Vocational Rehabilitation.

Last updated Thursday, January 06, 2005

Applying for VR services

How can a person with arthritis apply for vocational rehabilitation services?

Application for services should be made at your local VR office. For individuals who can not visit their local office, counselors will interview clients in the home.

There are several ways to contact vocational rehabilitation:

• Individuals who receive Disability Insurance Benefits (DIB) from Social Security (also called Social Security Disability Insurance or SSDI) may be referred to VR by the Social Security Administration.
• Self-referral by phone, letter, or a visit to the local office.
• Referral by a physician, other health care professional or health agency such as the Arthritis Foundation.

After your application is received, a VR counselor will be assigned. A general medical examination is required (paid for by VR). The counselor may request additional information such as school records, work history, Social Security data and current medical reports. Your medical history is very important and should be complete and updated. All of the above information helps the counselor determine whether you qualify for VR and what type of services are needed. The reports you share with the counselor are kept confidential.

When an application for rehabilitation is approved, the counselor and client develop an Individualized Written Rehabilitation Plan (IWRP). The plan describes in detail the person's employment goals and the services VR will provide. Your IWRP spells out how VR will assist you and what you are expected to accomplish. Regular reviews are made of your plan. If your condition changes, the IWRP will be revised accordingly.

The IWRP contains the following information:

• Reasons why you are eligible for VR services
• Long range employment goals
• Intermediate plans to accomplish goals
• Services provided by VR
• Starting and ending dates for services
• Estimated cost of services
• How and when the plan will be reviewed
• A statement of your responsibilities, including payment of some services if necessary
• A statement that you understand and approve the program and have been informed of rights and appeal process
• Criteria for deciding when you are rehabilitated
• Any plans for providing services after you are employed

The IWRP is very important. It becomes the written plan of action between the client and the state agency. Individuals need to work closely with the counselor to make certain that the plan accurately and fully describes a program which will help them reach their vocational goals. It is also a good idea for clients to share the IWRP with their physician and physical and occupational therapist. These professionals can determine if the activities are appropriate and will benefit the client.

In most cases, disagreements over a person's rehabilitation services or plan, can be settled between the counselor and client. However, any decision or action that a client is not satisfied with can be appealed.

The steps in appealing decisions of the VR counselor are:

1. Personally check with the counselor to make certain his or her decision is final.
2. Ask the counselor's supervisor to review the decision.
3. Meet with the counselor and supervisor. The supervisor will make a decision within ten days of the meeting.
4. If dissatisfied with the supervisor's decision, ask for a review by the VR District Supervisor. This is called an Administrative Review.
5. If dissatisfied with the District Supervisor's decision, request a Fair Hearing. This is a formal meeting before the State Director of VR or his/her representative.
6. If dissatisfied with the Fair Hearing decision, ask for a review by the U.S. Secretary of Education in Washington, D.C. This is the last step and final decision of an appeal.

Arthritis can often present a confusing picture, especially when the illness involves "good days and bad days". One counselor's evaluation may not reflect all the problems a client is having with arthritis. It is important to pursue the steps in the appeal process to be sure you get the services and programs for which you are eligible.

Each state is required to have a Client Assistance Program (CAP). This agency helps clients work out any problems they may have with their counselor or program, that they have been unable to correct themselves. Assistance from CAP is especially important when:

• the client and counselor have major disagreements over the IWRP or
• the client is considering an appeal.

Independent living centers

Independent Living Centers (ILC) are funded by federal and state government. They coordinate the services that enable people with disabilities to remain independent within the community. The centers also provide assistance in understanding and obtaining the rights and benefits of programs like VR. They will serve as an advocate when problems arise.

To locate the ILC that serves your area, look in the telephone book under "Independent Living Center" or call your local Arthritis Foundation chapter or VR office.

How VR affects other benefits

Disability Insurance Benefits (DIB) and Supplemental Security Income (SSI) will continue when you enter a rehabilitation program. However, there are two instances when benefits could be discontinued:

1. If an individual refuses rehabilitation services without good cause.
2. If Social Security determines an individual has medically improved and is no longer disabled under the Social Security guidelines. All people who receive disability benefits are periodically reviewed.

There are a number of work incentives offered by Social Security for people with disabilities who return to work. These incentives protect the person financially until the individual can pay his or her own way and obtain other health insurance. Some of these incentives include:

• Trial work period
• Continuation of benefits (DIB and/or SSI)
• Continuation of health insurance (Medicare and/or Medicaid).

Federal regulations may change from year to year, so check with the local Social Security or VR office for the current rules regarding disability benefits, VR services and work incentive programs.

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