1.1 Necessary, Appropriate, Least Possible Cost

Individuals receiving medical or psychological restoration services through DVR are expected to first use all comparable benefits and resources for which they are eligible (e.g., private insurance, Social Security benefits, Medicare, Medicaid, the Veterans Administration, Tricare, or other private or public programs). Provision of restoration services by DVR will not duplicate those available under other public health programs or private insurance policies.

A physical and psychological restoration service shall be provided under the following circumstances:

• The service is necessary to achieve the employment outcome;

• The service is not available through comparable benefits; and,

• The service is likely to correct or substantially improve an impairment that constitutes a substantial impediment to employment within a reasonable period (time-limited, not ongoing).

DVR does not customarily support medical treatments related to gender affirming surgery.