205.00 Significance of Disability Policy

(Revised May 2018)

See corresponding procedure: 205.00P Significance of Disability Procedure

Table of Contents

Overview

ACCES-VR is committed to serving individuals with significant disabilities. Assigning and tracking levels of significance assures that we are reaching individuals with significant disabilities, and In the event that ACCES-VR is unable to provide vocational rehabilitation services to all eligible individuals, establishing priority categories will also enable ACCES-VR to transition should an order of selection become necessary.

The ACCES-VR counselor must identify an individual as having a most significant, significant, or less significant disability without delaying the eligibility decision. The determination is based on the individual’s functional capacities, the services needed to reduce the impact of disability-related limitations and the duration of the rehabilitation services required for the individual to achieve an employment outcome.  Significance of disability is not based on a specific diagnosis or disability.  Significance of disability is determined using existing information and may be changed at any time during the life of the case. 

Significance of Disability Priority Categories

  1. Priority 1 – Eligible individuals with a Most Significant Disability. An individual with a most significant disability is an individual:
    1. who has a severe physical or mental impairment which seriously limits three or more functional capacities (such as mobility, communication, self-care, self-direction, interpersonal skills, work tolerance, or work skills) impacting an employment outcome; and
    2. whose vocational rehabilitation will require multiple vocational rehabilitation services over an extended period of time (6 months or more).
  2. Priority 2 – Eligible individuals with a Significant Disability. An individual with a significant disability is an individual:
     
    1. who has a severe physical or mental impairment which seriously limits one or two functional capacities (such as mobility, communication, self-care, self-direction, interpersonal skills, work tolerance, or work skills) impacting an employment outcome; and
    2. whose vocational rehabilitation will require multiple vocational rehabilitation services over an extended period of time (6 months or more).
  3. Priority 3 – Eligible individuals with a Less Significant Disability.  An individual with a less significant disability is an individual:
     
    1. whose vocational rehabilitation is not expected to require multiple vocational rehabilitation services; and
    2. whose vocational rehabilitation services will not require an extended period of time.

Determining Significance of Disability

There are three criteria to be reviewed for significance of disability:

Serious Limitations to Functional Capacity

ACCES-VR must determine which functional capacities are seriously limiting by reviewing available reports, including information provided by the individual, the individual’s family, and observations made by the counselor.

Serious limitation in a functional area means a reduction, due to a severe physical or mental impairment, to the degree that the individual requires services or accommodations not typically made for other individuals in order to prepare for, enter into, engage in, advance in or retain competitive integrated employment. For Significance of Disability, functional capacities must be seriously limited and include a reference to intensity, frequency and duration.

The counselor must consider these elements when determining whether the impairment seriously limits a functional capacity.

Intensity - The degree to which the limitation affects the individual’s ability to function.

Frequency - The number of times a given limitation affects the individual’s ability to function within a set period of time.

Duration - The length of time the limitation has existed or is expected to last.

Functional capacities to be considered are:

Mobility refers to a person’s ability to move to and from work or within a work environment, including walking, climbing, coordination, accessing and using transportation, as well as use of spatial and perceptual relationships.

Communication is a person’s ability to transmit and/or receive information though spoken, written or other non-verbal means.

Self-care is the ability to perform activities of daily living, to participate in training or work-related activities, including eating, toileting, grooming, dressing, cooking, shopping, washing, housekeeping, money management and health and safety needs.

Self-direction refers to one’s ability to independently plan, learn, reason, problem solve, memorize, initiate, organize, and make decisions. These processes allow individuals to assimilate information and learn specific skills related to job functions.

Interpersonal skills are the ability to establish and/or maintain personal, family or community relationships as they affect job performance.

Work tolerance is defined as a person’s capacity to meet the demands of the work place regardless of the work skills already possessed by the individual. Limitations may be due to physical disability, stamina/fatigue, effects of medication, or psychological factors.

Work skills are the ability to demonstrate specific tasks and work-related behaviors, to carry out job functions as well as the capacity to benefit from training necessary to obtain and maintain appropriate employment.

Multiple Rehabilitation Services Required to Reduce the Impact of Limitations on Employment

Only those services that are necessary, as a direct result of the disability are included in the determination of significance of disability. This includes services that are provided by others as comparable benefits. Specialized vocational training designed for individuals with disabilities, physical and mental restoration services, special transportation, and rehabilitation technology are examples of services that are to be included in this determination.

Assessment services, counseling and guidance and job placement services are required by all individuals to meet a specific employment goal but are not considered when determining significance of disability.

Duration of Services for an Extended Period of Time

A determination that services will be required for an extended period of time is made when required services are expected to last six or more months after eligibility has been determined.

Social Security Recipients

An individual who has a disability and is receiving SSI or SSDI benefits, as determined by the Social Security Administration, is automatically considered to have at least a significant disability. Further review by the counselor of the individual’s functional capacities may result in a determination that the individual has a most significant disability.  Changes may be made any time information becomes available.

Reference

Rehabilitation Act:

  • Section 7; Section 101; Section 102

Federal Regulations:

  • §361.5; §361.42; §361.48

Policy:

  • 202.00 Eligibility for Services