In making a determination of 'ineligible' or 'no longer eligible,' no applicant or group of applicants is excluded or found ineligible solely on the basis of the type of disability. Eligibility requirements are applied without regard to:

• Age, sex, race, color or national origin or the applicant
• Type of expected employment outcome
• Source of referral for VR services
• Particular service needs or anticipated cost of services required by an applicant or the income level of an applicant or applicant's family
• Applicants' employment history or current employment status and
• Applicants' educational status or current educational credentials

Applicants for VR services may be determined ineligible due to:

• Having no physical or mental impairment;
• Having an impairment that does not constitute or result in a substantial impediment to employment;
• Being unable to benefit from the provision of VR services in terms of an employment outcome. Prior to making this determination VR must demonstrate the applicant's inability to work based on clear and convincing evidence; or
• Not requiring VR services to prepare for, secure, retain, advance in, or regain employment.

An Ineligibility determination requires:

Full Consultation. An ineligible or no longer eligible determination is to be made only after providing the client or his/her representative, an opportunity for full consultation. 

Office Director Review. The office director makes the final ineligibility determination.

Informed in Writing. The client must be informed in writing of an ineligible or no longer eligible determination, including the reasons for the determination and the means by which the client may express and seek remedy for any dissatisfaction. 

Client Assistance Program. Nebraska VR must provide the Client Assistance Program (CAP) information to clients during the application process, when developing the Individualized Plan for Employment (IPE), case closure (successful/unsuccessful) or at any time the client disagrees with a VR final decision.

If the reason for ineligibility is based on "unable to benefit from the provision of VR services in terms of an employment outcome,” additional considerations apply.

Applicants receiving SSI/SSDI.  Individuals who receive SSDI or SSI on the basis of their disability and intend to achieve an employment outcome are presumed eligible. If there is a question of an individual's ability to benefit from services a trial work experience will be conducted after eligibility. 

Non-SSI/SSDI Applicants/Clients- Trial Work Experiences can be conducted at any time (before or after an eligibility determination). 

No Longer Eligible. Any client previously determined eligible including clients receiving SSI/SSDI may later be determined no longer eligible, based on the severity of their impairment, if the client cannot benefit from the provision of VR services in terms of an employment outcome. Prior to making this determination, VR must demonstrate this based on clear and convincing evidence which includes the use of trial work experiences.

Trial Work Experience must be conducted and include any necessary supports, there must be clear and convincing evidence to provide the specialist a high degree of certainty (beyond a reasonable doubt) the individual is incapable of benefiting from services. 

 

1. Review and assess data, including specialist observation, medical records, information provided by the individual or the individual's family, particularly information used by education officials, and determinations made by officials of other agencies to make the eligibility determination. If the individual does not meet all the above eligibility criteria, an ineligibility or no longer eligible determination is completed. 
2. Provide full consultation of the specific, objective factors the decision is based upon with the applicant/client and involved parties is required.  Full consultation involves a discussion to explain the ineligibility determination. This conversation needs to be made in person, by phone, or as a last resort written communication unless the client/recipient has died, or there is no way to contact the individual. It must include the specific evidence and rationale of the ineligibility determination. Best practice would be to review the 'Office Director Letter' with the applicant during this discussion to explain all aspects of the letter and be available to answer any questions. 
3. Refer to appropriate federal, state, or local programs and/or service providers best suited to address independent living and/or employment related needs. See Program Manual Information and Referral (I & R) to Other Programs
4. Complete documentation. Complete a detailed task note to include this specific evidencerbased information and rationale for the determination.
5. Office Director reviews case and makes the final determination. If the office director made the original determination or was involved in making the original determination, the review is to be conducted by a different office director who will make the final determination.
6. Send Termination letter with the Client Assistance Program (CAP) information for all ineligibility or no longer eligible decisions. (For 511 cases see process below)
7. Close case. Choose the appropriate Ineligible exit status in QE2- 6, 8, 21, or 22 depending on criteria on Exit Status Decision Tree. The case should not be closed in the computer system (QE2) until the 30 days has elapsed from the date of the final determination since the client/recipient has 30 calendar days to appeal. See Program Manual Chapter Client Appeals/Rights, Procedures 

For unable to benefit from service determinations the additional steps apply:

Prior to any determination that an individual with a disability is unable to benefit from vocational rehabilitation services in terms of an employment outcome because of the severity of that individual's disability or that the individual is ineligible for vocational rehabilitation services, the specialist must determine:

• There is sufficient evidence to conclude that the individual can benefit from the provision of vocational rehabilitation services in terms of an employment outcome; or 
• There is clear and convincing evidence that due to the severity of the individual's disability, the individual is incapable of benefitting from the provision of vocational rehabilitation services in terms of an employment outcome.

Review and assess data. Determine whether existing information provides clear and convincing evidence the applicant/recipient cannot achieve, or does not want to achieve, an employment outcome, such as assessments and reports from previous work experiences. There must be clear and convincing evidence to provide the specialist a high degree of certainty (beyond a reasonable doubt) the individual is incapable of benefiting from services. The clear and convincing standard constitutes the highest standard used in the court of law and is to be individually applied on a case-by-case basis. The term clear means unequivocal. For example, the use of an intelligence test result alone would not constitute clear and convincing evidence. Clear and convincing evidence might include a description of assessments, including situational assessments from service providers who have concluded they would be unable to meet the individual's needs due to the severity of the individual's disability. The demonstration of clear and convincing evidence must include, if appropriate, a functional assessment of skill development activities, with any needed supports (including assistive technology) in real life settings. Obtain a copy of the written reports used to make this determination and not base the ineligibility decision solely on verbal conversations with a service providers or schools. 

If existing information is not clear and convincing, a trail work experience must be conducted and include any necessary supports.

Trial Work Experience(s) must be provided in competitive integrated employment settings to the maximum extent possible, consistent with the informed choice and rehabilitation needs of the individual. VR must:

(A) Conduct an exploration of the individual's abilities, capabilities, and capacity to perform in realistic work situations.  

(B) Develop a written plan to assess periodically the individual's abilities, capabilities, and capacity to perform in competitive integrated work situations using trial work experiences, which must be provided in competitive integrated employment settings to the maximum extent possible, consistent with the informed choice and rehabilitation needs of the individual. 

(C) Periodically assess the individual's abilities, capabilities, and capacity to perform in competitive integrated work situations while participating in the trial work experience(s).

(D) Obtain a copy of the written reports used to make this determination.

(E) Follow steps 2-7 above when closing the case. 

12-Month Review. When ineligibility is based on a finding the individual is incapable of benefiting from VR services in achieving an employment outcome, a review to determine if the finding remains accurate is completed 12 months after the case closure date is required. Additional reviews will be conducted annually thereafter, if requested by the individual or their representative. Reviews are not required in situations where the individual has refused a review, is no longer present in the state, their whereabouts are unknown, or their medical condition is rapidly progressive or terminal. Details of the review discussion are documented in task notes, as are the details about the individual or representative declining reviews or other reasons the review was not completed. Attempts to contact and the outcome must be evidenced in task notes. 

511 Cases - Individuals intending to begin special (sub-minimum) wage employment:

1. Follow case closure procedures above for all ineligible, no longer eligible closures.
2. Send draft of Employment Not Expected from Services Letter to Program Director, Evaluation & Community Integration, to review documentation of decision. Program Director will provide feedback and a task note to QE2 that ineligibility is justified.
3. If the individual or family/authorized representative refuse a trial work experience, refer back to DD Service Coordinator to explain how DD services may be impacted by this decision prior to completing the Refusal to Participate. Disregard this form for individuals who are NOT recipients of DD services.
4. Complete Documentation Checklist for Youth (Age 24 and Younger) or Documentation Checklist for Adults (Age 25 and Older) and ensure all team members involved with individual have received a copy

* Please note:  if individual starts special (sub-minimum) wage employment or SMW after the VR case is closed, the 14c certificate holder is responsible to refer the person back to Nebraska VR for CCIR (Career Counseling and Information & Referral) obligations.

 

Section 511: Documentation Checklist for Adults (age 25 and older)

Section 511: Documentation Checklist for Youth (Age 24 and younger)

Section 511: Refusal to Participate - English

Exit Status Decision Tree

Section 511: Employment Not Expected from Services Letter

Termination Letter for SSA Recipients in English

Termination Letter for SSA Recipients in Spanish

Termination Letter for Non SSA Recipients in English