their designated representative that they may reapply for services when they are released from incarceration.

Institutionalized

The consumer has entered an institution other than a prison or jail and will be unavailable to participate in a VR program for an indefinite or considerable period of time (includes hospitals, nursing homes, treatment centers, etc.).

Provide information about community-based services where appropriate.

Other

Services may be denied or ended for other reasons. For example, the consumer has achieved employment without substantial VR services.

Document the reason for closure.

Referred to Another Agency or DARS Program

The services of another agency are more appropriate than a DRS program.

Follow procedures in 3.11.1 Overview/Referral to Other Resources

Transportation Not Feasible

Suitable transportation for accepting or maintaining employment is either not available or not feasible (too costly, inaccessible, etc.).

Document

  • that you considered transportation alternatives, etc., and
  • the reasons they were not available or feasible.

Unable to Locate or Moved Out of State

Contact with the consumer is lost after documented repeated attempts by telephone and mail over a reasonable period have failed. Also used when the consumer moves out of state and gives little evidence of returning any time soon.

Document your attempts to contact the consumer over a reasonable period.

If the consumer moves to another state and additional VR services are necessary,

  • when possible, provide the consumer with the name and address of the VR agency office nearest the new residence (obtain from the appropriate state office of VR services); and
  • upon request, provide the VR agency with copies of appropriate case folder materials.

*Apply the following general closure procedure in all cases closed before determining eligibility. The counselor

  1. notifies the consumer in writing (if the address is known) of the case closure and of the right of appeal;
  2. ensures that the case file contains the justification for closing the case; and
  3. uses an appropriate reason for closure.*

*Based on 34 CFR Sections 361.43 and 361.57

3.11.4 Closing a Case after Determining the Consumer Ineligible

There are four reasons a case may be closed as ineligible:

*Before closing any case as ineligible,

*Based on 34 CFR Section 361.43(a)

Consult the table in 3.11.6 Reasons and Procedure for Closing a Case Because of Ineligibility to

3.11.5 Reasons and Procedure for Closing a Case Because of Ineligibility

(Revised 04/14, 12/15)

Reason Definition Procedure
Disability Too Severe You determine, based on clear and convincing evidence obtained during the pre-eligibility trial work, that the severity of the disability or the resulting vocational impediments prevent vocational rehabilitation (VR) services from benefiting the consumer in terms of employment.

Review and approval by the area manager is required before closing a case, when the reason for closure is Disability Too Severe.

*Use this reason for closure only after completing multiple trial work experiences. Refer to 3.9 Pre-eligibility Trial Work for more information, and then complete the following steps:

  1. Before case closure, give the consumer an opportunity to fully discuss the decision, including the right of appeal
  2. Document clear and convincing evidence of ineligibility in accordance with 3.9.2 Key Terms
  3. Complete the certification of ineligibility form in ReHabWorks (DARS5212, VR Severity of the Disability), and send it to the consumer. This serves as the IPE amendment and documents the reason for case closure.
  4. Refer the consumer to a local nonintegrated (that is, extended employment) provider, when available*

*Based on 34 CFR Sections 361.57 and 361.43

Anticipate an annual computer-generated alert to review the case for reconsideration of eligibility.

No Disabling Condition

The assessment for eligibility reveals that the consumer does not have a disability.

Take the following actions to close the case:

  1. *Before case closure, give the consumer an opportunity to fully discuss the decision, including the right of appeal
  2. Refer the consumer to:
    • another DRS program; or
    • other programs that are part of workforce development (programs that can address the consumer's training or employment needs); and
    • document the referral in a case note
  3. Notify the consumer in writing of his or her ineligibility using ReHabWorks form DARS5104, VR Ineligibility Notice, and include:
    • reason(s) for the determination of ineligibility;
    • right of appeal; and
    • availability of the Client Assistance Program (CAP)
  4. Use the appropriate reason for closure*

*Based on 34 CFR Sections 361.57 and 361.43

No Impediment to Employment

The assessment for eligibility reveals no substantial impediment to employment.

Does Not Require VR Services

The consumer

  • does not require VR services to prepare for, obtain, retain, or regain employment;
  • already is receiving the needed services; or
  • already has available the needed services without DRS providing, paying for, arranging, or coordinating the services.

Required Review of Cases Closures as "Disability Too Severe"

*Review within 12 months (and annually thereafter, if requested by the consumer or, if appropriate, by the consumer's representative) any ineligibility determination that is based on a finding that the consumer is incapable of achieving an employment outcome due to the severity of the disability.*

*Based on 34 CFR Section 361.43(e)

3.11.6 Referral to Other Resources

When you close the case before eligibility, refer the consumer to another agency or program for services if the

Describe for the consumer the services available from the other agency or program. Contact the agency or program, set up an appointment for the person, and provide the agency or program with information requested about the consumer, when appropriate.

When needed, use the Texas Information and Referral Network (Finding Help in Texas) to assist in identifying available resources.