DI 26520: Vocational Rehabilitation (VR) and Other Referrals
BASIC (05-02)
The screening guidelines are divided into three categories and should be applied in the following order to applicants for SSDI benefits and SSI disability/blindness payments:
A. Policy - screen-out criteria
Any disability/blindness applicant, other than one with a visual impairment, who meets any of the following criteria should not be referred (in such cases, follow DI 26520.035).
Illness in terminal stage—irreversible or irremediable; or
Severe or rapidly progressive physical or mental impairment not responding to treatment so that training or employment would be precluded; or
No demonstrated mental or physical impairment (for a “not severe” impairment, see Screen-In); or
An acute medical or post-surgical condition which is expected to improve so that return to usual work may be anticipated; or
Organ or system impairment so severe that when considering non-medical factors, potential to do sustained work is doubtful; or
The presence of a significant impairment and either a sparse work record or a record of performing arduous unskilled labor for 35 years or more and having no more than a marginal education and no transferable skills; or
Applicant under age 15 unless the individual circumstances indicate a special readiness for beginning VR services.
If screen-out criteria are not met, proceed to DI 26520.025 B.
B. Policy - screen-in criteria
See DI 26520.010 for basis of referral of title XVI child applicants.
The applicant age 15 or over who meets any of the following screen-in criteria should be referred to a State VR agency (see DI 26520.030).
All applicants, except those who are terminally ill, whose primary impairment is a limited central visual acuity of 20/70 or less in the better eye with best correction, or an equivalent loss of either field of vision or visual efficiency, or visual problem so severe as to limit ability to engage in vocational or other daily activity; and all applicants whose impairment meets, or may lead to meeting, the definition of statutory blindness as defined in Section 216(i)(l)(B) or 1614(a)(2) of the Social Security Act; or
File reflects applicant's desire to work or applicant's working despite impairment and obviously under employed; or
Impairment can be corrected or substantially reduced with the aid of physical restoration or other medical treatment; or
File contains definitive evidence that applicant can benefit from vocational rehabilitation services (e.g., statement from physician or consultant); or
File indicates an SSI applicant has a plan for achieving self-support.
If screen-in criteria are not met, proceed to DI 26520.025 C.
C. Policy - applicant profile
1. General
The applicant profile is used only for those cases that do not meet the screen-out or screen-in criteria. It lists applicant characteristics and a range of possible circumstances, which will assist the screener in deciding whether or not to refer the case. The opinion of the DDS medical or psychological consultant should be sought, particularly, in making a decision based on the applicant profile.
2. Coordinating Profile Selection with Vocational Rehabilitation Services
The profile incorporates combinations of favorable and less favorable characteristics. All factors are not necessarily of equal weight. A case should not be screened out solely because of a preponderance of unfavorable factors. Evidence in file of a strong motivation to work should outweigh other less favorable characteristics. Combinations of factors that are appropriate for referral should be worked out in conjunction with the VR agency. Specific factors and combinations should be identified as appropriate for the following VR services, and any other types of services offered by the VR agency:
vocational evaluation
counseling and guidance
medical treatment/surgery/prosthetic appliances
education—academic or vocational training
job placement
3. Profile Listing
Age |
15 to 44 |
45 to 54 |
55 + |
Education (formal and vocational) |
12th grade and up |
8th to 12th grade |
0 to 7th grade |
Motivation to work |
High |
Unknown |
Low |
Physical or mental |
Mild |
Moderate |
Severe |
Medical prognosis |
Favorable |
Stable |
Poor |
Work History |
Stable |
Unstable |
Poor |
Explanation of Profile Characteristics
Age —Chronological age
Education (formal and vocational) —Actual grade level achieved or equivalent
Motivation To Work —General impressions of applicant's interest in working from file evidence, including work record, if any; applicant's statement about desire to work, comments of interviewers, physicians or former employers about attitude toward work.
Physical or Mental Limitations —Evident from medical or psychological reports, vocational assessments and observations.
Medical Prognosis —“Favorable” means a minor impairment or a moderate impairment which is expected to improve. “Stable” means moderate or severe impairment expected to remain at present level of severity. “Poor” means moderate to severe impairment which is expected to be rapidly progressive.
Work History —Consider regularity and level of earnings from earnings record or other work record, if any. Disregard this factor when evaluating childhood disability benefits (CDB) and disabled widow's benefits (DWB) cases or title XVI claims involving little or no work history.
Work is defined as activity performed in employment or self-employment for remuneration or gain or of a type normally performed for remuneration or gain.