8.1 Determination of Severity of Disability

The DVR Counselor shall determine the severity of an individual’s disability, and their priority for services, at the time eligibility is determined. The severity determination shall not delay the determination of eligibility and shall take place based upon the review and assessment of data used for eligibility determination and, if applicable, the outcomes of trial work experiences. If a preliminary priority rating is determined when sufficient information for eligibility is received, the priority will be updated upon receipt of additional information, when applicable. All individuals shall receive written notification, using an agency-approved letter intended for this purpose, of their priority for services classification. This written notification shall be provided any time there is a change to the priority classification.

The service record shall contain evidence to support the determination of severity of disability. Documentation in the service record shall be complete and accurate and include the relevant data page in DVR’s electronic case management system.

For individuals determined to be presumptively eligible based on SSI/SSDI verification, the existence of a significant disability is also presumed. Additionally, the DVR Counselor shall review and assess existing data and obtain any additional assessments necessary to determine if a most significant disability exists and to assist the individual in determining an appropriate employment outcome and necessary services.

A physical or mental impairment is determined to be severe if one or more physical or mental impairments exist resulting from amputation, arthritis, autism, blindness, burn injury, cancer, cerebral palsy, cystic fibrosis, deafness, head injury, heart disease, hemiplegia, hemophilia, respiratory or pulmonary dysfunction, mental illness, multiple sclerosis, muscular dystrophy, musculo-skeletal disorders, neurological disorders (including stroke and epilepsy), spinal cord conditions, including paraplegia and quadriplegia, sickle cell anemia, intellectual disability, specific learning disability, end-stage renal disease, or another disability or combination of disabilities determined on the basis of an assessment.

The impairments are considered to be severe because of the nature of the impairment. Other impairments may be severe for one individual but not for another, depending on the impact on the individual’s life activities. Sometimes an individual may have two or more impairments, neither of which alone is severe, but together cause serious functional limitations. These determinations shall be supported by assessment data and the analysis of the DVR Counselor as to the impact of the impairment(s) on the particular individual’s life activities.

A serious limitation means a reduction in functioning, due to a severe impairment, to the degree that the individual requires goods and services or special working conditions, such as job re-engineering, assistive technology, substantial on-the-job support or intensive supervision, not typically provided for other individuals in order to prepare for, enter, engage in, advance in, or retain employment in previous jobs, usual line of work and/or occupations usually available to people of equivalent age, education, and capacities who do not have disabilities. Non-disability related factors, such as geographical location, availability of public transportation and lack of financial resources or training, are not considered when determining whether or not a limitation meets the criteria for “serious.”

A functional capacity area is a set of life activities or skills in which the ability to function is significant to successful independence and/or employment. The functional capacity areas DVR identifies for the purpose of determination of severity of disability are communication, interpersonal skills, mobility, motor skills, self-care, self-direction, work skills, and work tolerance. 

The DVR Counselor shall analyze the impact, in terms of a competitive integrated employment outcome, of serious functional capacity limitations on the individual’s current employment, previous jobs, usual line of work, opportunities for advancement, and/or occupations usually available to people of equivalent age, education and, capacities who do not have an impairment.

● Communication – The ability to give and receive information through language (writing, speaking, listening, sign language, or other methods). Limitations may occur because of sensory, physical, cognitive, or psychological impairment; challenges due solely to language or cultural differences are not considered.

● Interpersonal Skills – The ability to establish and maintain personal, family, and community relationships as they affect or are likely to affect employment.

● Mobility – An individual’s physical access to their environment, either through their own ability (actions) or with the assistance of others; includes travel for activities of daily living, work, and training. It does not include lack of a driver’s license, geographic location, or availability of transportation.

● Motor Skills – The purposeful movement and control of the body necessary to obtain, perform, and maintain employment.

● Self-Care – The ability to care for self and one’s own living environment to the degree necessary to participate in work.

● Self-Direction – The ability to independently plan, initiate, problem-solve, organize, or carry out goal-directed activities to the degree necessary to work.

● Work Skills – The ability to learn, perform, and carry out essential job functions and duties toward the completion of job tasks.

● Work Tolerance – The capacity to effectively and efficiently sustain physical, cognitive, and/or psychological demands of a job. Limitations may be due to physical disability, stamina/fatigue, pain management, effects of medication, psychological, or other impairment related factors.

The requirement for multiple vocational rehabilitation services over an extended period of time means two or more core vocational rehabilitation services that require at least five months of service provision. In identifying the number of vocational rehabilitation services, the DVR Counselor shall not count those services which are supportive to another service. Supportive services include transportation, maintenance, services to family members, and personal assistance services.