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Ineligible, No Longer Eligible

Status: Archived

Approved Date: May 24, 2021

Federal and State Rehabilitation laws require individuals meet all the following criteria to be eligible for VR services:

  • must have a significant impairment, 
  • impairment must result in a substantial impediment to employment,
  • must be able to benefit from services through an employment outcome
  • must require Vocational Rehabilitation Services to prepare for, enter into, engage in, advance in, or retain gainful employment consistent with your strengths, resources priorities, concerns, abilities, capabilities, interests, and informed choice.
  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.  Full consultation is required with the applicant or recipient and as appropriate, authorized representative and other individuals involved. Full consultation involves an actual 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. 
  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 Information and Referral (I & R) to Other Programs
  4. Annual Review. Inform the individual they will be contacted in 12 months and annually thereafter if requested by the individual or by the individual's representative to review their situation to determine if at that time, they are capable of achieving an employment outcome.  Attempts to contact and the outcome must be evidenced in task notes. This review will not be conducted in situations where the individual has refused a review, the individual is no longer present in the state, the individual's whereabouts are unknown, or the individual's medical condition is rapidly progressive or terminal.
  5. Documentation. Complete a detailed task note to include this specific evidence based information and rationale for the determination.
  6. If the reason for ineligibility is “cannot benefit from services,” the specialist will:
  • Trial Work Experience. If there is not 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, a Trial Work Experience (TWE) 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. It must include sufficient variety and over a sufficient period of time for the specialist to determine there is clear and convincing evidence to conclude that due to the severity of the individual's disability, the individual is incapable of benefitting from the provision of VR services in terms of an employment outcome. The specialist must be involved and periodically assess the individual's abilities, capabilities, and capacity to perform in competitive integrated work situations while participating in the trial work experience(s). Upon the completion of the TWE, the specialist will complete a final determination of the individual's abilities, capabilities, and capacity to perform in realistic work situations and provide a full consultation of the specific, objective factors the decision is based upon with the individual and involved parties. The fact based information from the participation in the TWE will be entered into the casefile.
  • Office Director reviews the case and fully consults with the applicant and if appropriate his/her authorized representative. The office director  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.
  • Send Employment Not Expected from Services Letter specific to the individual. DO NOT modify or change pre-printed language in letter. Provide any needed copies of the letter to authorized representative, family and/or service providers. 
  1. Send Office DIrector letter with the CAP information for all ineligibility or no longer eligible decisions due to the following:
  • No significant impairment, 
  • No substantial impediment to employment,
  • Does not require services 
  1. If individual does not agree with the ineligibility decision, 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. Client Appeals/Rights, Procedures 
  2. Close case. choose the appropriate Ineligible exit status in QE2- 6, 21, or 22 depending on criteria on Exit Status Decision Tree.

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

  1. Follow case closure procedures above for all ineligible, no longer eligible closures above.
  2. After above required steps have been completed, compose specific to the individual, but DO NOT modify or change pre-printed language in letter. 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. Once finalized, send Employment Not Expected from Services letter to client and family/authorized representative and provide copies to DD Service Coordinator and I/DD Service Provider.
  5. Refer the individual to other federal, state, or local programs and/or service providers best suited to meet his/her rehabilitation needs as evidenced by the Information and Referral (I & R) to Other Programs document.
  6. 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
  7. Choose appropriate Ineligible exit status in QE2- 6, 21, or 22 depending on criteria on Exit Status Decision Tree.
  8. Add 12-month review to calendar, and annually thereafter if requested by the individual or, if appropriate by the individual's representative. 

* Please note:  if individual starts special or sub-minimum wage employment (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.

In making a determination of ineligibility or no longer eligible, no applicant or group of applicants is excluded or found ineligible solely on the basis of the type of disability; and the 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

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. 

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

Review Required. If determined ineligible or no longer eligible based on a finding the client is incapable of achieving an employment outcome, the client’s situation must be reviewed with him/her within 12 months and annually thereafter if requested by the client or by the client's representative. This review will not be conducted in situations where the individual has refused a review, the individual is no longer present in the State, the individual's whereabouts are unknown, or the individual's medical condition is rapidly progressive or terminal.

Applicants receiving SSI/SSDI. Applicants who receive SSDI or SSI based on their disability are presumed eligible for services and must be placed in either Priority Group Two or Priority Group One. (Refer to VRIS - Eligibility - Social Security Recipients)

All other applicants. Applicants for VR services not receiving SSI/SSDI based on their disability may be determined ineligible because;

  • No physical or mental impairment;
  • Impairment does not constitute or result in a substantial impediment to employment;
  • Unable to benefit in terms of an employment outcome from the provision of VR services. Prior to making this determination VR must demonstrate their inability to work based on clear and convincing evidence which includes use of trial work experiences; or
  • Does not require VR services to prepare for, secure, retain, or regain employment.

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 in terms of an employment outcome from the provision of VR services. Prior to making this determination, VR must demonstrate this based on clear and convincing evidence which includes the use of trial work experiences.

 


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