Appendix B - Definitions

Academic Training – Training provided to develop academic and reasoning abilities as well as skills for a specific occupation typically leading to certificates or degrees at the associate level or higher.

Ambulatory Surgery Center (ASC) – A distinct entity that operates exclusively for furnishing outpatient surgical procedures.

Aniseikonic Lenses – Lenses that correct for lack of binocular vision.

Assistive Technology Device (AT) – A non-medical piece of equipment or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve the functional capabilities of an individual with a disability.

Assistive Technology Service – Any service that directly assists individuals with disabilities in the selection, acquisition, or use of an assistive technology device. This includes assistive technology evaluations; purchasing, leasing or otherwise assisting with acquisition of an assistive technology device; selecting, designing, fitting, customizing, adapting, applying, maintaining, repairing or replacing assistive technology devices; coordinating and using other therapies, interventions or services with assistive technology devices, such as those associated with existing education and rehabilitation plans and programs; training or technical assistance to the individual, family members, guardians, advocates or authorized representatives in the use of the device; and, training or technical assistance for professionals, employers and others who are substantially involved in the major life functions of the individual to the extent necessary to the achievement of an employment outcome by an individual with a disability.

By Report (BR) – Procedures referred to as “By Report” or “BR” in the RVP that are unusual and so variable that no relative value is assigned.

Chiropractic – A form of medicine focusing on diagnosis, treatment, and prevention of mechanical disorders of the musculoskeletal system, especially the spine, under the principle that these disorders affect general health via the nervous system.

Chiropractic Adjustment – Treatment whereby a chiropractor uses his/her hands or a small instrument to apply a controlled, sudden force to a joint to attempt to correct structural alignment and improve the body's physical function.

Clinical Laboratory – A certified provider who performs microbiological, serological, chemical, hematological, radio bioassay, cytological, immunohematological, pathological, or other examinations of materials derived from the human body to provide information for diagnosis, prevention, or treatment of any disease or the assessment of a medical condition.

Cognitive Skills Training – Training in the development of cognitive skills to improve attention, memory, and problem solving.

Communication Skills Training – Training in specialized visual, auditory, or sign language communication techniques needed by an individual with a disability to communicate with others.

Community-Based Services – Services provided in realistic life settings as applicable for the specific service, such as realistic work settings, an applicant or eligible individual’s home, or the community environment, etc.

Competitive Integrated Employment – Work that is performed on a full-time or part-time basis (including self-employment) for which an individual is compensated at a rate that is not less than the customary rate paid by the employer for the same or similar work performed by other employees who are not individuals with disabilities, and who are similarly situated in similar occupations by the same employer and who have similar training, experience, and skills; or in the case of an individual who is self-employed, yields an income that is comparable to the income received by other individuals who are not individuals with disabilities, and who are self- employed in similar occupations or on similar tasks and who have similar training, experience, and skills; and is eligible for the level of benefits provided to other employees; that is at a location where the employee interacts with other persons who are not individuals with disabilities (not including supervisory personnel or individuals who are providing services to such employee) to the same extent that individuals who are not individuals with disabilities and who are in comparable positions interact with other persons; and that, as appropriate, presents opportunities for advancement that are similar to those for other employees who are not individuals with disabilities and who have similar positions.

Cued Language Transliteration – Communication that converts language from the spoken speech to the cued speech, making all sounds of that language uniquely visible on the hands and mouth. Transliterators also provide visual access to environmental sounds. In contrast, Sign Language Interpretation conveys what is being said in a manual language that is completely different from a spoken language.

Customized Employment – An employment process that uses a flexible blend of strategies, services, supports, and funds to facilitate employment outcomes for job seekers with complex needs through negotiated employment relationships. Customized employment individualizes the employment relationship between a job seeker and an employer in ways that meet the needs of both.

CPT codes – "Current Procedural Terminology" (CPT) codes, developed by the American Medical Association to identify medical services and related treatment procedures performed by physicians.

Dentistry – Conduct of dental diagnostic or therapeutic services, including oral surgery; furnishing, supplying constructing, or repairing prosthetic dentures, bridges, appliances, or other structures worn in the human mouth; diagnosis and treatment of diseases, pain, deformity, deficiency, injury, or physical condition of human teeth, jaws, or adjacent structure; extracts of human teeth; repairs of cavities; and dental x-rays.

Driver’s Training (specialized) – Driver’s training involving the use of specialized adaptive equipment, depending on the individual's needs.

Durable Medical Equipment – Equipment that can withstand repeated use and which generally does not have a value to the user in the absence of a medical or physical condition.

Employment Stipend – Payment to an employer for part or all of an individual's salary for up to one month when necessary to procure a job placement. After one month, the employer agrees to provide the individual commensurate wages and benefits as provided to other individuals performing the same or similar work.

Facility-Based Services – Services provided in environments designed specifically to furnish goods and services to persons with disabilities and other special populations, such as community rehabilitation program facilities, clubhouses, independent living centers, special residential facilities, extended employment sites, etc.

GED Preparation – Educational services provided on a one-on-one basis or through an adult learning program to help an individual prepare for obtaining a general equivalency diploma (GED).

Goods – Commodities obtained from vendors or via comparable benefits that have been determined necessary for participation in vocational rehabilitation services or attainment of an employment outcome.

HCPCS codes – “Healthcare Common Procedure Coding System” numbers, a national coding system for numerous medical and medically related services developed by the Health Care Financing Administration (HCFA).

Hearing Aid Dealer – Individual engaged in the practice of fitting and dispensing hearing aids.

High Index Lenses – Corrective lenses that are thinner and lighter than conventional glass or plastic corrective lenses for high amounts of nearsightedness or farsightedness.

Home Health Services – Medical services provided in the individual's place of residence (excluding hospitals or nursing homes) for the treatment of a medical or physical condition.

Independent Laboratory – Clinical laboratory that performs diagnostic tests and is independent of both the attending or consulting physician’s office and hospital. A hospital laboratory performing tests for individuals who are not admitted as patients may be certified as an independent laboratory.

Individualized Plan for Employment – is a written plan outlining an individual's vocational goal, and the services to be provided to reach the goal. The IPE identifies the individual's employment objective, consistent with his/her unique strengths, resources, priorities, concerns, abilities, and capabilities and provides a plan for monitoring progress toward achievement of the goal.

Inpatient Hospitalization – Hospitalization for more than 24 hours.

Interim Value – Relative values that have been published as a guideline for keeping pace with the rapid changes in procedure technology in the Relative Values for Physicians (RVP) manual. Any reimbursement disagreements should be resolved by treating “I” codes as “BR” or “RNE.”

Intermediate Nursing Care – Care provided to individuals whose physical or medical condition does not require the degree of care and treatment that a hospital, extended care facility, or skilled nursing care facility is designed to provide.

Interpreter Services – Communication of expressive and receptive language through oral, manual, or written communication techniques. Deaf interpreter services are distinct in that the interpreter must be certified with RID. See “Appendix A” for more detail.

Job Club – A structured group setting that provides assistance and support for job search activities, emphasizing self-directed job search techniques.

Job Coaching – Training provided by an individual other than the employer (unless under a program of natural support in a supported employment placement) to an eligible individual after placement in a paid employment situation. Services include job skill training at the work site, work site orientation, monitoring of the individual at the job site to assess employment stability, and coordination or provision of specific services at or away from the work site to maintain employment stability. Job coaching may include the purchase of a software, or an application license needed to provide coaching directly to the individual using a digital platform.

Job Placement – Services to help an individual obtain suitable, stable, and satisfactory employment in an integrated setting, which is consistent with the individual’s strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice. Services include individualized job search assistance, assistance in completing work applications, arranging for interviews, preparing for interviews, on-site job analyses, on-site consultation with employers, recommendations for work-site job modifications, and/or up to four hours of orientation to the workplace, as appropriate to the individual’s specific needs.

Job Seeking Skills Training (JSST) – Training to teach individuals how to conduct job searches, prepare résumés, complete applications, and interview effectively. The provision of job seeking skills training is intended to enable the individual to conduct the job search as independently as possible.

Job Shadowing – A community-based situational assessment provided in a real work setting where the individual observes and may assist in the performance of a specific job so that the individual has a sufficient understanding of job requirements when making a choice among potential employment goals.

Job Site Evaluation – A limited situational assessment (up to three hours) which consists of observing an individual with on a specific job to determine if the job and/or work setting is appropriate and/or to determine accommodations that may be needed.

Job Site Modification – Modification or adaptation of a workstation and/or job site to enable or improve the ability of an individual with a disability to access necessary tools, equipment, and materials for the performance of job tasks and/or perform required job tasks.

Lenticular Lenses – Corrective lenses that typically feature two different magnifications. One area of the lens has one refractive correction power, while the other area of the lens features a different power. For example, a pupil-sized circle in the center of the lens may be one power, while the outside edge of the lens is another. Which area has a stronger power depends upon the type of condition the doctor wishes to correct.

Licensed Professional Counselor (LPC) – Individual licensed to select, administer, score, and interpret tests measuring aptitudes, attitudes, abilities, achievements, interests, emotional, and other personal characteristics; to evaluate person’s personal and social functioning; to provide psychotherapy and counseling services which facilitate effective personal, emotional, social, education, and vocational development in individuals, couples, groups, and organizations; to provide mental health counseling; and, to provide counseling to build skills in communications, decision-making, problem-solving, adaptation to life changes, developing social skills, restructuring cognitive patterns, facilitating adjustment to personal crises and conflicts.

Maintenance – Monetary support provided to an individual for expenses such as food, shelter, and clothing that are in excess of the normal expenses of the individual and that are necessitated by the individual’s participation in assessment for determining eligibility and vocational rehabilitation needs or the individual’s receipt of vocational rehabilitation services under an Individualized Plan for Employment (IPE).

Marriage and Family Counseling – Provision of professional marriage and family psychotherapy to individuals, couples, and family groups to assess and treat emotional and mental problems and to modify intrapersonal and interpersonal dysfunctions.

Medical Emergency – A medical condition or presenting complaint which manifests itself by acute symptoms of sufficient severity that the absence of immediate medical attention could reasonably expect to result in a threat to life, immediate or delayed, or an organ or body part not returning to full normal function.

Myodisc Lenses – Corrective lenses to treat extremely high myopia often seen in low vision patients.

Note Taking Services – Services that accurately record the content of verbal material presented by an instructor, evaluator, or employer for an individual who is unable to hear or comprehend verbal communication.

On-the-Job Training (OJT) – Job skill training an employer provides to an individual with a disability at the job site after placement in a paid employment situation, with the clear expectation that employment in the same or a similar job for the employer will continue if training is successful.

Optician – Individual who duplicates, supplies, sells, or repairs eyeglasses or corrective lenses prescribed by optometrists or ophthalmologists.

Optometry – Profession of examining the eyes for visual defects and prescribing corrective lenses.

Orientation and Mobility Evaluation – Personal adjustment evaluation for persons who are or visually impaired to determine independent travel skills and needs.

Orientation and Mobility Training – Personal adjustment training provided to persons who are or visually impaired to teach independent travel skills.

Osteopathy – Medical therapy that treats medical disorders through the manipulation and massage of the bones, joints, and muscles.

Outpatient Hospital Services – Diagnostic, therapeutic, rehabilitative, preventive, and palliative services provided by or under the direction of a physician to an individual who is not receiving room and board or professional services on a continuous 24-hour-a-day basis.

Personal Adjustment Evaluation – An individualized and systematic process to evaluate an individual’s skills, behaviors, and needs in the areas of personal functioning, homemaking, orientation and mobility, adaptive communication, daily living skills, and, if applicable, low vision.

Personal Adjustment Training – Training provided to help individuals develop compensatory skills and/or to adjust behavior in the areas of independent living, personal functioning, homemaking, orientation and mobility, adaptive communication, daily living skills, and if applicable, low vision. PAT may include the purchase of a software, or an application license needed to provide support directly to the individual using a digital platform.

Personal Assistance Services – A range of services provided by one or more persons designed to assist an individual with a disability to perform daily living activities that the individual would typically perform without assistance if the individual did not have a disability. The services must be designed to increase the individual's control in life and ability to perform everyday activities on or off the job. The services must be necessary to the achievement of an employment outcome and may be provided only while the individual is receiving other vocational rehabilitation services. The services may include training in managing, supervising, and directing personal assistance services.

Physician Assistant (PA) – Individual licensed to perform delegated acts in the practice of medicine consistent with sound medical practice and under the direction and supervision of a licensed physician.

pl – Descriptor used in visual prescriptions which means "no power.” Equivalent to 0 diopters.

Podiatry – Evaluation and treatment of disease, ailment, pain, injury, deformity or physical condition of the human toe, foot, ankle, and tendons which insert into the foot using medical, surgical mechanical, manipulative, or electrical treatment procedures.

Practical Nursing (LPN) – Performance of services necessary to care for the ill and injured under supervision of dentist, physician, podiatrist, or professional nurse; administration of treatments and medications prescribed by licensed physician.

Professional Nursing (RN) – Performance of independent nursing functions and delegated medical, podiatric, and dental functions by a registered professional nurse. Includes evaluating health status through collection and assessment of health data; health counseling; therapy and treatment which is supportive and restorative to life and well-being; executing delegated medical functions as prescribed and authorized by licensed physician; referring to medical or community agencies; reviewing and monitoring therapy and treatment plan.

Provider – The individual and/or organization that renders a necessary good or service.

Psychology – Practice of evaluating mental or emotional function of a person; construction, administration, and interpretation of tests assessing intellectual abilities, personality characteristics, cognitive skills, psychopathology, and psycho physiological characteristics; diagnosis and treatment of emotional, behavioral, and mental disorders; psychotherapy and psychological counseling.

Psychotherapy – Treatment, diagnosis, testing, assessment, or counseling in a professional relationship to assist individuals or groups to alleviate mental disorders, understand unconscious or conscious motivation, resolve conflicts, or modify behaviors which interfere with effective emotional, social, or intellectual functioning.

Reader Services – Verbal communication of printed text for an individual unable to read or comprehend typical written or printed materials.

Rehabilitation Engineering – Original design and fabrication of devices and solutions to problems confronted by individuals with disabilities in preparing for, entering, and/or maintaining employment.

Vision Rehabilitation Therapy – Personal adjustment training provided to persons who are blind or visually impaired to identify, overcome, and/or circumvent barriers to communication, home and personal management, and independent mobility. May include counseling and guidance to enhance an individual's adjustment to blindness, self-reliance, and independent decision-making.

Rehabilitation Therapy Evaluation – Personal adjustment evaluation for a person who is blind or visually impaired to identify skills and needs in the areas of communication, home and personal management, adjustment to impairment, independent decision making, and independent mobility.

Rehabilitation Technology Evaluation – An assessment to identify the assistive technology devices, assistive technology services, and/or rehabilitation engineering services that are necessary for the individual to participate in vocational rehabilitation assessment and services and achieve and employment outcome.

Rehabilitation Technology Services – The systematic application of technologies, engineering methodologies, or scientific principles to address barriers confronted by individuals with disabilities in areas such as education, rehabilitation, employment, transportation, independent living, and recreation. The term includes rehabilitation engineering, assistive technology devices, and assistive technology services.

Relocation Costs – Financial support to cover relocation expenses of an individual with a disability and/or family when it is necessary enable an individual to participate in vocational rehabilitation services and attain an employment outcome.

Residential Modification – Structural modifications or adaptations to an individual’s residence  to facilitate access and independent functioning within the residence, as required for the individual to achieve an employment outcome.

RNE (Relativity Not Established) – unit values for procedures that are atypical, new, or unknown in common practice.

Relative Values for Physicians – A manual by which an entity can establish and negotiate fees for medical and surgical procedures with the same relative values used by many insurance companies.

Self-Employment – An employment outcome whereby the individual or the entity owned by the individual is responsible for paying employer and employee Social Security taxes, income taxes, insurance, licenses, and other employee benefits. Self-employment may be a sole proprietorship, partnership, or corporation.

Self-Employment Services and Consultation – Services that address professional fees paid to business consultants, accountants, attorneys, industry experts and mentors, etc., for assisting individuals to determine whether to pursue self-employment and in developing and implementing a viable business plan.

Service – The furnishing of labor, time, or effort on behalf of an individual to assess eligibility and vocational rehabilitation needs, accommodate barriers to employment, and enable the individual to achieve the planned employment outcome.

Services to Members of an Individual's Family – Supportive services provided to family members only when necessary to enable the applicant or eligible individual to achieve an employment outcome. Such services may include childcare and elder care when the individual is responsible for the daily living needs of children or parents, family relocation costs when necessary for the employment of the individual, family therapy, and transportation for family members.

Situational Assessment (SA) – A type of vocational evaluation conducted to assess work behaviors, interpersonal skills, and job-related skill levels for purposes of establishing eligibility or developing the Individualized Plan for Employment. May take place in community-based settings, including real life work settings and transitional employment settings, or in facility- based settings, such as community rehabilitation program facilities.

Skilled Nursing Services – Nursing services which require a substantial specialized judgment and skill based on knowledge and application of the principles of biological, physical, and social sciences, including the planning, organizing, and managing of a patient care plan.

Social Work – Psychotherapy and counseling provided to effect change in human behavior, emotional responses, and social conditions of individuals, couples, families, groups, and communities.

Sphere – Part of a visual prescription, measured in diopters, which identifies the major power of a lens.

Standardized Vocational Evaluation – A type of vocational evaluation utilizing formalized testing tools and standard protocols. Standardized vocational evaluations typically involve the use of formalized normed work samples, such as the Valpar, McCarron-Dial, written tests, etc. A standardized vocational evaluation must be conducted by an individual who is qualified to administer the standardized assessment tools.

Supplemental Evaluation – A type of vocational evaluation provided for an individual receiving supported employment services after the development of the Individualized Plan for Employment when necessary to reassess the particular on-going support services needed and/or the suitability of the particular placement. Supplemental evaluations typically take the form of situational assessments when additional information is necessary to determine an appropriate change or modification in the supported employment placement.

Supported Employment Services – Ongoing services needed to support and maintain employment of an individual with a most significant disability. DVR may provide such support up to 18 months unless, under special circumstances, the eligible individual and the rehabilitation counselor jointly agree to extend the time to achieve an employment outcome.

Training Books, Supplies and Materials – Non-adaptive materials required for the individual's participation in adjustment training programs, vocational training programs, and/or academic training programs, including books, manuals, normal supplies, special training materials, and training clothing.

Transportation – Travel and related expenses that are necessary to enable an applicant or eligible individual to participate in vocational rehabilitation services, including expenses for training in the use of public transportation, to achieve an employment outcome.

Trial Work Experience (TWE) – Service provided to an applicant or eligible individual in realistic work settings to enable the individual to demonstrate abilities and capabilities to perform in work situations. Such services are provided to individuals whose eligibility or continuing eligibility is questioned due to the severity of disability.

Tutorial Services – One-on-one specialized instructional services provided most often in educational settings to help an individual gain knowledge and skills in a specific subject area. Tutorial services may be provided to supplement a course of formalized academic or vocational training or to remediate an individual's knowledge or skill deficit in a particular area.

Usual and Customary Rate – The prevailing cost of a good or service that the general public would expect to pay.

Vehicle Modification – Structural modifications or adaptations to a motorized vehicle to enable an individual access to and operation of the vehicle when necessary for the individual to obtain an employment outcome.

Vocational Evaluation – Service by which an applicant or eligible individual, in partnership with the evaluator, identifies strengths, resources, abilities, capabilities, and interests to develop a viable employment outcome. May include standardized vocational assessment, situational assessment, community-based job shadows, trial work experiences, etc.

Vocational Training – Training typically provided through community colleges, vocational schools, technical institutes, and other certification programs to enable eligible individuals to develop the skills necessary to perform the tasks of a specific job.

Work Adjustment Training (WAT) – Training provided to help eligible individuals adjust behavior and/or develop compensatory skills in vocational areas, such as peer-work relationships, supervisory work relationships, general work behaviors and expectations, and work habits. Work adjustment training may take place in facility- or community-based settings, and it includes training to improve an eligible individual's interpersonal skills to the degree necessary to engage employment. WAT is provided to students in integrated community settings to the maximum extent possible. WAT may include the purchase of a software, or an application license needed to provide support directly to the individual using a digital platform.

Work Experience Training – Community-based training provided in real work settings for the limited purposes of exposing individuals to the world of work and what is required to maintain successful employment. Work experience is not intended to result in permanent employment.