Eligibility Eligibility DeterminatioDeterminatio

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Presented by: Presented by:

Paula Seanez and Betty Bennalley Paula Seanez and Betty Bennalley

20142014

34CFR 361.42 Assessment for determining eligibility and priority for services

The designated State unit (121 TVR) The designated State unit (121 TVR) must conduct an assessment for must conduct an assessment for determining eligibility and priority for determining eligibility and priority for services. The assessment must be services. The assessment must be conducted in the most integrated setting conducted in the most integrated setting possible, consistent with the possible, consistent with the individual’s needs and informed choice, individual’s needs and informed choice, and in accordance with the following and in accordance with the following provisions:provisions:

Basic RequirementsBasic Requirements

The determination of eligibility for The determination of eligibility for VR services must be based solely on VR services must be based solely on the following: the following:

i)i)A determination by qualified personnel that the A determination by qualified personnel that the applicant has a physical or mental impairment. applicant has a physical or mental impairment.

ii)ii)A determination by qualified personnel that the A determination by qualified personnel that the applicant’s physical or mental impairment applicant’s physical or mental impairment constitutes or results in a substantial impediment to constitutes or results in a substantial impediment to employment for the applicant.employment for the applicant.

Requirements ContinuedRequirements Continued

iii)iii) A determination by a qualified VR counselor A determination by a qualified VR counselor employed by the designated State unit (121 employed by the designated State unit (121 TVR) that the applicant requires VR services TVR) that the applicant requires VR services to prepare for, secure, retain, or regain to prepare for, secure, retain, or regain employment consistent with the applicant’s employment consistent with the applicant’s unique strengths, resources, priorities, unique strengths, resources, priorities, concerns, abilities, capabilities, interests, and concerns, abilities, capabilities, interests, and informed choice. informed choice.

Presumption of benefitPresumption of benefit

The designated State unit (121 TVR) must The designated State unit (121 TVR) must presume that an applicant who meets the presume that an applicant who meets the eligibility requirements in paragraphs (a)eligibility requirements in paragraphs (a)(1)(i) and (ii) of this section can benefit in (1)(i) and (ii) of this section can benefit in terms of an employment outcome unless it terms of an employment outcome unless it demonstrates, based on clear and demonstrates, based on clear and convincing evidence, that the applicant is convincing evidence, that the applicant is incapable of benefiting in terms of an incapable of benefiting in terms of an employment outcome from vocational employment outcome from vocational rehabilitation services due to the severity rehabilitation services due to the severity of the applicant’s disability. of the applicant’s disability.

Presumptive Eligibility for Presumptive Eligibility for SSA recipients & beneficiariesSSA recipients & beneficiaries

(i)(i) Any applicant who has been determined Any applicant who has been determined eligible for Social Security benefits under eligible for Social Security benefits under Title II or Title XVI of the Social Title II or Title XVI of the Social Security Act.Security Act.

(A)(A) Presumed eligible for vocational Presumed eligible for vocational rehabilitation services under paragraphs (a)rehabilitation services under paragraphs (a)(1) and (2) of this section; and (1) and (2) of this section; and

(B)(B) Considered an individual with a significant Considered an individual with a significant disability as defined in 34 CFR 361.5(b)disability as defined in 34 CFR 361.5(b)(31).(31).

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(ii)(ii) If an applicant for vocational If an applicant for vocational rehabilitation services asserts that he or rehabilitation services asserts that he or she is eligible for Social Security she is eligible for Social Security benefits under Title II or Title XVI of benefits under Title II or Title XVI of the Social Security Act, but is unable to the Social Security Act, but is unable to provide appropriate evidence, such as provide appropriate evidence, such as an award letter, to support that an award letter, to support that assertion, the State unit (121 TVR) must assertion, the State unit (121 TVR) must verify the applicant’s eligibility under verify the applicant’s eligibility under Title II or Title XVI of the Social Title II or Title XVI of the Social Security Act by contacting the Social Security Act by contacting the Social Security Administration. Security Administration.

(iii)(iii) This verification must be made within This verification must be made within a reasonable period of time that enables a reasonable period of time that enables the State unit (121 TVR) to determine the State unit (121 TVR) to determine the applicant’s eligibility for vocational the applicant’s eligibility for vocational rehabilitation services within 60 days rehabilitation services within 60 days of the individual submitting an of the individual submitting an application for services in accordance application for services in accordance with 34CFR 361.41(b)(2).with 34CFR 361.41(b)(2).

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Eligibility in my wordsEligibility in my words

Now that we’ve gotten through the Rehab. Now that we’ve gotten through the Rehab. Act’s version, here is my understandable Act’s version, here is my understandable version:version:

1.1.The individual is required to have a The individual is required to have a documented diagnosis from a qualified documented diagnosis from a qualified provider.provider.

2.2.The disability must cause/create a The disability must cause/create a substantial impediment to employment.substantial impediment to employment.

3.3.The individual must require VR services to The individual must require VR services to prepare for, secure, and retain suitable prepare for, secure, and retain suitable employment. employment.

Process of determining eligibilityProcess of determining eligibility

The counselor receives the medical The counselor receives the medical documentation from the providers and documentation from the providers and reviews the documentation looking for reviews the documentation looking for any impediments and/or limitations any impediments and/or limitations from the diagnosed disability. from the diagnosed disability.

The counselor then determines if the The counselor then determines if the substantial impediment (s) to substantial impediment (s) to employment require VR services to employment require VR services to prepare for, secure, or retain prepare for, secure, or retain employment. employment.

There are three questions you can ask There are three questions you can ask yourself as you determine eligibility: yourself as you determine eligibility:

Does this person have a diagnosed Does this person have a diagnosed disability?disability?Does this person have any disability related Does this person have any disability related impediments to preparing for, getting, impediments to preparing for, getting, keeping or advancing in employment that is keeping or advancing in employment that is compatible with his/her strengths, resources, compatible with his/her strengths, resources, priorities, concerns, abilities, capabilities, priorities, concerns, abilities, capabilities, interests, and informed choice?interests, and informed choice?

Process of determining eligibilityProcess of determining eligibility

Does the person require services to Does the person require services to prepare for, get, keep, or advance in a prepare for, get, keep, or advance in a job that is compatible with his/her job that is compatible with his/her strengths, resources, priorities, strengths, resources, priorities, concerns, abilities, capabilities, concerns, abilities, capabilities, interests, and informed choice? interests, and informed choice?

Process of determining eligibilityProcess of determining eligibility(continued)(continued)

Because of (disability), (client name) Because of (disability), (client name) experiences (functional limitations), which experiences (functional limitations), which causes an impediment to employment, as causes an impediment to employment, as is required to perform the functions of a is required to perform the functions of a (specific job duty).(specific job duty).

(Client name) requires (services) to (Client name) requires (services) to prepare for, get, and keep a job that is prepare for, get, and keep a job that is compatible with (his/her) unique compatible with (his/her) unique strengths, resources, priorities, concerns, strengths, resources, priorities, concerns, abilities, capabilities, interests, and abilities, capabilities, interests, and informed choice.informed choice.

Example of Eligibility FormulaExample of Eligibility Formula

Implementing the information: Implementing the information: Case StudiesCase Studies

Everyone gather around cause here Everyone gather around cause here we go!!!we go!!!

Split up into groups and review the Split up into groups and review the case studies.case studies.

34CFR 361.4434CFR 361.44Closure without EligibilityClosure without Eligibility

VR counselors may not close an applicant’s VR counselors may not close an applicant’s case prior to making eligibility case prior to making eligibility determination, UNLESS:determination, UNLESS:

i.i. Applicant declines to participateApplicant declines to participate

ii.ii. Applicant is unavailable to complete an Applicant is unavailable to complete an assessment to determine eligibility and assessment to determine eligibility and priority of services; and priority of services; and

iii.iii. The agency has made a reasonable number The agency has made a reasonable number of attempts to contact the applicant to of attempts to contact the applicant to encourage participation. encourage participation.

QUESTIONS????QUESTIONS????