02 Referral/Applicant Status

02-02-03-01 Time Limitations

The purpose of Applicant Status is to gather diagnostic information sufficient to make a determination of eligibility. Though planning activity may take place in Applicant Status, the emphasis must be on making an eligibility determination in a timely manner. The counselor must determine whether an individual is eligible for vocational rehabilitation services within 60 DAYS after the individual has submitted a signed application for services unless:

• the counselor determines, in consultation with the participant, that exceptional and unforeseen circumstances beyond the control of the counselor preclude making an eligibility determination within 60 days and the participant agrees to a specific extension of time by signing an Eligibility Determination Extension; or,

• the counselor determines, in consultation with the participant, that a specific extension of time is required to involve the participant in either trial work experiences or an extended evaluation period in order to determine eligibility.

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02-02-03-02 Initial Interview

Upon receipt of a referral or signed application, an initial interview should be scheduled as soon as possible to assure compliance with the 60-day eligibility time limit. A counselor or rehabilitation technician must conduct the initial interview. During this interview as well as in all communication with the participant, it is critical to utilize the mode of communication which most effectively facilitates communication. Interpreter services should be provided if identified as a need either through the Brief Sheet or through contact with the applicant or referral source. During the initial interview and throughout the VR process, it is essential to assess the communication process and participant's comprehension and adjust your communication style, use of interpreters or other appropriate modes of communication as necessary. The purpose of the initial interview is to:

• Exchange information with the participant,

• Establish a basis for the participant/counselor relationship,

• Provide a thorough review regarding DVR's process, procedures, and expectations;

• Start the diagnostic process needed to determine eligibility.

During the initial interview, document to the extent necessary, an appraisal of the individual's current functioning in the following areas:

• Medical - to include reported diagnosis, functional limitations, medications, surgeries.

• Social - to include family and other support network.

• Intellectual - to include level of functioning.

• Financial.

• Other issues affecting the participant's vocational rehabilitation.

• Psychological - to include reported diagnosis, functional limitations, medications, hospitalizations, etc.

• Education - to include levels of attainment and areas of study.

• Vocational - to include full work history, tasks performed, reasons for leaving jobs, transferable skills, etc.

• Independent living.

During the initial interview, the following forms should be reviewed with the participant and completed as follows:

• Application for VR services - obtain applicant and/or guardian signature as appropriate on DVR Application for Services if this has not yet occurred.

• Participant Rights and Responsibilities Handout - review the handout sheet with the applicant and/or guardian as appropriate. Obtain signature(s) of the applicant and/or guardian and provide them with a copy of the handout. A copy of the signed form must be placed in the hard file.

• Release of Information forms - while all efforts should be made to have the applicant gather existing information to document the reported disability, an alternative to gathering existing records is to have the applicant or guardian sign a release of information form. The release must be completed prior to obtaining the signature with copies of the forms retained in the case file.

During the initial interview, set short-term "homework" tasks for the applicant as appropriate given the reported impairment, to expedite the eligibility determination process and assess motivation. Examples would include, attendance at appointments with the counselor or other diagnostic appointments, exploration of vocational interests, contacting educational institutions or employers as appropriate, contacting other service providers such as Department of Labor or One Stop Centers, etc. Make the participant aware of the 60-day requirement for an eligibility decision and, as appropriate, his or her responsibilities in helping to expedite the process including providing verification of SSDI/SSI eligibility. Emphasizing job placement issues during the initial contacts with the applicant during the initial contacts helps to focus attention on the real mission of the agency and not on the immediate psycho-social service needs of the individual.

There may be some instances which warrant the individual to complete the Participant/Application information prior to the initial interview. For example, if the participant lives in an outlying area and cannot make regular or frequent visits to the DVR office. When circumstances like this exist, the participant should be provided with the Participant Information Worksheet (hard copy), the Application and the Participant Rights and Responsibilities handout. These can be mailed out if necessary. The Participant Information Worksheet is designed to complement the AWARE system for key entry. As noted, the Application and Participant Rights and Responsibilities form must accompany the Participant Information Worksheet. There is a date received section on the Participant Information Worksheet form which is to be completed by DVR staff when the packet is received in the DVR office. The date that the completed packet is received in the DVR office is the date that the participant becomes an official applicant and this begins the 60-day eligibility determination period.

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02-02-03-03 Requirements For AWARE

1. Complete AWARE Application datapages in order to officially open the case in the AWARE system. This can be done either during or following the initial interview.

2. Document all relevant data within the datapages or a case note. While the Application datapages readily capture most of the required information such as vocational background (work history), medical/psychological (Disability datapage) and financial, it is important to note that AWARE does not have categories for all the information that should be gathered at the initial interview. The interviewer should utilize Section D of the Application Documentation datapage (Other participant information or comments) or a separate case note to document pertinent social, intellectual (if not captured on disability related issues), independent living, education and attendant factor information, such as transportation and childcare issues as well as any other issues affecting the individual's vocational rehabilitation. Complete information regarding the individual's work history to include tasks performed, reasons for leaving jobs as well as disability related issues to include functional limitations is required.

3. The Application date used for AWARE should correspond with date that the signed application was received in the DVR office.

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02-02-03-04 Guidelines for Assessment

1. Counselor judgment is a critical factor in all issues pertaining to eligibility, particularly in determining, in consultation with the participant, the nature and scope of information necessary to determine eligibility and what assessment activities are needed that will provide such information.

2. The law emphasizes the use of information that is existing and current as appropriate considering the nature of the disability. The best way to determine the sufficiency of existing information is in relation to critical case questions formulated by the counselor when considering all eligibility criterions. When existing information is not sufficient, then appropriate assessment activities must be undertaken which will provide the necessary additional data.

3. When arranging for additional assessments, the counselor must review the need for add itional assessments with the participant.

4. During the assessment period, the financial needs test does not apply and the participant is also exempt from the determination of comparable benefits and services. Comparable services and benefits can be utilized voluntarily by the applicant but use of these benefits or services cannot be mandated by DVR during the assessment period.

5. Advise participants that diagnostic assessments provided during this phase of the rehabilitation process are for the purpose of gathering data related to eligibility determination and that recommended treatment resulting from an authorized diagnostic exam is not automatically covered by DVR. Provision of recommended treatment may or may not be provided in the future depending on outcome of eligibility determination and whether service is identified as "required" to obtain an employment outcome by the VR Counselor and participant.

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02-02-05-01 Diagnostics for Eligibility

Impairments must be substantiated in written form by a Medical Doctor, Doctor of Osteopathy, Physician's Assistant, Nurse Practitioner or other professional licensed or certified in the diagnosis of the impairment to include the following:

• Optometrist for eye infractions

• Certified Psychologist to diagnose mental health/emotional disorders

• Audiologist for hearing impairments

• Educational Diagnostician for learning disabilities or mental retardation

• Licensed Professional Clinical Counselors and Independent Social Workers for mental health diagnosis.

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02-02-05-02 Other Diagnostics

Reports from Licensed Professional Clinical Counselors, Independent Social Workers and Licensed Substance Abuse Counselors should be sought if the applicant is currently receiving treatment from this source. These reports should be considered in the overall assessment of the applicant.

• If the impairment is stable and non-progressive, existing data is generally sufficient for substantiating the impairment. Existing reports should be utilized whenever possible, however, when the impairment is not stabilized or is progressive, current reports should be obtained.

• If existing reports are not available or sufficient, the participant's own physician or physician of choice should be utilized whenever possible.

• Further diagnostics needed to substantiate or clarify functional limitations may be obtained, as appropriate, from individuals who are licensed or qualified according to statewide professional standards to include:

  • Speech, occupational or physical therapists

  • Vocational evaluators in private practice or in a facility

  • Rehabilitation engineer to assess a participant's potential to benefit from Rehabilitation engineering services

  • Educational Diagnostician's reports, school transcripts, or other school records

  • Licensed Professional Clinical Counselors

  • Independent Social Workers

  • Licensed Substance Abuse Counselors

  • Other diagnostics which lend information regarding the individual's level of functioning

Specialist exams should be utilized as described below:

• Visual Impairments

  • Ophthalmologist if eye disease or pathology is known or suspected;

  • Optometrist can be used for initial screening or for refraction errors.

• Hearing Impairments

  • Otolaryngologist (ENT) if on-going ear pathology is known or suspected;

  • Audiologist may be used for hearing evaluations.

• Learning Disability of Mental Retardation

  • Psychologist certified by the State Board of Psychological Examiners;

  • Clinical Psychologist under the State Personnel Board;

  • Educational Diagnostician certified by the State Department of Education;

  • Neuropsychologist when a learning disability is questionable.

• Mental or Emotional Disorders

  • Psychiatrist;

  • Psychologist certified by the State Board of Psychological Examiners;

  • Clinical Psychologist under the State Personnel Board;

  • Licensed Independent Social Worker; or Licensed Professional Clinical Counselor.

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02-02-05-03 Hospitalization for Diagnostics

If hospitalization is requested by a physiician for the purpose of diagnostic study, medical and supervisory consultation shall be obtained.

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