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Lyruegas, download your own copy of the form and go for option 3. File a NOD (you can use Statement in support of claim form) and explain exactly what happened and tell them explicitly what benefit you are looking for...also state that it has already been determined by the VA that you cannot work.
Now that I've read you post here I'm already preparing my NOD and if they do that either or option crap on me I'm gonna clean their clock by blowin' the whistle. Thanks for sharing because it does demonstrate another unlawful practice on the part of the VA.

Good point. Thanks.

Additional info I ferreted out on the net originally posted by USAVET on another forum. This info may be helpfull and provide insight to some.

VA ILp Program Circular

---

www.warms.vba.va.gov/admi..._05_01.doc

This is where I got it. Had to open the page to see it though so here is the full text.

Notice they can spend $25000.00 without any other approval. Lot of information on ILP. Seems the VA in some places want to spend little or nothing on the vet.


Veterans Benefits Administration Circular 28-05-01
Department of Veterans Affairs January 3, 2005
Washington, D.C. 20420

VOCATIONAL REHABILITATION AND EMPLOYMENT (VR&E)
GUIDELINES FOR THE ADMINISTRATION OF THE
INDEPENDENT LIVING (IL) PROGRAM

TABLE OF CONTENTS

PARAGRAPH PAGE

1. Background 2

2. Independent Living Program Overview 2

3. Independent Living Program Guidelines 2

4. Implementation 3

5. Questions 4

EXHIBIT

A. Philosophical Framework 5

B. Standards of Practice 6

C. Job Aids
C.1. IL Program Orientation 11
C.2. IL Needs Assessment and Planning Matrix 13
C.2.a. Veteran Case #1- Example 14
C.2.b. Veteran Case #2 - Example 15
C.2.c. Veteran Case #3 - Example 16
C.3. IL Plan Approval Request 17
C.4. IL Extension Request 18

D. Guidance
D.1. Preliminary IL Assessment 19
D.2. Case Support 21
D.3. Activities of Daily Living 22







LOCAL REPRODUCTION AUTHORIZED
INDEPENDENT LIVING PROGRAM GUIDELINES

1. BACKGROUND

a. Purpose. The purpose of this Circular is to provide guidance for the administration of the "Independent Living" (IL) Program through the use of the IL Guidelines.

b. Who Should Read. This circular effects all VR&E Division Counseling Psychologists and Vocational Rehabilitation Counselors.

2. INDEPENDENT LIVING PROGRAM OVERVIEW

a. Background. The IL component of the VR&E Program began with the enactment of Public Law 96-466, which charged the then-named Vocational Rehabilitation and Counseling Program with conducting a 4-year Pilot Program of IL Services. This program was to provide assistance for veterans with severe disabilities for whom VA determined that the achievement of a vocational goal was not reasonably feasible. In October 1986 Congress enacted Public Law 99-576, The Veteran's Benefits Improvement and Health Care Authorization Act of 1986, which eliminated the word "pilot" and altered the concept of reasonable feasibility by adding the word "currently". In December 1989, Public Law
101-237 made the IL Program a permanent part of the vocational rehabilitation program.

b. Current Law. In 1996 Congress passed Public Law 104-275, The Veterans Benefits Improvement Act of 1996, which restricted the provision of total programs of IL services to veterans who (1) Have a serious employment handicap resulting in substantial part from a service-connected disability rated 20% or more; and (2) For whom it has been determined that the achievement of a vocational goal currently is not reasonably feasible.

3. INDEPENDENT LIVING PROGRAM GUIDELINES

a. Goal. These IL guidelines were developed to address concerns pertaining to the consistency and delivery of IL services. Both internal and external evaluations have highlighted the need for increased knowledge among VR&E staff about IL and its purpose, as well as the need for more uniform application of regulatory guidelines.

b. Components. The IL Program Guidelines contain two components: the Philosophical Framework and the IL Standards of Practice (SOP).

(1) The Philosophical Framework is composed of nine statements. These statements are the principles which direct the scope and practice of IL services.

(2) The SOP outlines the steps counselors and case managers must follow. These steps are ordered sequentially to facilitate use of the SOP as both a procedural guide and a training tool. Adherence to the SOP will promote consistent and effective IL determinations and services.

(a) The SOP component of the IL Guidelines contains four sections. Each section has mandatory and/or optional job aids and documentation guidance. The job aids and documentation guidance will provide both structure and assistance to counselors and case managers as they complete required actions. There are three mandatory job aids and three guidance documents, which must be used. The optional job aid may be used at the counselor or case manager's discretion. Each section and the job aids and documentation guidance it contains are listed below.
Section A - Orient the veteran to the independent living (IL) process
o IL Program Orientation (28-0786)
Section B - Complete an independent living (IL) evaluation and if appropriate prepare an Independent Living Plan
o Preliminary IL Assessment - Guidance
o IL Needs Assessment and Planning Matrix (28-0787)
o IL Plan Approval Request (FL 28-520)
Section C - Provide independent living (IL) services
o Case Support - Guidance
o IL Extension Request (FL 28-521)
Section D - Concluding activities
o Activities of Daily Living - Guidance

(b) Applicable references from Title 38, United States Code (USC), Chapter 31; the Code of Federal Regulations (CFR); M28-1, Part II, Chapter 8, Change 7; VR&E Letters; General Counsel Opinions; and the CRCC Code of Ethics, found at www.crccertification.com/..._2002.pdf, are included in each section.

c. Guidance Documents. The three guidance documents (Preliminary IL Assessment, Case Support, Activities of Daily Living) must be reviewed and approved by the Office of Management and Budget prior to their publication. During the review process, activities of daily living questions included in the Preliminary IL Assessment and on the Activities of Daily Living guidance documents should be used. The following ratings may be assigned for each activity: 4 - Usually did with no difficulty, 3 - Usually did with some difficulty, 2 - Usually did with help or assistive device, 1 - Usually did not do because of disabilities, 0 - Usually did not do for other reasons. The total scores on these documents can be compared to assess and demonstrate the veteran's progress. Further explanation/investigation should be provided for activities rated "3" or lower.

d. Form Access. The IL Needs Assessment and Planning Matrix (28-0787) , IL Plan Approval Request (FL 28-520), and IL Extension Request (FL 28-521) are available in Jetform.

4. IMPLEMENTATON

a. Effective Date. Each VR&E Division should provide training on the use of the IL Guidelines, and begin use as soon as possible. Use of these materials must begin no later than February 15, 2005.

b. Existing Cases. The IL Guidelines should be integrated into all IL cases. However, steps in the rehabilitation process should not be performed again. Rather, the counselor or case manager should use the new IL Guidelines in the future.

EXAMPLE: A veteran has completed the IL evaluation process, and IL needs have been identified. The case manager should begin use of the IL SOP, starting with Section B(4) - Write an IILP with Objectives and Services that address verified IL needs.

c. Rescission. VR&E Letter 28-02-01.

5. QUESTIONS

Questions should be referred to Cheryl Church, VBAVACO, by e-mail or by calling (202)273-7431.


By Direction of the Under Secretary for Benefits



Judith A. Caden
Director, Vocational Rehabilitation and
Employment Service

Distribution: CO: 2908
SS (281) FLD: VBAFS, 1 each (Reproduce and distribute as needed based on RPC
290" src="http://www.ezboard.com/images/emoticons/glasses.gif">
EX: ASO and AR, 1 each




EXHIBIT A

Philosophical Framework

• Enhance participation in activities of daily living (ADL)

• Assist veteran to participate to the maximum extent possible and desirable in family and community life

• Provide most effective services and assistive technology based on sound research evidence

• Provide services that produce a sustaining influence that continues after rehabilitation

• Provide required holistic evaluation and services for all veterans who qualify

• Write plans that provide services for all identified independent living needs

• Consider veteran's wants/desires, but provide services based on documented needs

• Establish goals and measure/verify outcomes

• Explore the possibility of paid or volunteer employment, when feasible


EXHIBIT B


VR&E Independent Living Standards of Practice

A. Orient the veteran to the independent living (IL) process: Assist the veteran in understanding both his/her and the CP/VRC's rights and responsibilities in the IL process

Job Aids/Tools/Documents/Resources/Activities References/Regulations/Manual/CWINRS

1. Orient the veteran to the IL process. After a joint review, ask the veteran to sign the document.
• Provide a copy to the veteran.
• Place a copy in the CER folder.


Mandatory Job Aid
IL Program Orientation (28-0786)
Title 38 USC, Chapter 31
Section 3100 (Purposes), Section 3101 (Definitions), 3104 (Scope of services and assistance), 3120 (Program of independent living services and assistance)
38 CFR
21.76 (Independent living), 21.90 (Individualized
independent living plan), 21.160 (Independent Living
Services), 21.162 (Participation in a program of
independent living services), 21.192 ("Independent
living program" status), 21.310 (Rate of pursuit of an
independent living program)
M28-1, Part II, Chapter 8, Change 7
Paragraphs 8.01 (Introduction), 8.02 (Program Description), 8.04 (Scope of Services), 8.05 (Duration and Limitation of Services), 8.06 (Monetary Assistance), 8.07 (Travel), 8.08 (Procurement of Services), 8.12 (Individualized Independent Living Program), 8.14 (Evaluations for persons with TBI)
CRCC Code of Ethics A-1, A-2, A-3, Section B, C-1, C-2, Section F


B. Complete an independent living (IL) evaluation and if appropriate prepare an Individualized Independent Living Plan (IILP): The CP/VRC and the veteran will collaborate to complete an independent living evaluation and if appropriate develop an IILP

Job Aids/Tools/Documents/Resources/Activities References/Regulations/Manual/CWINRS

2. Conduct a preliminary evaluation of potential IL needs.

If no potential IL needs can be identified and/or achievement of appropriate IL goals is not feasible, the VR&E Officer must concur with this decision. If the VR&E Officer does not concur, the counselor must work with the veteran to develop a plan of IL services.

If a plan of IL services is not developed, the veteran must be provided due process.


Guidance
Preliminary IL Assessment
Title 38 USC, Chapter 31
Section 3101 (Definitions), 3104 (Scope of services and assistance), 3120 (Program of independent living services and assistance)
38 CFR
21.76 (Independent living), 21.90 (Individualized
independent living plan), 21.162 (Participation in a
program of independent living services)
M28-1, Part II, Chapter 8, Change 7
Paragraphs 8.01 (Introduction), 8.10 (Role of the Counseling Psychologist), 8.11 (Role of the Vocational Rehabilitation Panel), 8.12 (Individualized Independent Living Program), 8.14 (Evaluations for persons with TBI)
CRCC Code of Ethics A-1, A-2, A-3, Section B, C-1,
D-1, Section F

3. Investigate all potential IL needs. The assessment should be performed by a staff member or provider (e.g. IL Center) with specialized IL experience and/or training.

If no IL needs can be identified and/or achievement of appropriate IL goals is not feasible, the VR&E Officer must concur with this decision. If the VR&E Officer does not concur, the counselor must work with the veteran to develop a plan of IL services.

If a plan of IL services is not developed, the veteran must be provided due process.




Title 38 USC, Chapter 31
Section 3101 (Definitions), 3104 (Scope of services and assistance), 3120 (Program of independent living services and assistance)
38 CFR
21.76 (Independent living), 21.90 (Individualized
independent living plan), 21.162 (Participation in a
program of independent living services)
M28-1, Part II, Chapter 8, Change 7
Paragraphs 8.01 (Introduction), 8.08 (Procurement of Services), 8.10 (Role of the Counseling Psychologist), 8.11 (Role of the Vocational Rehabilitation Panel), 8.12 (Individualized Independent Living Program), 8.14 (Evaluations for persons with TBI)
CRCC Code of Ethics A-1, A-2, A-3, Section B, C-1,
D-1, Section F


Job Aids/Tools/Documents/Resources/Activities References/Regulations/Manual/CWINRS

4. Write an IILP with Objectives and Services that address verified IL needs.

Include specific expected outcomes that are measurable and/or verifiable. Outcomes must also be sustainable.

Obtain appropriate approval for program costs, if they exceed the $25,000 limit for case managers.



Optional Job Aid
IL Needs Assessment and Planning Matrix (28-0787)
Veteran Case #1 - Example
Veteran Case #2 - Example
Veteran Case #3 - Example


CWINRS Activity - Enter essential elements by updating the Claims Disposition Tab
Title 38 USC, Chapter 31
Section 3101 (Definitions), 3104 (Scope of services and assistance), 3120 (Program of independent living services and assistance)
38 CFR
21.76 (Independent living), 21.90 (Individualized
independent living plan), 21.162 (Participation in a
program of independent living services)
M28-1, Part II, Chapter 8, Change 7
Paragraphs 8.01(Introduction), 8.10 (Role of the Counseling Psychologist), 8.11 (Role of the Vocational Rehabilitation Panel), 8.12 (Individualized Independent Living Program), 8.14 (Evaluations for persons with TBI)
CRCC Code of Ethics A-1, A-2, A-3, Section B, C-1,
D-1, Section F


5. Submit the IILP to the VR&E Officer for concurrence prior to any parties signing the plan or authorizing any IL services included in the plan.


Mandatory Job Aid
IL Plan Approval Request (FL 28-520)

Title 38 USC, Chapter 31
Section 3101 (Definitions)
38 CFR
21.162 (Participation in a program of independent
living services)

























C. Provide independent living (IL) services: To ensure the success of the IILP, provide case support services that address all independent living needs. There should be an on-going holistic reassessment of IL needs, in areas such as socialization, safety, health and fitness, personal life control, housing, hygiene, personal and family adjustment, mobility and transportation, legal, spiritual, financial and benefits, communication, cognitive and meaningful activities

Job Aids/Tools/Documents/Resources/Activities References/Regulations/Manual/CWINRS

6. Monitor veteran progress as needed throughout the IL process during face-to-face meetings (except when alternatives such as completion via telephone, e-mail or mail may be necessary).

Include discussions with the veteran of any resulting concerns and appropriate actions to address the concerns.

Supervision should generally occur at least once per month.


Guidance
Case Support

CWINRS Activity - Enter documentation of the concerns and corrective actions

Title 38 USC, Chapter 31
Section 3100 (Purposes), Section 3101 (Definitions)
38 CFR
21.160 (Independent Living Services), 21.192
("Independent living program" status)
M28-1, Part II, Chapter 8, Change 7
Paragraphs 8.04 (Scope of Services), 8.05 (Duration and Limitation of Services), 8.06 (Monetary Assistance), 8.08 (Procurement of Services), 8.12 (Individualized Independent Living Program)
Case Management Task Force Report
CRCC Code of Ethics A-2, Section B

7. Complete an amended IL evaluation when additional and substantive potential IL needs are identified. A staff member or provider (e.g. IL Center) with specialized IL experience and/or training should perform this evaluation.

Write an amended plan if the most recent IL evaluation identifies IL concerns that necessitate a major modification of the IILP.

Submit the new IILP to the VR&E Officer for concurrence.


Mandatory Job Aid
IL Plan Approval Request (FL 28-520)



Title 38 USC, Chapter 31
Section 3101 (Definitions), 3104 (Scope of services and assistance), 3120 (Program of independent living services and assistance)
38 CFR
21.76 (Independent living), 21.90 (Individualized
independent living plan), 21.162 (Participation in a
program of independent living services)
M28-1, Part II, Chapter 8, Change 7
Paragraphs 8.01 (Introduction), 8.10 (Role of the Counseling Psychologist), 8.11 (Role of the Vocational Rehabilitation Panel), 8.12 (Individualized Independent Living Program), 8.14 (Evaluations for persons with TBI)
CRCC Code of Ethics A-1, A-2, A-3, Section B, C-1,
D-1, Section F

8. Obtain extension approval if a determination is made that up to an additional six (6) months of IL services are required to meet the agreed upon IL goals.


Mandatory Job Aid
IL Extension Request (FL 28-521)

Title 38 USC, Chapter 31
Section 3101; 38 CFR 21.76 (Independent Living)



D. Concluding activities: Complete all necessary actions to either return the case to Evaluation & Planning case status or to Interrupted or Rehabilitated case status

Job Aids/Tools/Documents/Resources/Activities References/Regulations/Manual/CWINRS

9. Rehabilitated. If IILP outcomes have been demonstrated that substantiate attainment of the independent living goals and the veteran has achieved maximum independence in daily living.

Guidance
Activities of Daily Living (included in the Preliminary IL Assessment)

CWINRS Activity - Update the Rehab Tab

10. Interrupted. If there is a need to temporarily interrupt the veteran's IL program and there is an expectation of and an estimated date for reentry.

11. Evaluation and Planning. If a determination is made that achievement of a vocational goal may be feasible.

Title 38 U.S.C., Chapter 31
Section , Section 3100 (Purposes), Section 3101 (Definitions)
38 CFR
21.76 (Independent living), 21..90
(Individualized independent living plan), 21.192
("Independent living program" status)
M28-1, Part II, Chapter 8, Change 7
Paragraphs 8.01 (Introduction), 8.05 (Duration and Limitation of Services), 8.12 (Individualized Independent Living Program)
CRCC Code of Ethics A-1, A-2, A-3, C-1, D-1,
Section F




VOCATIONAL REHABILTATION & EMPLOYMENT (VR&E)
INDEPENDENT LIVING PROGRAM ORIENTATION

In this orientation we will discuss:

• The Mission and Goals of the VR&E Independent Living Program
• Who Qualifies for the VR&E Independent Living Program
• The Different Types of VR&E Independent Living Services

INDEPENDENT LIVING MISSION

The purpose (or mission) of the Independent Living program is to provide services and assistance that will enable qualified veterans with service-connected disabilities to achieve independence in daily living, to the maximum extent possible.

INDEPENDENT LIVING GOAL

• The primary goal of the Independent Living program is to make sure that each veteran participant is able, to the maximum extent possible, to live independently and participate in family and community life.
• Your desires are always considered. The counselor, working with you during the evaluation process, will establish which services are necessary to address your independent living needs.

QUALIFYING FOR THE INDEPENDENT LIVING PROGRAM

To qualify for the VR&E Independent Living program it must be determined that you meet all of the following conditions:

• You have a serious employment handicap
• You have a service-connected disability rated 20% or more
• The achievement of a vocational goal is not currently reasonably feasible
• You are in need of independent living services
• You are currently able to achieve measurable improvements in independence in daily living

TYPES OF SERVICES OFFERED BY THE INDEPENDENT LIVING PROGRAM

Evaluation and Counseling services:

• A required evaluation to help determine your independent living needs
• Specialty consultants to help identify and evaluate your possible independent living needs. These consultants may include
o medical specialists

VA FORM
JAN 2005 28-0786


o physical therapists
o occupational therapists
o rehabilitation engineers

Possible services, if needed:

• Information on independent living services and referrals for necessary services
• Identification of and assistance in obtaining
o medical and health related services
o special technology and equipment needed to overcome the effects of disability
o services to assist in participation in activities which increase independence in daily living
o services to address any personal and/or family adjustment issues

Independent Living services must meet the following criteria:

• They must to be consistent with your independent living needs.
• They must contribute/assist in overcoming barriers to living more independently.
• They cannot worsen your disability.
• They must have measurable goals so that we can make sure you are making progress.
• They must result in improvements that you can continue after your program has been completed, without ongoing VA assistance.

INDEPENDENT LIVING CASE SUPPORT - WORKING WITH YOUR VA CASE MANAGER

Please remember that a program of independent living services is a team effort. While we are here to assist you, rehabilitation cannot happen without your input and dedication. Both you and your VA case manager are responsible for completing all mutually agreed upon assignments in a timely manner and for keeping all appointments.

NEXT STEP

You must complete an independent living evaluation. The independent living evaluation will determine:

• Whether you have any barriers to living independently; AND
• If you can currently benefit from independent living services; AND
• Your independent living needs and the specific services required to meet those needs

If your VA counselor determines that you have independent living needs and can benefit from independent living services, you and your VA counselor will work together to develop an independent living plan.

________________________________________ _______________
Veteran Signature Date
________________________________________ _______________
Case Manager Signature Date




IL NEEDS ASSESSMENT AND PLANNING MATRIX


ASSESSMENT NEEDS SERVICE OPTIONS MEASURES OUTCOMES
Summary of veteran's SCD, feasibility determination, and recommendations from assessment(s).




















Needs identified from assessment(s).

How each need will be met.
How impact of services will be evaluated.
Expected results of services.

IL ISSUES:
Summary of how provided services will address the veteran's IL needs.





PROVISIONS FOR SUSTAINING INFLUENCE:



VA FORM
JAN 2005 28-0787

EXHIBIT C.2.a.

ASSESSMENT NEEDS SERVICE OPTIONS MEASURES OUTCOMES
*

Veteran is 100% service-connected for MS. Resides in a nursing care facility and is 100% dependent for all ADLs. Family resides near the facility and available for visits. Veteran can only communicate by eye blink.

Comprehensive assessment and coordination with a treatment team, including a review by a speech pathologist, indicate that veteran has the potential to communicate if she has access to a computer with adaptation for eye blink control.


Access to communication tool to improve independence in the nursing facility and to improve opportunity for communication with family.

Computer.

Computer maintenance contract.

Adaptation for eye blink control.

Training to use computer.
Internet access.

Training facility staff and family members to use computer to communicate with veteran.

Ability to operate computer and control living environment.



Use of computer to communicate with staff and family.





Self-report and family report of improved communication.

Services improved ability to communicate with family.










Veteran is more independent in daily living.

IL ISSUES: Computer, adaptations for operation by eye blink and appropriate training will improve veteran's ability to communicate with her family. Computer offers veteran the potential to have greater control over her living space, lights, TV, radio, and ability to communicate with nursing staff.

PROVISIONS FOR SUSTAINING INFLUENCE: Veteran has continued to pay for internet connection after VA's contribution. Coordination with VA prosthetics insures that veteran's equipment will be maintained.






















EXHIBIT C.2.b.

ASSESSMENT NEEDS SERVICE OPTIONS MEASURES OUTCOMES
*

Veteran is service-connected 100% IU, anxiety reaction, and Parkinson Disease. Lives at home and is financially independent. Comprehensive assessment of veteran's independent living needs indicates veteran required assistance in adding a ramp to her home, purchasing a tub chair, improving ability to transfer in and out of bed, and housekeeping services as well as a live-in housekeeper. Veteran is also seeking individual to assist in composing book that she is writing on her computer.

Improved ability to live independently at home.
Physical modification of home.


Case management assistance to locate needed services.

Locate and purchase a tub chair and design adaptation for bed transfer and ramp.



Locate house-cleaning service.



Find Volunteer.

Physical changes to home, to improve veteran's ability to bathe independently and to transfer from bed.





House cleaning services to allow veteran to remain in home and keep home clean and safe.


Volunteer assistance to allow veteran's ability to continue with writing interests.

Veteran receives case management, coordination and purchase of needed services.

Veteran is able to remain in home.

Veteran pays for modification to home and for housekeeping assistance.

VA services involved case manager's assistance to locate needed community volunteering activity.
IL ISSUES: Physical modifications increase independence by improving access to home. Housecleaning services meet safety needs and maintain veteran's ability to live independently in her home.

Volunteer assists veteran in pursuing her interests, increasing her independence in community.

PROVISIONS FOR SUSTAINING INFLUENCE: Veteran has continued to pay for housekeeping and other services. Coordination and referral to VHA case management insures long term follow-up.


EXHIBIT C.2.c.

ASSESSMENT NEEDS SERVICE OPTIONS MEASURES OUTCOMES
*
Gulf War veteran, service-connected 100% TBI. Cognitive deficits, inadequate housing, lacks transportation, personal care attendant.

Comprehensive assessment including an evaluation from VA TBI Program recommends a program of cognitive rehabilitation.

















Services to improve independence in community.























Advocacy and case management.

Cognitive Rehabilitation Program.




Assistance in locating adequate housing.

Transportation access.


Personal care attendant.




Volunteer activity.



Referral to local Brain Injury Association.
Demonstrate ability to develop coping techniques for memory deficits and to use same in organizing scheduled activities.

Locate adequate housing that has access to public transportation.


Veteran uses public transportation to get to appointments.

Veteran secures personal care attendant, receives assistance from local IL Center in attendant training and management.

Locate volunteer position.




Veteran participates in local support groups and uses referral services.
Memory training allows veteran to develop a coping skill that allows him greater independence and reduced level of assistance from others.


Adequate housing with access to public transportation allows veteran greater independence in community.





Attendant training gives veteran skills to manage attendant thus improving veterans ability to live independently in community.

Participation as a volunteer in local library increases veteran's ability to function independently in community.

Brain Injury Association provides support. Veteran remains connected with needed resources and services.
IL ISSUES: Locate adequate housing, attendant care and transportation access which are basic independent living needs.

Memory training reduces the veteran's need for the assistance of others and allows veteran the opportunity to live independently.

Volunteer position increases independence in community.

Brain Injury Association meets case management needs.

PROVISIONS FOR SUSTAINING INFLUENCE: Participation in community activities reinforce veteran continuing needed medical care. Brain Injury Association offers on-going advocacy and case management support for treatment and care needs.






Department of Veterans Affairs


IL PLAN APPROVAL REQUEST

Date:

Veteran:

C#:

Please accept this request for the veteran to enter into a plan of Independent Living Services. It is expected that the veteran will improve the following skills/functions during a plan of independent living services:


The plan will not exceed the period necessary to restore independence in daily living, and the duration of the program will not exceed 24 calendar months {per VA CIR 28-90-1 (6)}.

• Concur with proposed IILP

• Do not concur with proposed IILP

(Explanation if VR&E Officer does not concur)


_______________________________ __________
Case Manager Date



_______________________________ __________
VR& E Officer Date


FL 28-520
JAN 2005




Department of Veterans Affairs


REQUEST FOR IL EXTENSION

Date:

Veteran:

C#:


Please accept this request for an extension of the veteran's independent living program. The additional ___ months {six month maximum, per VA CIR 28-90-1 (6)(a)} of independent living services are necessary to improve the veteran's ability to perform the following functions/tasks more independently:




• Concur with extension request

• Do not concur with extension request

(Explanation for not concurring)




_______________________________ ___________
Case Manager Date


_______________________________ ___________
VR&E Officer Date





FL 28-521
JAN 2005


EXHIBIT D.1.

Preliminary IL Assessment

Areas which should be examined during the initial assessment include: Activities of Daily Living; Alcohol/Substance Abuse; Housing, Personal, Emotional, and Spiritual Needs; and Leisure/Avocational Activities. The following questions provide guidance for counselors gathering information in these areas.

Activities of Daily Living (ADL)

How much difficulty does the veteran have in ….
o Taking care of self, including eating, dressing, or bathing?
o Moving in and out of a bed or chair?
o Walking several blocks?
o Walking one block, or climbing one flight of stairs?
o Walking indoors, such as around your home?
o Doing work around the house such as cleaning, light yard work, or laundry?
o Doing errands, such as shopping?
o Driving a car, or using public transportation?
o Visiting with friends or relatives?
o Participating in community activities, such as religious activities, social activities, or volunteer work?
o Taking care of other people such as family members?
o Participating in moderate recreational activities, such as playing golf?
o Writing using paper and pencil?
o Bending, stooping, lifting?
o Sleeping?
o Taking own medications?
o Using telephone?
o Handling own money?
o Preparing own meals?
o Using toilet?
o Participating in vigorous activities?
o Memory and concentration?
o Getting in and out of residence?
o Controlling environment, such as operating a fan, thermostat, or TV?
o Communicating electronically with family or friends?

Alcohol/Substance Abuse

o Does the veteran now, or has the veteran ever had a problem with alcohol or substance abuse?
o Is the veteran currently abstinent?
o (If the veteran is not abstinent) How much, how often, and what substance is being abused?

Housing, Personal, Emotional, and Spiritual Needs

o Where does the veteran currently live?
o Does anyone live with the veteran?
o Is the veteran having any problems with his/her current housing or living arrangement? Explain further if the veteran answers "YES".
o Does the veteran feel safe at home and on the street? Explain further if the veteran answers "NO".

Personal, Emotional, and Spiritual Needs

o How much control does the veteran feel they have over their life and choices that matter to them?
o In general, how does the veteran feel about his/her life?
o How much support does the veteran's family provide?
o Does the veteran have any problems in getting along with other people? Explain further if the veteran answers "YES".
o Does the veteran have any spiritual needs that are not being met? Explain further if the veteran answers "YES".

Leisure/Avocational Activities

o Ask the veteran about current hobbies and how much time is spent performing them each month.
o Are there former hobbies that the veteran can no longer perform? Explain further if the veteran answers "YES".
























EXHIBIT D.2.

Case Support

Determining the progress that a veteran is making in their Independent Living Program, and taking corrective actions when necessary, is a critical part of case management activities. While providing case support to veterans, the counselor should ask the following questions:

o Have there been any changes in the veteran's contact information?
o Are the services being provided contributing to the success of the IILP objectives?
o Is the veteran experiencing any financial problems?
o Is the veteran receiving all appropriate VA and other benefits (VHA, Special Adaptive Housing)?
o Is the veteran's housing/living situation satisfactory?
o Does the veteran feel safe in his/her home and community?
o Is the veteran experiencing any personal or family adjustment problems?
o Is the veteran encountering any physical stamina or strength problems?
o Is the veteran experiencing any memory, concentration or communication problems?
o Does the veteran require help in moving around in his/her home and/or community?
o Does the veteran feel a need, an interest, and the ability to improve his/her level of physical activity and personal fitness?
o Is the veteran socially isolated?
o Does the veteran wish to be more socially active?
o Are there any architectural barriers in the veteran's home?
o Is the veteran experiencing any legal problems?
o Does the veteran experience any problems with substance abuse (alcohol or drugs)?
o Does the veteran have any transportation issues?

The case manager should describe any actions that have been/will be taken to address areas of concern, and revise the IILP, if necessary.




















EXHIBIT D.3.

Activities of Daily Living

At the conclusion of a veteran's IL program, there must have been measurable improvements in functioning. Answers to the following questions, and a comparison with information obtained during the preliminary IL assessment, will provide evidence of the improvements made through IL services.

Activities of Daily Living (ADL)

How much difficulty does the veteran have in ….
o Taking care of self, including eating, dressing, or bathing?
o Moving in and out of a bed or chair?
o Walking several blocks?
o Walking one block, or climbing one flight of stairs?
o Walking indoors, such as around your home?
o Doing work around the house such as cleaning, light yard work, or laundry?
o Doing errands, such as shopping?
o Driving a car, or using public transportation?
o Visiting with friends or relatives?
o Participating in community activities, such as religious activities, social activities, or volunteer work?
o Taking care of other people such as family members?
o Participating in moderate recreational activities, such as playing golf?
o Writing using paper and pencil?
o Bending, stooping, lifting?
o Sleeping?
o Taking own medications?
o Using telephone?
o Handling own money?
o Preparing own meals?
o Usi