The Vocational and Case-flow process.

After the Diagnostic Interview the case will be reviewed by the UPS or Area

manager.

The VRC will make sure ID/Driver’s license is in place. Also the social security card

needs to be in the file. Income verification to include check stubs from the spouse and

consumer. The Rent or Mortgage statement and or any unpaid medical bills associated

with the disability should be in the file. A copy of the insurance if any should also be in

the file.

The VRC will make sure that the work history and transferable skills are done along with

contacts. Try to get three previous jobs the name, address, and phone number of the

employer. See what job the consumer liked the most and like the least and why.

Release for medical information from the treating doctor. Medical records should include

a history and physical. These should not be more than 2 years old or get the records but

do more current assessments. See below

Based on the disability assessments such as:

Psychological Evaluation for a Diagnosis/for Mental Health as well as IQ and

Academic Levels especially if considering training.

Neuropsychological Evaluation if the customer may need accommodations for the job

or testing such as longer to take a test, quite environment, someone to read the test to

them.

FCE/General Medical will examine functional limitations such as standing lifting,

bending stooping. Usually done for back leg injuries neck injuries.

Vocational Evaluation to examine possible vocational goals.

Extension time:

If there needs to be an extension due to eligibility taking longer than 60 days

document then need for the extension of time and document this in Rehab works. Talk

with the customer. A reason for an extension could be the customer missed a needed

evaluation.

The Only services that can be paid for is Assessments

at this time.

Once these steps are completed and reviewed by the UPS or Area Manager the

case will move to the next step eligibility determination.

Eligibility 60 days after the Diagnostic or before:

Once the diagnostic step has been completed and evaluations, medical records (no

more than 2 years old). Eligibility may be determined.

For Hearing aids make sure there is an ENT and or Audiogram for determining

Eligibility. If the consumer has worn hearing aids before and has been to an ENT in the

last 2 years get a copy of the ENT report. If not then Send to the ENT then once

clearance is obtained then send the customer for the hearing aid recommendation.

For Restorative/Surgery Cases complete a 3110/Surgery and Treatment

Recommendations which is completed by the surgical vendor who is going to do the

surgery/Doctor. Then LMC reviews the records; send the LMC a 3101/ Consultant

Review. Have the Area Manager Approve the restorative/surgery service. This step

will be reviewed by the UPS and Area Manager.

If the consumer has social security they can be presumed eligible. There should be a

copy of the award letter in the file. Make sure it is SSI or SSDI and not Social Security

Retirement.

Once the records and assessments have been received the presumptive eligibility

statement can be changed to a regular eligibility statement based on information from

the Assessment and Medical Records.

For Mental Health customer’s you would want records indicating the consumer is in

treatment with a MHMR provider and complaint with services. In many cases it may be

valuable to also do a Psychological Evaluation (see above in the diagnostic section).

For a customer pursuing a license do a CBC (Criminal Background Check) before the

IPE is done to make sure the customer is able to be licensed.

If the IPE is going to take longer than 90 days make sure an extension is done. Talk

with the Customer and document the reason the extension. Document this in rehab

works.

The Only services that can be paid for is Assessments

at this time.

Once this step is reviewed by the UPS or Area Manager the case can move to the

next step the IPE

IPE 90 days after eligibility or sooner:

The IPE and vocational goal will be reviewed by the UPS and Area Manager to examine

the services and vocational goal. Services can be authorized once this step is done.

IPE/goals can also be reviewed also for occupational demand/current job market.

Have the IPE services be consistent with the vocational goal.

One service to have on All IPEs is Vocational Counseling and Guidance.

Counseling and Guidance can be documented when developing the IPE and the note

can be after the assessing and planning note for the IPE.

Additional services can be done now based on the IPE such

as hearing aids, job placement, training etc.

Please do not skip one of these steps or move to the next step without having the

UPS or Area Manager approve it.

After the IPE is completed:

Counseling and Guidance is something that occurs throughout the case and can be

fussed on the treatment and management of the disability, also discussions on

developing the employment goal, or job search activities (using transferable skills). It

can be talking about how and when to disclose to employers or even to disclose the

disability at all. The frequency is determined by the IPE based on discussions with the

customer. It however, can occur more frequently than this, and anytime a Counselor

talks with the customer is an opportunity for counseling and guidance. When the

customer is in employment should be every 30 days.

Joint Annual Review is done every year after the IPE. Discuss what services are going

to be continued such as Vocational Counseling and Guidance or Job Placement. Also

document services that were completed such as hearing aids ect. Document any

changes to the customer’s financial or living situation.

Service Justification If there is a service that is not on the IPE but the vocational goal

is not changed and is related to the vocational goal, then a service justification note can

be done. An example might be if a hearing aid case was done and then it was

discovered that the customer would benefit from an FM amplification system but it was

not on the IPE a service justification note could be done

An IPE Amendment is done if the vocational goal is changed. If it Computer Aided

Drafting and the Customer decided to pursue a career as an Electrician and IPE

amendment would need to be done changing the vocational goal. Services would then

be put in place to help the customer achieve the vocational goal of Electrician instead of

Computer Aided Drafting.

Closing a case:

Successful: The case can be closed successful if the customer working in an area that

is within their vocational goal and it has been 90 days after the last substantial service.

If the case was significant or most significant then it has to be at least 6 months from

the IPE and 90 days since the last substantial service.

Document how employment was verified in Rehab works. Check stub, calling the

customer at work, going by the customer’s place of work, observing them at work, and

the work number when ready.

Document that post closure services were discussed with the customer.

Complete a closer case note discussing the customer’s barriers to employment and

the services that were provided to help the customer with the barriers to employment

such as vocational counseling and guidance, training, restorative services (surgery) job

placement etc.

Unsuccessful:

If the customer is not responding to attempt to contact them

Attempt to contact the customer at different times during the day. Document the

attempts.

Send a letter giving a time frame to contact you.

Email the customer.

Call a customer’s contact.

Before a case is closed unsuccessful check with the Area manger prior to closing the

case.

Phase Adjustment can be done to an unsuccessful case of about 1 year that has been

found working. The Area Manager can be requested to phase adjust the case.

Abbreviations:

ENT: Ear Nose and Throat Specialist.

CBC: Criminal Background Check

LMC: Licensed Medical Consultant

UPS: Unit Program Specialist

IPE: Individualized Plan of Employment

VRC: Vocational Rehabilitation Counselor

The key as always is to have a good referral source to a successful caseload. It is the

source of where the caseload gets its customers.

This a quick reference for the Vocational Counselors in Texas. It is brief overview of the

vocational process and the forms used in Texas. It; however, may be useful in other

states if the form numbers are swapped out for the appropriate forms.

David Vershaw II