ࡱ> 3 vbjbj -bvbvnrml 4 GGG8G,H4 fI|K(KKKL$L My{{{{{{$` ^ MLLMMP KK4PPPM K KyPMyPLPVbg ݊KI P% (˓4 ~>GM"ɇ4݊ ʖ0ޛMޛ݊P4 4 Chapter 2. Required Determinations 1. Employment Handicap  PRIVATE INFOTYPE="OTHER"  IntroductionThis topic contains general information on employment handicap determinations, including definitions existence of a vocational impairment role of disability rating in evaluating vocational impairment assessment of vocational impairment prompt notification of the determination potential sources for determining the existence of vocational impairment potential impairments contribution of the service-connected disability (SCD) to the impairment overcoming the vocational impairment of employed individuals and unemployed individuals, and existence of an employment handicap. Change DateJune 8, 2006 a. DefinitionsThe following definitions are integral to the employment handicap determination.  TermDefinitionEmployment handicap An impairment, resulting in substantial part from a service-connected disability (SCD), of an individuals ability to prepare for obtain, or retain employment consistent with his or her pattern of measured and/or demonstrated abilities, aptitudes, and interests.Reasonably developed job skillsGenerally recognized grouping of skills knowledge, and abilities which are transferable among related occupations and acquired through both training and experience.Continued on next page  STYLEREF "Map Title" 1. Employment Handicap, Continued  STYLEREF "Block Label" a. Definitions (continued) TermDefinitionStable, continuing employmentEmployment in one position or a series of similar positions for periods of 3-5 years with no or few breaks, or Current work, other than temporary employment (unless the work characteristically involves temporary but continuous assignments) Note: Employment alone is not evidence of stable, continuous employment.Suitable employmentEmployment which is consistent with the individuals interests, aptitudes, and abilities does not aggravate his or her disabilities is stable and continuing requires reasonably developed skills Note: Veterans expressed interests must be verified by measured and/or demonstrated interests.  b. Existence of a Vocational Impairment The term impairment means the restrictions on employability caused by one or more of the following factors the effects of the individuals service and non-service connected disabilities deficiencies in education and training negative attitudes toward the disabled, and other pertinent factors that result in restrictions on employability or in a lack of stable, continuing, suitable employment. Continued on next page  STYLEREF "Map Title" 1. Employment Handicap, Continued  STYLEREF "Block Label" b. Existence of a Vocational Impairment (continued)Employers may hold negative attitudes toward individuals with certain disabilities such as mental illness. The VRC/CP must consider the potential impact of employers negative perceptions. Note: Non-service connected disabilities include alcoholism and substance abuse. c. Role of Disability Rating in Evaluating Vocational ImpairmentDisability ratings provide only a general insight into the individuals vocational impairment. In contrast, the chapter 31 evaluation results in a determination of individual impairment due to a service-connected disability(ies) in combination with other vocationally relevant factors. Continued on next page  STYLEREF "Map Title" 1. Employment Handicap, Continued d. Assessment of Vocational ImpairmentThe table below lists factors which must be considered when determining the presence or absence of a vocational impairment. IfThenThe individuals disabilities do not limit his or her employability in occupations for which similarly circumstanced non-disabled persons compete and qualify, and training and education qualify him or her for suitable employment, and Negative attitudes toward disabled individuals are not evident, and The evaluation has not identified other restrictions on employment which have resulted in the absence of stable, continuing, suitable employment Note: The VRC/CP has a legal duty to assist the individual in developing evidence to support his or her claim for vocational rehabilitation benefits and services when evidence of record is insufficient, including medical treatment records employer evaluations, or records of prior training. Reference: For more information on duty to assist, see M28.III.2.C. The VRC/CP will find that the individual does not have a vocational impairment, and determine the individual is not entitled. Continued on next page  STYLEREF "Map Title" 1. Employment Handicap, Continued  STYLEREF "Block Label" d. Assessment of Vocational Impairment (continued) IfThenThe individuals disabilities limit his or her employability in occupations for which similarly circumstanced non-disabled persons compete and qualify, and training and education do not qualify him or her for suitable employment, or The evaluation has identified other restrictions on employment which have resulted in the absence of stable, continuing, suitable employment Note: The impairment may be in preparing for, obtaining, or maintaining employment and must have an impact on the individuals current situation or be reasonably projected for the future. The VRC/CP will find that the individual has a vocational impairment. e. Prompt Notification of the DeterminationThe VRC/CP must promptly provide the individual with a verbal and written notification explaining the determination indicating that they are entitled, or not entitled. Note: As a general rule, whenever possible, notification should be provided in sixty days or less. Continued on next page  STYLEREF "Map Title" 1. Employment Handicap, Continued f. Potential Sources of Information for Determining the Existence of a Vocational ImpairmentThe following sources of information may be used when determining that a vocational impairment exists Rehabilitation Needs Inventory (RNI) VHA and/or private medical records Rating decisions Labor market information Academic records or transcripts Prior counseling results/documentation History of employment and earnings, including Resumes Performance appraisals/position descriptions/attendance records Consultation with other service providers/professionals Individuals self-report g. Potential ImpairmentsThe following are potential impairments that may be considered in determining that a vocational impairment exists Physical limitations Psycho-social limitations Cognitive limitations Mobility limitations Sensory limitations Chronic pain Deficiencies in education and/or training, including civilian certifications or licensure Employer bias against persons with disabilities, including issues such as anticipated poor work performance and need for accommodation Lack of transportation History of unstable work or incarcerations Example: Some employers may view an individual with mental illness as unable to cope with typical stress inherent in the work place.Continued on next page  STYLEREF "Map Title" 1. Employment Handicap, Continued  PRIVATE INFOTYPE="PRINCIPLE"  h. Contribution of the SCD to the Impairment The SCD must contribute in substantial part to the vocational impairment. Therefore, its effects must be identifiable measurable, or observable. The effect of the condition must be currently evident or clearly projected for progressively debilitating conditions. When evaluating evidence that the vocational impairment results in substantial part from the SCD(ies), the VRC/CP must clearly show how the SCD impairs or does not impair the individuals ability to prepare for employment obtain employment, or retain employment consistent with his or her abilities, aptitudes and interests. Note: The SCD need not be the sole cause of the vocational impairment, but must contribute in more than an inconsequential manner. The non-service connected disability may compound the effects of the SCD on the impairment of employability, however a non-service connected disability alone can never be the sole basis of entitlement. Continued on next page  STYLEREF "Map Title" 1. Employment Handicap, Continued i. Overcoming the Effects of the Vocational ImpairmentOnce it is established that the SCD contributes in substantial part to the vocational impairment, the VRC/CP must determine if the individual has overcome the effects of the impairment through current, stable, and suitable employment.  j. Evaluating Employed Individuals for Overcoming ImpairmentUse the table below to determine whether an individual who is employed has overcome the vocational impairment(s).  If the employmentThen the individual isaggravates the disability(ies) is unstable, or is not consistent with the individuals pattern of abilities, aptitudes, and interestsnot suitably employed and has not overcome the effects of the impairment.requires reasonably developed skills does not aggravate the disability(ies) is stable and continuing, and is consistent with the individuals pattern of abilities, aptitudes, and interestssuitably employed, and has overcome the effects of the impairment. k. Evaluating Unemployed Individuals for Overcoming the ImpairmentUse the table below to determine if an individual who is unemployed has overcome the vocational impairment. If the individual isThen the individual hasNot prepared and/or qualified for employment in a suitable occupation, or Prepared and/or qualified for employment in a suitable occupation, but has failed to obtain or retain employment for reasons beyond his or her control not overcome the effects of the impairment.Continued on next page  STYLEREF "Map Title" 1. Employment Handicap, Continued  STYLEREF "Block Label" k. Evaluating Unemployed Individuals for Overcoming the Impairment (continued) If the individual isThen the individual hasPrepared and/or qualified for employment in a suitable occupation, but has failed to obtain or retain employment for reasons within his or her control (Example: total absence of employment-seeking behavior unrelated to disability)overcome the effects of the impairment. l. Employment Handicap DeterminationThe table below describes the circumstances under which an employment handicap may or may not be found to exist. Employment Handicap ExistsEmployment Handicap Does not ExistAn employment handicap is present when all of the following exist the individual has a vocational impairment the individuals SCD contributes in substantial part to the impairment, and the individual has not overcome the effects of the vocational impairment through current, stable, or continuing employment in a suitable occupation. Note: If reasonable doubt exists, it must be resolved in the individuals favor.An employment handicap is not present if either of the following exist the individual does not have a vocational impairment the individual has a vocational impairment, but the SCD does not contribute in substantial part to the impairment, or the individual has overcome, and continues to overcome, the effects of the vocational impairment to which the SCD contributes through current, stable, and continuing employment in an occupation consistent with the individuals interests, aptitudes, and abilities. PRIVATE INFOTYPE="FACT"  2. Serious Employment Handicap IntroductionThis topic contains general information on serious employment handicap (SEH) determinations, including definitions SEH determination required when an EH exists factors for determining significant vocational impairment when SEH is required for entitlement to services additional benefits available to veterans with SEH conditions required for a SEH determination, and SEH determination. Change Date June 8, 2006 a. DefinitionsThe following definitions are integral to the serious employment handicap determination.  TermDefinitionSerious employment handicapa significant impairment resulting in substantial part from a SCD of an individuals ability to prepare for obtain or retain employment consistent with his or her abilities aptitudes, and interests.Significant impairmentsignificant restrictions caused by service and non-service connected disabilities deficiencies in education and training negative attitudes toward the disabled, and other pertinent factors. Note: Significant impairment is assessed in terms of the magnitude of the vocational impairment as it relates to the difficulty projected for the individual to achieve rehabilitation.Continued on next page  STYLEREF "Map Title" 2. Serious Employment Handicap, Continued b. SEH Determination Required When an EH ExistsIn every case where a VRC/CP has determined that an employment handicap exists, the VRC/CP must also determine whether a serious employment handicap exists. c. Factors for Determining Significant Vocational ImpairmentFactors to consider in determining the significance of a vocational impairment alone or in combination, include, but are not limited to number of disabling conditions severity of disabling condition(s) record of neuropsychiatric condition lack of education and training for suitable employment negative attitudes toward the disabled long or substantial period of unemployment or unstable work history a pattern of reliance on government support programs, such as welfare, compensation, pension, workers compensation, social security disability, etc. withdrawal from society extent and complexity of needed rehabilitation services, and other evidence of significant restrictions on employability, e.g., high unemployment; age, race, and gender discrimination issues, etc. Note: The substantial contribution of the SCD to the impairment is decided when making the employment handicap determination, and should not be considered again for the determination of SEH. d. When SEH is Required for Entitlement to ServicesA finding of a significant vocational impairment and SEH is required for entitlement to VR&E services if the individuals SCD is 10% eligibility termination date (ETD) is expired, or months of remaining entitlement are exhausted and cannot be extended on the basis of an employment handicap. References: For additional information, see CFR 21.44 and CFR 21.78.Continued on next page  STYLEREF "Map Title" 2. Serious Employment Handicap, Continued e. Additional Benefits Available to Veterans with SEHVeterans with a SEH are eligible for additional benefits which may not be provided to veterans who do not have a SEH, including possible extension of the 12-year period of eligibility possible extension of the duration of a rehabilitation program beyond 48 months, if required to complete the program extended evaluation services independent living services more extensive supplies and services for individuals approved to pursue self-employment. References: For additional information, see CFR 21.57 and 21.258(b). f. Conditions Required for an SEH DeterminationA finding of SEH is based upon the determination that the individual has an employment handicap, and the vocational impairment is significant.Continued on next page  STYLEREF "Map Title" 2. Serious Employment Handicap, Continued g. SEH DeterminationThe table below describes the circumstances under which a SEH may or may not be found to exist.  If the VRC/CP DeterminesThen the VRC/CP willThat a significant vocational impairment and a SEH existfind the individual entitled to a program of VR&E services and assistance consistent with additional VR&E benefits available to veterans with a SEH.That a SEH does not exist, and the individual has a 10% SCD rating the ETD has expired, or does not have remaining months of entitlementdeny entitlement to a program of VR&E services and assistance Note: The VRC/CP has a legal duty to assist the individual in developing evidence to support his or her claim for vocational rehabilitation benefits and services when evidence of record is insufficient, including medical treatment records employer evaluations, or records of prior training. Reference: For more information on duty to assist, see M28.III.2.C.  3. Feasibility of Achieving a Vocational Goal IntroductionThis topic contains general information on determining the current reasonable feasibility of achieving a vocational goal, including definitions when is a feasibility determination required determining gainful employment considerations for feasibility determinations reduced work tolerance feasibility determination when a feasibility determination cannot be made actions following a feasibility determination required referrals to the rating board, and reviews of infeasibility. Change DateJune 8, 2006 a. DefinitionsThe following definitions are integral to the feasibility determination. TermDefinitionCurrent reasonable feasibilityAchievement of a vocational goal is currently reasonably feasible when the following conditions exist one or more vocational goals have been identified the individuals physical and mental conditions permit training for the goals to begin within a reasonable period, and the individual either has the educational skills and background to pursue the vocational goal, or will receive services through VA to develop these skills as part of the program Vocational goalgainful employment status consistent with the individuals abilities, aptitudes, and interests.Continued on next page  STYLEREF "Map Title" 3. Feasibility of Achieving a Vocational Goal, Continued  STYLEREF "Block Label" a. Definitions (continued) TermDefinitionGainful employmentincome-producing full-or part-time employment, or self-employment. Reduced work tolerancea limitation of the rate of pursuit of a rehabilitation program due to the impact of disability(ies) for an individual for whom the achievement of a vocational goal is otherwise feasible. b. When is a Feasibility Determination RequiredIn every case where a VRC/CP has determined that an employment handicap exists, the VRC/CP must also determine whether achievement of a vocational goal is currently reasonably feasible. c. Determining Gainful Employment The table below describes the criteria for determining gainful employment status. If the employmentThen the employment isis income-producing, full- or part-time employment, or self-employmentgainfulis a special situation such as a sheltered workshop and the individuals rate of pay is at or above the established minimum wagegainfulis therapeutic in nature and pays below the established minimum wagenot gainful temporary in nature and the occupational field is not normally characterized by temporary job assignments (e.g., union electrician work)not gainfulContinued on next page  STYLEREF "Map Title" 3. Feasibility of Achieving a Vocational Goal, Continued d. Considerations for Feasibility DeterminationsSubstantial information must be developed and considered to determine if the individual has the potential to profit from rehabilitation services, and achieve a vocational goal. The VRC/CP may not find pursuit of a vocational goal currently infeasible based solely upon possible worsening of the medical condition in the future. The VRC/CP will consider future changes in the individuals condition only in determining the objective to be selected. Note: The VRC/CP will resolve any doubt that achievement of a vocational goal is currently reasonably feasible by deciding in the individuals favor. e. Reduced Work ToleranceIf the individuals disabilities limit program pursuit, the VRC/CP must consider reduced work tolerance before denying current reasonable feasibility. Note: When the question of reduced work tolerance arises, the VRC/CP will refer the case to a VA physician to determine the degree of the individuals work tolerance. Using this information, the VRC/CP will establish the rate of pursuit the VA will consider full-time program participation. Continued on next page  STYLEREF "Map Title" 3. Feasibility of Achieving a Vocational Goal, Continued f. Feasibility DeterminationThe feasibility determination should be made as soon as possible after the development of substantial information. The table below describes the circumstances under which current reasonable feasibility may or may not be found to exist.  Current Reasonable Feasibility ExistsCurrent Reasonable Feasibility Does Not ExistCurrent reasonable feasibility is found when one or more vocational goals have been identified the individuals physical and mental conditions permit training for the rehabilitation goals to begin within a reasonable period, and the individual either has the educational skills and background to pursue the vocational goal, or will receive services through VA to develop these skills as part of the program use of reduced work tolerance will enable the individual to complete a rehabilitation program Current reasonable feasibility is not found when a vocational goal cannot be identified the individuals physical and mental conditions do not permit training for the rehabilitation goals to begin within a reasonable period, and the individual either does not have the educational skills and background to pursue the vocational goal, or will not receive services through VA to develop these skills as part of the program use of reduced work tolerance will not enable the individual to complete a rehabilitation program. g. When a Feasibility Determination Cannot be MadeIf, as the result of an evaluation, the VRC/CP cannot resolve the issue of current reasonable feasibility, the VRC/CP may authorize an extended evaluation for individuals with a serious employment handicap.Continued on next page  STYLEREF "Map Title" 3. Feasibility of Achieving a Vocational Goal, Continued h. Actions Following a Feasibility DeterminationThe following actions should be taken following each of the feasibility determinations listed below. If the VRC/CPThendetermines that achievement of a vocational goal is currently reasonably feasibleproceed with the rehabilitation process to development of a viable vocational goalcannot determine if achievement of a vocational goal is currently reasonably feasible and the individual has a serious employment handicapproceed with the rehabilitation process to develop an Individualized Extended Evaluation Plan cannot determine if achievement of a vocational goal is currently reasonably feasible, but the individual does not have a serious employment handicapdetermine that the individual is not entitled and refer to other sources of assistanceContinued on next page  STYLEREF "Map Title" 3. Feasibility of Achieving a Vocational Goal, Continued  STYLEREF "Block Label" h. Actions Following a Feasibility Determination (continued) If the VRC/CPThendetermines that achievement of a vocational goal is not currently reasonably feasible, and the individual is a veteran with a serious employment handicap Determine the individual not entitled to services leading to a vocational goal and consider the need for independent living services. Note: A determination that achievement of a vocational goal is currently not feasible without an extended evaluation requires compelling evidence that establishes infeasibility beyond any reasonable doubt. Note: The VRC/CP must obtain the VR&E Officers concurrence whenever the VRC/CP does not approve a program of independent living services following a infeasibility determination.determines that achievement of a vocational goal is not currently reasonably feasible, and the individual is a servicemember determine that the servicemember is not entitled and refer to other sources of assistance. Note: Establish a diary for follow up actions as the servicemember approaches discharge and consider other appropriate services. i. Required Referrals to Rating BoardThe VRC/CP must prepare a statement of the facts and refer the case to the Veterans Service Center (VSC) whenever a determination has been made that the achievement of a vocational goal is not currently reasonably feasible, and the individuals SCD is less than 100%. Note: The VSC rating board will reconsider the individuals rating if the infeasibility finding is based on factors associated with the SCD.Continued on next page  STYLEREF "Map Title" 3. Feasibility of Achieving a Vocational Goal, Continued j. Reviews of Infeasibility The determination of current reasonable feasibility is subject to ongoing review throughout the individuals rehabilitation program. Changes in circumstances may require a reconsideration of the vocational goal, and if necessary, a reevaluation of that goal. The VR&E Division will review determinations of infeasibility as warranted by the facts of each case, and either retain or change the determination, as appropriate. 4. Extended Evaluation IntroductionThis topic contains general information on extended evaluations, including purpose of an extended evaluation scope of an extended evaluation conditions for participating in an extended evaluation extended evaluation cannot be authorized outcomes of extended evaluations, and required concurrence.  Change DateJune 8, 2006 a. Purpose of an Extended EvaluationThe sole purpose of an extended evaluation is to provide the information needed to enable the VRC/CP to determine the individuals ability to achieve a vocational goal when this cannot be resolved during the initial evaluation. Note: When the VRC/CP cannot determine current reasonable feasibility, and the individual does not have a serious employment handicap, an extended evaluation cannot be authorized.  b. Scope of an Extended EvaluationServices approved under an extended evaluation must logically contribute to determining whether the individual meets the conditions for feasibility. The determination regarding feasibility should be made as expeditiously as possible after adequate information has been obtained. Services provided may include, but are not limited to diagnostic and evaluative services work adjustment training and situational assessments medical care and treatment assistive technology assessments independent living services specialized services for individuals with cognitive disabilities, and services to improve an individuals ability to achieve a vocational goal. Note: Generally, traditional school courses do not meet the criteria for an extended evaluation. In rare instances, traditional school courses in combination with other services may be provided, however academic coursework cannot exceed one school term. Continued on next page  STYLEREF "Map Title" 4. Extended Evaluation, Continued c. Conditions for Participation in an Extended EvaluationAuthorization of a program of extended evaluation services is subject to the following conditions the individual must have a serious employment handicap the extended evaluation program cannot be shorter than 2 weeks or longer than 12 months Note: The VRC/CP may approve an additional 6 months of extended evaluation services with the concurrence of the VR&E Officer.  d. Extended Evaluation Cannot be AuthorizedWhen the VRC/CP cannot determine reasonable feasibility, and the individual does not have a SEH, an extended evaluation cannot be authorized. Services to evaluate and improve rehabilitation potential may be provided during the initial evaluation to properly determine current reasonable feasibility. These special rehabilitation services to evaluate and improve rehabilitation potential can include diagnostic services personal and work adjustment training medical care and treatment training in mobility and ambulation, and other related services. During the provision of these services, the case remains in evaluation and planning status. The individual may not receive a subsistence allowance during evaluation and improvement of rehabilitation potential.Continued on next page  STYLEREF "Map Title" 4. Extended Evaluation, Continued e. Outcomes of Extended EvaluationsThe table below describes the two possible outcomes of the extended evaluation. IfThenThe individual meets the conditions for current reasonable feasibility. The VRC/CP determines that pursuit of a vocational goal is currently reasonably feasible, and will work with the individual to develop a plan of services.The individual does not meet the conditions for current reasonable feasibility. Note: The VRC/CP must consider the provisions of reduced work tolerance prior to making a negative determination of current reasonable feasibility.The VRC/CP must advise the individual and his/her representative of the decision, including appellate rights, and must consider the need for a program of independent living services  f. Required ConcurrenceThe VRC/CP must obtain the VR&E Officers concurrence whenever the VRC/CP does not approve a program of independent living services following an infeasibility determination. 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